Urinary tract infections Flashcards
(33 cards)
nephritis and cystitis
-inflammation of kidney and bladder
-dysuria, frequency, urgency
-can also be low back pain and abdominal pain
50% hematuria
-NO DISCHARGE
prostatitis
- lower back pain and pain in perirectal area and testicles
- can have high fever, chills and symptoms of bacterial cystitis
- NO DISCAHARGE
pyelonephritis
(kidney infection)
-pain in the FLANK of the body
-fever
-may have cystitis symptoms
-may have diarrhea, vomiting and tachycardia
20-50% of preg women, infection causes premature birth
-NO DISCHARGE
diagnosis of UTIs
- based on symptoms
- examination of urine for bacteria/inflammation- midstream- presence of >100,000CFU/ml bacteria
- most have pyuria (pus) and wbc (should not be there)
- culture
- use ESTERASE- to screen for pyuria nitrite
- LOOK FOR NITRITE: SOME BACTERIA LIKE E. COLI REDUCE NITRATE TO NITRITE
why are women 10 times more likely to get UTIs than men?
-shorter urethras
if the patient’s UTI is community acquired, what bacterias are probably infecting them? hospital acquired?
community- e. coli and staph saprophyticus
hospital- klebsiella, enterobacter, serratia, pseudomonas aerugenosa, enterococcus
enterics what do they do? characteristics-oxygen? normal flora? Gram? oxidase? serology based on? virulence factors
- cause UTI
- routinely in GI- small numbers
- hardy anaerobes
- LPS that contributes to inflammation
- gram neg rod
- oxidase neg
- serology based on O antigen of LPS and K/H antigens
- virulence factors: EXOTOXIN, FLAGELLA, CAPSULE LPS
how has enterics developed antimicrobial resistance
- it can switch out H and K antigens to prevent antibodies from recognizing it
Escherichia coli
what does it have that allow it to bind to host cells
what does it do that helps with diagnosis
- normal microbiota of colon
- has fimbriae and pili that help it bind cells
- it ferments lactose vs shigella and salmonella that don’t- positive mcconkeys agar
the degree of virulence in an e. coli infections is dependent on what 3 things?
1) presence of plasmid
2) presence of integrated prophages
3) pathogenicity islands
2 most common bacteria that cause UTIs
e. coli
coagulase neg staphylococci
virulence factors of E. coli
- adhesins- bind to cells lining the bladder and upper urinary tract
- endotoxin- causes inflammation
- hemolysin- lyses RBC causing inflammation
pathogenicity of E. coli
- have type I pilli that travel up the urethra and attach to mannose resides that are often on epithelial surfaces and are able to travel up the ureter to cause infection
- subpopulations of E. coli express P pili which bind to sugar residues on uroepithlial cells
what are two coagulase neg bacteria that cause UTIs and what are the catalase results. structures seen under microscope
-staphylococcus (catalase pos) viewed as clusters and streptococcus (catalase neg) seen as chains
staphylococci - type of bacteria oxygen catalase motility
gram pos (the staff stays positive even though they want to strangle each other (anaerobe) because they are stuck-nonmotile ) anaerobe catalase pos non-motile clusters
Coagulase negative staphylococci- what do they produce to enhance attachment and survival?
-biofilms
what are the two most common coagulase negative staphylococci
- s. epidermidis
cause infections in devices and immunocompromised people- treat with removal of device and vanco - s. saprophyticus
- cause UTIs
- novobiocin resistant (agar)
s saprophyticus
- second leading cause of UTI
- mostly in sexually active women
- coagulase neg staph (catalase pos, anaerobe)
two main community acquired UTI bacterias?
hospital?
- e. coli and coagulase negative staph
- proteus and pseudomonas, enterococcus
proteus mirabilis
pathogenesis and bacteria type
- cause of hospital acquired UTI (a nurse named Mirabel)
- gram neg
1) produce urease that hydrolyzes urea to ammonia making the urine more alkaline
2) alkalization leads to inorganic/organic compounds (MAGNESIUM AND CALCIUM MAKE KIDNEY STONES)
-SIGNAL OF PROTEUS- ALKALINE PEE
symptoms of kidney stones
- sudden onset of pain radiating from side of back or ab to groin
- intermittent pain often
- stones usually pass on own
treatment for kidney stones
TMP-SMX against Proteus
pseudomonas aeruginosa type of bacteria oxygen motility oxidase fermentation
- gram neg
- aerobe
- motile
- oxidase- positive- distinguishes between enterobacteria
- non fermenter
- CAN GROW IN ANY TEMP AND WITH LITTLE NUTRITION
what does pseudomonas have that make it distinguishable ?
pyocyanin in culture!
