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uti with leukocytes esterase positive but negative nitrite

Thread: uti with leukocytes esterase positive but negative nitrite

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  1. asmii said:

    uti with leukocytes esterase positive but negative nitrite

    35 yr old lady present w/ complaints of burning urination for the past 2 days and deep stick test of her urine demonstrate marked positivity for the but no reactivity for the nitrite .urine culture later grows out large no. of organisms. which of the following bacteria is most likely to be responsible for patients infection?

    1. enterobacter sp.

    2. enterccocus fecalis

    3. e.coli

    4 klebsiella pnemoniae

    5. pseudomonas aeruginosa
     
  2. Asclepius1's Avatar

    Asclepius1 said:
    E.coli ---both esterase reaction and nitrite test r +ve


    Enterococcus faecalis ----- esterase reaction is +ve but nitrite test is -ve
     
  3. Unregistered5 said:
    Klebsiella = esterase neg and nitrites pos
     
  4. md90's Avatar

    md90 said:
    35 yr old lady present w/ complaints of burning urination for the past 2 days and deep stick test of her urine demonstrate marked positivity for the but no reactivity for the nitrite .urine culture later grows out large no. of organisms. which of the following bacteria is most likely to be responsible for patients infection?
    1. enterobacter sp.
    2. enterccocus fecalis
    3. e.coli
    4 klebsiella pnemoniae
    5. pseudomonas aeruginosa
    "most likely"... would mean most common therefore E.coli would be the answer
     
  5. bckwood's Avatar

    bckwood said:
    Also in UTI only approximatly 25% of patients have a postive nitrate test with e. coli or Proteus spp.

    3. E. coli
    Cogito, ergo sum
     
  6. answer said:

    Exclamation e.faecilis

    the answer is e.faecilis...ecoli would have reactivity to the nitrates..e.faecilis does not..and plus this question is from qbank..i have had it before..good question!
     
  7. bckwood's Avatar

    bckwood said:
    Quote Originally Posted by asmii
    which of the following bacteria is most likely to be responsible for patients infection?
    I still say that the MOST LIKELY bug would be E. coli. Think about it, if 90% of all UTI's are caused by E. coli, and only 25% of those are Nitrate positive, then the MOST LIKELY cause would be E. coli.
    Cogito, ergo sum
     
  8. marceverett said:
    "Most Likely" doesn't mean ignore the other hints in the question.. E.Coli reduces.
     
  9. bckwood's Avatar

    bckwood said:
    Quote Originally Posted by marceverett
    "Most Likely" doesn't mean ignore the other hints in the question.. E.Coli reduces.
    Did you ever stop to think how the dipstick test works? What would happen if you had an over growth of the pathogen? Wouldn't it reduce the Nitrate all the way, therefore indicating a negative reaction? Therefore I still say the anwser is E. Coli. Or if it was not a first morning void, therefore not giving enough time for the Nitrate to be reduced. Many ways to explain away the negative Nitrate test. It is never 100% positive or negative in Micro.
    Cogito, ergo sum
     
  10. md90's Avatar

    md90 said:

    good question...

    35 yr old lady present w/ complaints of burning urination for the past 2 days and deep stick test of her urine demonstrate marked positivity for the but no reactivity for the nitrite .urine culture later grows out large no. of organisms. which of the following bacteria is most likely to be responsible for patients infection?
    1. enterobacter sp.
    2. enterccocus fecalis
    3. e.coli
    4 klebsiella pnemoniae
    5. pseudomonas aeruginosa
    Which answers are not correct?
    Enterobacter sp, why? includes E.coli, shigella, salmonella, Klebsiella, Enterobacter, Serratia, Proteus--and we know that not all of these species will cause UTIs

    Klebsiella pneumoniae and Pseudomonas aeruginosa are more commonly found in lungs and wounds respectively.

    That leaves us with Enterococcus faecalis and E.coli...
    E.faecalis is an opportunistic pathogen; is penicillin-G resistant, and can cause UTI and subacute endocarditis. Used to be known as streptococcus faecalis in the past. It can cause the same infections as the Enterobacteriae species.

    E.coli is an organism that is normally found in the intestines. They can colonize and invade the urinary tract... are more common in young women.

    So according to the literature and my knowledge... E.coli is the BEST answer, why?
    1. the case states that this is a young lady of 35 years, and we know that UTIs are more common in females b/c of the short urethra
    2. We have to assume that this is a doctor's visit or at a community clinic, and not at a hospital... (she is having burning pain for past two days).. E.faecalis is an opportunistic pathogen;
    3. have not found anywhere in the literature (sources that I checked)where it states that E.faecalis reacts to nitrates but do remember that E.coli doing so...
    4. Most community pathogens for UTI are E.coli and/or S.saprophyticus which is more common in younger women than E.coli BUT is not one of the answers...

    Any comments or questions????
    Thank you for the discussion and question...
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