Staph infections Flashcards
Staph Gram + or -?
+
Staph catalase + or -?
+
Staph aureus coagluase + or -?
+
Staph Epidermis coaglusase + or -?
-
Staph aureus shows up how on blood agar?
Golden beta hemolytic colonies
Coagulase - staph shows up how on blood agar?
Small white non hemolytic colonies
Most virulent of staph species?
Staph aureus
How do staph epidermis infections usually happen?
Prosthetic devices
Is staph aureus part of normal flora?
Yes
Rate of colonization of S. aureus greater in who?
Diabetes patient
HIV patient
Skin damage
Diseases that cause increased risk for S. aureus?
Chronic granulomatous disease
Job’s/Chediak-Higashi syndrome
Majority of MRSA cases are confined to where?
Skin and soft tissue (not that dangerous)
Pyogenic organisms cause what?
Abscesses
3 Toxins produced by Staph?
1) Cytotoxins
2) Pyogenic toxin superantigens
3) Exfoliative toxin
Pyogenic toxin superantigens mediate what two problems?
Food borne illness
Staph toxic shock syndrome
In staph food borne illness what gives the clue that it’s staph?
Symptoms in absence of viable bacteria
Where is toxin produced in toxic shock syndrome?
Site of colonization
IS there a staph vaccine?
No
Are anti-staph antibodies beneficial?
Only in-vitro so far
Infection of epidermis?
Impetigo
Infection of superficial dermis?
Folliculitis
Infection of deep dermis?
Carbuncles, furuncles, and abscess
Pyomyositis?
Infection of skeletal muscle
Cellulitis, erysipelas, and fascitisi?
Infection of subcutaneous tissue
Hidradenitis suppurativa?
Follicular infection of intertriginous areas
Staph sepsis usually produced by what?
Bacteremia
Leading cause of community acquired and healthcare acquired bacteremia?
Staph
3 categories of acquired zones?
1) Healthcare associated (nosocomial)
2) Community acquired
3) Healthcare associated community onset (long term care facility)
Infective endocarditis causes what growths that destroy heart valves?
Vegetations
How long for duration of therapy for uncomplicated infection?
14 days of IV therapy
What is SIRS?
Systemic inflammatory response syndrome, clinical syndrome complicating a nonifectious insult
What is septic shock?
Sepsis induced hypotension persisting despite adequate fluid resuscitation
Frequency of pathogens?
Gram + > Gram - > Fungals
To do list for septic patient?
Source of infection
Check respiratory status
Check perfusion
Check end organ effects
At what point is mortality establish as highest?
Septic shock
Methicillin resistance medicated by?
PBP-2a (Penicillin binding protein encoded by mecA)
Where is mega gene>
Mobile genetic element
Big risk factor for MRSA?
Recent antibiotic therapy
Which two antibiotics are especially correlated with MRSA?
Cephalosporin
Fluoroquinolone
Which is higher? Death rates from hospital acquired MRSA or community acquired?
Hospital acquired
When do MRSA infections show up in hospital acquired?
Healthcare acquired community onset
Key interventions Billings Clinic used>
Hand hygiene
Decontamination of environment
Contact precautions
Active surveillance cultures
Next threat on the horizon in terms of resistant staph?
Vancomycin resistant S. aureus
Staphylococcal scalded skin syndrome caused by?
Exfoliative toxin from Staph
S. aureus meningitis most commonly occurs with what?
Head trauma
neurosurgery
Abdominal pain in left upper quadrant is indicative of what in staph bacteremia?
Splenic abscess/infarction
What do you give as treatment before blood cultures are back?
Empiric antibiotic therapy
Vancomycin
If cultures come back as methicillin sensitive what do you give
Nafcillin
Oxacillin
Cefazolin
Penicillinase resistant penicillin
What do you give for meth resistant Staph?
Vancomycin
Diagnostic criteria for SIRS?
Temp > 38 HR > 90 RR > 20 WBC >12k 10% immature bands SBP
Vasodilatory shock?
Sepsis induced hypotension persisting despite adequate fluid resuscitation
