For urinary catheters and UTI the following are false, EXCEPT:
Catheters provide a surface for a bacterial biofilm formation and residual urine is increased through pooling below the catheter bulb. The biofilm forms on the surface of the catheter. The daily rate of colonisation is 5%, so that by 4 weeks almost 100% are colonised with bacteria. It is estimated that all long-term catheters are colonised with at least two organisms. In the UK, UTI is the most common hospital-acquired infection accounting for 23% of all infections and the majority of these are associated with catheters.
Regarding UTI and immunoactive prophylaxis all the following are true, EXCEPT:
OM-89 significantly reduced the incidence of UTI . Intravaginal probiotics restore vaginal lactobacilli. Probiotics containing L. rhamnosus GR-1 and L. reuteri RC-14 can prevent recurrent UTI. A type proanthocyanidins have been clinically demonstrated to attach to E. coli fimbriae, preventing the bacteria from attaching to the urinary tract or the urinary bladder. Interesting read.
The following factors suggest a complicated UTI, EXCEPT:
A complicated UTI indicates there is an abnormality in the urinary tract, either innate or as a result of pathology or medical intervention.
The following are true for Escherichia coli (E. coli) uropathogenesis, EXCEPT:
The spectrum of aetiological agents is similar in uncomplicated upper and lower UTIs, with E. coli the causative pathogen in 70%–95% of cases and Staphylococcus saprophyticus in 5%–10%. Occasionally, other Enterobacteriaceae, such as Proteus mirabilis and Klebsiella species are isolated. Virulence factors prevent E. coli from immune recognition or even actively reduce an immune response. They include adhesins, toxins, iron acquisition systems and immune evasion mechanisms.
Pathogen recognition receptors Toll-like receptor (TLR) 4 and TLR5 appear the most important receptors for endotoxins, with TLR4 recognising lipopolysaccharide (LPS), as the major component of the cell wall in Gram-negative bacteria.
Following are urea-splitting uropathogen, EXCEPT:
Urea-splitting bacteria are Proteus, Klebsiella, Pseudomonas, Providencia, Serratia species, Staphylococcus aureus and Ureaplasma urealyticum. Proteus mirabilis accounts for more than half of all urease positive urinary infections. Urea-splitting bacteria change the urine pH (>7.2) and allow easier precipitation of phosphate with several compounds, mainly ammonium and magnesium. The result is struvite stones.
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