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HPIM ID > 183e Infections due to HACEK group and Miscellaneous Gram Neg Bacteria > Flashcards

183e Infections due to HACEK group and Miscellaneous Gram Neg Bacteria Flashcards

1
Q

HACEK organisms

A

Gram Negative

  1. Haemophilus sp.
  2. Aggregatibacter (formerly Actinobacillus) sp.
  3. Cardiobacterium hominis
  4. Eikenella corrodens
  5. Kingella kingae
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2
Q

Where do HACEK bacteria normally reside?

A

Mouth

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3
Q

Infections that HACEK cause

A
  1. Local infections in the mouth

2. Bacterial endocarditis

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4
Q

Most common bacteria causing infective endocarditis

A
  1. Aggregatibacter sp.
  2. Haemophilus sp.
  3. Cardiobacterium hominis
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5
Q

Characteristics of HACEK endocarditis

A
  1. Occur in younger patients
  2. Associated with embolic, vascular, and immunologic manifestations
  3. Associated less commonly with congestive heart failure
  4. Clinical course is subacute
  5. Systemic embolization is common
  6. Aortic and mitral valves most commonly affected
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6
Q

Species that most often cause MITRAL valve vegetations

A

Aggregatibacter sp.

Haemophilus sp.

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7
Q

Species that most often cause AORTIC valve vegetations

A

Cardiobacterium hominis

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8
Q

Species where resistance is most commonly noted

A

Aggregatibacter sp.

Haemophilus sp.

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9
Q

When do most cultures yield positive for HACEK organism?

A

First week

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10
Q

T or F: Overall prognosis is better with HACEK endocarditis than with non-HACEK pathogens.

A

True

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11
Q

Most common species isolated from cases of HACEK endocarditis

A

Haemophilus parainfluenzae

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12
Q

Most common species of Aggretibacter most frequently causing infective endocarditis

A
  1. A. actinomycetemcomitans
  2. A. (formerly Haemophilus) aphrophilus
  3. A. paraphrophilus
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13
Q

Nature of valve where Aggregatibacter is more often associated compared to Haemophilus sp.

A

Prosthetic valve endocarditis

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14
Q

Usual clinical presentation of patients with endocarditis due to Aggregatibacter

A
  1. With periodontal disease or recently undergone dental procedures
  2. With underlying cardiac valvular damage
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15
Q

Species of Aggregatibacter isolated from soft tissue infections and abscesses in association with Actinomyces israelii

A

A. actinomycetemcomitans

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16
Q

Species of Aggregatibacter associated with bone and joint infection

A

A. aphrophilus

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17
Q

Common complications of endocarditis caused by C. hominis

A

Embolization
Mycotic aneurysms
Congestive heart failure

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18
Q

Most frequently recovered from sites of infection in conjunction with other bacterial species

A

Eikenella corrodens

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19
Q

Clinical sources of E. corrodens

A
  1. Sties of human bite wounds (clenched-fist injuries)
  2. Endocarditis
  3. Soft tissue infections
  4. Osteomyelitis
  5. Head and neck infections
  6. Chorioamnionitis
  7. Gynecologic infections associated with intrauterine devices
20
Q

Organism that is the least common cause of HACEK endocarditis

A

E. corrodens

21
Q

Most common infections caused by K. kingae

A

Bone and joint infections

Others: infective endocarditis, bacteremia

22
Q

Characteristics of K. kingae infections

A
  1. One of the most common cause of septic arthritis in children
  2. Associated with upper respiratory tract infection and stomatitis in invasive infections
  3. Rate of oropharyngeal colonization are highest in the first 3 years of life
  4. Can present with petechial rash similar to Neisseria meningitidis sepsis
23
Q

First-line therapy for HACEK endocarditis

A

Ceftriaxone 2g/d

24
Q

Antibiotics where Eikenella is resistant

A
  1. Clindamycin
  2. Metronidazole
  3. Aminoglycosides
25
Q

Treatment duration for native-valve endocarditis and prosthetic-valve endocarditis

A

Native-valve: 4 weeks

Prosthetic-valve: 6 weeks

26
Q

Alternative agents for for HACEK endocarditis

A
  1. Ampisulbactam 3g q6h (resistance to Haemophilus and Aggregatibacter sp. described)
  2. Levofloxacin 500-750mg/d (not for pt <18 y/o)
  3. Penicillin 16-18 M units q4h or Ampicillin 2g q4h
27
Q

Gram-negative bacteria seen as part of endogenous intestinal flora and isolated from variety of water sources, including well water, IV fluids, and humidifiers

A

Achromobacter xylosoxidans

28
Q

Treatment for Achromobacter xylosoxidans infection

A

Treatment based on in vitro susceptibility testing
Multidrug resistance is common

Antibiotics: Meropenem, Tigecycline, Colistin

29
Q

Where do Aeromonas sp. proliferate?

A

Potable water
Fresh water
Soil

30
Q

Infection and sepsis with this bacteria is seen in trauma and burn patients exposed by environmental (fresh water or soil) contamination of their wounds

A

Aeromonas sp.

31
Q

Infection with this gram-negative bacteria causes ecthyma gangrenosum resembling lesions seen in Pseudomonas aeruginosa infection

A

Aeromonas sp.

32
Q

Treatment for Aeromonas sp.

A

Should be based on susceptibility testing
High resistance

Fluoroquinolones, 3rd and 4th gen cephalosporins, carbapenems, aminoglycosides

33
Q

T or F: Antibiotic prophylaxis is indicated when medicinal leeches are used

A

True

34
Q

Fusiform, facultatively anaerobic gram-negative species associated with neutropenic patients with oral ulcerations

A

Capnocytophaga sp.

35
Q

Infected patients of this species frequently have history of dog bites or of canine exposure without scratches or bites

A

Capnocytophaga sp.

36
Q

Treatment for Capnocytophaga infection

A

Ampicillin sulbactam 1.5-3.0g every 6h
Clindamycin 600-900mg every 6-8h

If C. canimorsus is susceptible to penicillin:
Penicillin 12-18 M units every 4h

37
Q

Asplenic patients who sustained dog-bite injuries should receive this antibiotic as prophylaxis

A

Ampicillin/sulbactam

38
Q

Gram negative bacteria that is an important cause of nosocomial infections, including outbreaks due to contaminated fluids (disinfectants and aerosolized antibiotics) and sporadic infections due to indwelling devices and apparatuses.

A

Elizabethkingia meningoseptica (formerly Chryseobacterium meningosepticum)

39
Q

Treatment for Elizabethkingia meningoseptica infection

A

Fluoroquinolones
Co-trimoxazole
Piperacillin tazobactam

Susceptibility testing should be performed

40
Q

Bipolar-staining, gram-negative coccobacillus that colonizes the respiratory and GI tract of domestic animals cats and dogs, transmitted to humans thru bites or scratches or thru droplets or deposition on injured skin during licking

A

Pasteurella multocida

41
Q

Treatment for Pasteurella multocida infection

A 
Penicillin
Ampicillin / Ampisulbactam
2nd and 3rd gen cephalosporins
Tetracyclines
Fluoroquinolones
42
Q

Bacteria associated with infection in presence of medical devices including prosthetic joint and prosthetic valve infections, and peritonitis caused by dialysis catheters

A

Rhizobium (formerly Agrobacterium) radiobacter

43
Q

Treatment for Rhizobium radiobacter

A

Fluoroquinolones
3rd-4th gen cephalosporins
Carbapenems

44
Q

Ubiquitous organisms found in sea water colonizing devitalized tissues causing systemic infection

A

Shewanella putrefaciens

S. algae

45
Q

Treatment forShewanella putrefaciens and S. algae

A 
Fluoroquinolones
3rd-4th gen cephalosporins
b-lactam/b-lactamase inhibitor
Carbapenems
Aminoglycosides
46
Q

Bacteria responsible for life-threatening infections with severe spesis and metastatic abscesses particularly in children with defective neutrophil function

A

Chromobacterium violaceum

47
Q

Bacteria causing infection related to central venous catheters in compromised hosts

A

Ochrobactrum antrhopi

HPIM ID (2 decks)

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