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Urinary Tract Infection
Urinary Tract Infection
com | Medicine
Urinary Tract Infection (UTI)
Causative Organisms
Community-Acquired Hospital-Acquired
Escherichia coli Escherichia coli
Klebsiella pneumoniae Pseudomonas aeroginosa
Proteus Mirabilis Proteus sp.
Staphylococcus saprophyticus Enterobacter sp.
Enterococcus faecalis Serratia sp.
Enterococcus s p.
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Dipstick Test
Leukocyte Esterase
Leukocytes release Esterase in Urine
Differential Diagnosis of Bacteriuria (Forming Indoxyl, which reacts with a diazonium salt to give a colour change)
Correlates well for detecting > 10WBC/hpf
Rapid screening test
Sensitivity of 75-95%
Specificity of 65-95%
False –ve (common)(cause – unknown )
Nitrites
Bacteria (eg. Escherichia coli) convert nitrate – nitrite in Bladder
(Reacts with Napthylethylene – Colour Change)
Diagnosis of UTI Require Bacteria in Urine in Bladder for 4-8h
Urine Macroscopy (for enough conversion of Nitrate → Nitrite to be detectable)
Urine Microscopy (Urine Analysis) Tests
Urine Culture, Antibiotic Sensitivity Testing (Urine C&S) -ve +ve
Organism is not nitrate-reducing Moderately Reliable
Common Changes Found in Aged Urine Enterococci False +ve
S. saprophyticus Old Voided (non-sterile collection)
Acinetobacter of urine
Ultrasound
Noninvasive
Risk-Free Imaging Test
Used to Screen
Hydronephrosis
Kidney Stones
Abscesses
Urine Culture
Urine is cultured on Cystine-Lactose-Electrolyte-Deficient (CLED) Medium
using UROSTRIP method
Plate is intubated at 37°C for 24h
UROSTRIP
Sterilized filter paper
Estimate amount of organisms present in urine
Interpretation
Significant Bacteriuria Asymptomatic Bacteriuria
Presence of 105 bacteria/ml Significant bacteriuria in patient
of Mid-Stream Urine without symptoms
Symptomatic (MSU) Asymptomatic (MSU) Catheterized Patients
≥ 105 CFU coliforms/ml ≥ 105 CFU bacteria/ml ≥ 102 CFU bacteria/ml
(95% probability True on 2 consecutive
bacteriuria) specimens
(probability of True
bacteriuria – Single sp
80%, 2 sp. 95%)
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