micro renal modified

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dtminhthu
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48141
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micro renal modified
Updated:
2010-11-23 09:16:41
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micro renal modified
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micro renal modified
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  1. ascending pathogens of UTI
    • E. coli
    • Staphylococcus saphrophyticus
    • S. epidermidis
    • Proteus
    • Klebsiella
    • Pseudomonas aeruginosa
    • Enterococcus
    • Enterobacter
  2. hematogenous UTIs
    • Staphylococcus aureus
    • Mycobacterium tuberculosis (Renal TB)
  3. Staphylococcus saprophyticus
    • Gram + cocci, Catalase +, Coagulase -
    • Novobiocin resistant
    • 2nd leading cause of community-acquired UTI in sexually active women
    • More commonly associated with localized cystitis
  4. Staphylococcus epidermidis
    • Gram + cocci, Catalase +, Coagulase -
    • Novobiocin sensitive
    • Capsule, Part of normal flora that are inoculated to an internal site by adhering to inserted medical devices.
    • UTI in immunocompromised
  5. Enterobacter cloacae
    Enterobacteriaceae. Gram - rod. Often nosocomial and drug resistant“ICU bug”
  6. Klebsiella pneumoniae
    • Gram - rod. Lactose fermenter. Gas formation.
    • Capsule, Endotoxin, Large mucoid capsule and viscous colonies
    • Can cause emphysematous UTIs, especially in diabetics
  7. Pseudomonas aeruginosa
    • Gram -, Oxidase +, Non-lactose fermenting, Motile, Ubiquitous, Endotoxin, Flagella, Pili, Capsule
    • Exotoxin A (ETA) disrupts protein synthesis by blocking peptide chain elongation in eukaryotic cells
    • Antibiotic resistance
  8. Pseudomonas aeruginosa dx
    blue green pigment, fruity odor
  9. Enterococcus
    • Gram + cocci in short chains. Non, α-, or rarely β-hemolytic.
    • Can grow in high concentrations of NaCl and bile salts.
    • Adhesin proteins, hemolytic and proteolytic proteins
    • Resistant to antibiotics
    • Important nosocomial pathogen. Skin of hospitalized pts who have been treated w/ broad-spectrum antibiotics
  10. Enterococcus: Clinical manifestations
    • UTI: Dysuria and pyuria most commonly in hospitalized patients with an indwelling urinary catheter and receiving broad spectrum antibiotics
    • Peritonitis
    • Endocarditis
  11. Enterococcus dx
    • Blood agar, chocolate agar
    • Resistant to optochin (Strep pneumoniae is susceptible)
    • Does not dissolve in bile (S pneumoniae dissolves)
    • PYR positive (L-pyrrolidonyl arylamidase) (only S. pyogenes is PYR positive)
  12. Mostly associated with hemorrhagic cystitis
    adenovirus. Nonenveloped, DS linear DNA virus
  13. Hantavirus renal syndrome sx
    • Sx w/in 1-2 wks after exposure. Headaches, back & ab pain, fever, chills, nausea, blurred vision.
    • Flushing of face, inflamm or redness of eyes, rash.
    • Later sx: low BP, acute shock, vascular leakage, acute kidney failure --> severe fluid overload.
    • Complete recovery can take weeks or months
  14. Toxic shock syndrome sx
    Fever, vomiting, diarrhea, muscle pain, and erythroderma. Desquamation of palms and soles if infected by staph aureus (1-2 wks after illness)
  15. Neisseria gonorrhea
    • Gram - diplococci. Aerobic. Oxidase +
    • Pili- Pilin proteins- antigenically diverse Lipooligosaccharide (LOS)
    • IgA protease
  16. Reiter syndrome
    • Usually in young caucasian men; HLA-B27 related illness. Urethritis, conjunctivitis, polyarthritis, and mucocutaneous lesions.
    • Most have evidence of preceding or concurrent infection with C. trachomatis

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