Bacterial Pathogens Flashcards
12 Considerations for Antibiotic Usage
- *1. What condition are you treating?
- *2. What bacteria generally cause this type of infection?
3. What ABX are usually active against those bacteria?
4. What are the local resistance patterns (Antibiogram)?
5. Can the ABX reach the site of infection (organ penetration)?
6. What is the optimal route of administration?
7. Are there any contraindications?
8. Are dose adjustments needed (renal/hepatic disease)?
9. Are there any drug-drug interactions?
10. Is monitoring required?
11. Can a narrow-spectrum ABX be used after pathogen identification/sensitivities are available?
12. What is the planned duration of therapy?
Main Bacteria Groups
- Gram “+”
- Gram “-“
- Anaerobes
- Atypicals
Gram “+” Examples
- Staphylococci
- Streptococci
- Pneumococci
- Enterococci
Gram “-“ Examples
- Enterobacteriaceae
- Pseudomonas
- Gram-negative cocci/coccobacilli
Gram “+” Classifications
- Shape
- Production of proteins
- Hemolysis capabilities
Gram “+” Cocci - 1st/2nd Differentiation
- First: Catalase Test
- Chains/Pairs: catalase “-“
- Clusters: catalase “+”
- Second: Coagulase Test (for catalase “+”)
- Positive or Negative
Catalase Negative - Chain Examples
- Streptococcus pyogenes (GAS)
- Viridans streptococcus
Catalase Negative - Pair Examples (Diplococci)
- Streptococcus pneumoniae
- E. faecalis (former Group D. Strept)
- E. faecium (former Group D. Strept)
Catalase “+”/Coagulase “+” Example
S. Aureus (MSSA, MRSA)
Catalase “+”/Coagulase “-“ Example
S. epidermidis
S. lugdunensis
S. saprophyticus
Staphylcocci
- Common colonizers of skin/nose and cause range of infections
- Gram “+” clusters, Catalase “+” bacterium
- Mild to severe skin infections (ABSSSI/SSTI), life threatening pneumonia, and endocarditis
- Can also cause UTIs, post surgical infections, catheter infections, osteomyelitis, and more
MSSA
Methicillin-sensitive staphylcoccus aureus
MRSA
Methicillin-resistant staphylcoccus aureus
HA-MRSA
Heathcare-associated Methicillin-resistant staphylcoccus aureus
CA-MRSA
Community-acquired Methicillin-resistant staphylcoccus aureus
ABSSSI
Acute bacterial skin and skin structure infections
SSTI
- Skin and soft tissue infections
- EX: cellulitis, furuncles/carbuncles, wounds, trauma
Biofilms
- Innately resistant to antibiotics
- Difficult to treat and act as a source for bacterial dissemination
- May have to remove devices with biofilm development (catheters)
Biofilms + Abx Resistance
- Slow growth/metabolism of bacterial in biofilm (Abx often target replicating/metabolically active bacteria)
- Structure of biofilm (ECM proteins, bacterial proteins, dead bacteria, DNA) may limit penetration/diffusion
Streptococci
- Gram “+”, catalase “-“
- Chains/pairs
- Differentiated by hemolytic phenotype on blood agar or by Lancefield system
- Infections ranging from strep throat to endocarditis/meningitis
Streptococci + Blood Agar Types
- Alpha-Hemolytic: partial hemolysis, green/brown
- Beta-Hemolytic: complete, clear
- Gamma-hemolytic: no hemolysis
Alpha-Hemolytic Bacterium Examples
- **S. pneumoniae
- **Viridans streptococci
- S. mutans
- S. salivarius
- S. mitis
Beta-Hemolytic Bacterium Examples
- Broken down by Lancefield classes based on cell wall carbohydrates
- **Group A S. pyogenes (GAS)
- Group B - S. agalacitae
GAS Infection Examples
- Cellulitis, necrotizing fasciitis (SSTI)
- Pharyngitis (strep throat)
- Rheumatic fever
- Scarlet fever
- Glomerulonephritis