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49 Cards in this Set
- Front
- Back
- 3rd side (hint)
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How many women will have a UTI in their lifetime?
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50%
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Who is at risk for UTI in the male population?[3]
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-Young Boys
-Elderly Men -Men who have sex with men |
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What are the host defense mechanisms against UTI?[3]
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-Flushing
-Immunoglobulins -Urea |
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What are the normal flora of the bladder and kidney?
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None, the bladder and kidney are normally sterile
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What action can lead to iatrogenic UTI?
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Placement of a urinary catheter
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This action will directly introduce microbes into the bladder
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Name virulence factors which microbes need to overcome the host defense and start a UTI.[3]
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-Attachment Pili
-Ig proteinases -Ureases |
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Which type of microbe is of interest in UTI?
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Bacteria
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What fungus is of primary interest in UTI?
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Candida Albicans
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What are the #1 and #2 microbes to facilitate UTI?
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#1 - E. coli
#2 - S. saprophyticus |
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A UTI which is susceptible to antimicrobial agents, and arises with NO functional or anatomical obstacles to urine flow is said to be ...
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uncomplicated UTI
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Inflammation of the bladder
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Cystitis
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Inflammation of the Upper genitourinary tract and the kidneys
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Pyelonephritis
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Patient with kidney stones sees his physician due to suprapubic pain. His bladder is found to be inflamed:
What is the term for his condition? What other problems might the physician see? Is the mortality rate high or low compared to other UTIs? [See Hint] |
-Complicated UTI
-Pyelonephritis (we see cystitis) -Higher mortality rate than in Uncomplicated UTI [See Hint] |
Also occurs:
-Urinary flow obstruction -Biofilm -Urinary Reflux -Catheters |
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Travel of bacteria from the urethra to the bladder and then to the kidney
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Ascending UTI
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Travel from the kidney to the bladder, reach the kidney via hematogenous spread
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Descending UTI
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Which is more common:ascending UTI or descending UTI?
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Ascending UTI
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What are the settings for a UTI?[2]
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-Community acquired
-Hospital acquired |
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What type of UTI is seen on the hospital acquired setting?
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Non E.coli (60%)
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E.coli or Non E. coli
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What type of UTI is seen on the community acquired setting?
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E. coli (80%)
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E. coli or Non E. coli
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With each day of catheterization how much does the risk of UTI increase?
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3-5% per day
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How are microbes transported into the genitourinary tract with catheterization?
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Biofilm
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What is the most common complication of the urinary catheters?
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Catheter associated UTI
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What are the symptoms of cystitis?[4]
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-Dysuria
-Frequency -Urgency -Suprapubic pain and tenderness |
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What are the symptoms of pyelonephritis?[5]
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-Flank pain
-Fever of >38.3 C -Dyuria -Frequency -Urgency |
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What are the symptoms of prostatitis?[6]
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-Pain in lower back, perirectal area and testicles
-High fever -Chills -Dysuria -Frequency -Urgency |
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What bacterial family is associated with UTI?
Name the species which commonly cause UTI.[4] |
Enterobacteraceae
-E.coli -K. pneumoniae -Morganella morganii -Proteus mirbilis |
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Describe Enterobacteraceae [5]
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-Gram negative(LPS)
-Rods -GIT is normal habitat -cause opportunistic infections -Enter and attach to uroepithelial cells |
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Describe E. coli morphologically
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Gram negative rod
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How does E. coli enter the uroepithelial cells
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Minor damage during sexual intercourse
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What are the 2 classes of adhesins in E. coli?
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-Fimbrial
-Afimbrial |
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What virulence factor facilitates E. coli infection of the bladder?
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-Type I pili
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Type I pili or P pili
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What virulence factor facilitates E. coli infection of the kidney?
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-P pili
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Type I pili or P pili
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What is the percentage of E. coli strains that express P pilus in pyelonephritis?
Cystitis? |
->90%
-30% |
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Describe the cell wall of Proteus mirbilis?
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-Gram negative
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What are the virulence factors of Proteus mirabilus?[4]
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-Proteases
-Hemolysins -Biofilm formation -Urease |
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Why is urease important for the infection of the genitourinary tract by Proteus mirabilis?
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Urease produces ammonia which elevates the pH
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What gram positive bacteria contributes significantly to UTI?
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Staphylococcus saprophyticus
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What complication can arise from a mother have a UTI with
S. saprophyticus during partuition? |
Neonatal menigitis
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What microbe and by what mode of transport will one see renal abscess?
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S. aureus via hematogenous route
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What complication is commonly seen with Proteus spp UTI?
How does this complication occur? |
-Kidney stones
-Urease produces an alkaline environment (via ammonia) which promotes biofilm production and deposition of minerals |
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What is the bacterial count needed to diagnose a UTI in an asymptomatic patient?
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10^5 CFU/mL
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What is the bacterial count needed to diagnose a UTI in acute uncomplicated pyelonephritis?
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10^5 CFU/mL
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What is the bacterial count needed to diagnose a UTI in acute dysuria (women)?
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10^2 CFU/mL
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What is the bacterial count needed to diagnose a UTI in specimens collected by catheter?
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10^2 CFU/mL
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What is the diagnostic criteria for a UTI other than bacterial count?[2]
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-presence of symptoms specific for UTI
-presence of pathogens on lab detection |
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Why is bacterial count not diagnostic?
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It is variable
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10^2 to 10^6
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What enriched media is used to detect pathogens for UTIs?
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Blood agar
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What selective media is used to detect pathogens for UTIs?
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MacConkey's agar
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What does MacConkey's agar grow?
How does it select? |
-Gram negative bacteria
-Bile Salts in the agar inhibit gram positives (Except Enterococcus and some Stahphylococcus) |
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