Staph infections

Question 1

Staph Gram + or -?

Answer 1

+

Question 2

Staph catalase + or -?

Answer 2

+

Question 3

Staph aureus coagluase + or -?

Answer 3

+

Question 4

Staph Epidermis coaglusase + or -?

Answer 4

-

Question 5

Staph aureus shows up how on blood agar?

Answer 5

Golden beta hemolytic colonies

Question 6

Coagulase - staph shows up how on blood agar?

Answer 6

Small white non hemolytic colonies

Question 7

Most virulent of staph species?

Answer 7

Staph aureus

Question 8

How do staph epidermis infections usually happen?

Answer 8

Prosthetic devices

Question 9

Is staph aureus part of normal flora?

Answer 9

Yes

Question 10

Rate of colonization of S. aureus greater in who?

Answer 10

Diabetes patient
HIV patient
Skin damage

Question 11

Diseases that cause increased risk for S. aureus?

Answer 11

Chronic granulomatous disease

Job’s/Chediak-Higashi syndrome

Question 12

Majority of MRSA cases are confined to where?

Answer 12

Skin and soft tissue (not that dangerous)

Question 13

Pyogenic organisms cause what?

Answer 13

Abscesses

Question 14

3 Toxins produced by Staph?

Answer 14

1) Cytotoxins
2) Pyogenic toxin superantigens
3) Exfoliative toxin

Question 15

Pyogenic toxin superantigens mediate what two problems?

Answer 15

Food borne illness

Staph toxic shock syndrome

Question 16

In staph food borne illness what gives the clue that it’s staph?

Answer 16

Symptoms in absence of viable bacteria

Question 17

Where is toxin produced in toxic shock syndrome?

Answer 17

Site of colonization

Question 18

IS there a staph vaccine?

Answer 18

No

Question 19

Are anti-staph antibodies beneficial?

Answer 19

Only in-vitro so far

Question 20

Infection of epidermis?

Answer 20

Impetigo

Question 21

Infection of superficial dermis?

Answer 21

Folliculitis

Question 22

Infection of deep dermis?

Answer 22

Carbuncles, furuncles, and abscess

Question 23

Pyomyositis?

Answer 23

Infection of skeletal muscle

Question 24

Cellulitis, erysipelas, and fascitisi?

Answer 24

Infection of subcutaneous tissue

Question 25

Hidradenitis suppurativa?

Answer 25

Follicular infection of intertriginous areas

Question 26

Staph sepsis usually produced by what?

Answer 26

Bacteremia

Question 27

Leading cause of community acquired and healthcare acquired bacteremia?

Answer 27

Staph

Question 28

3 categories of acquired zones?

Answer 28

1) Healthcare associated (nosocomial) 2) Community acquired 3) Healthcare associated community onset (long term care facility)

Question 29

Infective endocarditis causes what growths that destroy heart valves?

Answer 29

Vegetations

Question 30

How long for duration of therapy for uncomplicated infection?

Answer 30

14 days of IV therapy

Question 31

What is SIRS?

Answer 31

Systemic inflammatory response syndrome, clinical syndrome complicating a nonifectious insult

Question 32

What is septic shock?

Answer 32

Sepsis induced hypotension persisting despite adequate fluid resuscitation

Question 33

Frequency of pathogens?

Answer 33

Gram + > Gram - > Fungals

Question 34

To do list for septic patient?

Answer 34

Source of infection Check respiratory status Check perfusion Check end organ effects

Question 35

At what point is mortality establish as highest?

Answer 35

Septic shock

Question 36

Methicillin resistance medicated by?

Answer 36

PBP-2a (Penicillin binding protein encoded by mecA)

Question 37

Where is mega gene>

Answer 37

Mobile genetic element

Question 38

Big risk factor for MRSA?

Answer 38

Recent antibiotic therapy

Question 39

Which two antibiotics are especially correlated with MRSA?

Answer 39

Cephalosporin | Fluoroquinolone

Question 40

Which is higher? Death rates from hospital acquired MRSA or community acquired?

Answer 40

Hospital acquired

Question 41

When do MRSA infections show up in hospital acquired?

Answer 41

Healthcare acquired community onset

Question 42

Key interventions Billings Clinic used>

Answer 42

Hand hygiene Decontamination of environment Contact precautions Active surveillance cultures

Question 43

Next threat on the horizon in terms of resistant staph?

Answer 43

Vancomycin resistant S. aureus

Question 44

Staphylococcal scalded skin syndrome caused by?

Answer 44

Exfoliative toxin from Staph

Question 45

S. aureus meningitis most commonly occurs with what?

Answer 45

Head trauma | neurosurgery

Question 46

Abdominal pain in left upper quadrant is indicative of what in staph bacteremia?

Answer 46

Splenic abscess/infarction

Question 47

What do you give as treatment before blood cultures are back?

Answer 47

Empiric antibiotic therapy | Vancomycin

Question 48

If cultures come back as methicillin sensitive what do you give

Answer 48

Nafcillin Oxacillin Cefazolin Penicillinase resistant penicillin

Question 49

What do you give for meth resistant Staph?

Answer 49

Vancomycin

Question 50

Diagnostic criteria for SIRS?

Answer 50

``` Temp > 38 HR > 90 RR > 20 WBC >12k 10% immature bands SBP ```

Question 51

Vasodilatory shock?

Answer 51

Sepsis induced hypotension persisting despite adequate fluid resuscitation