Term
| Biofilm-associated infections |
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Definition
intravenous catheter infections
urinary catheter infections
Device/implant infections
**Pacemakers/VADs
**prosthetic joints |
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Term
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Definition
| sophisticated communities of matrix-encased surface attached bacteria |
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Term
| What do hydrated structyres with water channels allow. |
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Definition
| Allow nutrients and o2 difussions |
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Term
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Definition
non-microbial host-derived componenets- platlets
cell-to-cell communication of molecules
dense matrix of polysccharides
bacterial proteins (adhesins) and virulence factors |
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Term
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Definition
| Nope, they are rough in nature |
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Term
| How are ways that you can deliver antimicrobials to the site of infection? |
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Definition
oral therapy
intravenous therapy
material design: embedding/coating device with antimicrobials
localized therapy
**topical antiseptics
**antimicrobial beads, spacers, and cements |
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Term
| What is the infectious diseases society of america 10X 20 initiative? |
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Definition
Pursuing a gloabl commitment to develop 10 new antimicrobial drugs by 2020
* this isn't going too well, only 2 new antibiotics are going to be approved |
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Term
| Limited targets for antimicrobials |
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Definition
cell wall synthesis
protein synthesis
DNA synthesis
anti-metabolites |
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Term
| Clinical implications of bacterial biofilms |
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Definition
Attachment and growth of bacterial communities
involved in prosthetic and catheter relation infections
common staphylococci pseudomonas spp, many others
biofilm microbes are 10-1000 X less susceptible to antimicrobials |
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Term
| Which organisms can form biofilms? |
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Definition
almost any organism will form biofilms under the right condition!
epidemiology is based on access/patient |
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Term
| Why are US hospitals now mandated to report Catheter related infections? |
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Definition
| the big idea is to prevent these events from occuring! |
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Term
| What are the two foci of preventative strategies for intravascular catheter-related infections? |
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Definition
catheter insertion site
catheter hub |
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Term
| CDC's steps to prevent resistance |
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Definition
1. vaccinate
2. remove vatheters
3. target pathogen
4. access experts
5. animicrobial control
6. use local data
7. treat infection not contamination/colonization
8. know when to say no
9. stop treatment
10. Isolate pathogen
11. break chain of contagion |
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Term
| What are treatment approaches of CRBSI?? |
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Definition
1) prevention- infection control practices, topical antiseptics, antibiotics coated devices
2) systemic and local therapy- intravenous therapy, antibiotic locks and washes. |
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Term
| what are the 2011 guidelines for the prevention of intravascular catheter-related infections |
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Definition
| 1) education and training health-care providers who insert and maintain catheters. 2) using maximal sterile barrier precautions during central venous catheter insertion 3) using a 2% chlorhedine preparation for skin antisepsis 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (education and training, max sterile barrier precauations, and 2% chlorhexidine for skin antisepsis) |
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Term
| what are 2009 guidelines for the treatment of invascular catheter-related infections |
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Definition
1) when denoting duration of antimicrobial therapy day 1 is the first day on which negative blood culture results are obtained
2) vancomycin is recommended of empirical therapy in health care settings which is an elevated prevalence of methicillin-resistant staphylococcus aureus (MRSA) for institutions in which the preponderance of MRSA isolates have vancomycin minimum inhibitory concentration(MIC) values > 2micrograms/ml alternative agents, such as daptomycin, should be used
3) linezolid should not be used for empirical therapy (ie for patients suspected but not proven to be CRBSI) |
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Term
| 2009 guidelines: non gram-positive isolates |
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Definition
1) empirical coverage for gram-negative bacilli should be based on local antimicrobial susceptibility data and the severity of disease (eg a fourth generation cephalosporin, carbapenem or beta lactam beta lactamase combination, with or without aminoglycoside)
2) in addition to coverage for gram-positive pathogens, empirical therapy for suspected CRBSI involving femoral catheters in critically ill patients should include coverage for gram-negative bacilli and candida species) fa |
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Term
| Why should an antibiotic lock therapy should be used? |
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Definition
| for cather salvage(B-LL);however if antibiotitc lock therapy cannot be used in this situation, systemic antibiotics should be administered through the colonized catheter. |
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Term
| Formulations of antibiotic lock solutions |
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Definition
| 1)ethanol, 2)anticoagulants (compatitbility vs biofilm proliferation- heparin, sodium citrate, ethylenediaminetertraacetate- EDTA)3) dose- often multiple times the level of organism susceptibility, 4) dwell time and stability, 5) preparation praticality for pharmacy. |
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Term
| Antimicrobial-coated catheters (Pros vs cons) |
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Definition
| Pros- reduced risk of infection, short term bridge for treatment. Cons- increased costs, local reactions, lack of long term success, resistance potential (chlorhexidine/silver sulfadiazine, minocycline/rifampin, platinum/silver, silver cuffs) |
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Term
| What are the 3 most common organisms in a urinary catheter infection? |
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Definition
| candida albicans, ecoli, entercoccus spp |
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Term
| What is the most common type of healthcare associated infection? |
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Definition
| Catheter administrated UTI |
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Term
| what is the hospital impact of CAUTI? |
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Definition
increased morbidity and mortality
excess length of stay (2-4 days)
increased cost
uncessary antimicrobial use |
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Term
| is routine use of systemic antimicrobial recommended? |
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Definition
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Term
| For recurrent disease, what kind of catheter should you use? |
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Definition
| antimicrobial coated catheter |
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Term
| What is CAU-ti prophylaxis? |
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Definition
| it is a comprehensive strategy, high priority recommendations for urinary catheter use, aseptic insertion, and maintenance |
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Term
| what kind of cathethers may prevent adhesions and proliferation? |
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Definition
| silicone/hydrophobic catheters. |
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Term
| How do you treat a prosthetic join infection? |
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Definition
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Term
| Risk factors of prosethetic joint infection? |
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Definition
| 1) prior surgery @ site of prosthesis, 2) Rheumatoid arthritis 3)immunocompromised states 4) diabetes mellitus 5) poor nutritional status 6) obesity 7) psoriasis 8) extremely advanced age |
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Term
| What are the three prosethetic joint infections pathogens that are most common? |
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Definition
Coagulase-negative staphylococci
staphylococcus aureus
gram negative aerobic bacilli |
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Term
what are three other device associated infections?
how effective is this?
What are the uses?
what are the advantages? |
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Definition
antibiotic spacers/beads/cement
use: to treat/prevent local infection of bone and soft tissue.
Data for effectiveness is limited
advantages: delivery direct local therapy @ high concentrations, fill dead space from debridement, low systemic effects |
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Term
| Common materials for delievery of antibiotic spacers/beads/cement |
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Definition
| PMMA, hydroxyapatite, ca2+ phosphate, microspheres, nanoparticles |
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Term
| antibiotics used in local therapy |
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Definition
| vancomycin, gentamicin, daptomycin, silver and SSD, rifampin, amikacin, amphotericin |
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