bactitech
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E. coli is THE most common isolate in urine cultures, period. We see S. sapro once in awhile, but nowhere near as often as E. coli. We probably set up 10-15 EC's a day - maybe more, and see S. sapro once every 2-3 weeks or less often. Our lab performs at least 150 urine cultures a day M-F and our patients cover a wide spectrum of patient types. We do four hospitals plus numerous clinics, nursing homes, and outreach locations.
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| SDK
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E.coli still more common then staph: saprophyticus....so 1st MCC is E.coli..
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| chemamr
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i agree, E. coli is the MCC
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| ureterpolyp
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from Emedicine Causes: The proliferation of bacteria within the urinary tract causes UTI. - Infections almost always are ascending in origin and are caused by bacteria present in the periurethral flora and the distal urethra. E coli usually causes initial infection, but other gram-negative bacilli and enterococci may also cause infection.
- Staphylococcal, especially S saprophyticus, infections are common among adolescent females.
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| bactitech
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Yes, that is all true. Don't forget, we see only the patients who the docs decide to culture. We absolutely see more EC in culture than Staph. sapro.
Where we do see Coagulase negative Staph a lot is in old men >65.
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| dariush
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it could be tricky, see, the NEWLY sexually-active girl starts using TAMPONS which is a great culture media for Staph. leading even maybe to Toxic-Shock-Syndrom. i agree not common anymore but a thing to think about.
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| Flying h4x0r
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staph. saprophyticus usually causes symptoms within 24 hours of intercourse
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| drswapna
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if they specifically ask most common gm +ve cocci in newly sexually active female then it is staph saprophyticus otherwise ecoli is still the MCC of UTI .
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| K1
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Hi Guys for the USMLE purpose take staph. saprophyticus whenever your case is a young female with cystitis after intercourse ( usually first intercourse- honey moon cystitis)
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| K1
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But what about a 34 year old female complaining of burning urination, suprapubic tenderness.
On urine exam: nitrites, leukocytes, ph-6.9, few erythrocytes
Which bug can be responsible for this?
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| msyamp
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ecoli
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| msyamp
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question 1 .A 25 year old female who recently returned from her honeymoon comes into the family practice clinic complaining of pain on urination and severe urgency.
Labs: Gram negative rods that are motile, do not ferment sorbitol, ferment lactose, utilize acetate as its only source of carbon, and use tryptophan to produce indole. Culture reveals colonies with green sheen on EMB agar.
question two:
A 25 year old hospital patient complains of pain and frequency of urination. Recent surgery requires that she use an indwelling urinary catheter. A diagnosis of cystitis is made.
Labs: Culturing urine samples on blood agar reveals highly motile gram negative rods. These organisms produce urease. Non-lactose-fermenting colorless colonies formed on MacConkey's agar.
Question three;
[left]A 25 year old sexually active female comes into the student health clinic complaining of painful and frequent urination. She does not report seeing any blood in her urine. Further testing shows no RBC or WBC casts which indicates that only the bladder is involved. [/left">
Labs: Catalase positive, coagulase negative gram-positive cocci in grapelike clusters that are resistant to novobiocin.
Question 4:
A 31 year old single man presents in the clinic with painful, burning urination and greenish-yellow, mucopurulent discharge. He admits to having several sexual partners.
Labs: intracellular gram negative diplococci in the PMNs. Organism is inoculated on Thayer-Martin media. Aerobic, oxidase positive.
Question five: A 34 year old male presents in the clinic with painful urination and watery discharge. A gram stain of the penile discharge is negative for pathogenic organisms. He admits to having been involved in a menage-a-trois a week ago. He says that it seemed like a very good idea at the time.
Labs: Inclusion bodies in Giemsa stain. Obligate intracellular bacteria. PCR is also a useful tool.
come on guys!!!!!
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| drswapna
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Q1-E coli
Q2-Proteus
Q3-Staph saprophyticus
Q4-gonococci
Q5-Chlamydia??/not very sure
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| msyamp
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yes you got it right
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