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Infection > S.aureus bacteraemia > Flashcards

S.aureus bacteraemia Flashcards

1
Q

What type of bacteria is staphylococci?

A

Gram positive cocci

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2
Q

What do clusters of staphylococci look like on gram stain?

A

Grape-like clusters

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3
Q

What is the most virulent of the staphylococcal species?

A

Staphylococcus aureus

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4
Q

Is staphylococcus aureus responsible for HAI or community based infections?

A

Both

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5
Q

S.aureus is part of the normal human flora: true or false?

A

True

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6
Q

S.aureus causes disease through which mechanisms?

A

Toxin-mediated

Non-toxin mediated

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7
Q

What percentage of healthy persons may be persistently or transiently colonised with S.aureus?

A

25-50%

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8
Q

Which patients are most at risk of colonisation of S.aureus?

A

Insulin-dependent diabetes
HIV infection
Patients undergoing haemodialysis
Patients with skin damage

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9
Q

Where is the most frequent site of S.aureus colonisation?

A

Anterior nares

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10
Q

Where are sites which S.aureus commonly colonises?

A 
Anterior nares
Skin
Vagina
Axilla
Perineum
Oropharynx
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11
Q

Why are colonisation sites of S.aureus important?

A

Serve as reservoir for future infections

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12
Q

Persons colonised with S.aureus are at greater risk of subsequent infection than uncolonised individuals: true or false?

A

True

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13
Q

How are S.aureus blood stream infections traditionally classified?

A

By environment of acquisition: healthcare associated or community acquired

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14
Q

With what type of infections is S.aureus the most commonly identified agent?

A

Skin and soft tissue infections

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15
Q

What is another word for a furcuncle?

A

A boil

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16
Q

What are furuncles and carbuncles?

A

Localised pyogenic staphylococcal infections

17
Q

What is a carbuncle?

A

A cluster of boils

18
Q

What type of infections in hospital may be caused by S.aureus?

A

Wound infection, vascular line, catheter-related infection

19
Q

What are frequent sites of distant metastases of S.aureus bacteraemia?

A

Bones and joints (esp prosthetics)
Epidural space and IV discs
Native and prosthetic cardiac valves/cardiac devices
Visceral abscesses in spleen, kidneys and lungs

20
Q

What investigations would you do for suspected S.aureus infections?

A

Microscopy and culture of specimens
Multiple blood cultures
Repeat blood cultures after commencing antimicrobial therapy
Biopsy samples (bone infections)
Imaging: X-ray, CT, MRI, radionuclide imaging
Transthoracic echocardiography, TOE

21
Q

What is the basis of treatment for invasive staphylococcal infections?

A

Antibiotic therapy
Source identification and clearance
Appropriate surgical intervention

22
Q

What has been associated with an increased risk of complications and higher mortality in S.aureus infections?

A

Delay in the administration of appropriate antibiotic therapy and persistent bacteraemia

23
Q

What antibiotics are indicated for S.aureus infections?

A 
Flucloxacillin
Vancomycin
Teicoplanin
Linezolid
Daptomycin
24
Q

What is the minimum duration of treatment for uncomplicated S.aureus bacteraemia with flucloxacillin?

A

14 days

25
Q

Why is vancomycin not the ideal drug to use for a sensitive S.aureus infection?

A

Poor tissue penetration, slow bactericidal activity, inconvenient administration and side effects

26
Q

Why is teicoplanin a good antibiotic for S.aureus infections?

A

Single daily dosing and use three times weekly after appropriate loading

27
Q

Why is linezolid a good antibiotic for S.aureus infections?

A

Bacteriostatic, synthetic oxazolidinone, good penetration into bone and excellent oral bioavailability

28
Q

Why is daptomycin a good antibiotic for S.aureus infections?

A

Rapid bactericidal activity against S.aureus, well tolerated, once daily dosing

29
Q

What is the first line treatment for MSSA?

A

Flucloxacillin

30
Q

What type of administration is flucloxacillin for S.aureus infection?

A

IV

31
Q

What is the first line treatment for MRSA?

A

Vancomycin

32
Q

47yr old lady IVDU, 5 day history fever, cough, SOB. Painful swollen right groin. Alert and orientated. 90% O2 on air. Pyrexial at 38.5C. BP 110/60. 110HR. 32RR.
Bloods: WCC 31.9, urea 8
Doppler US DVT? infected right leg

What organism likely to be responsible for CXR findings?
Antibiotics commence on?

A

Staph aureus

IV flucloxacillin

33
Q

Blood cultures positive for S.aureus. 2wks therapy, ongoing cough, fever, right sided chest discomfort and right groin pain/discharge.
Bloods: WCC 18, CRP 210

Which investigations?
What does CXR show?

A

ECHO
CXR
Repeat blood cultures
US groin

Post-pneumonic effusion

Infection (13 decks)

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