Infectious Disease 1 Flashcards
Gram stains
GRam positive color
purple (crystal violet): due thick peptidoglycan layer in cell wall
gram stains
gram negative color
stains pink
Common bacterial pathogens for select sites of infections
CNS meningitis
Steep. Pneumoniae
Neisseria Meningitidis
H. Influenzae
Group B. Strep
Listeria (young/old)
Common bacterial pathogens for select sites of infections
Mouth
Mouth flora (peptostreptococcus)
Upper respiratory
Strep. Pneumoniae
H. Influenzae
Steep. Pyrogenes
M. Catarrhalis
Common bacterial pathogens for select sites of infections
Lower respiratory tract (community)
Strep Pneumoniae
H Influenzae
Atypicals: (Legionella, Mycoplasma, Chlamydophila)
Enteric GNR (alcohol use disorder)
Common bacterial pathogens for select sites of infections
Lower respiratory (hospital)
MRSA
P. Aeruginosa
Acinetobacter baumanni
Enteric gnr (INCLUDING esel +mdr)
Strep. Pneumoniae
Common bacterial pathogens for select sites of infections
urinary tract
E. Coli, proteus, klebsiella
Staph. Saprophytic
Enterococci
Common bacterial pathogens for select sites of infections
Bone Joint
staph. aureus
staph epidermis
streptococci
N. gonnorhe
(GNR only in specific situations)
Common bacterial pathogens for select sites of infections
heart/ endocarditis
Staph. aureus, including MRSA
staph epidermis
streptococci
enterococci
gram positive rod organisms
Listeria
monocytogenes
corynebacterium
gram positive anaerobes
peptostreptococcus
clostridium spp.
clostridiouids difficile
propionibacterium acnes
grass negative cocci bacteria
neisseria species
GNR that do not colonize gut
Pseudomonas aeruginosa
H. Influenzae
Providencia spp.
GNR that colonies the gut (enteric)
proteus mirabilis
E. Coli
Klebsiella spp
serrate spp
Enterobacter cloacae
Citrobacter spp.
curved or spiral shaped GNR
h. pylori,
campylobacter spp
Treponema spp
Borella spp
Leptospira spp
MIC definition
Lowest concentration with no growth
Common Resistant Pothagoens
Kill Each And Every Strong Pathogen
Klebsiella Pneumoniae (ESBL, CRE)
E. Coli (ESBL, CRE)
Acinetobacter baumannii
Enterococcus faecalis/faecium (VRE)
Staph aureus (MRSA)
P. auruginosa
Mechanisms of resistance
intrinsic:
ex:
Selection pressure:
Enzyme inactivation (ex: beta lactamases)
collateral damage w. C. Diff
healthy GI flora is killed by abc
overgrowth of resistant pathogens
SS: diarrhea, abdominal cramping, colitis (can be fatal
all abx can cause c diff.
BBW: clindamycin
goals of antimicrobial stewardship programs
improve safety
reduce resistance
reduce AE
promote cost effectiveness
hydrophilic agents characteristics and ex
beta lactase
aminoglycosides
glycopeptides (vance()
daptomycin
polymyxins
small vd
renal elimination
low intracellular conc
increased clarance in spesis
pooor-noderate bioavailability
lipophyllic agents and their characteristics
quinolones
macrolides
rifampin
linezolid
tetracycline
chloremphenicol
Large vd
hepatic metabolism
achieve intracellular once
clearance changed minimally i spesis
excellent bioavailability
Dose optimization strategies
CMAX:MIC (concentration-dependent
aminoglycosides , quinolones, dap,
dose optimization strategies
Time>MIC (time dependent
betalactams (PCNs, cephalosporins, carbopenems)
PCNS
natural PCNS
EX:
coverage:
IV formulations
PO: formulations
PCNS
EX: PCN G, PCN V
coverage: GRam + cocci (strep. enterococcus), GRam + anaerobes (like in the mouth)
NOTE: no staph coverage
IV formulations: pcnG aq.
IM: pcn G Benzathine (Bicillin L-A)
PO: formulations:
pcnvk
PCNS
AMINO PCNS
EX:
coverage:
IV formulations
PO: formulations
PCNS
EX:amoxicillin, ampicillin
coverage: Adds HNPEK coverage to natural PCN coverage
IV formulations: ampicillin
PO: formulations: amoxicillin
ampicillin (very poor bioavailability. rarely used)
PCNS
amino pcns+betalactamase inhibitor
EX:
coverage:
IV formulations
PO: formulations
PCNS
EX:amox/clav, amp/sulbactam
coverage: adds MSSA, more resistant strains of HNPEK, and gram negative anaerobes (B. Frag)
IV formulations
PO: formulations: unseen
PCNS
extended spectrum beta lactamase
EX:
coverage:
IV formulations
PO: formulations
PCNS
EX: zosyn
coverage: adds CAPES+pseudamonas
IV formulations:pseudamonas
PO: formulations
PCNS
EX: anti staph
coverage:
IV formulations
PO: formulations
PCNS
EX: NAFCILLIN
oxacillin
coverage: MSSA and strep ONLY
IV formulations: nafcillin, oxacillin
PO: formulations: dicloxacillin
pcns as a class
cover:
don’t cover:
enterococcus
do not cover atypical OR MRSA
pcn class effects
beta lactate allergy
risk of surgery
1st gen cephalasporins
class effects for carbapenems
esbl producing organisms
Common resistant pathogens
Staph Aureus
P. aeruginosa
Acinobacter
E. Coli (ESBL, CRE)
Klebsiella Pneumoniae
Dose optimization strategies
Aminoglycosides
CMax: MIC
Dose optimization strategies
Time dependent
ALL BETA LACTAMS
1st gen ceph. ex and what they cover
IV cefazolin
PO: keflex
cover: staph, streptococci, PEK, mouth anaerobe
2nd gen ceph
cefuroxime :IV/PO/IM
better gram negative (HNPEK)
Cefotetan and cefoxitin have anaerobic activity (b frag)
3rd gen cepf
group 1: similar to aminopcns
