A 21-years old woman presents to the office with 3-day duration of discomfort wi
ID: 174004 • Letter: A
Question
A 21-years old woman presents to the office with 3-day duration of discomfort with urination and increased urinary frequency. She has noted that the urine has a strong odor as well. She denies fever, abdominal pain, back pain, vaginal discharge, or skin rash. She is sexually active and takes oral contraceptive pills. On examination, she is comfortable appearing and afebrile. She has no costovertebral angle tenderness. Abdominal exam is notable only for suprapubic tenderness. Microscopic examination of the sediment of a centrifuged urine sample reveals 10-15 white blood cells (WBC) per high power field and numerous bacteria. What type of microorganism would a Gram stain of the urine most likely show? What is the most common etiologic agent of this infection? What is the most likely reservoir of this infection? What is the most likely mechanism by which this microorganism infects the urinary tract? Treatment and Prevention?Explanation / Answer
1. The Gram stain of urine most likley show Gram-negative bacteria. When the urine sample is stained with Gram's stain, it usually gives pink color which is characteristic of gram negative bacteria.
2.The etiologic agent of urinary tract infection is bacteria E. coli. It remains the predominant uropathogen.
3. The bacteria E. Coli can easily travel from large intestine through bowel to the urethra and can cause infection.
4. The bacteria that causes urine infection typically enters the bladder via urethra. However, infection may occur though blood or lymph. It is believed that the bacteria enter the urethra from bowel . Females, being more susceptible due to their anatomy. After gaining entry into the bladder, the bacteria gets stick to the wall of the bladder and form a biofilm that resists body's immune response.
5. Treatement: The treatement is done by providing antibiotics.
Prevention:
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