Bacteria Flashcards
Causes of pneumoniae (6)
Mycoplasma
Chlamydia
Actinomyces (aspiration type)
Porphhyromonas (aspiration type)
Streptococcus pneumoniae
Legionaires
Spirochetes
Lyme (Borellia burgdorferri)
Syphillis (Trepona Pallidium)
Leptospira (Leptospirosis)
Atypical bacteria
Rickettsia infections (Rickettsia rickettsii)
Chlamydial infections (gonorrhoae, meningo)
Mycobacterium pneumoniae (walking)
Legionella sp. (Legionnaires disease)
List of gram pos anaerobes
Actinomyces
Clostridia
Peptostreptococcus
Propionibacterium
Gram negative anaerobes
Bacteroides
Fusobacterium
Prevotella
Porphyromonas
What kind of infections does Actinomyces cause, what is its gram, and what type of bacteria
Head and neck Infections
Intra-abdominal Infections
Aspiration pneumonia
What kind of infections does Peptostreptococcus cause, what is its gram, and what type of bacteria
Oral Infections (dental abscesses)
Intra-abdominal Infections
What kind of infections doesPropionibacterium cause, what is its gram, and what type of bacteria
Foreign body infections
Prosthetic device
Clinical presentation of anaerobic infection
Abscess formation with tissue necrosis
Suppurative/purulent
Foul odor of pus or infected tissue
Site of infection typically near where anaerobic flora reside
Mouth, jaw and neck (from dental roots)
Abdomen/pelvis (from GI tract)
Lungs (from aspiration)
Often polymicrobial
Gram + anaerobic infections Diagnostic findings
CXR - Aspiration pneumonia
* Infiltrates with or without cavitation
* Lucency within infiltrates suggest necrotizing tissue
* Air fluid levels within circumscribed infiltrate = lung abscess
Abdominal/Pelvic CT - Intra-abdominal abscess
Gram pos anaerobic diagnosis - what do you order and what does it take to form a diagnosis
clinical suspicion, gram stain, culture (can take a week)
Gram positive anaerobic tx for oral/throat/neck
clindamycin, augmentin, unasyn
Cl - Au - SYn
or Cl - Au - Uni
gram positive anaerobic infections treatment for GI/pelvic abscess
Oral therapy: moxifloxacin
IV therapy: mod/severe infection.
ertapenem OR ceftriaxone + metronidazole
very severe: imipenem
Gram positive anaerobic treatment lungs - abscess
(must be able to penetrate lung parenchyma to get sample)
* Beta-lactam plus a beta-lactam inhibitor like **ampicillin-sulbactam (Unasyn) or
* Carbapenem **(imipenem or meropenem)
* Clindamycin (not 1st line) - only those w/ Beta-lactam allergy
Think breathing air. War causes death and foul dead bodies.
A unified Penem becomes clean.
Gram positive anaerobic infections lungs - aspiration
-Outpatient
Augmentin or doxycycline
Doug
-Inpatient
Beta-lactam plus a beta-lactam inhibitor
ampicillin-sulbactam (Unasyn) or
metronidazole plus either Amoxil or pen G
*Uni PMetro
Gram positive anaerobic prophylaxis - Dental procedures
Abscess prevention
In patients with joint implants:
PCN or amoxicillin
Dental and minor procedures for endocarditis prophylaxis
Amoxicillin
Colorectal surgery prophylaxis
- Metronidazole (Flagyl) PLUS 2 or 3 gen cephalosporin or Cipro
- Carbapenems
Metro 2/3 C, Penem
Name all clostridial organisms
C. perfringens, C. sepicum, C. tetani, C. botulinum, C difficile
What kind of infections does C perfringens cause?
SSTI (cellulitis, myostitis), gas gangrene (clostrial myonecrosis), minor gastroenteritis, after any injury that devitilized tissue
so same as C. septicum, plus GI
What kind of infections C. sepicum does cause?
SSTI
Gas gangrene
C. difficile
antibiotic associated colitis
C. tetani infections
Tetanus infections
where is clostriudiam found
soil
C. botulinum infections
Botulism
Clostridium SSTI diagnosis - what is special about them
They can grow in 6 hours in a culture
Whats special about C. tetani diagnosis?
Cultures are not sensitive to it, so it can only be done on clinical suspicion.
C. perfringes gastroentiteritis characteristics
found in feces, soil, air, water and produces an enterotoxin that can become ingested
C. botulinum characteristics
Toxin producing bacteria with 8 different subtypes
-comes from contaminated food, home canned goods, commercial products
Direct injections
Through a wound
formerly C difficile characteristics. what is its new name
Pseudomembraneous colitis
-soil, water, pets, humans
produces a toxin
humans can be asymptomatic carriers
due to overgrowth in colon from abx, or from an IC person who encounters it
Clostridium Tetani characteristics
produces spores, found in soil, transmitted after injury via wound or burns
intravenous drug use.
-spre enters wound and travels to peripheral nerve endings causing muscle stimulation
-its permanent
-incubation period 5-30 days
C. Botulinum Diagnosis
Toxin assay by the CDC laboratory
Culture - isolated organism on a stool, wound, or food source
think about it. Botox is commercialized. We are really good at culturing it. We inject it into people all the time. Its also in cans of food. So don’t mix this up with Tetanus - the thing that can’t be cultured.
They have to keep track of it because it could potentially be deadly. They have to monitor people who inject it. So, of course it has to be reported to the CDC for testing.
What are the gram negative anaerobic infections?
Bacteriodes
Porphyromonas
Fusobacterium
Prevotella
What infections does bacteriodes cause and what characteristics
intra abdominal infections
-part of normal bowel flora
-more virulent than others
Porphyromonas infections
aspiration pneumonia and perioonitis
fusobacterium infections and characteristics
wound, infections/abcesses
pulmonary and intracranial
-normal oral and large bowel flora
prevotella infecitons and what characteristics
intra abdominal and SSTI
normal oral and large bowel flora
*you eat cheese and it goes into your mouth and GI (similar to pepsid
gram negative anaerobic infections clinical presentation
Same as gram positive, all can lead to bacteremia
BUT shock is absent
gram negative anaerobic infections diagnosis
Clinical suspicion, gram stain, and culture which can take a week
Anaerobic negative infections treatment
- Drainage and debridgement, fistula tract excision
- Antibiotics based on site
-Oral/throat/neck - clindamycin or metronidazole
-GI/Pelvic Abscess
* Extended spectrum PCNs
* pip/taz (Zosyn) or
* carbapenems or
* metronidazole (Flagyl) plus cephalosporin (ex. cefepime)
Anaerobes responsible for BV
Gardnerella - most prevalent
Prevotella, Peptostreptococcus, Bacteroides
Mycoplasma hominis and Ureaplasma urealyticum (not anaerobes)
