Bacterial, Viral, Fungi, Infections IV Flashcards
common bacteria in acute and subacute endocarditis
acute - staph aureus
subacute - strep viridians
when does endocarditis become fatal
if left untreated
tx requires use of bacterial antibiotics for a long period of time
what are most strains of staph aureus resistant to
penicillin G
what is used to treat staph aureus
methicillin (nafcillin, oxacillin)
strains of staph aureus that have become resistant to methicillin
MRSA - methicillin resistant staph aureus
differences between MRSA and community acquired MRSA
- CA MRSA usually acquired in hospital
- CA MRSA is susceptible to clindamycin carries the PVL toxin
- outpatient penicillin like antibiotics does not work on MRSA
how do you clear uncomplicated skin infections related to CA MRSA
incision and drainage plus clindamycin or doxycycline
what does complicate infection related to CA MRSA require for treatment
IM or IV antibiotics like vancomycin
when vancomycin is overused, there is an emergence of vancomycin resistant staph aureus. what must be done in the hospital with these patients
- patient placed in strictest of isolation
- dedicated personnel care for these patients to reduce transmission
- government agencies get involved
what is VISA
vancomycin intermediate staph aureus
why are VISA worse than VRSA
more treatment failures in VISA and are harder to detect in laboratory
type of hemolysis is strep viridian
alpha hemolytic (must rule out strep pneumonia)
viridian streptocci that causes deep tissue abscesses
S. milleri group
viridian streptocci that cause subacute bacterial endocarditis
– S. mutans
• Also causes dental caries.
– S. mitis
– S. salivarius plus many others.
how do you detect viridian streptococci and what do you treat with
detect with blood cultures
treat with penicillin G for weeks
what do strep viridian like to attach to
tiny imperfections on damaged valves
how is strep viridian avoided
patients with damaged valves are given penicillin as prophylaxis before any dental work to avoid endocarditis
nutritionally deficient strep
Abiotrophia sp
how do you grow abiotrophia
cannot grow on ordinary blood agar hence requires specific vitamin or nutrients provided by other bacteria or mammalian cells (aka it needs a feeder colony)
what does abiotrophia sp resemble
strep viridians or non hemolytic strep species
what does abiotrophia cause
endocarditis
describe enterococcus
gram pos cocci in chains
non hemolytic strep
Group D strep
where are enterococcus natural habitat and what are they resistant to
gut
resistant to bile salts, acids, NaCl
major species of enterococcus
e. faecalis and e. faecium
of the two species of enterococcus, which is more susceptible and which is more resistant/what is it resistant to
e. facelis is more susceptible/sensitive (is = is susceptible)
e. faecium is more resistant to ampicillin and vancomycin (um = ultra mean)
what type of infections do enterococcus lead to
- opportunistic infections
- urinary tract infections in women
- endocarditis
- wound infections in intensive care units
in wound infection in intensive units, what does it mean by a “me-too” organisms in wound
enterococcus plus e.coli
enterococcus plus anaerobes
what types of conditions lead to opportunistic infections by enterococcus
after taking broad spectrum antibiotics such as cephalosporin and gentamicin –> wipe out of normal flora
what is e. faecium resistant to
ampicillin and vancomycin (common in hospital acquired infections)
how do you control e. faecium
handwashing, employee education, good cleaning of rooms between patients
Reducing use of vancomycin
describe corynebacterium
gram pos (non spore forming nor acid fast) pleomorphic shapes (coccibacilli or irregular rods) chinese letters
two opportunistic pathogens of corynebacterium
c. ulcerans and c. jeikeium (jk)
types of infections do the two pathogenic corynbacterium cause
c. ulcerans - skin infections
c jeikeium - nosocomial bloodstream and wound infections
common agents that cause osteomyelitis
- staph aureus (acute and chronic)
- coag neg staph (chronic and foreign bodies like prosthetic joints)
- diabetes (mixed aerobes and anaerobes)
occasional agents that cause osteomyelitis
- gram neg
- TB
- syphilis
- fungal infections
treatment of osteomyelitis
surgery and prolonged antibiotics
