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Pharmacy Year 2 Semester 2 > Staphlylococcus aureus - infections in practice > Flashcards

Staphlylococcus aureus - infections in practice Flashcards

1
Q

Microbiology of S.aureus

A
  • Gram positive
  • spherical, non-motile bacterium
  • size: circa 1um in diameter
  • yellow/golden colour - aureus=gold
  • colonises skin, nasal passages and GIT
  • Normal human flora, but can cause suppurative (pus-forming) infections
  • Transmission: air borne, human contact, infected surfaces
  • PVL-associated S.aureus
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2
Q

Growth of Staphylococcus aureus

A
  • aerobic respiration or facultative anaerobe
  • binary cell division reproduction
  • staphylococcus - “bunch of grapes” - shape
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3
Q

Produces

A

-coagulase - used as a marker, also a virulence factor that confers resistance to phagocytosis

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4
Q

MRSA

A

Meticillin-resistant Staphylococcus aureus

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5
Q

MSSA

A

Meticillin-sensitive Staphylococcus aureus

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6
Q

Resistance

A

Strains of Staph a. emerging resistant to meticillin and related beta-lactams
MRSA also resistant to other antimicrobials

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7
Q

HA-MRSA

Patients groups affected

A

Hospital-acquired MRSA
->60s
-some contract infection after hospital admission and procedures (HAIs)
-immunocompromised, dialysis patients
-patients undergoing invasive medical procedures
-infection sources are colonised assymptomatic patients
Transmission
-healthcare providers
-patients

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8
Q

CA-MRSA

patient groups affected

A
  • Community-acquired MRSA
  • younger, otherwise healthy patients

Transmission:

  • patient already colonised
  • events (trauma/cuts) leads to soft tissue and skin infections
  • spread within patient faster
  • strains more virulent
  • may lead to more severe illness
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9
Q

3 types of S.aureus infection

A

Skin

  • mucosal membrane infections
  • pimples, boils
  • leg ulcers
  • pressure sores
  • cellulitis
  • wound infection
  • slapped cheek syndrome
  • necrotising fasciitis (rare)

Invasive

  • Surgical wound infection
  • UTIs
  • septicaemia
  • pneumonia, endocarditis
  • osteomyletis
  • septic arthritis
  • menginitis

Other

  • Food poisoning
  • Toxic Shock Syndrome (TSS)
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10
Q

Conjunctivitis
Causes
Who does it affect?

A 
S.aureus - chronic/recurrent cases
Also
-Streptococci
-chlamydia
-gonorrhoea
-viruses 
-allergic conjunctivitis 
Affects
-young, old, diabetes, immunocompromised
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11
Q

Conjunctivitis symptoms+signs

A
  • grittiness
  • itching
  • discharge
  • pink eye
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12
Q

Conjunctivitis complications

A
  • scarring

- secondary systemic infection

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13
Q

Conjunctivitis treatment

A
  • self limiting within 1-2 weeks
  • chloramphenicol drops -2hourly/QDS
  • chloramphenicol ointment QDS
  • fusidic acid gel - BD
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14
Q

Pharmacist’s role and public health role in Conjunctivitis

A 
Role
-OTC sales of chloramphenicol
-POM to P switch
-PGD - Chloramphenicol/fusidic acid in minor ailment scheme or pharmacy first scheme 
Public health role
-regular hand washing/drying
-good eye care, no contact lens use
-towels/pillows/make-up applicators - beware!
-HPA factsheet on conjunctivitis
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15
Q

Impetigo

1) Causes
2) Types
3) Epidemiology

A

1) Staphylococcus aureus, Streptococcus pneumoniae

2) Primary - infection caused by infecting a cut/bite/graze
Secondary - where an underlying skin condition exist

3) Summer months
- Teenagers, children, diabetics, immunocompromised
- schools, nurseries, army barracks, contact sports

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16
Q

Signs and symptoms of impetigo

A
  • bullous - affecting trunk, arms legs with large blisters

- non-bullous - accounts for 70% of infections, itchy sores with yellow-brown crusts around nose and mouth

17
Q

Complications of impetigo

A
  • lymphangitis
  • cellulitis
  • guttate psoriasis
  • scarlet fever
  • septicaemia
18
Q

Treatments for impetigo

A

-self limiting within 2-3 weeks
-fuscidic acid cream TDS/QDS
-Mupirocin ointment TDS (MRSA)
-Oral flucloxacillin QDS
-Oral eryhtromycin QDS
(antibiotic doses above are as per BNF)

19
Q

Pharmacist’s role and public health role in impetigo

A

Role

  • differential diagnosis
  • GP referral
  • PGD - minor ailment scheme

Public health Role

  • regular hand washing before/after treating
  • short nails
  • towels washed and food preparation
  • school nursery isolation, broken skin condition
  • HPA advice
20
Q

Device-related infections
causes
epidemiology

A

S.aureus (including MRS) introduced to the body via surgical opening
-surgical patients, hospitalised patients with IV lines
patients in community with long-term IV or urinary catheter, chemotherapy patients

21
Q

Devices at risk of MRSA

A
  • vascular or urinary catheters
  • tracheostomy tubes
  • feeding tubes
  • CNS shunts
  • orthopaedic implants
22
Q

Signs and symptoms of device-related infections

A
  • redness, warmth, inflammation and pain at site
  • exudate at site
  • fever, malaise
  • tachycardia
23
Q

Complications of device-related infections

A
  • endocarditis

- septicaemia

24
Q

Treatment of device-related infection

A

-removal of temporary device
-sometimes removal of infected tissue
IV antiboitic: 7-10 day course
-Flucloxacillin
-clarithromycin
-vancomycin
-rifampicin
-clindamycin
-linezolid

25
Q

Pharmacist roles in device-related infection

A
  • Infection control training for patients, carers, pharmacy staff, care home staff
  • counselling patients on prevention therapy/pre-screening
  • wards - patient identification and isolation - gloves and aprons when with MRSA infected/colonised patients
26
Q

pharmacist public health role in device-related infection

A
  • -hand washing policies and audit of these
  • strict sterile technique
  • sterile cleaning suppies
  • MRSA leaflets and public health campaigns
27
Q

Summary of S.aeurus

A
  • numerous and resistant strains make it more difficult to combat
  • commonly carried in nose and skin
  • multiple transmission methods and virulence factors
  • multiple infection sites in body
  • numerous medical conditions with varying degrees of severity

Pharmacy Year 2 Semester 2 (33 decks)

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