URINARY TRACT INFECTION   SYMPTOMS @ Frequent dysuria @ Slight haematuria @ Suprapubic pain

Suprapubic pain  

Pathogens Causing UTI E. coli > 50% Proteus 10-15% Klebsiella 10% Enterococci 8-10% S.saprophyticus (young women) 5-8% S.aureus & epidermidis 2-6% Ps.aeruginosa 4%

Staph. saprophyticus

@ S. saprophyticus is a coagulase- negative Staphylococcus @ It is second in importance to Escherichia coli as a cause of cystitis in young women. @ It is distinguished in the laboratory by its resistance to novobiocin.

Novobiocin Resistance

Urethral Syndrome @ Symptoms: dysuria frequency of micturition without bacteriuria. @ Low bacterial counts: as low as 102/ml. Causes of urethral syndrome: @ Trauma from intercourse @ Organisms: Chlamydia, N. gonorrhoeae, Gardnerella vaginalis, herpes simplex.

Gardnerella vaginalis

Pyelonephritis Symptoms: @ Fever, nausea, weakness. @ Rigors, loin pain @ Protein and blood in urine Lab. Diagnosis: @ Microscopy of MSU for WBC and RBC @ Blood for culture. @ MSU culture

Acute pyelonephritis

Blood culture sets in pyelonephritis: @ Two sets taken at different times. @ Each set contains two bottles: aerobic and anaerobic. @ Drawbacks of taking one set: * If negative, it may be false because bacteraemia is intermittent * Isolation of Staph. epidermidis (skin) may be false positive in one set

Blood culture bottles

DIALYSIS PERITONITIS @ Occurs a patient suffers from chronic renal failure and he is on peritoneal dialysis. Lab. Diagnosis: @ Microscopy of the dialysis fluid: * Fluid is cloudy * Contains > 100 pus cells / mm3. @ Aerobic and anaerobic fluid culture after centrifugation of the sample.

Peritoneal dialysis.

Organisms Causing Dialysis Peritonitis: Staph. epidermidis 45% Staph. aureus 15% Streptococci and enterococci 12% E. coli 8% Other coliforms 5% Ps. aeruginosa 4% Diphtheroids 2% Candida albicans 2% Miscellaneous 7%

Staph. epidermidis