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Musculoskeletal System > Bacterial Infections > Flashcards

Bacterial Infections Flashcards

1
Q

Sources of osteomyelitis

A

hematogenous
contiguous
trauma, fx or surgery

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2
Q

Hematogenous - OA

A

spread through the blood (infection elsewhere in the body)
monomicrobial monomicrobial
Staphylococcus aureus

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3
Q

Contiguous - OA

A

Puncture wound, foot ulcer (concern with diabetes)
Infection is adjacent or near a bone
Polymicrobial: Gram + cocci, Gram – rods, anaerobes

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4
Q

Trauma, fx, or surgery

A

nosocomial infection

S. aureus

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5
Q

Risk factors of OA

A 
-Diabetics
Foot injury
-Surgery
-Artificial surfaces
Joints
Screws
-IV drug users
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6
Q

Sx of OA

A

-Fever - develops in infection are hematogenous
-Chills
-Fatigue
-Localized pain** e.g. pt with hip replacement
-Inflammation (redness, swelling, heat, and pain)
-Infection due to trauma:
Purulent drainage from wound = cloudy and pus

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7
Q

Dx of OA

A

Blood sample:
Gram stain & culture (grow it)
Positive identification in about 50% of cases*
CBC: increase in WBC
ESR (erythrocyte sedimentation rate): increased
take DRAINAGE
Bone Biopsy: Gram stain & culture
Imaging- what it looks like but won’t tell you how to tx

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8
Q

Ab sensitivity test

A

what antibiotic the bacteria is sensitive to

NEED TO KNOW FOR MRSA

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9
Q

Tx of OA

A

Drainage- want this to have the infection out
Debridement- scrape out infection as possible
Surgery-
Long term IV antibiotics

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10
Q

Long term IV tx for OA

A

6 wks to 2 months
IV line

S. aureus 
-nafcillin
-oxacillin 
MRSA 
-vanco
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11
Q

Staph a.

A

Most common cause of osteomyelitis

  • hematogenous
  • contiguous
  • trauma/fracture/surgery

opportunistic pathogen
nosocomial infection
-device related
-postsurgical complications

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12
Q

Stap A. characteristics

A 
gram-positive cocci
gram stain - purple 
grape like clusters 
catalase +
Coagulase +
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13
Q

why is biofilm important in OA?

A

allows it to attach to the surface

  • difficult to grow in culture
  • microbial community attached to a surface
  • encased exopolysaccharide matrix or glycocalyx
  • highly resistant to antibiotics and immune system
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14
Q

Heart valves and teeth

A

biofilm can attach to these surfaces

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15
Q

best tx of biofilm

A

debridement
replacement of the prosthetic
tx with antibiotics

GET RID OF BIOFILM right away!!!!

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16
Q

MRSA

A
  • Methicillin Resistant Staphylococcus aureus
  • mecA gene encodes PBP2a (pencillin-binding protein)
  • Methicillin (beta lactams) can not bind to PBP2a, cell wall synthesis is not inhibited.
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17
Q

DOC for MRSA

A

vanco

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18
Q

staph a and enterotoxin

A

affect GI system

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19
Q

P. aeruginosa - OA

A

IV drug use

Puncture wounds

20
Q

Characteristics of P. aeruginosa

A 
Gram-negative rod
Highly antibiotic resistant
Characteristic color
Characteristic sweet, grape like odor
Forms a biofilm
Alginate capsule
21
Q

Pott’s disease

A

OA caused by TB

22
Q

OA caused by salmonella

A

in children with sickle cell anemia

23
Q

Reactive arthritis

A

autoimmune condition due to an infection at a different location in the body.

no infection present at the joint
due to infection somewhere else in the body

24
Q

Reiter’s syndrome

A 
classic reactive arthritis 
TRIAD: 
1. inflammation of joints, polyarticular, knee 
2. conjunctivitis 
3. urethritis/cervicitis
25
Q

Pathogens assoc. with Reactive arthritis

A

Usually presents 2-4 weeks after primary infection.
GI infection
Examples: Campylobacter jejuni, Salmonella, Shigella and Yersinia
STD:
Chlamydia- urethritis/cervicitis/conjuctivitis

26
Q

Disease association to reactive arthritis

A

HLA-B27

27
Q

Septic arthritis

A

inflammation due to infection of the joint. (suppurative, purulent, infectious)

pus-producing organism
synovial fluid will be cloudy - infection

28
Q

pathogens involved in septic arthritis

A

gonococcal

nongonococcal

29
Q

Sources of infection

A

Hematogenous
Contiguous- near the joint
Direct inoculation- antiinflammatory injection (unclean)

30
Q

Joints affected in septic arthritis

A

knee 40-50%
hip 20-25%
ankle/shoulder/elbow 10-15%
wrist 10%

31
Q

Risk factors for septic arthritis

A 
History of arthritis
Prosthetic joint - 2-10% of all recipients
Gonorrhea
Trauma
Immunosuppressed
IV drug users
32
Q

Symptoms

A 
Fever
Joint pain
-monoarticular
-polyarticular- may be traveling
Inflammation
Limitation of movement- can't move joint
33
Q

Dx for septic arthritis

A 
Patient history very important: gonorrhea, any issues at the joint?
Joint Fluid
-Gram stain
-Culture
CBC: increase in neutrophils
ESR
CRP
Imaging Techniques
34
Q

Septic Arthritis : Gonorrhea

A 
Neisseria gonorrhoeae
-sexually transmitted
Most common cause of septic arthritis in young, sexually active adults
Gram negative, diplococci****
Fastidious
Thayer-Martin Chocolate agar*********
Pili: Attachment, Antigenic variation
35
Q

Thayer-Martin Chocolate Agar

A

blood is lysed to release heme

Ab added to help niserria grow

36
Q

Gonorrhea vs. stap a.

A

Most common cause of septic arthritis in young, sexually active adults

Other than this population=> think stap a.

37
Q

Gonococcemia

A

spreading through blood stream
why in females > males (1-3% of women, lower for men)?

=> women tend to be asymptomatic for gonorrhea

38
Q

Migratory joint - Gonoccemia

A

polyarticular

different joints at different times

39
Q

SA - Early prosthetic joint infections!

<3 months

A

staph a.

40
Q

SA - Delayed infection of prosthetic joint

>3 months

A

CoNs

-coagulase negative stapyloccocus e.g. staph epidermis

41
Q

Staph a. - Septic arthritis

A

nongonoccocal

Adults
Children > 2 years old
Monoarticular

42
Q

Other Nongonococcal pathogens- SA

A

Steptococcus sp.

P. aeruginosa - IV drug users

43
Q

Gonorrhea in women - complication

A

PID

infertility

44
Q

Staph. a. no culture

A

why no growth ? biofilm

45
Q

SA - Lyme Disease

A

Pathogen: Borrelia burgdorferi

Early: bull’s eye rash
Disseminated: pain in joints, bones and muscles
Late: recurring arthritis, large joints
60-80% of untreated individuals develop arthritis

46
Q

Tx of SA

A 
Rapid destruction of the joint
Drainage of infected joint
Antibiotics
Several weeks IV
Gonococcal: ceftriaxone
S. aureus: nafcillin or oxacillin
MRSA: vancomycin
47
Q

Surgery related SA

A

Prosthetic

—Tx: Surgery to replace joint + 6 weeks IV antibiotics

Musculoskeletal System (27 decks)

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