Chapter 10: Hospital-Acquired Gram-Negatives Flashcards

1
Q

What are the Hospital-acquired infections?

A

4 W’s
Wind: Penumonia - ventilation, intubation
Water: UTI - Foley
Wound: Surgery
Wires: bloodstream infection - intravenous

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2
Q

What are the 4 often highly resistant gram-negative bacteria?

A

Pseudomonas, Acinetobacter, Stenotrophomonas and Burkholderia

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3
Q

Pseudomonas aeruginosa

A
obligate aerobic (non-lactose fermenter)
Gram-negative rod 
Motile: virulence 
Produces pyoverdin (green pigment) and pyocyanin (blue pigment) 
Grape-like scent 
Weak invasive 
Exotoxin A: like diphtheria toxin
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4
Q

What are the Pseudomonas aeruginosa infections?

A
BE PSEUDO
Burns 
Endocarditis
Pneumonia 
Sepsis 
External Malignant otitis media
UTI
Diabetic osteomyelitis
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5
Q

Most ______ pts have their lungs colonized with Pseduomonas aeruginosa. What do these pts develop?
Who is highly susceptible to peumonia caused by Pseduo aeruginosa?

A

Cystic fibrosis

Chronic pneumonia which progressively destroys their lungs

Immunocompromised pts

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6
Q

Who have an increased risk of osteomyelitis (related to wounds) due to Pseudomonas aeruginosa?

A

Diabetic pts: Foot ulcers infected, infection penetrates into bone
IV drug abusers: vertebrae or clavicle
Children: puncture wounds to foot wearing tennis shoe

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7
Q

How does Pseudomonas aeruginosa lead to sepsis?

A

Infected “wires” or catheters, or from burn-wounds, water, wind etc

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8
Q

What are frequent causes of right heart valve endocarditis in IV drug abusers?

A

Staphylococcus aureus

Pseudomonas aeruginosa

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9
Q

Malignant external otitis

A

Pseudomonas external ear canal infection burrows into the mastoid bone
Primarily in elderly diabetic pts

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10
Q

Burkholderia cepacia

A

Oxidase-positive aerobic gram-negative bacillus
Virulence: Extremely antibiotic resistant
Grow in water, soil, plants, animals
Infection in burn and ventilated pts

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11
Q

Who has the greatest risk for Burkholderia cepacia?

A

Cystic fibrosis

Asymptomatic carriage, bronchiectasis (dilated infected airways) or rapidly progressive pneumonia with bacteremia

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12
Q

Stentotrophomonas maltophilia

A

Colonizer
Part of normal respiratory flora
Can cause pneumonia, line-related bacteremia
Virulence: extremely antibiotic resistant

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13
Q

Acinetobacter

A

Virulence: multiple acquired mechanisms of antibiotic resistance
Aerobic gram-negative bacteria
Soil and water

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14
Q

Acinetobacter baumanni

A

Survive on environmental surfaces: increase transmission in healthcare settings
Cause: HAP, line-related bactermias, burn infections, foley UTI,

May appear gram-positive or look like Neisseria : can be coccobacillary (short rods) or coccal in appearance, or diplococci on solid media

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