A 35-year-old woman presents to her gynecologist with complaints of burning on urination for the past 2 days.
Dipstick test of her urine demonstrates marked positivity for leukocyte esterase, but no reactivity for nitrite. Urine
culture later grows out large numbers of organisms. Which of the following bacteria are most likely to be
responsible for this patient's infection?
A. Enterobacter sp.
B. Enterococcus faecalis
C. Escherichia coli
D. Klebsiella pneumoniae
E. Pseudomonas aeruginosa
I agree with cardio2008...
C. E. Coli.
thanks. B was my second choice. good question.
why are you 2confused2bdoctor
u r right BBB
The correct answer is B. The positive leukocyte esterase test indicates the presence of neutrophils in the urine,
suggesting a bacterial infection. The nitrite test exploits the fact that most Enterobacteria (gram-negative enteric
rods) are able to form nitrite from nitrate; thus, the nitrite test is used to diagnose urinary tract infections. One
limitation of this method is the fact that enterococci (gut streptococci) do not produce nitrite from nitrate, but can
nonetheless cause urinary tract infections. Enterococcal urinary tract infections are often nosocomial and
classically acquired in the intensive care unit, although they can occur in other settings.
Enterobacter sp. (choice A), Escherichia coli(choice C), Klebsiella pneumoniae(choice D), and Pseudomonas
aeruginosa(choice E) can cause urinary tract infections and would usually be picked up by the dipstick for
nitrites. False-negative results might still be seen with these organisms if the infection was light, the bladder had
been recently emptied prior to collection, and the urine was "new" and had not yet grown enough bacteria to
produce a positive result.
hahaha..when i started studying for this steps back in months, i was so confused..and couldnt think of anything..days passed, months passed..
2C2BD