To Kill a Bug Flashcards
A pt presents w/an erythematous fluctuant area on her right bicep. She is dx with an abscess w/surrounding cellulitis. An I&D is done an wound cultured. What is next?
Prescribe an antibiotic and discharge home, check cultures in 48 hours
A preliminary report is reported the next day (pt with abscess). Gram + cocci in clusters. What is most likely organism?
Staphylococcus species
25 YO female present with dysuria, frequency and urgency. What is the best tx plan for her?
Initiate antibiotics based on the most likely offending organism
What are some common gram + cocci organisms?
Streptococcus, Staphylococcus, Enterococcus, Peptostreptococcus
What are some common gram + bacilli organisms?
Bacillus anthracis, Clostridium sp, Corynebacterium sp, Listeria sp
What are some common gram - cocci organisms?
N. gonorrhea, N. meningitides, Moraxella catarrhalis
What are some common gram - Lactose-fermentors?
Serratia sp, Enterobacter sp, E.coli, Klebsiella sp, Citrobacter sp
What are some common gram - Non-Lactose Fermentors?
Psuedomonas, Proteus, Shigella, Salmonella, Stenotrophomon, Campylobacter, Legionalla, Bacteroides, Yersinia, Acinetobacter
Which organism normally colonizes the skin, nares, and respiratory tract?
Staph aureus
Staph aureus can cause what?
Cellulitis, abscess, bone, joint, endocarditis
What else is a common bacteria on the skin?
Staph epidermidis
What organism is associated with prosthetic and device infections?
Staph epidermidis
Staph epidermidis can contaminate what?
Blood cultures
What are the two organisms that are alpha hemolytic?
Strep. pneumoniae, strep viridans
What are the two organisms that are beta hemolytic?
Group A hemolytic strep (pyogenes), Group B hemolytic strep
What are the two organisms that are gamma hemolytic?
Enterococcus, Peptostreptococcus
What is an example of an opportunistic pathogen?
Enterococcus. Effects immunocompromised, prolonged hospitalizations, etc.
Enterococcus commonly causes what type of infection?
Urinary tract
Enterococcus normally colonizes which part of the body?
Intestine
Which two Enterococcus species have increasing resistance (VRE)?
Faecalis and Faecium (Gram + chains)
What are the enteric gram negatives?
Enterobacteriaciae family
Which organisms are in the Enterobacteriaciae family?
E.coli, Proteus, Serratia, Acinetobacter, Citrobacter, Enterbacter, Salmonella, Klebsiella
Enteric gram negatives can cause what types of infections?
Community: UTI, abdominal infections
Hospital: Late Hospital Acquired or Ventilator assisted pneumonia, complicated UTI
What are the H-N-M organisms?
Gram - cocci, Haemophilus, Neisseria, Moraxella
Common infections of Haemophilus and Moraxella include what?
Upper and lower respiratory tract infections
Common infections of Neisseria are what?
Meningitis and STIs
What is a gram - non-lactose fermenting organism?
Pseudomonas Aeruginosa
Common infections with P. Aeruginosa
Wounds, osteomyelitis, corneal ulcer (contact lens), hot tub folliculitis, Late hospital acquired of healthcare associated pneumonia
What are some common gram + anaerobes?
Clostridium sp, Actinomyces, Lactobacillus, Propionibacterium, Peptostreptococcus
What are some common gram - anaerobes?
Bacteroides fragillis, Fusobcaterium, Porphyromonas, Veillonella
Anaerobes usually cause what types of infections?
Co-infections
Erysipelas is caused by which pathogen?
Beta-hemolytic strep (S.pyogenes)
Uncomplicated cellulitis is caused by which pathogens?
Beta-hemolytic streptococci and s. aureus
Furuncles, carbuncles, or abscess are caused by which pathogen?
S. Aureus including MRSA
Which 4 pathogens cause conjunctivits?
- S. aureus
- S. pneumoniae
- H. influenza
- M. catarrhalis
Throat infections are caused by which pathogens?
Group A beta-hemolytic streptococcus (S. pyogenes)
Mouth/tooth infections caused by which pathogens?
Streptococcal species, Peptosctreptococcus and other gram + anaerobes
Community acquired pneumonia is caused by which 4 pathogens?
SMCH (smooch)
- Streptococcus pneumonia
- Mycoplasma pneumonia
- Chlamydia pneumonia
- Haemophilus influenza
Empiric therapy
Antibiotics chosen prior to knowing identification and sensitivity of pathogen
Broad spectrum
Effective against a broad range of bacteria
De-escalation
Narrowing therapy from broad agents
Anti-microbial stewardship
Preserving broad-spectrum antibiotics, limit development of resistance
Opportunistic infection
An infection caused by an agent (bacteria, virus, fungi, protozoa) that is capable of causing disease only when the host’s resistance is lowered by a disease or drug
Nosocomial infection
An infection acquired in a hospital setting or health care facility
What is colonization?
Identification of an organism that normally grows in the organ system, NOT considered pathogenic in the context of the pts clinical picture
What is an example of colonization?
Lactobacillus found in a vaginal culture
What is contamination?
An unintended introduction of a bacterial organism that isn’t infectious
What is an example of a contamination?
Coagulase - staph species in a single set of blood cultures
What is an infection?
Invasion of a host by disease causing agents. Identification of a likely pathogen in a pt with symptoms consistent w/expected signs and symptoms of the disease
What is an example of an infection?
+ strep pyogenes throat culture in setting of exudates, odynophagia and erythema
6 examples of sterile sites
CSF, blood, peritoneum, synovial fluid, pleural fluid, urine
A female present with urinary symptoms, she has a culture which reports E.coli. Which does the organism most likely reflect?
Infection
20 YO female has a throat swab. It is + for strep pyognes. She is afebrile, w/out any symptoms. What is the most likely significance of this organism?
Colonization
All of the following are opportunistic pathogens except?
Enterobacteriaciae
Enterococcus, Pseudomonas, Clostridium Dificile
What are the SPACE organisms?
Serratia Pseudomonas Acinetobacter Citrobacter Enterobacter Klebsiella
Which drugs cause highest seizure risk?
Cefepime, Fluoroquinolones, Carbapenems
Which drugs are hepatotoxic?
Nafcillin, Oxacillin, Fluoroquinolones
What is and ADR with aminoglycosides?
Nephrotoxicity and ototoxicity
Which drugs frequently cause CDIFF
Clindamycin, ampicillin, amoxicillin, fluoroquinolones, cephalosporins
How to treat CDIFF
Metronidazole IV or PO; Vanco PO
