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Year 2- Infectious Disease > Staph. Aureus Bacteraemias > Flashcards

Staph. Aureus Bacteraemias Flashcards

1
Q

What type of bacteria is Staph Aureus?

A

Gram positive cocci

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2
Q

Which bacteria is the most virulent* within the staphylococcal species?

*harmful

A

Staph Aureus

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3
Q

How can S.aureus survive in the body?

A

Has an environment resistant peptidoglycan wall surrounded by a microcapsule
Produce a range of surface proteins involved in host colonisation, tissue invasion and also produce toxins

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4
Q

Which toxins can S.Aurues produce?

A

Cytolytic toxins
Exfoliative toxins
Enterotoxins
TSST-1

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5
Q

What do cytotoxins do?

A

Break down neutrophils releasing lysosomal enzymes in surrounding tissues

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6
Q

What is Staphylococcal scaled skin syndrome?

A

A condition which is mediated by exfoliative toxins and characterised by exfoliative dermatitis

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7
Q

Which symptoms are enterotoxins usually related to?

A

GI symptoms

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8
Q

Which type of staphylococcal toxins is associated commonly with food poisoning?

A

Enterotoxins

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9
Q

Which type of toxin is associated with toxic shock syndrome?

A

TSST-1

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10
Q

Staph aureus is found in healthy humans as well, it makes up a part of the gut flora.
In which patient is the rate of colonisation higher?

A

In patients with:
-Insulin-dependant diabetes
-HIV
-Haemodialysis
-Skin damage

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11
Q

Which part of the body is the most frequent site of colonisation?

A

Anterior nares (nose)

->skin, vagina, axilla, perineum and oropharynx may also be colonised

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12
Q

What are the different classifications of S.Aurues blood stream infections?

A

Healthcare or community associated
Primary or secondary infections

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13
Q

Which bone related infections is S.Aureus responsible for?

A

Osteomyelitis
Septic arthritis
Discitis

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14
Q

Which skin related infections is S.Aureus responsible for?

A

Deep-seated abscesses
Necrotising fasciitis
Pyomyositis

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15
Q

Which cardio related infections is S.Aureus responsible for?

A

Infective endocarditis

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16
Q

Which lung related infections is S.Aureus responsible for?

A

Pneumonia
Empyema

17
Q

Approximately 1/3 of patients with staph aureus bacteremia develop local complications or distant metastatic complications.

Where are some of the frequent sites of distant metastases?

A

Bones and joints, especially where prosthetic materials are present
Epidural space and IV discs
Native and prosthetic cardiac valves, cardiac devices
Visceral abscesses in spleen, kidneys and lung

18
Q

Which investigations are used to investigate S.Aureus infections?

A

Microscopy and culture of specimens
Biospy samples for bone infections
XR, CT, MRI depending on issue
Transthoracic ECHO

19
Q

What is important to note about blood cultures?

A

Multiple required before commencing antibiotic therapy

Recommended to repeat cultures 48-72hrs after commencing antimicrobial therapy

20
Q

Which imaging is bets for bone infections like osteomyelitis?

A

Xray

21
Q

Which imaging is best to look for abscesses?

A

CT

22
Q

Which imaging is best for looking for any spine infections?

A

MRI

23
Q

What is the management of S.Aureus infections?

A

Antibiotic therapy
Source identification and clearance
Any appropriate surgical intervention

24
Q

Okayyyy…antibiotic management xx

What is the minimum duration of treatment of flucloxacillin for an uncomplicated S.Aureus infection?

A

14 days

25
Q

Okayyyy…antibiotic management xx

Why is Vancomycin a poor choice of antibiotic for S.Aureus infection?

A

Poor tissue penetration
Slow bactericidal activity
Inconvenient administration
Adverse side effects

26
Q

Okayyyy…antibiotic management xx

What are the advantages of Telcoplanin in S.Aureus infections?

A

Single daily dosing

27
Q

Okayyyy…antibiotic management xx

What are the advantages of Linezolid in S.Aureus infections?

A

Good penetration into bone
Very good oral bioavailability

28
Q

Okayyyy…antibiotic management xx

What are the advantages of Daptomycin in S.Aureus infections?

A

Well tolerated
Once daily dosing

29
Q

First thing to do when choosing which antibiotics to use if determining if the S.Aureus is methicillin resistant (MSSA/MRSA).

What is the first line treatment for a MSSA S.Aureus infection?

A

Flucloxacillin

30
Q

First thing to do when choosing which antibiotics to use if determining if the S.Aureus is methicillin resistant (MSSA/MRSA).

What is the first line treatment for a MRSA S.Aureus infection?

A

Any other antibiotic previously mentioned e.g. Vancomycin, Telcoplanin, Linezolid, Daptomycin

31
Q

For S.Aureus bacteremia, what is the treatment duration?

A

14 days, IV antibiotics

32
Q

If patient has a penicillin allergy, flucloxacillin cannot be used. What is the alternative?

A

Vancomycin

33
Q

Why is Daptomycin not suitable for lung infections?

A

It is inactivated by pulmonary surfactant in the lungs

34
Q
A

Year 2- Infectious Disease (12 decks)

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