CIC Organisms Flashcards
Aspergillosis
Aspergillus sp.
- associated with immunocompromised hosts
- associated with construction dust
- standard precautions
Botulism
Clostridium botulinum
- usually food borne (ingestion of toxins)
- standard precautions
- descending weakness or paralysis in alert person
Candidiasis
Candida sp.
-usual skin or mucous membrane infections
Shingles
Herpes zoster
- standard precautions unless disseminated, the Airborne/Contact Precautions
- prefer immune HCW to provide care
Chickenpox
Varicella
- maculopapular evolving to vesicular skin eruptions (3-4 days)
- lesions: monolocular, collapse on puncture
- INCUBATION: 13-17 days
- Airborne/Contact precautions
- prefer immune HCWs provide care
Cholera
Vibrio chloerae
- contact precautions
- mortality: 50% within hours if untreated from circulatory collapse, renal failure resulting from profuse, painless diarrhea
- INCUBATION: usually 2-3 days
- not usually endemic in US
Conjunctivitis (pink eye)
- bacterial or viral
- contact precautions if viral
- adenovirus - common viral cause
Creutzfeldt-Jakob Disease
- prion
- progressive dementia, death within 3-12 months
- INCUBATION- 15 months-30 years
- standard precautions
- special equipment decontamination concerns
Erythema Infectiosum
Fifth Disease
Parvovirus B19
- INCUBATION- 4-20 days
- intrauterine infection:10% hydrops fetalis and fetal death
Bacillus cereus food poisoning
INCUBATION: rapid 1-6 hrs
Cryptosporidosis
Cryptosporidium parvum
- parasitic infection
- diarrhea, anorexia, vomiting, cramping
- INCUBATION- 1-12 days
- standard precautions
Staph aureus food poisoning
- rapid incubation 2-4 hrs
Salmonella food poisoning
-semi rapid incubation- 12-36 hours
Anthrax
Bacillus anthracis
- usually manifests as skin infection
- if inhaled, respiratory & GI tract infections
- INCUBATION- usually within 48 hrs
- PAPR/contact precautions during powder exposure
Gram positive bacteria
- Streptococcus
- Staphylococcus
- Bacillus
- Clostridium
- Corynebacterium
- Listeria
Clostridium perfringes food poisoning
-rapid incubation: 10-12 hours
Rotavirus food poisoning
-semi rapid incubation: 1-3 days
Campylobacter food poisoning
Moderate incubation:1-10 days
Vibrio food poisoning
Semi rapid incubation: 12-24 hrs
Norovirus and Norwalk-like viruses food poisoning
Semi rapid incubation: 1-2 days
Hepatitis A food poisoning
Slow incubation:15-30 days
Toxoplasmosis food poisoning
Slow incubation:10-23 days
Hanta virus
- endemic southwest US
- transmission: aerosolization of rodent excretia
- INCUBATION: 2-60 days
- standard precautions
Trichinosis food poisoning
Slow incubation: 8-15 days
Giardia food poisoning
Slow incubation: 3-10 days
Hepatitis A
- transmission- fecal oral
- incubation- 15-50 days
- standard precautions
Hepatitis B
- transmission: bloodborne
- standard precautions
- INCUBATION: 45-180 days
- vaccine - given at birth & 11-12 yrs of age
Hepatitis D
- Co-infection with Hepatitis B
- INCUBATION: 2-8 weeks
- transmission: bloodborne, not usually sexual
- standard precautions
Hepatitis B antibodies
IgM -appears with symptoms during acute illness -can persist 3-12 months from exposure IgG -persists for life -marker for natural HBV infection
HBsAG
- hepatitis B surface antigen - infection marker
- found in serum 1-2 months after exposure
- if found greater than 6months - chronic infection
Hepatitis C
- 70% asymptomatic
- INCUBATION: 2 weeks-6 months
- transmission: bloodborne
- standard precautions
Hepatitis E
- transmission: fecal oral
- seen as imported infection if identified in US
- standard precautions
HIV/AIDS tests
ELISA
-positive 3 weeks to 6 months after exposure
Western Blot
-detects antibody bound HIV protein
-seroconversion likely if “positive” detected at least 2 weeks after “indeterminate”
Influenza
- INCUBATION: 1-3 days
- droplet precautions
- PAPR/N-95 for aerosolization procedures
Lyme Disease
Borrelia burgdorferi
- INCUBATION: 3-32 after tick bite
- standard precautions
- endemic northeast US
- standard precautions
HIV/AIDS
- transmission: bloodborne
- INCUBATION: 1-3 months
- standard precautions
Legionella
- INCUBATION: 2-10 days
- standard precautions
- commonly found in tap water
- must be inhaled to cause infection
Measles (Rubeola)
- INCUBATION: 7-10 days
- airborne precautions through 4th day or rash
- IgM detected 3-4 days after rash onset
- immediately reportable to health department
Meningitis Meningococcus
Neisseria meningitidis
- Gram negative diplococcus
- droplet precautions until 24hrs effective antbx
- prophylaxis for exposed HCW
Viral meningitis
- more prevalent during late summer
- most often seen in ages
Pertussis
Whooping cough
- INCUBATION: 6-20 days
- paroxysmal coughing that can last 1-3months
- droplet precautions until 5 days effective antbx
Meningitis Pneumococcus
Streptococcal pneumonia
- associated with otitis, skull fx, pneumonia
- No HCW prophylaxis
- standard precautions
Pediculosis
- head and body lice, crabs
- contact precautions until effective tx
RSV
- INCUBATION: 1-10 days
- droplet/contact precautions
- infects all ages, resp distress usually in young children & other immunocompromised populations
- Common HAI on peds units
Gonorrhea
-INCUBATION: 2-7 days
-S/S: male-penile drainage
female- urethritis, PID
-standard precautions
-Gram stain & culture, antigen testing
Herpes Simplex 2
- INCUBATION: 2-12 days
- blisters of lesions (mouth, perianal, fingers)
- Contact Precautions for neonatal infection or disseminated blisters until lesions are dry and crusted
- C-section if active vaginal infection to prevent neonatal exposure during birth
Syphillis
-INCUBATION: 10 days-3 months
-Painless chancre & lymph nodes
-maculopapular rash
-can be latent for years
-RPR or VDRL tests
Standard precautions
Chlamydia
- INCUBATION: hours to 5 days
- 25% males asymptomatic
- Females: cervical discharge, pelvic pain
- Standard precautions
Gram Stain
- classifies gram negative or gram positive
- cell wall pepridoglycans - gram positive
- gram positive - blue dye
- gram negative - red dye
Tuberculosis testing
- Acid fast bacilli sputum or BAL specimen
- CXR - identifies extent of disease
- TST - shows presence of TB infection (previous or acute) may be slightly positive for atypical mycobacterium infections, e.g. M avium
- Quantiferon gold -
Tuberculosis treatment
- usually treated 6-12 months, 18 months if HIV positive
- usually 4-5 medications regimen: isoniazid, rifampin, pyrazinamide, ethabutamol, streptomycin
Sputum culture validity
-fewer than 10 epithelial cells
AFB cultures
first morning specimens for 3 days maximizes optimum results
ESBL
- extended spectrum beta lactamase
- MDRO due to microorganism enzyme that resists antimicrobials, usually penicillins and cephalosporins
MRSA colonization testing
-usually determined by PCR of nares, axilla, or perianal area
H. pylori
- gram negative
- associated with peptic ulcers
Gram Stain
- classifies gram negative or gram positive
- cell wall pepridoglycans - gram positive
- gram positive - blue dye
- gram negative - red dye
Aerobic
needs oxygen
anaerobic
does not need oxygen
Shigella dysenteriae
- INCUBATION: 1-3 days
- disease caused with very small amount of inoculums
E. coli
- Enterotoxin producing
- traveler’s diarrhea
Ova & Parasites
-best found with fresh stool specimen e.g., Giardia, toxoplasmosis, etc.
Wound cultures
-results more valid when drainage cultured after site cleaned
Oxacillin
Used to determine methicillin sensitivity
Dialysis fluids
- should be tested for microorganisms
- other routine environmental cultures not usually recommended
MIC
minimum inhibitory concentration
-susceptibility test that determines least amount of antibiotic (per millimeter) that impedes organism growth
Gram negative bacteria
- Neisseria, Enterococcus
- most rods and spirochetes
TB treatment
- 4 drug regimen
- Susceptibility testing on isolates
- 6 drug regimen in geographic locations with resistant strains
- Direct observed therapy
Bacterial spores
-“protect” bacteria in adverse conditions allowing growth
positive TB skin test
- Prior exposure to M. tuberculosis
- Prior BCG vaccination
- Cross-reactivity to skin test antigens
Immune changes in elderly
- Delayed hypersensitivity
- Defense against foreign antigens
- Increased serum levels of IgG and IgA