(IV)Gram Negative Rods *Pseudomonads + Burkholderia Flashcards
2 main Burkholderia species:
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2 main Burkholderia species:
B. cepacia (pulmonary infection in cystic fibrosis patients)
B. pseudomallei (Meloidosis)
Characterize (7) : Pseudomonas
(1) Gram (-) rod
(2) **Oxidase (+) **
(3) Catalase (+)
(4) Blue/green pigment
(5) Grape-like odor
(6) Obligate aerobe
(7) Encapsulated
What type of environments does Pseudomonas prefer?
Aquatic
Name the only Enterobacteriaceae which is an obligate aerobe
Pseudomonas
Name the 2 populations most at risk of developing pneumonia due to Pseudomonas
(1) Cystic fibrosis patients
(2) Hospital patients
Name the 2 populations most at risk of developing osteomyelitis due to Pseudomonas
(1) Diabetics
(2) IV drug users
What organism is most associated with burn injuries?
Pseudomonas
Name 2 types of nosocomial infections that Pseudomonas commonly causes
(1) Pneumonia
(2) UTIs
Name 2 types of skin infections caused by Pseudomonas
(1) “Hot tub folliculitis”
(2) Ecthyma gangrenosum
(If pseudomonas enters circulation ⇒ sepsis and seeds skin ⇒ Ecthyma gangrenosum)
Other than S. aureus, name a common cause of otitis externa
Pseudomonas
(Peudomonas is most common cause of perichondritis)
Name 2 organisms which produce toxins which ribosylate EF-2
(1) Pseudomonas
(2) Diphtheria
Name 4 treatment options for Pseudomonas
(1) Pip-tazo
(2) Flouroquinolones (Ciprofloxacin)
(3) Aminoglycosides (Gentamicin)
(4) Cephalosporins (Ceftazidime)
B. Pseudomallei culture shows characteristic […] colonies
B. Pseudomallei culture shows characteristic wrinkled colonies
Burkholderia cepacia is infamous for affecting patients with […]
Burkholderia cepacia is infamous for affecting patients with cystic fibrosis
Burkholderia psuedomallei infection
transmission:
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clinical presentation:
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Burkholderia psuedomallei infection
transmission:
Direct inhalation, contact with superficial wound (Found in soil and water)
clinical presentation:
Melioidosis (INFECTIOUS)
- Pneumonia (acute or chronic) (chronic infection can be misdiagnosed as TB)
- multiple abscesses around body **(acute or chronic)**
- Septicemia
“PMS”
**Note: presentation highly variable, may be acute, subacute or chronic
**Note: Melioidosis may affect almost ANY ORGAN SYSTEM (hence difficult to diagnose)
***Note: 20-80% of people living in endemic areas have subclinical latent melioidosis with the bacterium living inside macrophages, may reactivate decades later
Cetrimide agar is a type of agar used for the selective isolation of the gram-negative bacterium, […]
Cetrimide agar is a type of agar used for the selective isolation of the gram-negative bacterium, Pseudomonas aeruginosa.
As the name suggests, it contains cetrimide, which is the selective agent against alternate microbial flora.Cetrimide also enhances the production of Pseudomonas pigments such as pyocyanin and fluorescein, which show a characteristic blue-green and yellow-green colour, respectively.
PAE is a Gram-negative rod, oxidase positive, most strains produce […] pigment
PAE is a Gram-negative rod, oxidase positive, most strains produce **green flourescent (pyoverdin) **pigment
people with contact lens are at risk of […] infection
people with contact lens are at risk of Pseudomonas Aeruginosa infection
- Staphylococcus aureus (from rubbing eye)
- Acanthamoeba (from amoeba, rare but serious)
PAE causes **contact-lens associated keratitis **and spa-associated folliculitis
64) A soft contact lens user presents with painful red eye and keratitis. What is the most likely statement?
A. C.trachomatis causes trachoma in this group
B. Burkholderia pseudomallei is a likely cause
C. Pseudomonas aeruginosa is the most likely cause
D. Chloramphenicol is the antibiotic of choice
E. Vibrio spp. is a likely cause
Eye infections: keratitis (due to contaminated contact lenses/fluid, ocular medications or minor eye trauma; may lead to panophthalmitis)
Pseudomonads are mostly oxidase […]
Pseudomonads are mostly oxidase positive
Pseudomonas Aeruginosa (PAE) clinical presentation: (vvv. IMPT!!!)
Hospital acquired:
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Community acquired:
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Pseudomonas Aeruginosa (PAE) clinical presentation: (vvv. IMPT!!!)
Hospital acquired:
- UTI (due to catheterization or residual bladder urine)
- Pneumonia (diffuse bronchopneumonia or rapidly-progressing multi-focal necrotizing pulmonary lesions, particularly in cystic fibrosis patients)
- Septicaemia (especially in neutropenic patients, classically associated with ecthyma gangrenosum – small skin nodules that hemorrhage, necrose & ulcerate)
- Gastrointestinal infections (necrotizing enterocolitis, especially in young infants and neutropenic cancer patients)
- Skin & soft tissue infections (typically hemorrhagic and necrotic, burn patients especially at risk)
- Others: bone & joint infections, endocarditis, meningitis
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Community acquired:
- Ear infections: malignant otitis externa (especially in elderly diabetics), chronic suppurative otitis media**
- Eye infections: keratitis (due to contaminated contact lenses/fluid, ocular medications or minor eye trauma; may lead to panophthalmitis) (If wrong antibiotic used/therapy delayed = LOSS OF EYE with enucleation!!!)
- Skin infections: jacuzzi/whirlpool rash (folliculitis)
- Nail infections (paronychia): green nail from wet environment
Pseudomonas literally means false unit, being derived from the Greek pseudo (ψευδο - false) and monas (μονος - a single unit).
They are largely nocosomial infections. They can be found in […]
They include the species:
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Pseudomonas literally means false unit, being derived from the Greek pseudo (ψευδο - false) and monas (μονος - a single unit).
They are largely nocosomial infections. They can be found in soil and water.
They include the species:
- Pseudomonas Aeruginosa
- Burkholderia (B. pseudomallei and B.cepacia)
- Stenotrophomonas maltophilia
Stenotrophomonas maltophilia emerges in patients on […]
Stenotrophomonas maltophilia emerges in patients on carbapenems
What are the 4 common sources of Hospital Aquired Infections (HAIs)? Mneumonic: “4 Ws”
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What are the 4 common sources of Hospital Aquired Infections (HAIs)? Mneumonic: “4 Ws”
Wind - Pneumonia (ventilators)
Water - UTI (foley)
Wound
Wires - IV lines
What is the antibiotic treatment for psuedomonas aeruginosa? (vvvvv IMPT!!!)
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Prophylactic for neutropenic patients
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What is the antibiotic treatment for psuedomonas aeruginosa? (vvvvv IMPT!!!)
- Pip-Tazo (designed anti-pseudomonal drug, but resistance has emerged)
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3rd generation cephalosporins (ceftazidime specifically), aminoglycosides (gentamicin), quinolones
(ciprofloxacin) - For severe neutropenia, common to use two antibiotics in combination (e.g. ceftazidime + gentamicin)
Prophylactic for neutropenic patients
- ciprofloxacin
Who are at risk of nosocromial PAE infection? (there’s a lot. name 6)(IMPT!!)
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Who are at risk of nosocromial PAE infection? (there’s a lot. name 6)(IMPT!!)
- prolonged antibiotics patients (repeated/chronic infections)
- cystic fibrosis, bronchiectasis
- immunocompromised
- cancer
- burnt victims
- ICU
