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.…/cfu-scope-by-medixg…
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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

Bladder cells regurgitate bacteria to prevent UTIs

Duke Medicine researchers have found that bladder cells have a highly effective way to combat E. coli bacteria that cause urinary tract infections (UTIs).

In a study published online May 28, 2015, in the journal Cell, Duke researchers and their colleagues describe how bladder cells can physically eject the UTI-causing bacteria that manage to invade the host cell.

This response is analogous to having indigestion and vomiting to rid the stomach of harmful substances.

The finding suggests there may be a potential way to capitalize on this natural tendency in bladder cells to help treat recurring UTIs.

The figure shows the different stages of a urinary tract infection. Panels 2, 4, 5 and 11 are courtesy of N. Gunther, A. Jansen, X. Li and D. Auyer (University of Maryland), respectively. CFU, colony-forming units; PMNs, polymorphonuclear leukocytes.

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


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


  • 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


  • 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


  • 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

The Bacteria of the London Underground

If you’ve ever been to London, then you’ve probably at least heard horror stories of the cramped and uncomfortable conditions that Londoner’s are faced with when the tube lines are busy. However the person who just stuck a sweaty armpit in your face isn’t the only cause for concern on the underground.

More than 1.34 billion passengers ride the tube each year, and each of them transport millions of bacteria on their journey. All of that human movement provides a perfect transport system for these little bugs to travel rapidly from one part of London to another within minutes. Should we be worried about what health problems this may pose?

Well a team was sent into the underground to swab surfaces to uncover what monstrosities lurk down there. The image above shows the results of their findings. The line that comes out on top of all others is the Northern line, harbouring 1,647 CFU/10 cm^2. This means that for every 10 cm^2, over 1,600 viable bacterial cells were happily surviving and making themselves at home. This was nearly three times as many bacterial cells than seen within the central line, which came in second place.

The team also looked at identifying the most contaminated tube stations. Stratford was found to take home the gold, although it is only the 7th busiest station in London.  

They also found that the most bacteria contaminated surfaces were unsurprisingly the surfaces that are in contact with a lot of humans on a daily basis. This included: the ticket machines, the barriers, the seats, escalators, and the metal poles within the tubes themselves.

So what does this all mean for you commute home? There is probably no need to run out and buy hand sanitiser. In reality, we’re surrounded by bacteria all the time, and just because the tube has high levels of viable cells does not necessarily mean that all of these organisms are bad for you. This study only quantified what was growing in the depths of the underground and did not identify probable disease causing species. That being said, the group do still recommend that you maintain good personal hygiene on a daily basis to ensure that you do not contract anything nasty.

Read more: Mind the Germs