Sepsis CLASP week Flashcards
What gram positive organisms do not take up the gram stain and look pink/red?
Neisseria gonorrhoeae
What is the cell wall of gram positive organisms made of?
peptidoglycan layer and plasma membrane
What organism is present when the catalase is positive or negative?
+ve = staphylococcus
-ve = streptococcus, enterococcus
How is staphylococcus differentiated with coagulase?
+ve = s. aureus
-ve = s. epidermis
How is streptococcus differentiated with haemolysis?
alpha (partial) = s. virdians, s. pneumoniae
beta (complete) = group a strep, s. pyogenes
What drug is usually given for s. aureus sepsis?
IV fluclox.
IV vancomycin if allergic / MRSA sepsis
What are staph negative bugs resistant to?
Flucloxacillin
Where does streptococci not cause problems and why?
In the GI tract because it is a commensal bacteria.
What organism is indicated in gamma haemolysis?
enterococci
What bacteria is most likely to cause endocarditis and what scoring system is used?
S. viridans - Duke’s criteria
What illnesses does strep. pneumonia cause?
Otitis, meningitis, pneumonia
Where does enterococcus cause problems?
In the intestines
What is the drug of choice for enterococcus?
amoxicillin - vancomycin if allergic
What are the 4 categories for gram positive bacilli?
~ clostridium
~ corynebacterium
~ bacillus
~ listeria
What are some serious gram negative bacteria which cause sepsis?
- E. Coli
- Pseudomonas aeruginosa
- Neisseria meningitidis
- N. gonorrhoeae
What is unique about gram negative bacteria?
~ the outer membrane of the cell wall contains endotoxin
~ the periplasmic space which is the b-lactamase location
What bacteria causes neonatal meningitis?
E. coli
What needs to be monitored daily on gentamicin (only given IV)?
Renal function
What antibiotic is used for MRSA?
vancomycin
Why is C. diff hard to treat?
Spore formation which makes them resistant.
What are specific SE of penicillins?
hypersensitivity / skin reactions
Which antibiotics cause c. diff?
co-amoxiclav, cephalosporin, clindamycin, ciprofloxacin
What are SE of macrolides (e.g. erythromycin, clarithromycin, azithromycin)?
GI disturbance, hepatitis, QT interval?
What are SE of aminoglycosides (e.g. gentamicin)?
nephrotoxicity, ototoxicity
What is a SE of chloramphenicol?
aplastic anaemia
What are SE of tetracyclines (e.g. doxycycline)?
hepatotoxicity, staining teeth, photosensitivity, dysphagia
What is a SE of nitrofurantoin?
peripheral neuropathy, pulmonary fibrosis, teratogenic in the third trimester
How do antibiotics affect the pill?
GI upset - reduces absorption of pill
What drugs have sick day rules?
ACEI/ARB, diuretics, metformin, NSAIDs
