Chapter 1.10 Hostpital Acquired Gram-Negatives Flashcards
Who is most likely to get hospital-acquired gram negative infection?
Hospitalized patients whose natural defenses are compromised by intravenous catheters, endo-tracheal tubes, Foley catheters and surgical incisions
What disease are included in hospital-acquired infections?
Pneumonia, urinary tract infections, wound infections, and bloodstream infections
What are the 4 Ws for hospital-acquired infections?
Wind- pneumonia
Water- urinary tract infection
Wound
Wires- intravenous lines
What is the most common family of organisms associated with hospital-acquired infections?
Enterbacteriacae family of gram-negative organisms: E.coli, Klebsiella, and Enterobacter
What are the 4 highly-resistant gram-negative bacteria?
Pseudomonas, Acinetobater, Steneotrophomonas, and Burkholderia
What is important about Psudomonas aeruginosa?
It colonized and infects sick, immunocompromised hospitalized patients
It is resistant to almost every antibiotic
What are the characteristics of Pseudomonas aeruginosa?
Obligate aerobic (non-lactose fermenter)
Gram negative rod
Produces green fluorescent pigment and blue pigment
Grape-like scent
What is the color of a wound infected with pseudomonas aeruginosa?
Greenish-blue
What exotoxin is associated with Pseudomonas aeruginosa?
Exotoxin A
What is the clinical presentation of a cystic fibrosis patient with pneumonia caused by pseudomonas aeruginosa?
Pseudomonas aeruginosa is colonized in their lungs
Chronic inflammation destroys their lungs
Who is susceptible to Osteomyelitis from pseudomonas aeruginosa?
Diabetic patients, intravenous drug abusers, and children
What is the clinical presentation of a diabetic patient with osteomyelitis from pseudomonas aeruginosa?
Foot ulcers infected with pseudomonas aeruginosa
Can penetrate into bone causing osteomyelitis
How do children develop osteomyelitis from pseudomonas aeruginosa?
Secondary to puncture wounds of the food
Ex. Stepping on nail while wearing tennis shoes because tennis shoes are a sweaty, moist environment for water-loving pseudomonas
What can be the end result of a patient with burn-wound infections from pseudomonas aeruginosa?
Fatal sepsis
What is malignant external otitis?
A pseudomonas external ear canal infection that burrows into the mastoid bone – seen in elderly patients
What is the Mneumonic for Pseudomonas aeruginosa infections?
BE PSEUDO Burns Endocarditis Pneumonia Sepsis External malignant otitis media UTI Diabetic osteomyelitis O
What are the characteristics of Burkholderia cepacia?
Oxidase-positive, aerobic gram negative bacillus
Where is Stenotrophomonas maltophilia normally found?
Normal respiratory flora
Who is susceptible to disease by Stenotrophomonas maltophilia?
Hospitalized and immunocompromised persons
What are the infections associated with Stenotrophomonas maltophilia?
Pneumonia and line-related bacteremia
What are the characteristics of Acinetobacter?
Aerobic gram-negative bacteria found in solid and water
What can be caused from Acinetobacter?
Hospital-acquired pneumonia, line related bacteremia, burn infections and Foley catheter-associated urinary tract infections
Why does Acinetaobacter get confused with Neisseria or gram-positive organisms?
They can be cocci bacillary (short rods) or coccal in appearance or form diplococci on solid media
What is the best prevention method for hospital-acquired infections?
Prevent them in the first place
Good hygiene by health care practitioners
Limiting use of invasive devices
Judicious use of antibiotics
