UTI in a nutshell ypical Clinical scenarIo Young female Dysuria, frequency Uranalysis WBC ++ · Nitrite +ve Urine c&s Escherichia coli growth Resistant to all beta lactams and beta lactamase inhibitor e carbapenems Levofloxacin 500 mg ad po x 3d
UTI in a nutshell • Typical clinical scenario • Young female • Dysuria, frequency • Urianalysis • WBC +++ • Nitrite +ve • Urine C&S • Escherichia coli growth • Resistant to all beta lactams and beta lactamase inhibitor except carbapenems • Rx • Levofloxacin 500 mg qd po x 3d
Uranalysis尿常规 酸色(CO) 尿液化学分析 Look for evidence of pyuria( WBc counts 定性(BIL 剩体定性(KE 尿沉渣定量分析 Hematuria 上皮细胞(E · And bacteriuria 842.5 尿沉渣镜检 红细胞(RE Nitrite 原细胞 粘液丝 般上皮细胞(EC Bacteria in urine pellets 粒管型
Urianalysis 尿常规 • Look for evidence of pyuria (WBC counts) • Hematuria • And bacteriuria • Nitrite • Bacteria in urine pellets
Specific Gravity m■■■■■■ 60s656910105101010151020125100 60 sec/seg 60-120 sec/seg ⅣvD +30c C Cetonicos 105 60 sec/seg 2011-02 Protein/Proteinas normal 1(n 400) 8(140(200) Proteinas 23054941 60 sec/seg Glucose/Glucosa/ heg 150. 15) 30 0.3) LOT Glucose
Bacteriuria or contamination Bacteriuria Contamination >105 CFU/ml on voided Microbes from external samples >102 CFU/ml on genitals during sample catheterized collection suprapubical aspiration ·S, aureus,S, 103-105CFU/m epidermidis, mixed suspiCious flora Common microbes <103 CFU/ml E coli, enterococcus
Bacteriuria or contamination? Bacteriuria • > 105 CFU/ml on voided samples • > 102 CFU/ml on catheterized/ suprapubical aspiration • 103 – 105 CFU/ml: suspicisous • Common microbes: E.coli, enterococcus Contamination • Microbes from external genitals during sample collection • S. aureus, S. epidermidis, mixed flora • < 103 CFU/ml
UTI in a nutshell Typical clinical scenario Young female Dysuria, frequency Uranalysis BC Nitrite +ve Urine C&s Escherichia coli growth Resistant to all beta lactams and beta lactamase inhibitor e carbapenems Levofloxacin 500 mg ad po x 3d
UTI in a nutshell • Typical clinical scenario • Young female • Dysuria, frequency • Urianalysis • WBC +++ • Nitrite +ve • Urine C&S • Escherichia coli growth • Resistant to all beta lactams and beta lactamase inhibitor except carbapenems • Rx • Levofloxacin 500 mg qd po x 3d