Infectious disease Flashcards

1
Q

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

A

Strep equi subs zooepidemicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of streptococcus is most virulent and give an example

A

Beta hemolytic - strep canis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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 +
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What bacteria are part of the Enterobacterales

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

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

A

Cephalosporins
Macrolides
Sulfonamides
Fluoroquinolones
Low concentrations aminoglycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

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

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the treatment of choice for actinomyces?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name 2 filamentous bacteria

A
  • Actinomyces spp
  • Nocardia spp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What bacteria have a positive Acid fast stain

A

Mycobacterium spp (partial positive for Actinomyces)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the drug of choice for E. Faecalis?

A

Penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the drug of choice for mycobacterium?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What organism is associated with necrotizing fasciitis in dogs?

A

Strep canis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

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

A

Clostridia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name 2 antipseudomonal drugs

A

Ceftazidime
Piperacilline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

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

A

Doxycycline
Enrofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What the antibiotic of choice for Campylobacter

A

Macrolides (erythyromycin, tylosin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What characterizes kidney injury in Lyme nephritis?

A

Kidney injury is secondary to immune complex deposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What tick is responsible for Borrelia transmission

A

Ixodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

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

A

Thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What infectious agent should be considered in dogs that have eaten raw salmon (Pacific Northwest of the USA)?
Neorickettsia helminthoeca
26
Name a bacteria associated with encephalitis and endocarditis as severe manifestations and what is the antibiotic combination of choice for treatment?
Bartonella spp (gram -) Fluoroquinolone + doxy
27
Which pathogen causes abortion in pregnant dogs?
Brucella canis
28
Name 4 intracellular bacteria
- Mycoplasma spp - Ehrlichia canis - Anaplasma phagocytophilum - Bartonella spp - Brucella spp
29
How is blastomycosis contracted and what are the main sites of disease?
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
30
What is the main fungal pathogen in cats
Cryptococcus
31
Where can cryptococcus be found in the environment and what are the main organs affected in dogs and cats?
Cryptococcus neoformans --> Desiccated bird excrements Cryptococcus gattii --> decaying wood bark Cats: nasal cavity, skin, CNS Dogs: CNS (mostly), eyes, nasal cavity, urinary system
32
What are the most common sites of infection of coccidiomycosis in dogs?
Lung and bone +/- CNS (Rare in cats but affects skin and lungs)
33
What are the cytological characteristics of histoplasma?
- Found in the cytoplasm of neutrophils or macrophages - Basophilic (blue) staining center surrounded by a lighter halo (Very small for fungal organism)
34
What are the most common primary sites of histoplasmosis
GI and lungs
35
What are the 3 types of aspergillosis and which is more common in dogs vs cats?
Sinonasal aspergillosis Sino-orbital aspergillosis (common in cats) Invasive aspergillosis (common in immunocompromised dogs - ie GSD)
36
Which fungal organism is a commensal and indicative of host immunocompromise?
Candida sp.
37
What fungal organisms have antibody / antigen testing available
1. Antibody testing: - Coccidioidomycosis - Aspergillus for sino-nasal aspergillosis 2. Antigen testing: - Blastomycosis and Histoplasmosis (cross-react) - Cryptococcus - Potentially aspergillosis for invasive form
38
Other than antifungals, what are treatment considerations for blastomycosis?
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.
39
True or false: recurrence of coccidioidomycosis is rare.
False, recurrence is common in dogs and cats (25% of cats in one study having repeat bouts)
40
True or false: dogs with histoplasmosis have a better outcome than cats with histoplasmosis
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
41
What type of aspergillosis has the best prognosis
Sino-nasal aspergillosis (Sino-orbital and invasive require long-term systemic antifungals)
42
Main systems affected by canine distemper virus. What is an almost pathognomonic sign?
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
43
What is the diagnostic of choice for diagnosis of Distemper
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
44
What is the best prognostic indicator in cats with feline panleukopenia
Leukopenia (cats with WBC < 1.0x10^9/L twice as likely to die as cats with WBC > 2.5x10^9/L)
45
What viruses require special disinfection measures in the environment
- Canine parvovirus (CPV-2) - Feline panleukopenia virus - Feline calicivirus (Accelerated hydrogen peroxide or concentrated bleach usually efficient)
46
Where is latent feline herpesvirus usually located
Trigeminal ganglia
47
In a cat with nasal discharge and conjunctivitis, what virus is more likely to be associated with corneal ulcerations / stomatitis
- Corneal ulcerations -> feline herpesvirus (FHV-1) - Stomatitis -> feline calicivirus (FCV), can also be FHV-1
48
What are the 2 viruses responsible for feline respiratory disease? What is the preferred diagnostic test? Which one can cause severe systemic disease
- 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
What treatment can be used for FHV-1? What is the mechanism of action?
Famciclovir Guanosine analog that inhibits viral DNA polymerase
50
What explains that some cats with FIP develop an effusive form and other, a non-effusive form?
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
What is the standard diagnostic test for FIP? Name 2 other tests that can be done
- 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
Name 2 antiviral agents that can be used for FIP
- 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
What is the survival rate for cats with FIP treated with GS-441524 or remdesevir
~80-90% (most cats who do not survive die early in the course of treatment)
54
What is the delay of response to GS-445124 or remdesevir in cats with FIP
~ 2-4 weeks for resolution of clinical signs and effusion ~ 2 months (possibly longer) for normalization of globulins
55
What are adverse effects of GS-441524 and remdesevir therapy for FIP
- Pain at injection site - Increased ALT - Eosinophilia - Lymphocytosis - Increased ALP - Increased creatinine (rare) - Uroliths made of GS-441524
56
When do clinical signs start following infection with canine parvovirus? When does fecal shedding start?
Clinical signs after 4-10 days Fecal shedding after 4 days (usually before clinical signs)
57
Which population of dogs is at risk of developing myocarditis from parvovirus?
< 2weeks old --> myocardial cell proliferation is incomplete and rapid myosite division is still occurring.
58
What are prognostic indicators for canine parvovirus infection on a CBC
Leukopenia, lymphopenia, eosinopenia, monocytopenia on admission and at 24 and 48h predictive of death (Neutropenia not predictive of death)
59
In the 2021 JVECC study "Prognostic indicators at presentation for canine parvoviral enteritis: 322 cases (2001-2018)", what were indicators of non-survival
- Lower blood glucose - Higher total serum magnesium - Low Hct
60
What is the sensitivity and specificity of fecal antigen ELISA for Parvo?
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
Apart from supportive care, what therapies can be considered for canine parvovirus enteritis
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
What are some normal host defines mechanisms preventing UTI?
- 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
Why are patients with pyometra often polyuric?
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
At what phase of the estrus cycle does pyometra occur?
The luteal phase
65
What are the 4 categories of necrotizing soft tissue infections?
- Type 1 - Polymicrobial - Type 2 - Monomicrobial - Type 3 - Gram negative monomicrobials - Type 4 - Fungal
66
What is the pathological process of necrotizing soft tissue infections?
Microbial infasion associated with localized thrombosis, leading to liquefactive necrosis of the superficial fascia and soft tissue
67
What is toxic shock syndrome?
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
What causes the severe virulence of Strep / Clostridium in necrotizing soft tissue infection
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
How is the definitive diagnosis of necrotizing soft tissue infection made?
Histopathology --> fascial necrosis and myonecrosis + deep angiothrombotic microbial invasion and liquefactive necrosis
70
What are antibiotic treatment protocols that can be considered in necrotizing soft tissue infections?
- 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
What are characteristics of clindamycin that make this drug effective in necrotizing soft tissue infections? Why are fluoroquinolone avoided?
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
How quickly should surgical intervention occur in necrotizing soft tissue infections? How frequently should the wound be checked after surgical debridement?
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
What are advantages of polyurethane and teflon catheters?
- Decreased adherence of certain bacteria (Staph, Acinetobacter, Pseudomonas) - Less thrombogenic
74
Name 2 risk factors of catheter-related bloodstream infection (that are not patient-related)
- Indwelling catheter duration - Multiple catheterization attempts (promote thrombosis which allows adherence of bacteria)
75
What is the incidence of catheter-related bloodstream infections in veterinary patients
0-26%
76
What is the definition of catheter site colonization / catheter site infection / catheter-related bloodstream infection / catheter-related sepsis / catheter-associated bloodstream infection
- 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
What are the 4 possible pathways leading to catheter-related bloodstream infections
- 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
List 7 measures to prevent catheter-related bloodstream infections
- 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
What cultures are recommended for diagnosis of catheter-related bloodstream infection
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
Discuss the need for catheter removal in case of catheter-related bloodstream infection
- 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
What is the only reason for a scheduled catheter replacement
A catheter placed under sub-optimal conditions emergently should be replaced within 48h
82
What bacteria are especially known to form biofilms in catheters
Staphylococcus aureus and coagulase negative Staphylococci
83
What bacteria are commonly responsible for catheter-related bloodstream infections
- Staph pseudintermedius - Streptococcus species - Acinetobacter species * For ICU patients, shift towards Gram neg pathogens: - Enterobacter - E Coli - Proteus - Pseudomonas - Serratia
84
What are the 3 different type of bacterial resistance?
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
Define MDROs vs XDR vs PDR
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
What are risk factors for MDROs?
- Predisposing disease - Prior antimicrobial use - ICU hospitalization - Duration of hospitalization - Surgical / invasive procedures - Mechanical ventilation
87
Briefly describe the mechanism of resistance, labarotory considerations, treatment considerations for the following MDRO: MRSP/MRSA
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
Briefly describe the mechanism of resistance, labarotory considerations, treatment considerations for the following MDRO: Enterococcus
- 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
Briefly describe the mechanism of resistance, labarotory considerations, treatment considerations for the following MDRO: Pseudomonas Aeroginosa
- 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
Briefly describe the mechanism of resistance, labarotory considerations, treatment considerations for the following MDRO: ESBL
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
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?
- 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
List 4 key components of infection control programs
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
2021 JVECC retrospective study on canine parvovirus showed which negative biochemical prognostic indicators at presentation?
- Low HCT - Decreased blood glucose concentrations - Increased total serum magnesium concentrations
94
Do multi-drug resistant organisms have increased virulence? Do they cause increased morbidity?
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
What are the 3 main general approaches recommended to limit antimicrobial resistance
- Prevent disease occurrence (hygiene, barrier precautions, vaccines) - Reduce overall antimicrobial use - Improve antimicrobial drug use
96
What is the definition of a hospital associated infection?
Infectious event diagnosed >48h after hospital admission, (on or after day 3 in hospital) without proven prior incubation
97
What are risk factors for hospital associated infections?
- Severity of underlying illness, trauma (esp if open Fx) - Prolonged length of stay - Mechanical ventilation - Indwelling devices - Antimicrobial use +/- anti-ulcer medications
98
How does spread of pathogens primarily occur in hospitals?
Via the hands of personnel
99
Name 4 potentially zoonotic bacteria of concern in veterinary hospitals
- Campylobacter - Salmonella - Clostridium difficile - Leptospira - MRSP
100
How frequently should catheter dressings be changed
Every 48h or as soon as soiled for bandage with gauze / BandAid Every 7 days for transparent dressings or as soon as soiled
101
What is the incidence of health-care associated infections in cats and dogs
12% in cats, 16% in dogs (in ICU)
102
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
Only indications is involvement of bladder wall / bladder wall mass Diabetes, immunosuppresion, anatomical abnormalities, Ucath in place not an indication
103
What influenza viruses can cause disease in dogs
H3N8 and H3N2
104
What are the 4 possible types of progression of disease following infection with FeLV
- 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
What cells are infected by FIV
Immune cells -> mostly CD4+ T cells but also CD8+ T cells, B cells, macrophages, dendritic cells and astrocytes
106
What other vector-borne disease is often cause of co-infection with Lyme disease
Anaplasma (both transmitted by Ixodes)
107
What Anaplasma species is (are) tested on the 4Dx SNAP
Anaplasma phagocytophilum (-> granulocytes) and Anaplasma platys (-> platelets)
108
What Babesia species are most present in the US and what are the predisposed breeds? What is the treatment?
Baebsia canis subspecies vogeli -> Greyhounds Treatment: imidocarb Babesia gibsoni -> Pitbulls (transmission by fighting behaviors) Treatment: atovaquone + azithromycin
109
What ticks can transmit Rocky Mountain Spotted Fever
- Dermacentor variabilis, Dermacentor andersoni - Rhipicephalus sanguineus
110
What breeds are predisposed to parvovirus enteritis
Rottweiler, Doberman (Labrador, GSD, Springer Spaniel)
111
Name 3 mechanisms of DNA transfer responsible for spread of antimicrobial resistance
- 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)