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Flashcards in Urine Bench Deck (40)
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1

Procedure for CCMS specimens
- calibrated loops?
- How is colony count determined?

Clean genitals, expel fists 1/3 of urine, collect middle 1/3 for culture, and expel the remaining 1/3
- use .001 ml cal loop
- 10, 000 CFU/ml (of 1 or 2 organisms)= identify and do susceptibilities (3 or more organisms is contamination)
- > 100,000 CoNS is treated like pathogen

2

Procedure for foley (indwelling) cath specimens
- calibrated loops?
- How is colony count determined?

Clamp cath for 1/2 to 1 hour, take the specimen from catcher tubing (not cath bag). Cath tips will not be culturedClean genitals, expel fists 1/3 of urine, collect middle 1/3 for culture, and expel the remaining 1/3
- use .001 ml cal loop
- 10, 000 CFU/ml (of 1 or 2 organisms)= identify and do susceptibilities (3 or more organisms is contamination)
- > 100,000 CoNS is treated like pathogen

3

define: in-and-out catheter
- calibrated loops?
- How is colony count determined?

Obtained by catheterizing the patient to obtain the sample
- use .001 ml cal loop
- 10, 000 CFU/ml (of 1 or 2 organisms)= identify and do susceptibilities (3 or more organisms is contamination)
- > 100,000 CoNS is treated like pathogen

4

Define: - cystoscopy

Obtained at time of cystoscopy, sometimes collected from meters at time of cystoscopy. These are labeled right or left kidney urine.

5

Define: suprapubic aspirate
- calibrated loops?
- How is colony count determined?

Collected directly from the bladder by using a syringe and needle entering the bladder through the skin
- divide BAP, MAC and CNA into two segments ("2" and "3") using .001 ml loop streak "3" side, .01 ml loop break "2" side and Inoculate a thio tube.
- if growth, perform colony count and identify all organisms and perform susceptibilities
- if thio only is growing, Gram stain and set up appropriate media

6

Recommended media for CCMS
- purpose of medium

MAC - selective for GNRs (lactose)
CNA - Selective for GPC/GPRs

7

Recommended media for Foley cath
- purpose of medium

MAC - selective for GNRs (lactose)
CNA - Selective for GPC/GPRs

8

Recommended media for in-and-out
- purpose of medium

BAP - All purpose medium (hemolysis)
MAC - selective for GNRs (lactose)
CNA - Selective for GPC/GPRs

9

Recommended media for suprapubic
- purpose of medium

BAP - All purpose medium (hemolysis)
MAC - selective for GNRs (lactose)
CNA - Selective for GPC/GPRs
THIO - Enhances aerobes, facultative, and obligate anaerobes

10

Recommended media for cytoscopy
- purpose of medium

BAP - All purpose medium (hemolysis)
MAC - selective for GNRs (lactose)
CNA - Selective for GPC/GPRs
THIO - Enhances aerobes, facultative, and obligate anaerobes

11

What colony count is suggestive of infection and requires complete identification/susceptibility of the organism: CCMS

> or = to 10,000 CFU/mL

12

What colony count is suggestive of infection and requires complete identification/susceptibility of the organism: foley cath

> or = to 10,000 CFU/mL

13

What colony count is suggestive of infection and requires complete identification/susceptibility of the organism: in-and-out

> or = to 1,000 CFU/mL

14

What colony count is suggestive of infection and requires complete identification/susceptibility of the organism: suprapubic

> or = to 1,000 CFU/mL

15

What colony count is suggestive of infection and requires complete identification/susceptibility of the organism: cystoscopy

> or = to 1,000 CFU/mL

16

What most common Staph causes UTIs?
- what tests should you run?
- results?

Staph aureus
Staph saprophyticus

17

What most common Strep causes UTIs?
- what tests should you run?
- results?

Enterococci
Streptococcus agalactiae (group B)
Strep pyogenes (Group A)

18

What most common GNR causes UTIs?
- what tests should you run?
- results?

Enterobacteriaceae:
E. coli
Pseudomonas
Proteus
Klebiella

19

What most common GPR causes UTIs?
- what tests should you run?
- results?

Clostridium species
Bacillus species: (almost always considered contamination)

20

What most common Corynebacterium causes UTIs?
- what tests should you run?
- results?

ureliticum

21

What most common Yeast causes UTIs?
- what tests should you run?
- results?

Candida species

22

What most common Staph causes UTIs?
- what tests should you run?
- results?

*

23

What most common Staph causes UTIs?
- what tests should you run?
- results?

*

24

Correlate the number of organisms seen on a gram stained direct smear of urine with the overall colony count

presence of one or more organisms per OIF correlates with a colony count of > 10^5

25

Correlate the presence of many squamous epithelial cells in a direct smear with specimen quality

presence of many squamous epithelial cells indicates contamination

26

List 5 most common contaminants found in urine cultures due to improper collection technique

1. CoNS
2. Cornebacterium
3. Lactobacillus
4. Viridans Strep
5. Bacillus species

27

Colony/gram stain morphologies of: CoNS

GPC

28

Colony/gram stain morphologies of: Corynebacterium

GPR

29

Colony/gram stain morphologies of: Lactobacillus

GPR - skinny

30

Colony/gram stain morphologies of: Viridans strep

GPC