Step I ecoli vs staph saprophyticus

[MissMedicine]

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is there a difference bw how these two uti's present... in particular, does one present with intermittent suprapubic pain? if the pt is a 20 something yr old... which one is it more likely?? I am stuck on a question... thanks!

 

[smgilles]

is there a difference bw how these two uti's present... in particular, does one present with intermittent suprapubic pain? if the pt is a 20 something yr old... which one is it more likely?? I am stuck on a question... thanks!

S. saprophyticus is the second leading cause of UTI's in sexually active women, second to E. coli.

 

[DrQuinn]

staph saprophyticus is usually in sexually active females.
E coli in everyone else.

This is what i ues to differentiate the two on boards. in real life it doesn't matter which bug you got.

Q, DO

 

[MissMedicine]

yea s saprophyticus is the second... so wouldnt e coli then be the first? are staph saprophyticus g+cocci right? hmmm im kinda torn. statistically, i think e coli is still more common even among sexually active women, no?

 

[MissMedicine]

hmm the question stem doesnt even sayif she is sexually active, only her age.

 

[Idiopathic]

E. coli if given age only. Of course, gram + versus gram - would be a clue, and we were told that occasionally a gram stain will show so few gram + bugs that you will assume it is a contaminant, but in that case, it is almost always saprophyticus.

Obviously, 'honeymoon' UTI's and UTI's in younger women (back-to-front wiping?) are more likely to be e coli. If you are given no gram stain or picture, go with e coli, regardless of sexual history.

 

[MissMedicine]

E. coli if given age only. Of course, gram + versus gram - would be a clue, and we were told that occasionally a gram stain will show so few gram + bugs that you will assume it is a contaminant, but in that case, it is almost always saprophyticus.

Obviously, 'honeymoon' UTI's and UTI's in younger women (back-to-front wiping?) are more likely to be e coli. If you are given no gram stain or picture, go with e coli, regardless of sexual history.

the question doesnt give g+ or g- info, but just asks which is most likely to be found in the urine of a 20 some odd women with what seems like a worsening uti... g+cocci or g-bacilli?

 

[Brian Pavlovitz]

I'd go with g-bacillus (E. coli), just because it's the most common. Not sure if a UTI with S. saprophyticus would present differently, though. Guess you'd just have to wait for the culture 😀

Taking Step 1 soon? I take mine this Friday

 

[MedicinePowder]

MissMedicine, I'm pretty sure the answer to that question is E.coli. I remember the specific question. If you are not given any other information, it's E.coli unless they cue you-in that you are dealing with a young "SEXUALLY" active female.

 

[Idiopathic]

Agree...no info = e.coli.

 

[Gauss]

Always go with E Coli first
But look at the symptoms, are you seeing urethritis, cystitis, or pyelo?
Urethritis/Cervicitis is chlam/gono
Dysuria, Frequency, Urgency, suprapubic tender = cystitis
Above + CVAT = pyelo -->beware of sepsis, fever spikes chills & WBC

Also don't forget about Toxic shock from Staph toxin (tampons), which for you gunners will never grow blood cultures because its a toxin - but you will look septic and get pulmonary RDS

 

[Stinger86]

E. coli, unless you're given additional identifying information that might lead you to another bug (such as gram staining, morphology, etc )

 

[StringBean]

Another vote for e.coli. Actually I just saw that EXACT statement on my micro cards last night... "s. saprophyticus is the #2 cause of UTI in young women (after e.coli)"

😀