cfu!

MediXgraph developed an App (CFU Scope) which can accurately calculate the number of colonies in an agar plate.
MediXgraph desarrolló una (Alcance CFU) App que puede calcular con precisión el número de colonias en una placa de agar.

http://www.thebiologistapprentice.com/…/cfu-scope-by-medixg…
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2

CONCACAF announced today the 13 North American cities – Atlanta, Baltimore, Boston, Charlotte,  Chicago, Dallas, Houston, Kansas City, Los Angeles, New York, Philadelphia,  Phoenix, and Toronto – that will welcome the 2015 CONCACAF Gold Cup, next July 7-26. (click the map to enlarge the schedule)

2015 CONCACAF Gold Cup Qualified Teams

  1. Canada (Automatic Qualifier)
  2. Mexico (Automatic Qualifier)
  3. United States (Automatic Qualifier)
  4. Costa Rica (Winner – 2014 Copa Centroamericana UNCAF)
  5. Guatemala (Runner-up – 2014 Copa Centroamericana UNCAF)
  6. Panama (Third Place – 2014 Copa Centroamericana UNCAF)
  7. El Salvador (Fourth Place – 2014 Copa Centroamericana UNCAF)
  8. Jamaica (Winner – 2014 CFU Caribbean Cup)
  9. Trinidad & Tobago (Runner-Up – 2014 CFU Caribbean Cup)
  10. Haiti (Third Place – 2014 CFU Caribbean Cup)
  11. Cuba (Fourth Place – 2014 CFU Caribbean Cup)
  12. French Guyana or Honduras (CFU/UNCAF Play-in Winner)

The Seeded Nations are

  • Group A – United States
  • Group B – Costa Rica
  • Group C – Mexico

More Information

Urinary Tract Infections

Definition of UTI

  • Pathologic bacteria in urine
    • Asymptomatic patients: growth of > 10^5 (100,000) CFU/mL
    • Symptomatic patients: 10^2 (100) CFU/mL

Classification of UTI

  • Lower tract infections: urethritis, cystitis
  • Upper tract infections: pyelonephritis, prostatitis
  • Community-acquired
  • Nosocomial: catheter-related

Etiology

  • E. coli - most common
  • Gram negative rods
  • Adenovirus - children

Pathophysiology

  • Colonization of external genetalia
  • Bacteria can ascend into the urinary tract 
  • Upper tract infection most common complication of lower tract infection
  • Hematogenous spread - S. aureus

Who gets UTIs?

  • Females > males
  • Increased incidence with sexual activity
  • Childhood: M > F

Female Patients

  • Vaginal introitus and distal urethra normally colonized by gram positive organisms
  • Female urethra more prone to gram negative infection 
    • Close to anus
    • Short length 
  • Risk factors
    • Hygiene issues
    • Sexual activity
      • Void after intercourse decreases this risk

Male Patients

  • Rare
  • > 50 years of age, BPH is main cause

Other Risk Factors

  • Pregnancy
  • Unsterile or prolonged catheterization
  • Obstruction
  • Vesicourethral reflux

Cystitis

  • Most common manifestation of UTI
  • Infection/inflammation of bladder
  • Most commonly E. coli, can be adenovirus
  • Clinical presentation
    • Irritative voiding 
    • Supraspubic discomfort
    • Other urinary complaints?
  • PE
    • Unremarkable
    • No CVA tenderness
  • Lab
    • Urinalysis
      • (+) LES
      • (+) Nitrites
    • Urine gram-staining
      • E. coli
      • Contamination possible
  • Acute urethral syndrome
    • “Painful voiding syndrome”
    • Dysuria with sterile culture
    • Irritants, trauma, etc.
  • Management
    • Antimicrobials
      • Short-term (< 7 days) for uncomplicated cases
      • Longer therapy (7-10 days) for DM, recurrent UTI, over 65, Men
    • Symptomatic treatment
  • Follow-up
    • Repeat urine C&S 3-5 days after antibiotics finished

Pyelonephritis

  • Infection/inflammation of renal parenchyma and pelvis
  • Most commonly E. coli or Proteus sp. 
  • Presentation
    • Flank pain
    • Fever
    • Chills
    • Toxic appearance
    • CVA tenderness
  • Lab
    • Urinalysis
      • (+) LES
      • (+) Nitrites
      • WBC casts
    • Urine gram stain
      • E. coli
      • Contamination possible
    • CBC
      • Leukocytosis with left shift
  • Imaging
    • Only done in complicated cases
  • Complications
    • Sepsis/shock
    • Scarring/fibrosis
      • Chronic pyelonephritis
  • Management
    • Usually treated as outpatient
    • Empiric therapy
      • Broad-spectrum antibiotics
        • IV 
        • PO quinolone
        • No nitrofurantoin
        • Watch resistance for Augmentin and Bactrim 
      • 14+ days
        • Inpatient: 24 hours after fever resolves
        • Outpatient: 14 days
  • Follow-up
    • Repeat urine C&S 1-2 weeks after treatment completed
    • Treatment failure
      • Imaging or referral

UTIs in Pregnancy

  • Asymptomatic bacteriuria very common - treat due to risk of complications to fetus
  • Cystitis
    • No fluoroquinolones
    • Recheck urine C&S
  • Pyelonephritis
    • Hospitalization
    • Empiric IV therapy, then PO
    • No fluoroquinolones
    • Recheck urine C&S

Nosocomial UTIs

  • Foley catheters 
  • Care for UTIs not reimbursed by Medicare/Medicaid 

Recurrent Infections: more than 2-3 per year

Vesicoureteral reflux (VUR)

  • Reflux of urine from bladder into ureters/renal pelvis
  • Common cause of UTI in children
  • Renal scarring due to volume and duration of reflux
  • Presentation
    • Weight loss
    • Nocturnal enuresis
    • Failure to thrive
  • Labs
    • Urinalysis
      • (+) LES
      • (+) Nitrites
    • Urine gram stain
      • E. coli
    • Cast formation
  • Imaging
    • Voiding cystourethrogram (VCUG)
    • Management of VUR
      • Mild
        • Spontaneous resolution usually
        • Antibiotics until puberty
      • Severe
        • Surgical intervention
        • Antibiotics into condition corrected

Mi sono iscritta al secondo anno ed ora smetto di essere matricola. Ho dato 6 esami, conosciuto 50 persone, innamorata una volta, pianto tante volte ed imparato più di quanto potessi immaginare. È andata sempre bene e se sta per andare male serve solo ad insegnarmi che non sono una media del 30 o 72 cfu a rendermi la migliore, ma il vedermi allo specchio e farmi meno schifo mi rende sicuramente migliore di quello che ero l'anno scorso perché ora me ne frego un po’ di più del sentirmi gli occhi addosso, del dover soddisfare necessariamente le aspettative di tutti. Penso solo alle nuove cose che ho dentro, penso a quello, a questo, a te, a te, a te ed anche a te!
Non sono più matricola e va bene così.