PC2 1.1.4 Urine Cultures

relapse

same bacteria

reinfection

new bacteria

pyuria

increased PMNLs

pyelonephritis

kidney infection

asymptomatic bacteriuria

>10^5

acute uncomplicated uti

>10^5 & symptoms

complicated uti

functional/structural abnormalities

Clinical indications for urine cultures include... (7)

1) complicated/relapse/recurrent uti

2) men

3) diabetes

4) pyelonephritis

5) pregnancy

6) kidney transplant

7) recent catheterization

The four methods of urine collection are...

1) clean catch midstream

2) indwelling catheter

3) in & out catheter (straight/intermittent )

4) suprapubic aspiration

What is the difference between an indwelling catheter & an in & out catheter?

indwelling catheters are more long term (~3 months)

in & out catheter is used multiple times a day because it empties the bladder immediately

Which urine collection method is best for infants?

suprapubic aspiration

Match the urine collection method with the correct challenge it faces

1) clean catch

2) indwelling catheters

3) in & out catheters

A) not representative of bladder (colonization)

B) increased risk of bacteria moving to bladder

C) no evidence cleansing beforehand helps

1) clean catch - C

2) indwelling catheters - A

3) in & out catheters - B

What are the two main testing methods for urine?

1) urine dipstick

2) microanalysis

What are the important markers for the dipstick test? (3)

1) leukocyte esterase

2) blood

3) nitrites

What are the two ways a dipstick test can be affected?

1) drugs & conditions

2) exposure to air

What are the four markers we use for microanalysis & what do they mean?

1) WBCs - inflammation & infection

2) SECs - contamination

3) RBCs - tissue damage/catheter trauma

4) casts - severe infection

Lower colony counts are considered if what two methods were used?

1) in & out

2) insertion of new indwelling

What two medias are used?

1) blood agar

2) macconkey agar

We expect to grow gram negative organisms on both types of media, but __________ agar works best for invasive yeasts.

blood

What are the 3 ways to minimize contamination?

1) rapid processing (w/in 24H)

2) refrigeration

3) preservative (24-48H)

A clue a culture is contaminated is when there are _____ isolates present, also known as a polymicrobial infection (which is rare).

2+