Session 7 - UTI Flashcards Preview

Semester 3 - Urinary > Session 7 - UTI > Flashcards

Flashcards in Session 7 - UTI Deck (59)
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How are urine samples collected?

• Mid stream, as urethera's normal flora should not be collected


How can samples be collected from small children?

• Adhesive bag places over genitals


What is the issue with using an adhesive bag to collect urine from children?

• False positive rate of 20%


Where are catheter samples collected from?

• Needle placed up catheter tube
• Not from the bag


What is suprapubic aspiration of urine?

• Needle placed through suprapubic region of pelvis into bladder and urine aspirated up


How are collected samples stored between collection and culture?

• Transported at 4*C with a small amount of boric acid in collection tube
• Prevents bacterial division


• Prevents bacterial division
What investigations can be performed on cloudy urine?

• Turbidity test
• Dipstick testing


What is turbidity?

• Whether the urine looks cloudy - If so, indicative of UTI


What are four dipstick tests which can be performed on urine?

• Leukocyte esterase - Indicates presence of WBCs
• Nitrite - Indicates presence of nitrate reducing bacteria
• Haematuria - Present in UTI and many other conditions
• Proteinuria - Present in UTI and many other conditions


In what 6 situations is microscopy used on urine culture?

• Kidney disease
• Suspected endocarditis
• Children under 6
• Schistosomiasis
• Suprapubic aspirate
• When requested


What is urine culture and what needs to occur before infection can be confirmed?

• A number of colony forming units must occur - >100,00 per ml (10^5 cfu/ml) distinguished bacteriuria/contamination


What are the five main advantages of urine culture?

• To investigate complicated UTIs
• Gives epidemiology of isolates
• Sensitivity testing
• Specificity testing
• Control of specimen quality
○ Can differentiate between properly collected and contaminated samples (poorly collected samples may contain epithelial cells)


What 5 details are needed to correctly interpret a urine culture?

• Clinical details
○ Symptoms
○ Previous antibiotics
• Quality of specimen
• Delays in culture
• Microscopy
• Organsims location


What is sterile pyuria?

Pus in urine


What does sterile pyuria indicate?

• A UTI is present but unable to be cultured


Give three situations where sterile pyuria would be present?

• Patient already treated with antibiotics
• OR infected with bacteria that are difficult isolate or culture

OR can be due to tuberculosis or appendicitis (appendix stuck on bladder


What are three other causes of UTI symptoms

• Vaginal infection/inflammation
• Sexually transmitted pathogens
• Mechanical/physical/chemical causes


What are general treatments for UTI?

• Increase fluid intake
• Address underlying disorders


How is an uncomplicated UTI treated?

• 3 day course of antibiotics
• 3 day course reduces the selection pressure for resistance


What is given for complicated UTI treatment?

5 day course antibiotics


Should amoxicillin be used to treat complicated UTI's?

• No

50% of isolates (bacteria) resistance


How should pyelonephritis/septicaemia be treated?

• 14 day course of antibiotics
• Use more potent agent with systemic activity


When is antibiotic prophylaxis indicated?

• Three or more episodes of UTI in one year

No treatable underlying condition


What is antibiotic prophylaxis

• Single, low, nightly dose of antibiotics to prevent bacteria build up in static urine
• All breakthrough infections documented


What is pyelonephritis?

• Infection in kidney


What is the worst case scenario in a UTI?

• Bacteria manage to invade blood stream from urinary tract
• Gram negative septicaemia will occur


What are you likely to see in a culture of contaminated urine?

• Simple Squamous Epithelial cells


What is sensitivity of a test?

The rate of true positives


What is specificity of a test?

Rate of true negatives