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Sepsis/SIRS/MODS > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q

Which emerging pathogen has been associated with hemorrhagic pneumonia is dogs?

A

Strep equi subs zooepidemicus

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2
Q

What type of streptococcus is most virulent and give an example

A

Beta hemolytic - strep canis

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3
Q

Indicate if the following bacteria are Gram + vs Gram - and aerobic vs anaerobe:
- Staph spp
- Nocardia spp
- Bacteroides spp
- Enterococcus spp
- Campylobacter spp
- Clostridium spp
- Actinomyces spp
- Klebsiella
- Bordetella bronchiseptica
- Fusobacterium spp
- Pasteurella spp

A
  • Staph spp = Aerobic Gram +
  • Nocardia spp = Aerobic Gram +
  • Bacteroides spp = Anaerobe Gram -
  • Enterococcus spp = Aerobic Gram +
  • Campylobacter spp = Aerobic Gram -
  • Clostridium spp = Anaerobe Gram +
  • Actinomyces = Anaerobe Gram +
  • Klebsiella = Aerobic Gram +
  • B bronchiseptica = Aerobic Gram +
  • Fusobacterium = Anaerobe Gram -
  • Pasteurella spp = Aerobic Gram +
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4
Q

What bacteria are part of the Enterobacterales

A

E Coli, Klebsiella, Enterobacter, Salmonella, Yersinia, Proteus

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5
Q

Which antibiotic class are enterococcus faecalis and faecium inherently resistant to?

A

Cephalosporins
Macrolides
Sulfonamides
Fluoroquinolones
Low concentrations aminoglycosides

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6
Q

True or false: Enterococcus faecium is easier to treat than enterococcus faecalis

A

False

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7
Q

Name 5 Gram positive and 5 gram negative organisms of clinical importance

A

Gram positive:
- Staphylococcus
- Streptococcus
- Enterococcus
- Nocardia
- Mycobacterium
- Clostridium (anaerobe)
- Actinomyces (anaerobe)

Gram negative:
- Enterobacteriaceae (e. coli, salmonella, enterobacter)
- Pasteurella multocida
- Bordetella bronchiseptica
- Campylobacter
- Fusobacterium (anaerobe)
- Bacteroides (anaerobe)

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8
Q

What is the treatment of choice for actinomyces?

A

High dose penicillin / amoxicillin (>20 mg/kg PO q6-8h for several weeks)

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9
Q

What is the drug of choice for nocardia?

A

TMS (3 months for skin infection, 6 months for pulmonary, >12 months in case of systemic infection or immunocompromise)

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10
Q

Name 2 filamentous bacteria

A
  • Actinomyces spp
  • Nocardia spp
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11
Q

What bacteria have a positive Acid fast stain

A

Mycobacterium spp (partial positive for Actinomyces)

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12
Q

What is the most common infection cause for Actinomyces / Nocardia

A

Often via trauma (wound, especially bite wound) or migrating foreign body (grass awn)
* Nocardia most often in immunocompromised patients, Actinomyces often associated with opportunistic infections

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13
Q

What is the drug of choice for E. Faecalis?

A

Penicillin

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14
Q

What is the drug of choice for mycobacterium?

A

Macrolide +/- rifampin or pradofloxcin +/- doxycycline (for 2-3 months after clinical resolution)

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15
Q

What organism is associated with necrotizing fasciitis in dogs?

A

Strep canis

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16
Q

What organism is associated with necrotizing soft tissue infection and gas gangrene?

A

Clostridia

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17
Q

Name 2 antipseudomonal drugs

A

Ceftazidime
Piperacilline

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18
Q

What is the recommended oral and parenteral antibiotic for bordetella bronchiseptica?

A

Doxycycline
Enrofloxacin

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19
Q

What the antibiotic of choice for Campylobacter

A

Macrolides (erythyromycin, tylosin)

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20
Q

What characterizes kidney injury in Lyme nephritis?

A

Kidney injury is secondary to immune complex deposition

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21
Q

What tick is responsible for Borrelia transmission

A

Ixodes

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22
Q

What is a characteristic of Mycoplasma that makes them resistant to which antibiotics?

A

They lack cell wall which makes the resistant to B-lactam antimicrobials

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23
Q

What common hematologic abnormality can be found with anaplasma or erlichia infections?

A

Thrombocytopenia

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24
Q

Which infectious agent causes Rocky Mountain Spotted fever and what are characteristics of the disease?

A

Rickettsia rickettsii
Infection of endothelial cells leading to widespread petechial hemorrhage and edema (very severe, high mortality)

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25
Q

What infectious agent should be considered in dogs that have eaten raw salmon (Pacific Northwest of the USA)?

A

Neorickettsia helminthoeca

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26
Q

Name a bacteria associated with encephalitis and endocarditis as severe manifestations and what is the antibiotic combination of choice for treatment?

A

Bartonella spp (gram -)

Fluoroquinolone + doxy

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27
Q

Which pathogen causes abortion in pregnant dogs?

A

Brucella canis

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28
Q

Name 4 intracellular bacteria

A
  • Mycoplasma spp
  • Ehrlichia canis
  • Anaplasma phagocytophilum
  • Bartonella spp
  • Brucella spp
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29
Q

How is blastomycosis contracted and what are the main sites of disease?

A

Mycelial spores (found in soil) are inhaled into the lungs –> body temperatures stimulate conversion of the fungus into yeast –> replication and transmission through blood stream and lymphatics

Common sites for disease: lungs, eyes, skin, CNS

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30
Q

What is the main fungal pathogen in cats

A

Cryptococcus

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31
Q

Where can cryptococcus be found in the environment and what are the main organs affected in dogs and cats?

A

Cryptococcus neoformans –> Desiccated bird excrements

Cryptococcus gattii –> decaying wood bark

Cats: nasal cavity, skin, CNS
Dogs: CNS (mostly), eyes, nasal cavity, urinary system

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32
Q

What are the most common sites of infection of coccidiomycosis in dogs?

A

Lung and bone +/- CNS

(Rare in cats but affects skin and lungs)

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33
Q

What are the cytological characteristics of histoplasma?

A
  • Found in the cytoplasm of neutrophils or macrophages
  • Basophilic (blue) staining center surrounded by a lighter halo
    (Very small for fungal organism)
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34
Q

What are the most common primary sites of histoplasmosis

A

GI and lungs

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35
Q

What are the 3 types of aspergillosis and which is more common in dogs vs cats?

A

Sinonasal aspergillosis
Sino-orbital aspergillosis (common in cats)
Invasive aspergillosis (common in immunocompromised dogs - ie GSD)

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36
Q

Which fungal organism is a commensal and indicative of host immunocompromise?

A

Candida sp.

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37
Q

What fungal organisms have antibody / antigen testing available

A
  1. Antibody testing:
    - Coccidioidomycosis
    - Aspergillus for sino-nasal aspergillosis
  2. Antigen testing:
    - Blastomycosis and Histoplasmosis (cross-react)
    - Cryptococcus
    - Potentially aspergillosis for invasive form
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38
Q

Other than antifungals, what are treatment considerations for blastomycosis?

A

Routine anti-inflammatoires can be considered, although the only study to evaluate efficacy showed no improvement in survival.

Vitamin D supplementation for its role in immunomodulation and mucosal immunity.

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39
Q

True or false: recurrence of coccidioidomycosis is rare.

A

False, recurrence is common in dogs and cats (25% of cats in one study having repeat bouts)

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40
Q

True or false: dogs with histoplasmosis have a better outcome than cats with histoplasmosis

A

True, 95% survival to discharge in dogs with 2/3 surviving to 6 months of treatment vs 55% of cats surviving to discharge in one study

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41
Q

What type of aspergillosis has the best prognosis

A

Sino-nasal aspergillosis
(Sino-orbital and invasive require long-term systemic antifungals)

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42
Q

Main systems affected by canine distemper virus. What is an almost pathognomonic sign?

A

GI, respiratory, neuro
+ can cause uveitis / retinitis and footpad / nasal hyperkeratosis

Myoclonus at rest is almost pathognomonic

  • Neurological signs are often progressive despite treatment and are a poor prognostic sign
  • Shed in the respiratory secretions for up to 90 days after infection
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43
Q

What is the diagnostic of choice for diagnosis of Distemper

A

RT-PCR (preferably on whole blood, can also be done on conjunctival swabs, CSF, and urine)

Can also use immunohistochemistry on nasal or footpad biopsies

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44
Q

What is the best prognostic indicator in cats with feline panleukopenia

A

Leukopenia
(cats with WBC < 1.0x10^9/L twice as likely to die as cats with WBC > 2.5x10^9/L)

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45
Q

What viruses require special disinfection measures in the environment

A
  • Canine parvovirus (CPV-2)
  • Feline panleukopenia virus
  • Feline calicivirus

(Accelerated hydrogen peroxide or concentrated bleach usually efficient)

46
Q

Where is latent feline herpesvirus usually located

A

Trigeminal ganglia

47
Q

In a cat with nasal discharge and conjunctivitis, what virus is more likely to be associated with corneal ulcerations / stomatitis

A
  • Corneal ulcerations -> feline herpesvirus (FHV-1)
  • Stomatitis -> feline calicivirus (FCV), can also be FHV-1
48
Q

What are the 2 viruses responsible for feline respiratory disease? What is the preferred diagnostic test? Which one can cause severe systemic disease

A
  • Feline herpesvirus-1 (FHV-1) and feline calicivirus
  • PCR on oropharyngeal swab preferred but positive result for FHV-1 does not indicate current infection
  • Highly virulent feline calicivirus can cause severe systemic illness
49
Q

What treatment can be used for FHV-1? What is the mechanism of action?

A

Famciclovir

Guanosine analog that inhibits viral DNA polymerase

50
Q

What explains that some cats with FIP develop an effusive form and other, a non-effusive form?

A

Cats with poor cell mediated immunity (CMI) response develop pyogranulomatous vasculitis because of deposition of antigen-antibody complexes within the venular epithelium –> pleural + peritoneal effusion

Cats with partial CMI response are able to slow replication of the virus with subsequent granuloma formation in a variety of tissues –> non-effusive, but may deteriorate to effusive if the CMI response wanes.

51
Q

What is the standard diagnostic test for FIP? Name 2 other tests that can be done

A
  • Standard = Detection of pyogranulomatous vasculitis on histopathologic examination with intralesional virus antigen (immunostaining)
  • Immunocytochemistry on macrophages in effusion - but low sensitivity and can have false positives
  • FIP virus real PCR (Idexx) detecting mutations in locations associated with FIP - but can have false positives
52
Q

Name 2 antiviral agents that can be used for FIP

A
  • GS-441524
  • Remdesevir (= GS-5734)

(GS-441524 is a metabolite of remdesevir)

Adenosine analog that gets incorporated in nascent viral RNA and terminates viral RNA synthesis

53
Q

What is the survival rate for cats with FIP treated with GS-441524 or remdesevir

A

~80-90% (most cats who do not survive die early in the course of treatment)

54
Q

What is the delay of response to GS-445124 or remdesevir in cats with FIP

A

~ 2-4 weeks for resolution of clinical signs and effusion

~ 2 months (possibly longer) for normalization of globulins

55
Q

What are adverse effects of GS-441524 and remdesevir therapy for FIP

A
  • Pain at injection site
  • Increased ALT
  • Eosinophilia
  • Lymphocytosis
  • Increased ALP
  • Increased creatinine (rare)
  • Uroliths made of GS-441524
56
Q

When do clinical signs start following infection with canine parvovirus? When does fecal shedding start?

A

Clinical signs after 4-10 days

Fecal shedding after 4 days (usually before clinical signs)

57
Q

Which population of dogs is at risk of developing myocarditis from parvovirus?

A

< 2weeks old –> myocardial cell proliferation is incomplete and rapid myosite division is still occurring.

58
Q

What are prognostic indicators for canine parvovirus infection on a CBC

A

Leukopenia, lymphopenia, eosinopenia, monocytopenia on admission and at 24 and 48h predictive of death

(Neutropenia not predictive of death)

59
Q

In the 2021 JVECC study “Prognostic indicators at presentation for canine parvoviral enteritis: 322 cases (2001-2018)”, what were indicators of non-survival

A
  • Lower blood glucose
  • Higher total serum magnesium
  • Low Hct
60
Q

What is the sensitivity and specificity of fecal antigen ELISA for Parvo?

A

Se 18-82% (false negatives due to low viral load in early disease, dilution by diarrhea, and antibody binding of CPV-2 in GI tract)

Sp up to 100%

61
Q

Apart from supportive care, what therapies can be considered for canine parvovirus enteritis

A
  1. Antiviral drugs
    - Recombinant feline IFN-omega ->decreased mortality rates
    - Neuraminidase inhibitors (oseltamivir) -> no clear benefit
  2. Passive immunotherapy
    - Equine hyperimmune serum anti-endotoxin -> conflicting results
    - Immune canine plasma -> no clear clinical benefit
  3. Canine G-CSF -> could increase mortality, not recommended
  4. Fecal microbiota transplantation -> faster resolution of diarrhea
62
Q

What are some normal host defines mechanisms preventing UTI?

A
  • Normal micturition
  • Extensive renal blood duspply
  • Normal urinary anatomy
  • Urethral and ureteral peristaltism
  • Mucosal defence barriers
  • Antimicrobial properties of the urine (+ zinc-associated antibacterial factors in prostatic fluid)
  • Systemic immunocompetence
63
Q

Why are patients with pyometra often polyuric?

A

E.Coli is the most common bacteria isolated in promettra. Some pathogenic strains of E.Coli produce the bacterial endotoxin lipopolysaccharide, which can cause insensitivity to ADH in the glomerulus and proximal tubules.

64
Q

At what phase of the estrus cycle does pyometra occur?

A

The luteal phase

65
Q

What are the 4 categories of necrotizing soft tissue infections?

A
  • Type 1 - Polymicrobial
  • Type 2 - Monomicrobial
  • Type 3 - Gram negative monomicrobials
  • Type 4 - Fungal
66
Q

What is the pathological process of necrotizing soft tissue infections?

A

Microbial infasion associated with localized thrombosis, leading to liquefactive necrosis of the superficial fascia and soft tissue

67
Q

What is toxic shock syndrome?

A

Acute, severe systemic inflammatory response initiated by a microbial infection at a normally sterile site. Usually involves exotoxin-releasing staph/strep.
Causes early circulatory shock and multiorgan dysfunction.

68
Q

What causes the severe virulence of Strep / Clostridium in necrotizing soft tissue infection

A

Release of toxins

  1. Strep
    - Exotoxin superantigens
    - Proteinases of cell enveloppes
    - Hyaluronidase
    - Complement inhibitors
    - Streptolysins
  2. Clostridium -> toxins leading to:
    - Hemolysis
    - Platelet aggregation
    - Leukocyte destruction
    - Histamine release
    - Destruction of collagen and hyaluronic acid
69
Q

How is the definitive diagnosis of necrotizing soft tissue infection made?

A

Histopathology –> fascial necrosis and myonecrosis + deep angiothrombotic microbial invasion and liquefactive necrosis

70
Q

What are antibiotic treatment protocols that can be considered in necrotizing soft tissue infections?

A
  • Aminopenicillins, penicillin G, cephalosporine fro initial therapy
  • Clindamycin
  • Amniglycosides, 3rd gen cephalosporin
  • Gentamicin

For broad spectrum coverage, Clindamycin + amino glycoside or 3rd gen cephalosporin is recommended

71
Q

What are characteristics of clindamycin that make this drug effective in necrotizing soft tissue infections?

Why are fluoroquinolone avoided?

A

Clindamycine:
- remains effective during stationary phase of strep (which happens with high tissue concentrations)
- turns off exotoxin synthesis
- inhibits strep M-protein synthesis
- suppresses lipopolysaccharide-induced monocyte synthesis of TNF

Fluoroquinolones:
- limited activity against strep
- may cause bacteriophage-induced lysis of S. Canis, enhancing its pathogenicity

72
Q

How quickly should surgical intervention occur in necrotizing soft tissue infections? How frequently should the wound be checked after surgical debridement?

A

Surgical debridement 4-6 hours after presentation

Immediately post-op check the area every 30-60 min to make sure the necrosis is not continuing to spread (which would require further debridement)

73
Q

What are advantages of polyurethane and teflon catheters?

A
  • Decreased adherence of certain bacteria (Staph, Acinetobacter, Pseudomonas)
  • Less thrombogenic
74
Q

Name 2 risk factors of catheter-related bloodstream infection (that are not patient-related)

A
  • Indwelling catheter duration
  • Multiple catheterization attempts (promote thrombosis which allows adherence of bacteria)
75
Q

What is the incidence of catheter-related bloodstream infections in veterinary patients

A

0-26%

76
Q

What is the definition of catheter site colonization / catheter site infection / catheter-related bloodstream infection / catheter-related sepsis / catheter-associated bloodstream infection

A
  • Catheter site colonization: Positive growth of micro-organisms in culture of catheter tip or hub or SQ segment (can be false positive)
  • Catheter site infection: visualized catheter site inflammation and positive culture (with or without fever / purulent exudate from site)
  • Catheter-related bloodstream infection (CRBI): matching positive culture from the catheter and the blood with signs of local inflammation at catheter site or unexplained fever
  • Catheter-related sepsis: CRBI with SIRS
  • Catheter-associated bloodstream infection: Positive blood culture with unexplained fever or SIRS in patient having a catheter in place but without confirmatory positive culture of the catheter
77
Q

What are the 4 possible pathways leading to catheter-related bloodstream infections

A
  • Direct introduction of skin flora into the vessel during catheter placement
  • Migration of skin flora by capillarity around the catheter
  • Contamination of the catheter hub and intra-luminal migration of pathogens
  • Hematogenous spread from a septic focus seeding the catheter
78
Q

List 7 measures to prevent catheter-related bloodstream infections

A
  • Hand washing
  • Aseptic insertion of catheter: use at least 3-7 cycles of alternating 2% chlorhex and 70% isopropyl alcohol and let dry before placement
    Wear sterile gloves for central and arterial catheters + gown, drape, cap, mask for central catheters
  • Put caps on any opening / stopcock and wipe with alcohol before injections
  • Use minimum number of lumens required
  • Assess for catheter need and remove as soon as not required
  • Dress catheter with sterile gauze / Band-Aid and bandage or sterile transparent dressing
  • Monitor catheter site and vessel at least every 24h
  • Change administration sets every 4-7 days (every 24h if administering lipids, every 4-6h for blood products)
  • Prefer polyurethane catheters
79
Q

What cultures are recommended for diagnosis of catheter-related bloodstream infection

A

Requires percutaneous blood culture combined with catheter culture

Options for catheter cultures:
- Quantitative culture of catheter tip (ideal)
- Quantitative culture of blood sampled form catheter lumen (if multi-lumen, sample from each lumen) - culture from the catheter should be 3-5 times greater than percutaneous one
- Non-quantitative culture of blood from catheter showing positivity at least 2h before percutaneous one
- If culturing a segment of catheter rolled over a blood agar plate, should be positive > 15 CFU/plate to be compatible with CRBI

80
Q

Discuss the need for catheter removal in case of catheter-related bloodstream infection

A
  • If catheter is not required and patient has new fever or signs of site inflammation, remove catheter (and ideally culture catheter and blood)
  • If patient has signs of septic shock and suspect CRBSI, remove catheter and place a new one at a different site
  • If patient is not in shock, can keep catheter while waiting for culture results. If culture is negative, catheter can be kept. If culture is positive but fever resolves with antimicrobials and catheter is required and can’t be replaced (eg tuneled catheter), can be kept (can use antibiotic locks). Otherwise recommend replacing catheter but can use guidewire replacement at the same site.
81
Q

What is the only reason for a scheduled catheter replacement

A

A catheter placed under sub-optimal conditions emergently should be replaced within 48h

82
Q

What bacteria are especially known to form biofilms in catheters

A

Staphylococcus aureus and coagulase negative Staphylococci

83
Q

What bacteria are commonly responsible for catheter-related bloodstream infections

A
  • Staph pseudintermedius
  • Streptococcus species
  • Acinetobacter species
  • For ICU patients, shift towards Gram neg pathogens:
  • Enterobacter
  • E Coli
  • Proteus
  • Pseudomonas
  • Serratia
84
Q

What are the 3 different type of bacterial resistance?

A
  1. Intrinsic resistance: inherent feature of a microorganism (eg. Pseudomonas with most beta-lactams, Mycoplasma with beta-lactams, Gram - with vancomycin)
  2. Circumstantial resistance: in vitro test predicts susceptibility, but in vivo, antibiotic lacks efficacy (penetration to site vs inactive in local pH)
  3. Acquired resistance: change in phenotype of microorganism decreases effectiveness of antimicrobial
85
Q

Define MDROs vs XDR vs PDR

A

MDRO = multi drug-resistant organism
- not susceptible to at least 1 agent in 3 or more classes of antimicrobials to which they are susceptible

XDR = Extensively drug resistant organism
- Not susceptible to all but 1 or 2 classes of antimicrobials

PDR = pan drug resistant organism
- not susceptible to all known or licensed antimicrobials currently available

86
Q

What are risk factors for MDROs?

A
  • Predisposing disease
  • Prior antimicrobial use
  • ICU hospitalization
  • Duration of hospitalization
  • Surgical / invasive procedures
  • Mechanical ventilation
87
Q

Briefly describe the mechanism of resistance, labarotory considerations, treatment considerations for the following MDRO:

MRSP/MRSA

A

Methicillin-resistant staph

  • Mechanism: acquisition of a mecA gene which encodes an altered penicillin binding protein –> resistance to all B-lactam family
  • Culture: resistance to oxacillin may be present = same thing
  • Frequently also resistant to clindamycin, fluoroquinolone, macrolides and TMS
  • Tx:
    –> Aminoglycosides
    –> Tetracyclines, chloramphenicol, rifampin can be considered in less severe cases (bacteriostatic)
    –> Vancomycin
    –> Linezolid considered as last resort if staph is vancomycin resistant
88
Q

Briefly describe the mechanism of resistance, labarotory considerations, treatment considerations for the following MDRO:

Enterococcus

A
  • Mechanism: intrinsic resistance to cephalosporins, clindamycin, ahminoglycosides. Acquired: acquisition of aminoglycoside modifying enzymes or alterations in penicillin binding protein
  • Lab: isolation from culture may not necessitate treatment –> not highly pathogenic organisms.
  • Tx: Ampicillin + gentamicin (synergy) vs vancomycin
89
Q

Briefly describe the mechanism of resistance, labarotory considerations, treatment considerations for the following MDRO:

Pseudomonas Aeroginosa

A
  • Mechanisms: Decrease in intracellular drug entry from efflux pumps or altered membrane structure, enzymes that modify or destroy antimicrobials, target mutation (DNA gyrase mutation)
  • Lab: Acquired resistance against aminoglycosides, fluoroquinolone and B-lactams
  • Tx: Amikacin, anti-pseudomonal B-lactam (= piperacillin, ceftazidime, ticarcillin, carbapenems), fluoroquinolones if susceptible
90
Q

Briefly describe the mechanism of resistance, labarotory considerations, treatment considerations for the following MDRO:

ESBL

A

Extended-spectrum beta lactamase

  • Mechanism: B-lactamase = enzyme that hydrolyzes and disrupts the B-lactam ring in the B-lactam group of antimicrobials.
    ESBL –> also hydrolyze 3rd gen cephalosporins
  • Lab: Identified in E.Coli, Klebsiella pneumoniae, Enterobacter
  • TX: Carbapenems. Fluoroquinolones or aminoglycoside if susceptible
91
Q

In order of most effective to least effective, what are the 5 main components of the hierarchy of controls for active infection control in an establishment?

A
  • Elimination: preventing physical entry of pathogens in the facility (challenging)
  • (Substitution)
  • Engineering controls: physical separation of hazards from other patients and staff (isolation facilities, disinfection)
  • Administrative controls: protocols / procedures to keep patients and staff separated from hazards
  • PPE
92
Q

List 4 key components of infection control programs

A
  1. Surveillance:
    - Active = collecting samples of patients or environment for the purpose of surveillance
    - Passive = collecting data drawn from routine clinical testing
    - Syndromic = subjective clinical data (symptoms)
  2. Active infection control:
    - Elimination of hazards
    - Engineering controls
    - Administrative controls
    - PPEs
  3. Giving feedback to stakeholders
  4. Having a dedicated biosafety team
93
Q

2021 JVECC retrospective study on canine parvovirus showed which negative biochemical prognostic indicators at presentation?

A
  • Low HCT
  • Decreased blood glucose concentrations
  • Increased total serum magnesium concentrations
94
Q

Do multi-drug resistant organisms have increased virulence? Do they cause increased morbidity?

A

They have the same virulence as antimicrobial-sensitive organisms and have the same outcome once appropriate antimicrobial therapy is initiated

They can still increase morbidity due to delay in initiating an appropriate antimicrobial and sometimes need for drugs with more adverse effects

95
Q

What are the 3 main general approaches recommended to limit antimicrobial resistance

A
  • Prevent disease occurrence (hygiene, barrier precautions, vaccines)
  • Reduce overall antimicrobial use
  • Improve antimicrobial drug use
96
Q

What is the definition of a hospital associated infection?

A

Infectious event diagnosed >48h after hospital admission, (on or after day 3 in hospital) without proven prior incubation

97
Q

What are risk factors for hospital associated infections?

A
  • Severity of underlying illness, trauma (esp if open Fx)
  • Prolonged length of stay
  • Mechanical ventilation
  • Indwelling devices
  • Antimicrobial use
    +/- anti-ulcer medications
98
Q

How does spread of pathogens primarily occur in hospitals?

A

Via the hands of personnel

99
Q

Name 4 potentially zoonotic bacteria of concern in veterinary hospitals

A
  • Campylobacter
  • Salmonella
  • Clostridium difficile
  • Leptospira
  • MRSP
100
Q

How frequently should catheter dressings be changed

A

Every 48h or as soon as soiled for bandage with gauze / BandAid

Every 7 days for transparent dressings or as soon as soiled

101
Q

What is the incidence of health-care associated infections in cats and dogs

A

12% in cats, 16% in dogs (in ICU)

102
Q

Among these conditions, which one(s) is (are) indication(s) to treat a UTI for longer than 3-5 days:
- Diabetes
- Bladder wall infection (eg. encrusting cystitis)
- Immunosuppression
- Ectopic ureter
- Bladder wall mass
- Urinary catheter

A

Only indications is involvement of bladder wall / bladder wall mass

Diabetes, immunosuppresion, anatomical abnormalities, Ucath in place not an indication

103
Q

What influenza viruses can cause disease in dogs

A

H3N8 and H3N2

104
Q

What are the 4 possible types of progression of disease following infection with FeLV

A
  • Regressive infection -> asymptomatic, no shedding, can be reactivated later
  • Abortive infection -> no viremia, strong antibody response
  • Focal infection -> virus present in some tissues but not blood / bone marrow
  • Progressive infection -> infection of bone marrow with cellular destruction and viremia (->anemia, immune suppression, 60 times more likely to develop lymphoma)
105
Q

What cells are infected by FIV

A

Immune cells -> mostly CD4+ T cells but also CD8+ T cells, B cells, macrophages, dendritic cells and astrocytes

106
Q

What other vector-borne disease is often cause of co-infection with Lyme disease

A

Anaplasma (both transmitted by Ixodes)

107
Q

What Anaplasma species is (are) tested on the 4Dx SNAP

A

Anaplasma phagocytophilum (->granulocytes) and Anaplasma platys (-> platelets)

108
Q

What Babesia species are most present in the US and what are the predisposed breeds? What is the treatment?

A

Baebsia canis subspecies vogeli ->Greyhounds
Treatment: imidocarb

Babesia gibsoni -> Pitbulls (transmission by fighting behaviors)
Treatment: atovaquone + azithromycin

109
Q

What ticks can transmit Rocky Mountain Spotted Fever

A
  • Dermacentor variabilis, Dermacentor andersoni
  • Rhipicephalus sanguineus
110
Q

What breeds are predisposed to parvovirus enteritis

A

Rottweiler, Doberman

(Labrador, GSD, Springer Spaniel)

111
Q

Name 3 mechanisms of DNA transfer responsible for spread of antimicrobial resistance

A
  • Transformation: uptake of naked DNA from the environment provided by a lysed donor bacterium
  • Transduction: transfer of DNA by viruses (bacteriophages)
  • Conjugation: cell-to-cell contact and transfer of plasmids (most important)

Sepsis/SIRS/MODS (4 decks)

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