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Content: Detects GNB, but not all uropathogens can do this (ex. S. saprophyticus and Enterococcus)
Culturing
Culture and antibiotic sensitivity testing important for complicated infections to be sure of eradication
Escherichia coli - cause of UTI
Most common agent of all UTI's 
Predominate species of GNB in the colonic flora
Escherichia coli: virulence
Virulence of Uropathogenic Strains (UPEC)
- Type 1 fimbriae (cystitis), P fimbriae (pyelonephritis)
- hemolysins, aerobactin (siderophore)
- Resistance to serum killing, capsule, IBC formation
- Antibiotic resistance a problem (MDR GNB; ESBL)
Escherichia coli: dipsticks
Urine dipsticks positive for nitrites, Gram (-) rod, lactose (+), indole (+), oxidase (-)
Staphylococcus saprophyticus
*Causes 5-15% of community acquired UTI's in newly sexually active women ("honeymoon cystitis")*
Infection usually symptomatic
*Always nitrate negative* on urine dipsticks, low CFU's on culture, sensitive to antibiotics
Proteus mirabilis - UTIs
GI tract of mammals
Urinary tract most common site of infection. Infections in community, hospitals and LTCF
*Most common in patients with structural abnormalities and catheters& esp. long term indwelling catheters*
Proteus mirabilis - virulence
Biofilms and encrustations on catheters *urease*→ ↑ pH → renal calculi, catheter obstruction 
Urine with *pH > 7* → culture for Proteus, check for *calculi (urolithiasis) *
Proteus: General Characteristics
Gram (-) rod, lactose (-), Indole (-), H2S (+), oxidase (-)
*Urease (6-10X's more potent as that produced by other bacteria)*
*swarming mobility*
Klebsiella pneumoniae - UTIs
GI tract of humans
1-2% of community acquired UTI's, 5-17% of complicated UTI's
Klebsiella pneumoniae - abx resistance
Antibiotic resistance a problem (MDR, ESBL, carbapenemases)
Klebsiella pneumoniae - culture
*Copious capsule*, Urease (+), Lactose (+), Indole (-)
Pseudomonas aeruginosa - UTIs
Ubiquitous in the health-care environment 
Associated with foreign body in urinary tract
Pseudomonas aeruginosa - abx resistance
Antibiotic resistance a problem. * Treat as a complicated infection. Remove obstruction to prevent relapse.*