Bugs and drugs Flashcards
MSSA
3d
2a
Skin and soft tissue infection
Endocarditis
Toxin-mediated diseases
Rx: flucloxacillin or erythromycin
MRSA
3d
2a
1r
Skin and soft tissue infection
Endocarditis
Toxin-mediated diseases
Rx: vancomycin or linezolid (resistant to beta lactams)
Staphylococcus epidermidis commensal 1d 1a 1r
Skin commensal
Device associated infections (prosthetic valve endocarditis)
Rx: 50% flucloxicillin resistant. regimen depends on sensitivity. Combinations include rifampicin
Staphylococcus saprophyticus
1d
2a
UTI in young women
Rx: Flucloxacillin or nitrofurantoin
Enterococcus commensal 3d 2a 2r
Commensal of GI and GU
UTI
Endocarditis
Polymicrobial infection after perforation
Rx: Amoxicillin (B. faecalis) or vancomycin (B. faecium)
(resistent to cephalosporin, with some vancomycin resistant enterococci, too)
Strep pneumoniae appearance? commensal 2d 2a 1r vaccine?
Draughtsman colonies pharyngeal commensals CAP Meningitis Vaccines available Rx: Benzyl penicillin (IV) or amoxicillin (penicillin resistent)
Strep viridans commensal 4 types 1d 2a
Pharyngeal commensals
Includes S.mitis, S.oralis, S,salivarius, S.mutans
Native valve endocarditis
Rx: Benzyl penicillin (IV) with synergistic gentamicin
Group A strep
6d
Recent infection marker?
3a
Strep pyogenes
pharyngitis/strep throat
skin and soft tissue infections (necrotising fasciitis)
rheumatic/scarlet fever
puerpural sepsis
ASOT/DNAse B suggests recent infection
Rx: penicillin (V) for pharyngitis, benzyl pen (IV) or amoxicillin
Group B strep
commensal
5d
3a
Strep agalactiae commensal of female GU tract UTI Neonatal sepsis/meningitis endocarditis septic arthritis Rx: Benzyl pen (IV) + gent if severe or amoxicillin
Group C strep
3 types
2d
2a
S. equi, S. equisimilus, S.zooepiodemicus.
Pharyngitis
skin and soft tissue infections
Rx: Benzyl pen (IV) or amoxicillin
Group D
2 types
2d
2a
enterococcus and Strep bovis (endocarditis + associated with colon cancer)
Rx: Benzyl pen (IV) or amoxicillin
Group F
3 types + special name
1d
2a
“milleri group”
S.anginosus, S.constellatus, S.intermedius.
intra-abdominal abscess, often polymicrobial.
Rx: Benzyl pen (IV) or amoxicillin
Group G
1d
2a
S.dysgalactiae
Skin and soft tissue infections
Rx: Benzyl pen (IV) or amoxicillin
Nocardia
1s
4d
1a
Partially acid fast
pulmonary, cutaneous and systemic infections including brain abscesses
Rx: Co-trimoxazole
Actinomyces
2d
2a
IUCD-related infections
Cervicofacial infections
Rx: Benzyl pen (IV) or amoxicillin
bacillus anthracis
1d
3 toxins
2a
anthrax
3 toxins: oedema factor (EF), protective antigen (PA), lethal factor (LF). PA+EF = oedema toxin, PA+LF = necrosis toxin.
Rx: Benzyl pen or ciprofloxacin
bacillus cereus
1d
timeline?
food poisoning
1-5 hours after eating rice
D&V that lasts 8-16 hours and is self-limiting
clostridium botulism
transmission?
2d
4a
classically food borne infant botulism from honey wound botulism from IVDU Rx: anti-toxin in wound botulism need debridement +/- benzyl pen or metronidazole
clostridium difficile
2d
2a
antibiotic associated diarrhoea
pseudomembranous colitis
Rx: metronidazole or vancomycin
Clostridium perfringens
3d
3a
self-limiting food poisoning
pigbel necrotising enteritis
gas gangrene
Rx: debridement + benzyl pen or metronidazole
clostridium tetani appearance? 1d vaccine? 2a
resembles drumsticks
tetanus = spasms and resp failure
vaccinate children
Rx: HTIG + metronidazole
corynebacterium shape commensal 1d vaccine? 3a
club shaped
non-diphtheria strains are commensal
C. diphtheria causes diphtheria (respiratory [grey plaque on throat] or cutaneous lesion)
diphtheria toxin vaccine
Rx: horse diphtheria antitoxin plus penicillin or erythromycin
Listeria monocytogenes motile? positive for? source? 3d 2a 1r
tumbling motility beta haemolytic food-borne listeriosis in pregnancy neonatal listeriosis listeria meningitis Rx: amoxicillin and gentamicin (cephalosporin resistant)
helicobacter pylori
positive for 2 things?
1d
2 lines of treatment
oxidase positive
strongly urease positive
gastric ulcer disease
1st line = PPI, clarithromycin, amoxicillin
2nd line = PPI, bismuth, tetracycline, metronidazole
campylobacter positive for? source? 1d 3a
oxidase positive
food borne illness
bloody diarrhoea
Rx: usually self limiting but can use erythromycin or ciprofloxacin if needed
Vibrio cholera positive for? source 1d 2a
oxidase positive food borne illness watery diarrhoea cholera toxin Rx: hydration and tetracycline
Brucella source goats sheep cattle positive for? 2a
Zoonotic B.melitensis = goats/sheep B.abortus = cattle slow growing urease positive Rx: gentamicin plus rifampicin
Bortadella pertussis
1d
diagnosis
1a
whooping cough/pertussis
pertussis routine vaccine
per-nasal swabs & grow on Bordet gengou agar
Rx: erythromycin
Moraxella catarrhalis
3d
positive for what 2 things?
2a
otitis media sinusitis exacerbaiton COPD Tributyrin positive Rx: co-amoxiclav or cefuroxime (beta-lactamase positive)
Haemophilus influenzae require what to grow capsule? vaccine? 5d 4a 1r
Requires X (haemin) and V (NAD) for in vitro growth Polysaccharide capsule (serotypes A-F) - Meningitis, Epiglottitis, Hib vaccine
non-capsular strains - otitis media, sinusitis, COPD exacerbation
Rx: amoxicillin or ceftriaxone (meningitis)
5-10% beta lactamase positive - coamoxiclav or cefuroxime
Neisseria meningitidis shape capsule 2d notify? 5a
"meningococcus" diplococcus Capsular types A, B, C, W135, Y. meningitis and septicaemia notifiable disease Rx: benzyl pen (IV) or ceftriaxone chemoprophylaxis (rifampicin or ciprofloxacin) to household contacts + vaccine
neisseria gonorrhoeae
transmission
2d
“gonococcus”
sexually transmitted
ophthalmia neonatorum (conjunctivitis during delivery)
oral neisseria
commensal?
commensal flora
bactericides fragilis
commensal?
1d
1a
commensal of GI
Polymicrobial intra-abdominal infection
Rx: Metronidazole
Psudomonas aeuriginosa culture? source? 2d 5a
blue-green colour on culture (procyanin & pyoverdin)
environmental
HCAI
Chronic colonisation in CF
Rx: ciprofloxacin, gentamicin or pseudomonal beta lactam (ceftazidime, tazocin, meropenem)
resistence problematic
Burkholderia cepacia
source
1r
4a
environmental
chronic colonisation in CF
colistin resistant
Rx: ciprofloxacin or pseudomonal beta lactam (ceftazidime, tazocin, meropenem)
E. coli
commensal?
3d
3a
Commensal of GU/GI tract UTI, diarrhoea, HUS (O157) Rx: UTI = co-amoxiclav or trimethoprim (increasing rates of ESBL) Rx other = cefotaxime
Klebsiella pneumoniae commensal? 2d 2a 1r
commensal GI
UTI and LRTI
Rx: co-amoxiclav or ciprofloxacin (amoxicillin resistent - increasing ESBL)
Enterobacter cloacae
commensal
2d
3a
commensal of GI/GU
UTI and LRTI
Rx: amoxicillin, trimethoprim, ciprofloxacin
proteus mirabilis commensal positive for? culture? 1d 1a 1r
commensal of GU/GI tract urease positive swarming colonies UTI (staghorn?) Rx: amoxicillin (nitrofurantoin resistant)
acinetobacter spp
commensal
2d
2a
commensal of GU/GI
UTI
HCAI
Rx: amoxicillin or ciprofloxacin (increasing rates of MDR)
salmonella source 3 types 2d 3a
food borne diseases
D&V
Rx: usually self limiting
S.typhi and S.paratyphi: bacteraemic illness
Rx: ciprofloxacin or ceftriaxone
