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Acids, alcohols and gases are usually detected in these tests when bacteria are grown in selective liquid or solid media , as mentioned above. In order to perform these tests en masse, automated machines are used.

Recurrent Canine Urinary Tract Infections • MSPCA-Angell

These machines perform multiple biochemical tests simultaneously, using cards with several wells containing different dehydrated chemicals. The microbe of interest will react with each chemical in a specific way, aiding in its identification. Serological methods are highly sensitive, specific and often extremely rapid laboratory tests used to identify different types of microorganisms. The tests are based upon the ability of an antibody to bind specifically to an antigen. The antigen usually a protein or carbohydrate made by an infectious agent is bound by the antibody, allowing this type of test to be used for organisms other than bacteria.

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This binding then sets off a chain of events that can be easily and definitively observed, depending on the test. More complex serological techniques are known as immunoassays. Using a similar basis as described above, immunoassays can detect or measure antigens from either infectious agents or the proteins generated by an infected host in response to the infection.

Polymerase chain reaction PCR assays are the most commonly used molecular technique to detect and study microbes. For instance, traditional PCR techniques require the use of gel electrophoresis to visualize amplified DNA molecules after the reaction has finished. Once an infection has been diagnosed and identified, suitable treatment options must be assessed by the physician and consulting medical microbiologists. Some infections can be dealt with by the body's own immune system , but more serious infections are treated with antimicrobial drugs.

Bacterial infections are treated with antibacterials often called antibiotics whereas fungal and viral infections are treated with antifungals and antivirals respectively.

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A broad class of drugs known as antiparasitics are used to treat parasitic diseases. Medical microbiologists often make treatment recommendations to the patient's physician based on the strain of microbe and its antibiotic resistances , the site of infection, the potential toxicity of antimicrobial drugs and any drug allergies the patient has. In addition to drugs being specific to a certain kind of organism bacteria, fungi, etc.

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Because of this specificity, medical microbiologists must consider the effectiveness of certain antimicrobial drugs when making recommendations. Additionally, strains of an organism may be resistant to a certain drug or class of drug, even when it is typically effective against the species. These strains, termed resistant strains, present a serious public health concern of growing importance to the medical industry as the spread of antibiotic resistance worsens. Antimicrobial resistance is an increasingly problematic issue that leads to millions of deaths every year.

Whilst drug resistance typically involves microbes chemically inactivating an antimicrobial drug or a cell mechanically stopping the uptake of a drug, another form of drug resistance can arise from the formation of biofilms. Some bacteria are able to form biofilms by adhering to surfaces on implanted devices such as catheters and prostheses and creating an extracellular matrix for other cells to adhere to.

Additionally, the extracellular matrix and dense outer layer of bacterial cells can protect the inner bacteria cells from antimicrobial drugs. Medical microbiology is not only about diagnosing and treating disease, it also involves the study of beneficial microbes. Microbes have been shown to be helpful in combating infectious disease and promoting health. Treatments can be developed from microbes, as demonstrated by Alexander Fleming's discovery of penicillin as well as the development of new antibiotics from the bacterial genus Streptomyces among many others.

Medical Microbiology. From Wikipedia, the free encyclopedia. See also: Infection. Main article: Diagnostic microbiology. Journal of Clinical Microbiology. Egerton Bulletin of the Ecological Society of America. Brock Biology of Microorganisms 13th ed. Pearson Education. Robert Koch: a life in medicine and bacteriology. Archived from the original on December World Health Organization.

Retrieved Advances in Pediatrics. Journal of the American Medical Association. June Centers for Disease Control and Prevention. In Baron, S ed. Medical Microbiology 4th ed. University of Texas Medical Branch at Galveston. Archived from the original on 13 June In Bittar, Neville, E, B ed.

Medically Speaking: Urinary Tract Infections, Ming-Hsien Wang, MD

Infection control in home care. Archived from the original on 11 May Bibcode : PNAS.. Journal of General Virology. Microbiology: A human perspective. McGraw Hill. Occupational Medicine. Horizon Scientific Press. Encyclopedia of Microbiology. Oxford Academic Press. Archived from the original on May 15, Retrieved May 9, Pyelonephritis not caused by bacterial ascension is caused by hematogenous spread, which is particularly characteristic of virulent organisms such as S. The affected kidney is usually enlarged because of inflammatory PMNs and edema.

Recurrent Canine Urinary Tract Infections

Infection is focal and patchy, beginning in the pelvis and medulla and extending into the cortex as an enlarging wedge. Cells mediating chronic inflammation appear within a few days, and medullary and subcortical abscesses may develop. Normal parenchymal tissue between foci of infection is common. Papillary necrosis may be evident in acute pyelonephritis associated with diabetes, obstruction, sickle cell disease, pyelonephritis in renal transplants, pyelonephritis due to candidiasis, or analgesic nephropathy. Although acute pyelonephritis is frequently associated with renal scarring in children, similar scarring in adults is not detectable in the absence of reflux or obstruction.

Elderly patients and patients with a neurogenic bladder or an indwelling catheter may present with sepsis and delirium but without symptoms referable to the urinary tract. When symptoms are present, they may not correlate with the location of the infection within the urinary tract because there is considerable overlap; however, some generalizations are useful.

In urethritis , the main symptoms are dysuria and, primarily in men, urethral discharge. Discharge can be purulent, whitish, or mucoid. Characteristics of the discharge, such as the amount of purulence, do not reliably differentiate gonococcal from nongonococcal urethritis. Cystitis onset is usually sudden, typically with frequency, urgency, and burning or painful voiding of small volumes of urine.

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  • Nocturia, with suprapubic pain and often low back pain, is common. The urine is often turbid, and microscopic or rarely gross hematuria can occur. A low-grade fever may develop. Pneumaturia passage of air in the urine can occur when infection results from a vesicoenteric or vesicovaginal fistula or from emphysematous cystitis. In acute pyelonephritis , symptoms may be the same as those of cystitis.

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    One third of patients have frequency and dysuria. However, with pyelonephritis, symptoms typically include chills, fever, flank pain, colicky abdominal pain, nausea, and vomiting. If abdominal rigidity is absent or slight, a tender, enlarged kidney is sometimes palpable.

    Costovertebral angle percussion tenderness is generally present on the infected side. In urinary tract infection in children , symptoms often are meager and less characteristic. Diagnosis by culture is not always necessary.


    If done, diagnosis by culture requires demonstration of significant bacteriuria in properly collected urine. Urine collection is then by clean-catch or catheterization. To obtain a clean-catch, midstream specimen , the urethral opening is washed with a mild, nonfoaming disinfectant and air dried. Contact of the urinary stream with the mucosa should be minimized by spreading the labia in women and by pulling back the foreskin in uncircumcised men. The first 5 mL of urine is not captured; the next 5 to 10 mL is collected in a sterile container. A specimen obtained by catheterization is preferable in older women who typically have difficulty obtaining a clean-catch specimen and in women with vaginal bleeding or discharge. Many clinicians also use catheterization to obtain a specimen if evaluation includes a pelvic examination. Testing, particularly culturing, should be done within 2 h of specimen collection; if not, the sample should be refrigerated.

    Microscopic examination of urine is useful but not definitive. The presence of bacteria in the absence of pyuria, especially when several strains are found, is usually due to contamination during sampling. WBC casts, which may require special stains to differentiate from renal tubular casts, indicate only an inflammatory reaction; they can be present in pyelonephritis, glomerulonephritis , and noninfective tubulointerstitial nephritis.

    Pyuria in the absence of bacteriuria and of UTI is possible, for example, if patients have nephrolithiasis , a uroepithelial tumor, appendicitis , or inflammatory bowel disease or if the sample is contaminated by vaginal WBCs. Women who have dysuria and pyuria but without significant bacteriuria have the urethral syndrome or dysuria-pyuria syndrome. Dipstick tests also are commonly used. A positive nitrite test on a freshly voided specimen bacterial replication in the container renders results unreliable if the specimen is not tested rapidly is highly specific for UTI, but the test is not very sensitive.