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Infectious Disease Therapeutics > Infectious Disease Intro Pt.2 > Flashcards

Infectious Disease Intro Pt.2 Flashcards

1
Q

What are the three ways of diagnosing an infection?

A
  1. History
  2. Physical Examination
  3. Laboratory Testing
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2
Q

In diagnosing an infection, patient history includes…

What does each tell us in regards to the infection?

A

a) Signs and symptoms - severity and potentially location
b) source of infection - trauma, contact with another person, etc.
c) try and determine which organism is most likely the cause (if not severely ill, tests not done and go with best guess0

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3
Q

In diagnosing an infection, physical examination includes…

Examples and presentation

A
  • Will be different for each infection, but the GOAL is to localize the infection

a) Measles - characteristic rash
b) Meningitis - neck stiffness
c) pneumonia - cough and sputum production; chest sounds

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4
Q

In diagnosing an infection, laboratory testing may include…. (examples)

A
  • WBC and Differential (differential means with percentages)
  • ESR and CRP
  • Renal and Hepatic Function –> Need to know to choose an antibiotic. Some antibiotics may cause renal damage and/or decreased hepatic function
  • Others - such as electrolytes
  • Microbiology
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5
Q

What is the goal of laboratory microbiology testing? What are some examples?

A
  • Goal is to determine invading pathogen(s), so that the proper antibiotic can be used

a) Gram stain
b) Culture
c) Sensitivity testing

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6
Q

What is a gram stain? Purpose?

A

Quick and easy way to gain an idea of the organism

is it gram + or - ?

cocci vs bacillus

presence of WBC –> they do stain. If no WBC, need to start wondering if just colonization rather than infection

is it even a bacteria?

Not all organisms stain well – Ex. TB

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7
Q

Positive Cocci Clusters

A

Staphylococci

Coagulase Positive

Coagulase Negative

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8
Q

Coagulase Positive Example

A

Staphylococcus Aureus

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9
Q

Coagulase Negative Examples

A

Staphylococcus epidermidis
Staphylococcus saprophyticus
Staphylococcus hominis
Staphylococcus hemolyticus
Staphylococcus warneri

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10
Q

Positive Cocci Pairs (Diplococci)

A
  • Pneumoncocci

e.g. streptococcus pneumoniae

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11
Q

Positive Cocci Chains

A

Streptococci

a) Beta-hemolytic
- Streptococcus pyogenes
- Streptococcus agalactiae
- Groups C, F, G

b) Alpha-hemolytic
- Viridians streptococci
- Streptococcus pneumoniae

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12
Q

Positive Bacilli Small

A
  • Listeria
  • Cutibacterium
  • Corynebacterium
  • Gardnerella
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13
Q

Positive Bacilli Large

A

a) Spore forming
- Clostridium
- Bacillus

b) Nonspore-forming
- Lactobacillus

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14
Q

Positive Bacilli Branching or Non-filamentous

A
  • Nocardia
  • Actinomyces
  • Erysipelothrix
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15
Q

Negative Cocci

A
  • Neisseria Meningitis
  • Neisseria Gonnorhea
  • Veillonella
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16
Q

Negative Bacilli Lactose-Fermenter

A

a) Oxidase Positive
- Aeromonas
- Pasturella
- Vibrio

b) Oxidase-negative
- Escheria coli
-Klebsiella spp.
- Enterobacteur spp.
- Citrobacter spp.

17
Q

Negative Bacilli Non-lactose Fermenter

A

a) Oxidase-Positive
- Pseudomonas spp.
- Flavobacterium spp.
- Alcaligenes spp.
- Achromobacteur spp.
- Moraxella spp.

b) Oxidase negative
- Proteus spp.
- Proficendia spp.
- Seratia spp.
- Morganella spp.
- Salmonella spp.
- Shigella spp.
- Stenotrophomonas
- Acinebacteur spp. (coccobacilli)

18
Q

Gram-negative coccobacilli

A
  • Haemophilus influenzae
  • Moraxella catarrhalis
19
Q

Negative Bacilli are commonly found in…

A
  • The G.I. Tract
20
Q

What is the best method for revealing an organism?
What is determined?
Are all organisms shown?

A

Laboratory - Culture

  • Biochemical profile determined
    –> Coagulase + or -
    –> Oxidase + or -
  • Not all organisms grow well
21
Q

MALDI- TOF MS

A

Matrix-assisted laser desorption/ionization time of flight mass spectrometry

Vaporizes bacterial samples with laser. This ionizes proteins and other macromolecules. The ‘cloud’ of ionized analyte is separated by mass and charge. This influences the time of flight to a detector which creates a ‘fingerprint’”. The fingerprint is compared to a data base to identify the microorganism

22
Q

What type of testing determines what type of antibiotics an organism is susceptible to?

A
  • Sensitivity Testing
23
Q

Define Sensitivity Testing. What is based on?

A
  • Determines which antibiotics the organism is susceptible to
  • Based on the minimal inhibitory conc. (MIC)
  • The lowest antimicrobial concentration that prevents growth after 24 hours of incubation
24
Q

What other information should be considered along with sensitivity testing?

A

Site of Infection and subsequently the penetration of the antibiotic

25
Q

When a sensitivity analysis is conducted what do the letters S, R, and I mean?

A

S = Sensitive
R = Resistant
I = Intermediate

26
Q

In regards to the degree of susceptibility from a sensitivity test, what is actually susceptible?

A
  • Shows the susceptibility of an organism, not the person, to an antibiotic
27
Q

T/F: Choosing an antibiotic with an S is sufficient for a microbial condition

A

No

  • Need to take into account the site of infection and the penetration of the antibiotic
28
Q

How is the MIC calculated?

A

-Minimum Inhibitory Concentration

  • Test tube of antibiotics
  • Introduce a standard amount of organism and allow for a standard amount of time
  • if clear (no turbidity) than antibiotic is working
  • If not clear (turbidity) than organism growing
  • Disk with an antibiotic on an agar plate
  • Antibiotic diffuses out, antibiotic is inhibiting that organism growth
  • Sample of organism must come from patient
  • Measure the zone of inhibition and that is correlated

The best antibiotic choice is not always the one with the largest zone of inhibition as may need a large dose to reach that amount in the blood stream

29
Q

What is an E-test?

A
  • The test has a single antibiotic with a gradient of antibiotic dosage

Cloudy Parts = Antibiotic Growing
Clear = Organism not growing

  • Not absolute. Can see some growth in the clear.
30
Q

Immunologic testing is useful when….

A

When the organism cannot be cultured or treatment has already begun

31
Q

What is antibody testing? Does it provide a diagnosis?

A
  • Detects the presence of antibodies directed against the pathogen
  • Can not tell you when the infection happened, but can help solidify a diagnosis
32
Q

What does antigen testing detect? What can it detect?

A
  • Detects presence of an antigen in the serum, urine, CSF, etc.
  • Bacterial, Fungal or Viral
  • Various methods used
  • Would tell you if the infection is current
33
Q

What does PCR detect?

A
  • Polymerase Chain Reaction
  • Detects very low amounts of specific DNA in clinical specimens
34
Q

What can be used to see viruses?

A

Electron Microscopy

35
Q

What is the difference between empiric and direct antibiotic therapy?
As pharmacists we want to move from….. to……

A

Direct –> Antibiotic chosen due to knowing the exact causative organism and susceptibility

Empiric –> An educated guess antibiotic –> DO not know the causative organism

As pharmacists we want to move from empiric to direct when we have information we need.

Infectious Disease Therapeutics (17 decks)

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