Paediatric Microbiology Flashcards
How does microbiology help?
Make a diagnosis (infective)
Treat appropriately (empirical)
Interpret results appropriately (“focus”)
Minimise inappropriate antibiotics
Minimise healthcare-care acquired infection
Patient has these symptoms: 2 months old
Miserable
Temperature
Vomiting
Urine microscopy +
Admit
What do you think it is?
What culture do you think grew?
UTI
E. Coli
What do we give to help with E. Coli UTI to a child?
On IV cefuroxime
Rapid improvement
What other investigations are there for a child with E.Coli UTI?
Renal tract US
What are the SCH guidelines for UTI in neonates and infants?
UTI in neonates, infants, acutely ill, suspected pyelonephritis or vomiting
First line treatment is IV cefuroxime for 7 days
Oral switch trimethoprim but may need full course IV
NB REFER TO SENSITIVITIES on ICE report
What would you think happened to this patient with these symptoms? What do you think grew?
2 year-old
Complex medical history
Pyrexia
Increase fits
Admitted
Urine for MC&S
IV antibiotics
UTI
Culture result after 24hrs shows E.Coli
Patient with this history: 2 year-old
Complex medical history
Pyrexia
Increase fits
Admitted
Urine for MC&S
IV antibiotics
Still feels unwell after IV cefuroxime
What should you do?
Should we change treatment?
What to?
Do a sensitivity result after 48 hours
E coli
Extended spectrum ß-lactamase producer (ESBL)
Resistant to all penicillins and cephalosporins
Change to meropenem
Patient has these symptoms
10 year old girl
Ankle pain
Lethargy
A&E
X-ray = ?
What do you think the X-ray shows?
Osteomyelitis
The blood culture in a girl with osteomyelitis shows gram- positive cocci in clumps not chains - what is it?
SA
Normal flora
Virulent invader
Toxins
Enzymes
Beware MRSA!
What are the SCH guidelines for osteomyelitis/ septic arthritis?
First line:
IV Cefuroxime
Liaise with Microbiologist
Treat for (minimum) six weeks
IV > PO switch
Long term therapy: ?OPAT
SA - what should we do with it in osteomyelitis and septic arthritis?
Staphylococcus aureus
Sensitive to flucloxacillin
Oral switch once responding
Patient has these symptoms:
Sick seven year old
Temperature
Semi-comatose
Purple rash on skin
What is the likely diagnosis?
Treatment?
Inv?
Bacterial meningitis or meningococcal sepsis
First line intravenous cefotaxime
Blood Cultures
EDTA blood for PCR
CSF (?delay)
DON’T DELAY START OF TREATMENT
What is Neisseria meningitidis sensitive to?
Cefotaxime
Ceftriaxone
What do we give notifications about to the local Health Protection Unit (PHE)
All meningitis
All invasive meningococcal
All encephalitis
24/7
What is used for prophylaxis is meningitis, invasive meningococcal and encephalitis?
Ciprofloxacin or Rifampicin (oral)
