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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
Q

What is the implant infection at 3-24 months?

A

Delayed (low grade)

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26
Q

What is the implant infection at >24 months?

A

Late

27
Q

In CoNs and PJI what is there a presence of?

A

Biofilm

28
Q

What culture should be done in PJI diagnosis?

A

Tissue and bone

29
Q

Give two treatments for PJI?

A

Removal of prosthesis and cement

Re-implantation of joint after antibiotic treatment

30
Q

What is uncommon but an acute or severe infection of the subcutaneous soft tissues?

A

Necrotising fasciitis

31
Q

What are the common areas of necrotising fasciitis?

A

Limbs, abdominal wall, perineal and groin area and post-operative wound

32
Q

What are three clinical clues for necrotising faasciitis?

A
  1. Highly painful with signs of inflammation
  2. Spread through tissues rapidly
  3. Systemic toxiciy
33
Q

Agony with no visible signs - pain disproportionate to superficial appearances?

A

Necrotising fasciitis

34
Q

What is type I necrotising fasciitis

A

Anerobes plus multiple other bacteria “synergistic gangrene”

35
Q

What is type II necrotising fasciitis?

A

Flesh-eating bacteria - group A streptococcus

36
Q

What is the main treatment for necrotising fasciitis?

A

Surgical debridement

37
Q

What antibiotics are used to treat strep pyogenes in necrotising fasciitis?

A

Penicillin + clindamycin

38
Q

What class of antibiotics kills actively multiplying bacteria in exponential growth phase?

A

Penicillin

39
Q

What antibiotic stops bacterial protein production and switches off bacterial toxin?

A

Clindamycin

40
Q

Name three antibiotics used for synergistic necrotising fassciitis?

A

Pip-taz, clindamycin and gentamicin

41
Q

Name the organism in Gas Gangrene?

A

Clostridium perfringens (part of normal bowel flora), gram positive strictly anaerobic rods

42
Q

What is produced by clostridium perfringens in gas gangrene?

A

Spores

43
Q

What is the pathogenesis of gas gangrene?

A

Spores germinate and accumulation of gas bubbles in tissues space gas gangrene crepitus occurs

44
Q

What is the three step treatment for gas gangrene?

A
  1. Urgent debridement
  2. Antibiotics high dose - penecillin, metronidazole
  3. Hyperbaric oxygen
45
Q

What disease is characterised by Clostridium tetani, gram positive stricly anaerobic rods and spores found in soil, garden and animal bites?

A

Tetanus

46
Q

What does the neurotoxin cause in tetanus?

A

Spastic paralysis

47
Q

What is the incubation for tetanus?

A

4 days to several weeks

48
Q

What disease is lock jaw found in?

A

Tetanus

49
Q

What are the treatment steps for tetanus?

A
  1. Surgical debridement
  2. Antitoxin
  3. Penicillin + metronidazole
  4. Booster vaccination toxoid
50
Q

In BJI staph what is used instead of flucloxacillin if pen allaergic?

A

Vancomycin

51
Q

In BJI what is clindamycin used for?

A

Antitoxin properties (PVL, group A strep), penetration into tissue

52
Q

Name a few antibiotics used for coliforms in BJI?

A

Gentamicin
Cephalosporin like ceftriaxone
Sometimes ciprofloxacin oral

53
Q

In infections of implanted devices what, produced by bacteria, allows microorganisms to proliferate in a hostile environment?

A

Biofilm - slime (protein + polysaccharide)

54
Q

What is the route for early postoperative and delayed (late) implant infection?

A

Perioperative

55
Q

What is hte route for late implant infection?

A

Haematogenous

56
Q

Name three organisms in early postoperative implant infection?

A

Staph aureus
Streptococci
Enterococci

57
Q

Name two organisms in delayed (late) implant infection?

A

Coagulase negative staphylococci

P.acnes

58
Q

Name two organisms in the late implant infection stage?

A

S.aureus and E.coli

59
Q

Bacteria in abscesses or biofilms are phenotypically resistnat to what>

A

Antibiotics

60
Q

Name three antibiotics given for PJI gram positive bacteria?

A

Flucloxacillin
Vancomycin
Teicoplanin

61
Q

Name four antibiotics given for PJI gram negative bacteria?

A

Clotrimazole
Amoxicillin
Ciprofloxacin
Ceftriaxone

62
Q

What is the duration treatment for knee PJI?

A

6 months

63
Q

What is the duration for hip PJI?

A

3 months

64
Q

How to image the response of PJI?

A

MRI or CT

JL Musculoskeletal (35 decks)

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