Shared Flashcard Set

Details

Infections in the compromised host
Most common organisms and management for vascular access site infections, CMI, humoral immunity, splenic dysfunction, necrotizing fasciitis, burn wounds
14
Microbiology
Professional
09/21/2011

Additional Microbiology Flashcards

 


 

Cards

Term

Necrotizing fasciitis involving Gram + cocci in clusters or tetrads

- diagnosis and order of management of various strains

Definition

1. Staphylococcus aureus esp MRSA

    - treat as if MRSA w/ vancomycin, linzolid, and/or daptomycin

 

2. Methicillin sensitive S. aureus

   - treat w/ nafcillin, oxacillin, 1G cephalosporin, clindamycin

Term

Necrotizing fasciitis with Gram + cocci in chains

- diagnosis and management

Definition

Suspect Streptococci pyogenes

 

Treat with penicillin G, early cephalosporin, or clindamycin

Term

Necrotizing fasciitis treated for Strep or S. aureus but no improvement

- diagnosis and management

Definition

Differential diagnoses

- inadequate debridment

- improper Gram stain review

- additional organisms

- mixed infections

 

Management

- ribosomal protein inhibitors to stop toxin production

   ~clindamycin

   ~ linezolid

Term

Necrotizing fasciitis caused by mixed infection involving Gram +/- rods and cocci

- management

Definition

1. Suspect mixed flora w/ anaerobes

2. Empirical therapy

 - β-lactam/β-lactamase inhibitor

     ~amp/sulbactam

     ~pip/tazobactam

 - carbapenem

     ~imi-, mero-, or doripenem

     ~ertapenem

 - advanced cephalosporin or quinolone  + metronidazole or clindamycin

 

3. Adjust antibiotics after culture results

Term

Burn Wound Organisms

- Gram (+) organisms

- Gram (-) organisms

- Fungi

- Viruses

Definition

Gram (+) organisms

- S. aureus

- S. epidermidis

- Enterococcus (inc. VRE)

 

Gram (-) organisms

- Pseudomonas

- Enterobacteriaceae

- Acinetobacter baumanii

- Bacteroides spp

 

Fungi

- Candida

- Aspergillus

- Fusarium

- Alternaria

- Zygomycetes

 

Viruses

- HSV

- VZV

- CMV

Term

Burn wound antibiotic treatment

- Pseudomonas aeruginosa

- Staphylococcus aureus (MRSA, MSSA)

Definition

Pseudomonas aeruginosa

- anti-Pseudomonal β-lactam

   ~pip/tazo

   ~ceftazidime

   ~cefimpe

   ~carbapenem

- aminoglycosides

- fluoroquinolones

- colistin

 

MRSA

- vancomycin

- linezolid

- daptomycin

 

MSSA

- nafcillin or oxacillin

- cephalosporin

Term

Vascular access site infection management for S. aureus or epidermidis

- considerations

- therapy

- MSSA or MSSE?

- Treatment time course if device removed? Not removed?

Definition

Considerations

1. remove device if patient very ill

2. remove device if severe local infection

3. consider echocardiogram for endocarditis

 

Treatment for:

MRSA

- daptomycin, vancomycin

MSSA or MSSE

- oxacillin or nafcillin

- cephalosporin

 

Tx time course if deviced removed

- 2 weeks

 

Tx time course if deviced remains

- 4 weeks w/ blood cultures @ 5 weeks

 

Term

Vascular access site infection by yeast

- Tx for sick patient

- Tx for mildly-moderately ill patient

 

Definition

Sick patient

- capsofungin

- voriconazole

- amphotericin B

- REMOVE VASCULAR DEVICE!!

 

Mild/Moderately sick patient

- fluconazole

- REMOVE VASCULAR DEVICE!!

Term

Fever of unkown origin in renal transplant patient

- organisms

Definition

CMV

- few or no focal Sx

- abnormal liver enzymes

- Rx

   ~ganciclovir or valganciclovir

TB

Fungi

- Cryptococcus (esp w/ CNS Sx - meningitis)

    ~initial Tx = ampB + flucytosine until response

    ~ maitenance = fluconazole 200-400 mg/d until culture and cryptococcal Ag are negative

- Coccidioides

- Histoplasma

 

Term

Multiple myeloma common pathogens

- pathogens and treatment

Definition

Encapsulated bacteria esp:

- Streptococcus pneumoniae

   ~ Tx:

       - high dose PCN

       - advanced cephalosporin (ceftriaxone, cefotaxime, cefempime)

       - quinolone (levo- & moxifloxacin)

       - vancomycin

 

- Haemophilus influenzae

  ~ Tx:

      - ceftriaxone

      - β-lactam/β-lactamase inhibitor (amp/sul or pip/tazo)

      - carbapenem (ertapenem)

      - quinolone

      - TMP/SMX

      - IV Ig ?


Term

Chronic granulomatous disease pathogens

- pathogens

Definition

Pathogens = catalase (+) organisms

- S. aureus

- Enterobacteriaceae

- Aspergillus spp

Term
Infections associated with splenic dysfunction or splenectomy
Definition

Severe infections:

-Streptococcus pneumoniae

-Haemophilus influenzae

-Neisseria meningitidis

-Babesia microti

-Ehrlichia

-Bartonella bacilliformis

-Capnocytophaga canimorsis

Term

Osteomyelitis in sickle cell anemic patients:

- most common etiological pathogens

- best way to get diagnosis of organism

Definition

Organisms:

Salmonella (70%)

Staphylococcus aureus (10%)

Other Gram (-) rods (7%)

 

Diagnosis:

- blood culture + bone culture

- pus culture from fistula is uncertain

Supporting users have an ad free experience!