Chapter·MicrobiologyHospital-acquired infections

Catheter-associated urinary tract infectionsDownloads

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1

A 62-year-old man comes to the physician because of a 2-day history of fever, chills, and flank pain. Five days ago, he was catheterized for acute urinary retention. His temperature is 39.3°C (102.7°F). Physical examination shows right-sided costovertebral angle tenderness. Urine studies show numerous bacteria and WBC casts. Urine culture on blood agar grows mucoid, gray-white colonies. Urine culture on eosin methylene blue agar grows purple colonies with no metallic green sheen. Which of the following is the most likely causal pathogen?

AEscherichia coli

BKlebsiella pneumoniae

CPseudomonas aeruginosa

DProteus mirabilis

EStaphylococcus saprophyticus

2

A 26-year-old female presents to her primary care physician concerned that she has contracted a sexually transmitted disease. She states that she is having severe pain whenever she urinates and seems to be urinating more frequently than normal. She reports that her symptoms started after she began having unprotected sexual intercourse with 1 partner earlier this week. The physician obtains a urinalysis which demonstrates the following, SG: 1.010, Leukocyte esterase: Positive, Nitrites: Positive, Protein: Trace, pH: 5.0, RBC: Negative. A urease test is performed which is negative. This patient has most likely been infected with which of the following organisms?

AEnterobacter cloacae

BStaphylococcus saprophyticus

CProteus mirabilis

DKlebsiella pneumoniae

EEscherichia coli

3

A 25-year-old woman comes to the physician because of a 2-day history of a burning sensation when urinating and increased urinary frequency. She is concerned about having contracted a sexually transmitted disease. Physical examination shows suprapubic tenderness. Urinalysis shows a negative nitrite test and positive leukocyte esterases. Urine culture grows organisms that show resistance to novobiocin on susceptibility testing. Which of the following is the most likely causal organism of this patient's symptoms?

AKlebsiella pneumoniae

BProteus mirabilis

CPseudomonas aeruginosa

DStaphylococcus epidermidis

EStaphylococcus saprophyticus

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