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Overview
- urine is normally sterile
- it becomes contaminated when urine is voided by the normal flora of the urethra, fecal or vaginal flora; therefore bacteria in the urine does not necessarily mean there is a UTI
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UTI infections
3 ways: hematogenous, ascending route, and catheters, cytoscopes
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hematogenous route
- this is a rare route of UTI infection
- microorganisms are in the blood stream from another site of infection and are deposited in the kidneys
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ascending route
- this is the most common routemicroorganisms ascend from the urethra from urogenital area and cause cystitis, or continue ascending up the uereters and causes pyelonephritis
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catheters, cytoscopes route
- this routes happens when microorganisms are deposited into the bladder via catheters or cytoscopes
- this is a common nosocomial infection
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Cystits
- bladder infection is the most commone UTI
- sx: frequency in urination or dysuria (painful urination)
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Pyelonephritis
- it is kidney infection
- sx: midback pain and pus in the urine
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What are the 2 ways of collecting speciman?
- Catherized specimen
- Voided speciman
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catheterized speciman
- this is the best specimen since urine does not pass through the urethra -- very sterile
- difficult to collect
- there is a risk of introducing infection due to poor or unsterile technicques
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voided speciman
- patients void midstream urine aka clean catch midstream specimen (CCMS)
- first stream is to cut down normal flora pathogen
- patient instruction is important as there is risk of contaminating urine with urethral, vaginal or fecal flora
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True UTI diagnostics
- to determine true UTI and not contamination, a colony count is performed
- both the number and colonies and the different types of species will tells us if there is a true infection
- infections normally contain greater than 100,000 organisms/mL of urine
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Colony Count
- > 100,000 organisms/mL is a true UTI
- between 10,000 - 100,000 organisms/mL is in the gray area - Dr will decide
- < 10,000 organisms/mL is usually contaminated
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Urine sample on a BAP agar
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