Urine

A clean-catch midstream urine specimen from a woman was sent to the microbiology laboratory for culture. The patient had a history of dysuria, frequent urination, suprapubic pain, no fever, no flank pain, or any urinary symptoms in the last 4 weeks before her current episode. The urine grew out 1,000 cfu/mL of Escherichia coli. Which of the following categories would the patient be classified?

Acute, uncomplicated UTI in women

A clean-catch midstream urine specimen from a 57-year-old woman was sent to the microbiology laboratory for culture. The patient had a history of fever, chills, and flank pain upon examiation. The urine grew out 10,000 cfu/mL of Escherichia coli. Which of the following categories would the patient be classified?

Acute, uncomplicated pyelonephritis

The organism Acinetobacter baumannii is known to have caused which of the following outbreaks?

Afghanistan and Iraq U.S. soldiers outbreak

This is a catalase-positive, coagulase-negative, gram-positive coccus isolated from a urine specimen from a 20-year-old female college student. The image shown is a Mueller Hinton plate streaked with a 0.5 MacFarland standardized inoculum and a 5 microgram disk of novobiocin after overnight incubation. What is the identification of the isolate?

Staphylococcus saprophyticus

A clean catch urine was streaked to a sheep blood agar plate and a MacConkey plate with a one microliter (0.001 mL) loop. The images to the right demonstrate the observed growth. How would you report the colony count and growth?

103 CFU/mL of a gram-negative bacillus

If a blood agar plate and an EMB plate are both inoculated with 0.001 mL of urine, and 90 colonies of Staphylococcus aureus grew on the blood agar plate, what should be reported?

90,000 colony forming units/mL of Staphylococcus aureus

A clean-catch midstream urine specimen from a 30-year-old woman was sent to the microbiology laboratory for culture. The patient had no urinary symptoms, but the urine culture grew out 100,000 cfu/mL of Escherichia coli from two cultures collected 24 hours apart. Which of the following categories would the patient be classified?

Asymptomatic bacteriuria in female patients

A rapid urine screening test that can be performed to detect the presence of Staphylococcus species is which of the following tests?

Catalase test

A tech is working on a urine culture and finds the following isolates: Escherichia coli: >100,000 cfu/mL Staphylococcus epidermidis: 5,000 cfu/mL How should the tech continue with the culture work up?

Perform sensitivity on E. coli and list the S. epidermidis as a contaminant

Acceptable sources for urine culture from a patient with suspected urinary tract infection include all EXCEPT:

Drainage bag from nephrostomy catheter

A patient has a urinalysis performed and results are: Leukocyte esterase: Positive Nitrate: Positive What organism would the tech expect to find on the urine culture plates?

E. coli

Illustrated in the photograph is a bile esculin agar plate inoculated with a bacterial isolate from a urinary tract infection. The most likely identification is:

Enterococcus faecalis

An alpha-hemolytic streptococcus isolated from a urine culture is resistant to optochin and bactracin, grows in 6.5% NaCI broth, and is PYR positive. The organism is MOST likely:

Enterococcus species

Which Enterobacteriaceae is the most common cause of uncomplicated urinary tract infections (UTIs)?

Escherichia coli

Which of the following is a common cause of urinary tract infections?

Escherichia coli

Which of the following organisms is the most common cause of acute cystitis?

Escherichia coli

This member of the Enterobacteriacea gave these reactions: H2S (TSI)NegativeOrnithineNegativeLysinePositiveCitratePositiveUreaPositivePhenylalanineNegativeMotilityNegative What is this organism?

Klebsiella pneumoniaeEscherichia coliYersinia enterocolitica

In an urinalysis, tests are performed that serve as a method of screening for urinary tract infections. Which of following tests detects the presence of inflammatory cells?

Leukocyte esterase test

A tech is interpreting a urine culture from a catheter as the source. There is 1 colony of Staphylococcus epidermidis present on the blood agar which was streaked with a 0.001 loop. What should the tech do next?

List S. epidermidis as a possible contaminant

A tech is interpreting a urine culture with a source of suprapubic aspiration. There is one colony of Staphylococcus epidermidis present on the blood agar which was streaked with a 0.01 loop. What should the tech do next?

List and provide a sensitivity for the S. epidermidis

A tech is working on a urine culture and finds the following isolate: Escherichia coli: 5,000 cfu/mL

List the E.coli as a possible contaminant

All of the following patients may submit an urine specimen from an indwelling catheter EXCEPT?

Patient seen for an annual physical

An urinalysis is commonly performed to detect bacteriuria or pyuria. In an urinalysis, tests are performed that serves as a method of screening for urinary tract infections. Which of following tests detect bacteria that produces enzymes to reduce nitrate?

Nitrate reduction test

A 25-year-old female patient suspects of having an urinary tract infection (UTI) and presents to her doctor for a check-up. Her urine specimen is slightly turbid and the chemical and microscopic urinalysis results are as follows: Specific Gravity1.009Glucose0pH8Protein1+WBC15/hpfRCS1/hpfCrystalsNoneCasts2 hyaline/hpfEpithelial cells0/hpfBacteria2+ What should her doctor do next?

Order a culture and sensitivity

A urine sample yielded a lactose-negative, Gram-negative bacillus on primary isolation. Biochemical testing showed the following reactions: Oxidase negative H2S positive Urea positive Phenylalanine deaminase positive The organism which most closely fits this profile belongs to the genus:

Proteus

A bacterium was isolated as the cause of a urinary tract infection. The organism showed no lactose fermentation on MacConkey agar (MAC). On triple sugar iron (TSI) media, the organism produced an A/A with H2S. What organism is most likely observed?

Proteus vulgaris

Prior to receiving antibiotic therapy, a patient had a urinary tract infection with gram-negative, motile rods producing the following reactions: Indole: posH2S (TSI): posMR: posVP: negPhenylalanine deaminase: posUrea: posCitrate: posOrnithine decarboxylase: negGelatin hydrolysis: pos Based on the reactions above, what organism is MOST likely causing the infection?

Proteus vulgaris

A female was seen by her physician with symptoms of fever, flank pain, frequency, urgency, and dysuria. A urinalysis was performed and had the following results. Which of the following clinical manifestations will this patient have? pH7.6ProteinPositiveBloodPositiveNitritePositiveLeukocyte esterasePositiveBacteriaGram Negative Rods 4+CastsWhite Cell castRed Cell castCulture100,000 cfu/mL of Escherichia coli

Pyelonephritis

A tech is working on a urine culture and finds the following isolates: Escherichia coli: >100,000 cfu/mL Enterococcus faecalis: 50,000 cfu/mL Klebsiella pneumoniae: 30,000 cfu/mL How should the tech continue with the culture work up?

Quantitate culture and report as mixed urethral flora/contaminants

Gram positive cocci isolated from a catheterized urine culture on a 76-year-old male gave the following reactions: Blood agar- creamy, white, opaque colonies with are not hemolytic Catalase- positive Slide coagulase- negative Tube coagulase- negative Novobiocin- susceptible The next action that the medical laboratory professional should take is to:

Report the isolate as coagulase negative staphylococcus

All of the following organisms have capsular material as a defense mechanism EXCEPT:

Staphylococcus saprophyticus

Illustrated in the photograph are smooth, non-hemolytic, white 48 hour old colonies incubated at 37oC growing on the surface of blood agar. This isolate was recovered from a urine culture. Microscopic examination of a gram stain reveals gram positive cocci. The catalase reaction was positive and the coagulase test was negative. This isolate is a common agent of urinary tract infections. What is the name of this isolate?

Staphylococcus saprophyticus

Which of the following urine specimens is a method of collection for uncontaminated urine from the bladder in uncooperative patients or patients unable to void due to physiologic conditions?

Straight Catheterized Urine

A urine specimen, from a premature infant, was sent for culture to the microbiology laboratory and it grew out 30,000 cfu/mL of a coagulase negative staphylococcus. The physician felt that the growth was skin contamination as the urine was collected in a U-Bag that was attached around the infant's genitalia area. The physician sent a second specimen for culture and it was reported as no growth after 48 hours. Which of the following specimens is the most probable specimen type for the second specimen that was sent to the microbiology laboratory for culture?

Suprapubic Bladder Aspiration Urine

A urine culture contains the following organisms: Proteus mirabilis: 2,000 cfu/mL Klebsiella pneumoniae: 10,000 cfu/mL In which of the following urine sources would both organisms be worked up with a full sensitivity?

Suprapubic aspiration

A tech working in the laboratory receives a phone call from a doctor who is upset that his patient has a negative urine culture. The doctor indicates that the urinalysis result is positive for leukocyte esterase so the culture should be positive. The doctor feels that the urine culture was not properly handled. How can you explain the discrepancy in the urinalysis and culture to the doctor?

The patient could have another infection, such as a sexually transmitted infection (STI)

A urine culture and sensitivity (C&S) specimen is collected at 8 AM at an outpatient clinic and the courier will not be able to pick it up until 2 PM that same day. If refrigeration is not available, how should the specimen be stored until testing is performed?

The specimen should be placed in a container with the proper preservative.