How many women have a recurrent UTi at some point in their life
20-30%
10%
78%
5%
45-55%
Urinary tract is in women the most common site of what kind of infection
bacterial
parasitic
fungal
viral
UTIs are a significant cause of mortility
Majority of UTIs are
acute
short lived
chronic
fatal
asymptomatic
What is the usual route of bacterial infection in UTIs?
minor calyx - major calyx - ureter
urethra - bladder
urethra - ureter - bladder
isthmus of utherus - fundus of utherus - bladder
bladder - kidneys
utherus - bladder - kidneys
Septicaemia occurs when
There is a low concentraion of bacteria in the blood
Bacteria from the urinary tract invade bloodstream
The blood is sterile
Bacteria infect the kidneys, resulting in an inflammation
There is bacterial infection, in any organ of the body
Pylonephritis occuring without bladder infection is
called heamatogenous spread
rare
not possible
common
called cystitis
Nosocomial is another word for community acquired infection
Enterobacteriacaea
are gram negative bacteria
are gram positive bacteria
include E. coli
include Staph aureus
most common cause of UTIs
common in hospital acquired UTIs, but not so in community acquired
Hospital acquired UTIs are commonly a result of
Pseudomonas aeruginosa
Klebsiella
Enterobacter
Citrobacter
Pseudomonas putida
Proteus
Salmonella typhi
Corynebacterium
Streptococcus
Yersenia pestis
Amongst gram positive bacteria causing UTIs belong
Staphylococcus saprophyticus
Enterococcus
E. coli
Staphylococcus aureus
Staphylococcus epidermis
Mycobacterium tuberculosis
Most common gram positive bacteria in UTIs is
Staphylococcu saprophyticus
Enterococcus faecium
Staphylococcus auricularis
Escherichia coli
Immunodeficient patients (unlike other patients) with UTI are often found to be infected with
Klebssiella
Common bacteria causing UTI by heamatogenous spread are
Select the bacteria you would expect to be present in the following cases: Nosocomal UTI patient with an immunodeficiency: ❌ UTI acqured by a heamatogenous spread: ❌ Gram positive hospital acquired UTI: ❌ Most common to cause an UTI: ❌
Select a correct statement about community acquired UTI:
80% of cases are caused by E. coli
40% of cases are caused by E. coli
most commonly caused as a cosequence of catheter insertion
60% is caused by gram negative bacteria
60% is caused by gram positive bacteria
What are the symptoms of UTI?
microturition
macrourination
dysuria
urgency
lack of need to pass urine
itching
angular stomatitis
pallor
Match the correct definitions: ❌ - Cloudy urine due to the presence of pus cells ❌ - Cloudy urine due to the presenece of bacteria ❌ - Presence of blood in the urine ❌ - A burning pain on passing urine ❌ - Infection of the kidney
Which of the following are symptoms pf pyelonephritis
symptoms of lower UTIs
back pain
easy bruising
keratitis
malnutrition
fever
Which of the following statements about pyelonephritis are correct
it is often caused by staphylococci
if recurrent can cause severe kidney damage
if recurrent can cause irreversible bladder damage
it is infection of the bladder
renal abscesses are usually absent
it is also called upper urinary tract infection
is more severe than lower UTI
Who is at risk of aymptomatic UTI
young adults
pregnant women
immunodeficient patients
diabetic patients
patients with Duchenne muscular dystophy
children and elderly
30 year old men
Asymptomatic UTI can only be detected by laboratory screenings
Bacteriuria can proceed into bacteraemia
At what bacterial concentraion is bacteriuria considered significant
>10^5 organisms/mL
<10^5 organisms/mL
>10^9 organisms/mL
>10^4 organisms/mL
<10^4 organisms/mL
10^6 - 10^9 organisms/mL
How can infection be distinguished from contamination?
by quantative culture methods
by modern PCR
good specimens will always contain periurethral flora
infected urine usually contains only one species
threshold for contaminated specimen is >5 species
contaminated specimen would contain <10^4 organisms/mL
infected specimen wowuld contain >10^3 organisms/mL
Urinary tract is normally sterile
Low bacterial counts are always insignificant
How can urine samples be collected?
Suprapubic aspiration
Nephrostomy tubes
Nasopharyngeal aspirates
Excision
First stream urine
Midstream urine
Lumbar puncture
Presence if WBC in urine is
always indicative of UTI
abnormal
normal
an indicative of contamination
can form urinary casts
indicative of infection if at concentraion >10/mL
Sterile pyuria could indicate
antibiotic therapy
nothing, it´s not possible
infection by organisms not detectable by conventional techniques (e.g. Mycobacterium tuberculosis, Chlamydia, Gonorrhoea)
infection by organisms not detectable by conventional techniques (e.g. Staphylococcus saprophyticus, Salmonella typhi, E. coli)
diseases not caused by bacteria (e.g. renal canaliculli, neoplasms)
viral UTI
Culture is performed
after microscopy
prior to microscopy
when UTI is suspected
to establish whether or not UTI is to be suspected
to identify the organism
to count the bacteria
Which of the following statements about agar cultures are correct:
mixed growth is indicative of contamination
bacteria can be identified by the colour which is a result of sugar fermentation
bacteria are idedntified by the time they take to grow to 1mm thickness
bacteria can be identified by the colour which is a result of toxin release
sensitivity plates are set up after culture is performed
culture plates are usually completed within 24 hours
What is the routine treatment for UTI?
Amoxicillin; if patients are allergic to penicillin
Amoxicillin
Ciprofloxacin; if patients are allergic to penicillin
Ciprofloxacin
Oritavancin
Oritavancin combined with Vancomycin
Cefoxitin; if patients are allergic to penicilin
Cefoxitin
Which statements about microorganisms causing UTIs are correct
viruses cause significant UTIs
E. coli is the predominant pathogen
they are usually of endogenous origin
community acquired UTIs are commonly caused by multiple-resistant gram negative bacteria
they cause an UTI via blood
Which statements about tretment of UTIs are correct
oral antibiotcs are not effective for lower UTI
lower UTIs are usually short lived
upper UTIs are usually short lived
upper UTIs often require systemic administration of drugs
antibiotics must be administred intramuscularly