L40 Flashcards
Pseudo
- GN or GP
- Air environment
- Ferment lactose?
- Oxidase +/-
- Plate characteristics
GN rod Aerobic (blowing fire) NO lactose fermentation (flow chart) Oxidase + ring Grows on MacConkey - grape smell!!
Where/when are pseudo infections commonly seen?
NOSOCOMIAL
Drugs to treat pseudo
- Fluoro - cipro
- Pip/tazo
- 3rd & 4th cephalo (ceftaz & cefepime)
- Meropenem = big guns
Pseudo virulence factors
Pili & flagella = adherence
LPS = endotoxin –> massive septic shock
CAPSULE
You just said LPS = endotoxin. Which endotoxin is this and what are its effects?
Exotoxin A
Mechanism = X protein synthesis
X phagocytes –> necrotizing tissue
How does pseudo secrete its virulence toxins?
T3SS
What are the clinical conditions caused by pseudo infection?
HA/VA-pneumonia Bactermia --> endocarditis S/ST infection Osteomyelitis UTI External ear otitis
Is pseudomonas bacteremia a primary or secondary infection?
Secondary to pseudo pna, catheter/line infection, UTI, GI infection
If there was a normal place to find pseudo in the body, where would you find it?
GI
What kind would might you see resulting from pseudo bactermia?
Ecthyma gangrenosum
Is pseudomonas endocarditis commonly seen? Which patients would you see this endocarditis in?
Rare, BUT if present - high mortality
IVDUs
Describe ecthyma gangrenosum.
Not specific to pseudo
Ulcer - punched out lesion
Raised margins
Which patients are most likely to get a lethal pseudo skin/ST infection?
BURN pts
Blue/green wounds
Grape odor
What skin/ST infection is common and caused by pseudomonas? Treat?
Hot tub folliculitis
No antimicrobials needed
Which oro-maxo-facial infections can be caused by pseudo?
Eye - contact lens solution
OTITIS EXTERNA - think dirty hot tubs
How do you treat otitis externa?
Ciprofloxacin drops
Acinetobacter baumanii
- GN/GP
- Shape
- Motile?
- O2 enviro
- Lactose fermentation?
- Oxidase +/-
GN Coccobacillus Non-motile Aerobic NO lactose fermentation Oxidase NEG - differentiation from pseudo!!!
Where is acinetobacter found?
Water & soil
- CAPSULE
Normal skin, RT, GI colonizer
What types of infections does acinetobacter cause?
NOSOCOMIAL
Usually part of flora
The infections you need to think of for acinetobacter
VAP
CAUTI
Line infections –> bactermia
Wound infections
Treat acinetobacter
Broad GN coverage drugs: cephalo, carba, beta lactam + lactamase inhbitor, fluoro, aminoG, etx
What other GN rods might you seen in the ICU? Aka nosocomial?
Strenotrophomaonas
What is a GN bacteria that looks like pseudo and is most often seen in sickle cell pts?
Burkholderia
