Intraabdominal infections Flashcards
What are the types of intra-abdominal infections
Peritonitis, Abscesses, Complicated intra-abdominal infection (CIAI) (secondary peritonitis), Cholecystitis and cholangitis, appendicitis
What are the main types of enterics bacteria, common GI anaerobes
E. coli and Klebsiella/bacteroides species
What gram positive bacteria needs to be accounted for more when the infection is healthcare associated
Pseudomonas
What antibiotics work best against enterobacteriaceae
Ceftriaxone, Pip/Taz, Cefepime
What antibiotic types work best against GI anaerobes (bacteriodes, clostridium peptostreptococcus)
Pip/Taz, carbapenems, metronidazole
What antibiotic types work best against pseudomonas
Pip/taz, carbapenems EXCEPT ertapenem, cefipme
What resistance mechanisms would Carbapenems be used for
Extended Spectrum Beta-lactamases (ESBL)
What antibiotics are enterococcus faecalis susceptible to
Ampicillin, ampicillin/sulbactam, Pip/Taz, imipenem, vancomycin, linezolid, daptomycin
What antibiotics are used for Vancomycin resistant Enterococcus faecium (VRE)
Daptomycin or linezolid
What is peritonitis, what is the difference between primary and secondary
Inflammatory response of peritoneum secondary to bacteria, primary has an unknown cause and is spontaneous while secondary is due to known cause
What is peritoneal dialysis-associated, what orgamism is common for causing this
Flora following the catheter to the peritoneium causes inflammation, Staph aureus
What patients are more likely to experience Spnetaneous bacterial peritonitis (SBP/ primary peritonitis)
patients with liver failure and alcoholic cirrhosis
What medication increase the risk for SBP
PPIs
What are presentation symptoms someone with SBP should have
fever, abdominal distention, abdominal pain, worsening altered mental status, N/V, hypovolemic hypotension
How is SBP diagnosed
Ascitic fluid has PMN greater than 250 cells/mm3
What organisms usually cause SBP
Stretococcus species, enterics, NO ANAEROBES
What are the treatment options for SBP, how long is the duration of therapy and when should patients feel better
Ceftriaxone and cefotaxime, 5 days, 24-48 hours
When would a patient get prophylaxis for SBP, what are the prophylactic drugs
If they get SBP at all they need prophylaxis/ Levofloxacin, Ciprofloxacin or Bactrim
T/F: SBP can have positive gram-stain culture but could also be negative as well while also just being monomicrobial
True
What is an abscesses, how are they usually treated
focal collection of necrotic tissue, bacteria, inflammatory cells and my preceded peritonitis
What causes a complicated intra-abodominal infection, symptoms
anatomical disruption and extend beyond a single organ/ peritoneal space, abdominal distension, hypovolemia, organ failure
What are the classifications of CIAI
mild/moderate community acquired, high-risk community-acquired, healthcare associated
What are the bacteria associated with CIAI
Enterics, anaerobes, pseudomonas
What antibiotics are used to treat mild/moderate infection treatment CIAI
Cefoxitin, Metronidazol PLUS Ceftriaxone or ceftotaxime
