Bugs causing UTIs Bug (Bacteria only) Comments E. coli #1 leading cause of UTI S. saprophyticus #2 leading cause of UTI, common in young, sexually active women K. pneumoniae Proteus P. aeruginosa Common cause in patients with indwelling catheters Serratia Enterobacter cloacae E. faecalis Urinary tract infections cystitis ("bladder infection") dysuria polyuria suprapubic pain WBCs in urine no casts systemic symptoms (e.g. fever) uncommon pyelonephritis (infection reaches upper urinary tract or kidney) fever chills flank pain / costovertebral angle (CVA) tenderness WBC casts in urine hematuria Diagnosis positive leukocyte esterase test = bacterial UTI positive Nitrite test = Gram-Negative bacterial UTI Predisposing factors urinary catheterization diabetes pregnancy kidney surgery congenital defects vesicoureteral reflux (urine flows from bladder back to ureters) BPH Epidemiology women affected 10x more frequently than men shorter urethra proximity of urethra to anus colonization of vagina by fecal flora leading cause of UTIs is urinary catheters
QUESTIONS 1 of 3 1 2 3 Previous Next (M1.MC.15.75) A 22-year-old sexually active female presents to the emergency department in severe pain. She states that she has significant abdominal pain that seems to worsen whenever she urinates. This seems to have progressed over the past day and is accompanied by increased urge and frequency. The emergency room physician obtains a urine dipstick which demonstrates the following: Urine:Specific gravity: 1.010Leukocyte esterase: PositiveProtein: TracepH: 7.2RBC: NegativeNitrite: Negative. A urease test is performed which is positive. What is most likely cause of UTI in this patient? Tested Concept QID: 106729 Type & Select Correct Answer 1 Klebsiella pneumoniae 12% (23/200) 2 Staphylococcus saprophyticus 31% (62/200) 3 Proteus mirabilis 26% (51/200) 4 Escherichia coli 24% (47/200) 5 Serratia marcescens 1% (2/200) M 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review tested concept Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (M1.MC.15.75) A 26-year-old female presents to her primary care physician concerned that she has contracted a sexually transmitted disease. She states that she is having severe pain whenever she urinates and seems to be urinating more frequently than normal. She reports that her symptoms started after she began having unprotected sexual intercourse with 1 partner earlier this week. The physician obtains a urinalysis which demonstrates the following, SG: 1.010, Leukocyte esterase: Positive, Nitrites: Positive, Protein: Trace, pH: 5.0, RBC: Negative. A urease test is performed which is negative. This patient has most likely been infected with which of the following organisms? Tested Concept QID: 106704 Type & Select Correct Answer 1 Proteus mirabilis 2% (1/47) 2 Klebsiella pneumoniae 2% (1/47) 3 Escherichia coli 77% (36/47) 4 Staphylococcus saprophyticus 11% (5/47) 5 Enterobacter cloacae 2% (1/47) M 1 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review tested concept