Common Nosocomial Infections

Question 1

What are the common cause of nosocomial infections?

Answer 1

Klebsiella
Enterobacter
Pseudomonas
CONS

Question 2

Klebsiella

Answer 2

CH ?: KLEBSIELLA
- Gram (-)
Transmission: Contact
CM:
1. Nosocomial PN
2. Sepsis
3. Meningitis
Dx:
1. BCS
Mgt
1. Meropenem 30mkd IV q8 + Amikacin 15-20 mkd OD IV
2. WOF carbapenem resistance

Question 3

Enterobacter

Answer 3

CH ?: ENTEROBACTER
- Gram (-) bacteria
CM:
1. Causes pathogenic, opportunistic infections in
immunocompromised hosts, those with mech vent.
Mgt
1. Cefepime (4th gen ceph) 100mkd IV q12
2. Imipenem 60-100 mkd q6 IV
3. Amikacin 15-20 mkd OD IV
4. FQ Ciprofloxacin 20-30 mkd q12 IV

Question 4

Pseudomonas aeruginosa

Answer 4

CH 205: PSEUDOMONAS AERUGINOSA
- Strict aerobe, gram (-)
- Usually colonizes moist substrates
Patho
- Bacteria produces exotoxin A which cause local
necrosis and systemic bacterial invasion
CM
1. NB- 2-5% of NICU infection. Freq. preceding
conjunctivitis
2. Endocarditis, PN, OE, chronic mastoiditis, keratitis, OM,
UTI
3. CNS: meningitis, abscess
4. Ecthyma gangrenosum
Dx
1. BCS, C/S of CSF, UA – dx of choice
Mgt
1. Ceftazidime 90-150 mkd q8 IV
2. Cefepime 100 mkd q6 IV
3. Piptazo 300-400 mkd IV q6-8 + Aminoglycoside
(Gentamicin 7.5 mkd q8 IV)
4. Multidrug resistance is a public health concern due to
limited treatment options and challenge to infection
control (also to Acinetobacter baumanii)

Question 5

Coagulase negative streptococci

Answer 5

CH 185: COAGULASE NEGATIVE STREPTOCOCCI (CONS)
Etiology:
1. S.epidermidis (most common)
2. S.haemolyticus
3. S.hominis
4. S. saphrophyticus
5. S.lugdunensis
- Most common cause of nosocomial neonatal infections
- N flora of skin, throat, mouth, vagina, urethra
CM
1. Bacteremia
2. Endocarditis
3. Central venous catheter infection
4. CSF shunt infection à meningitis
5. UTI (sexually active F)
Dx
1. BCS – rapid growth w/in 24h
8. No BCS of CONS in neonate should be considered
contaminated
Mgt
1. Vancomycin 45-60 mkd IV q6/8 – DOC