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JL Musculoskeletal > Microbiology > Flashcards

Microbiology Flashcards

1
Q

Name four underlying risk factors for bone joint infection (BJI)?

A
  1. Implants
  2. Immunosuppressed
  3. Diabetes
  4. IVDU
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2
Q

Name three bacterium causing prosthetic-joint infection?

A
  1. CoNS, S. aureus
  2. Streptococcus spp.
  3. Propionibacterium acnes
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3
Q

Name two organisms causing septic arthritis?

A

S. aureus

Streptococci

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4
Q

Name three organisms causing post-traumatic infection?

A
  1. S.aureus
  2. Polymicrobial coliforms
  3. Pseudomonas
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5
Q

Name four organisms causing vertebral osteomyelitis?

A
  1. S.aureus
  2. Coliforms
  3. Streptococcus spp.
  4. Mycobacterium tuberculosis
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6
Q

Name 4 organisms causing diabetic foot infection?

A
  1. S.aureus
  2. Streptococcus spp.
  3. Coliforms, pseudomonas
  4. Anaerobes
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7
Q

What is the most common causative pathogen of osteomyelitis?

A

S. aureus

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8
Q

What bacterium should you consider in children with BJI?

A

Kingella in children

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9
Q

What are teh clinical presentations of acute BJIs?

A

Signs of infection - temperature, systemic sign, pain swelling redness over area and reduced motility of joint

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10
Q

What is the criteria for diagnosing systemic inflammatory response syndrome? (SIRS)

A

Two or more of:

  • temperature >38 or 90
  • RR > 20 or PaCO2 12000 or
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11
Q

What is the term for infection of joint space?

A

Septic arthritis

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12
Q

What are the three ways organisms are introduced in septic arthritis?

A
  1. Haematogenous spread
  2. Contiguous spread
  3. Direct inoculation
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13
Q

How to diagnose acute septic arthritis?

A
  1. Blood culture if pyrexial
  2. CRP, FBC etc
  3. Joint fluid aspirate
  4. Crystals white cells and gram stain
  5. Ultrasound scan
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14
Q

What is the emperic treatment for septic arthritis in children

A

Flucloxacillin and ceftriaxone for 2-4 weeks

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15
Q

What is the term for inflammation of bone and medullary cavity, usually in long bones or vertebrae?

A

Osteomyelitis

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16
Q

In acute osteomyelitis what will the two organisms likely be>

A

Staph aureus MSSA

Streptococci

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17
Q

In chronic osteomyelitis what might the organisms be?

A

M. tuberculosis, pseudomonas aeruginosa, salmonella, brucella, coliforms

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18
Q

What are the four methods of spread in osteomyelitis?

A
  1. Haematogenous
  2. Contiguous
  3. Peripheral vascular disease
  4. Prosthesis associated - prostehtic joint
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19
Q

What is the incubation for acute osteomyelitis?

A

Few days -

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20
Q

Why are infants more at risk of septic arthritis?

A

Due to vessels crossing metaphysis to epiphysis

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21
Q

In chronic osteomyelitis should you use antibiotics immediatly?

A

No - wait for specimens from culture

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22
Q

What is the treatment for osteomyelitits?

A
  1. Blood culture if pyrexial
  2. Bone biopsy
  3. Empiric high dose flucloxacillin 4-8 weeks
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23
Q

What are the four risk factors for infection in prosthetic joints?

A
  1. Rheumatoid arthritis
  2. Diabetes
  3. Malnutrition
  4. Obesity
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24
Q

What is the implant infection at 0-3 months?

A

Early postoperative

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25
What is the implant infection at 3-24 months?
Delayed (low grade)
26
What is the implant infection at >24 months?
Late
27
In CoNs and PJI what is there a presence of?
Biofilm
28
What culture should be done in PJI diagnosis?
Tissue and bone
29
Give two treatments for PJI?
Removal of prosthesis and cement | Re-implantation of joint after antibiotic treatment
30
What is uncommon but an acute or severe infection of the subcutaneous soft tissues?
Necrotising fasciitis
31
What are the common areas of necrotising fasciitis?
Limbs, abdominal wall, perineal and groin area and post-operative wound
32
What are three clinical clues for necrotising faasciitis?
1. Highly painful with signs of inflammation 2. Spread through tissues rapidly 3. Systemic toxiciy
33
Agony with no visible signs - pain disproportionate to superficial appearances?
Necrotising fasciitis
34
What is type I necrotising fasciitis
Anerobes plus multiple other bacteria "synergistic gangrene"
35
What is type II necrotising fasciitis?
Flesh-eating bacteria - group A streptococcus
36
What is the main treatment for necrotising fasciitis?
Surgical debridement
37
What antibiotics are used to treat strep pyogenes in necrotising fasciitis?
Penicillin + clindamycin
38
What class of antibiotics kills actively multiplying bacteria in exponential growth phase?
Penicillin
39
What antibiotic stops bacterial protein production and switches off bacterial toxin?
Clindamycin
40
Name three antibiotics used for synergistic necrotising fassciitis?
Pip-taz, clindamycin and gentamicin
41
Name the organism in Gas Gangrene?
Clostridium perfringens (part of normal bowel flora), gram positive strictly anaerobic rods
42
What is produced by clostridium perfringens in gas gangrene?
Spores
43
What is the pathogenesis of gas gangrene?
Spores germinate and accumulation of gas bubbles in tissues space gas gangrene crepitus occurs
44
What is the three step treatment for gas gangrene?
1. Urgent debridement 2. Antibiotics high dose - penecillin, metronidazole 3. Hyperbaric oxygen
45
What disease is characterised by Clostridium tetani, gram positive stricly anaerobic rods and spores found in soil, garden and animal bites?
Tetanus
46
What does the neurotoxin cause in tetanus?
Spastic paralysis
47
What is the incubation for tetanus?
4 days to several weeks
48
What disease is lock jaw found in?
Tetanus
49
What are the treatment steps for tetanus?
1. Surgical debridement 2. Antitoxin 3. Penicillin + metronidazole 4. Booster vaccination toxoid
50
In BJI staph what is used instead of flucloxacillin if pen allaergic?
Vancomycin
51
In BJI what is clindamycin used for?
Antitoxin properties (PVL, group A strep), penetration into tissue
52
Name a few antibiotics used for coliforms in BJI?
Gentamicin Cephalosporin like ceftriaxone Sometimes ciprofloxacin oral
53
In infections of implanted devices what, produced by bacteria, allows microorganisms to proliferate in a hostile environment?
Biofilm - slime (protein + polysaccharide)
54
What is the route for early postoperative and delayed (late) implant infection?
Perioperative
55
What is hte route for late implant infection?
Haematogenous
56
Name three organisms in early postoperative implant infection?
Staph aureus Streptococci Enterococci
57
Name two organisms in delayed (late) implant infection?
Coagulase negative staphylococci | P.acnes
58
Name two organisms in the late implant infection stage?
S.aureus and E.coli
59
Bacteria in abscesses or biofilms are phenotypically resistnat to what>
Antibiotics
60
Name three antibiotics given for PJI gram positive bacteria?
Flucloxacillin Vancomycin Teicoplanin
61
Name four antibiotics given for PJI gram negative bacteria?
Clotrimazole Amoxicillin Ciprofloxacin Ceftriaxone
62
What is the duration treatment for knee PJI?
6 months
63
What is the duration for hip PJI?
3 months
64
How to image the response of PJI?
MRI or CT

JL Musculoskeletal (35 decks)

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