Intro to Bloodstream Infections Flashcards
Primary vs secondary bloodstream infection
Primary: the organism in the blood cannot be identified as arising from any source
Secondary: the organism in the blood is secondary to an identified source of infection (more common)
Is bloodstream infection the same as sepsis?
NO!
Most common cause of
1. Community
2. Hospital
based sepsis
- E coli
2. Coag negative staph
4 common contaminating organisms
Coag negative staph (but can be real infection if person has IV catheter, prosthetic valve/joint) Propionibacterium acnes Corynebacterium Bacillus Contaminants dont require treatment
3 organisms that are never contaminants
Staph aureus
Gram-negative bacilli
Yeast
Staph aureus investigations
Repeat 2 sets of blood cultures every 48 hours until the blood is cleared
Echo to look for endocarditis
Infectious disease consult
Strep pneumo treatment
Penicillin, ampicillin and ceftriaxone usually susceptible
Ceftriaxone to be safe
How can you tell between strep pneumo and group A strep on a gram stain
Both gram +
Strep pneumo in pairs
GrA strep in chains (so is enterococcus)
Viridans group strep tx
Ceftriaxone
Drain the abscess if there is one
Where is
1. E faecalis
2. E faecium
more common?
- Community
2. Hospital
Tx for
1. E faecalis
2. E faecium
And what 3 things are ineffective against enterococcus?
- ampicillin, pip=tazo, imipenem
- linezolif
Cephalosporins, meropenem, and ertapenem are ineffective
Examples of gram - bacilli
E coli Klebsiella Proteus Enterobacter Serratia Pseudomonas Bacteroides
Empiric tx for pseudomonas
Local antibiogram is KEY
Pip-tazo, meropenem, imipenem, or ceftazidime
Candida treatment
Micafungin empirically
Usually can switch to fluconazole
