Term
| I am a Spontaneous bacterial peritonitis, the source is unidentified, and is common in Liver Failure patients, what am I? |
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Definition
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Term
| I am an infection due to a perforation of the GI tract, uterus, or urinary tract. Usually due to a traumatic physiologic or iatrogenic injury. What am I? |
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Definition
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Term
| I am a persistent or recurrent infection of the peritoneum after surgical and antimicrobial therapy. What am I? |
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Definition
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Term
Common Pathogens of the GI tract:
Stomach |
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Definition
| Streptococcus, Lactobacillus |
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Term
Common Pathogens of the GI tract:
Bilary Tract |
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Definition
| Well actually it is normally sterile here; however if it is infected it might have: E. coli, Klebsiella, or Enterococci |
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Term
Common Pathogens of the GI tract:
Proximal Small Bowel: |
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Definition
| Streptococcus, Enterococcus, E. Coli, Klebsiella, Lactobaccilus or diptheroids. |
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Term
Common Pathogens of the GI tract:
Distal Illeum |
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Definition
| E. coli, Kelbsiella, Enterobacter, Enterococcus, B. Frag, Peptostretococcus, or Clostridium. |
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Term
Common Pathogens of the GI tract:
Colon |
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Definition
| Bacteroides spp, E. coli, Peptostreptococcus, Clostridium, Klebsiella, Enterococcus, or Enterobacter. |
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Term
| What is the most common organisms seen with Primary Peritonitis of cirrhotic origin? |
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Definition
E. Coli!!!
Klebsiella pneumonia
Streptococus spp. |
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Term
| What is the most common organisms seen with primary peritonitis with a dialysis origin? |
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Definition
Staph Aureus, strep, some gram neg.
THINK STAPH because of the PLASTIC!! |
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Term
| How do you treat Primary peritonitis due to Cirrhosis? |
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Definition
You need a Beta-lactam to cover gram neg (e. coli and klebsiella). And Vanc to cover gram positive.
1. Vanc + zoysn |
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Term
| How long would you treat Primary Peritonitis due to cirrhosis? |
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Definition
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Term
| How do you treat primary peritonitis due to peritoneal dialysis? |
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Definition
Give antibiotics directly into the peritoneal cavity.
The only drugs tested this route are: Vanc, Gent, Ceftaz. |
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Term
| If the peritonitis is healthcare related what bugs are you thinking? |
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Definition
Site dependent.
nosocomial pathogens
MRSA, Pseudomonas, Anaerobes
MDR organisms. |
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Term
| You have a patient who has been in the hospital for 14 days and has interabdominal fludi collection, high white count. You need to treat for peritonitis. Do you want to use Zosyn or Ceftriaxone? |
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Definition
Zosyn.
Ceftriaxone does not cover pseudomonas. |
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Term
| What are your options for treating healthcare related peritonitis? |
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Definition
1. Zosyn
2. Antipseudomonal carbapenem (mero, dori, imi)
3. Ceftazidime or Cefepime + metronidazole
4. FQ + metronidazole. |
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Term
| What is considered peritonitis prophylaxis treatment? |
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Definition
1. Traumatic bowel injury (repaired wihtin 12 hours)
2. Gastroduodenal perforations (repaired within 24 hours)
3. Non-perforated injuries (acute appendicitis, cholecytitis, bowel necrosis or obstruction.) |
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Term
| What is considered peritonitis treatment? |
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Definition
1. Bowel injuries >12 hours old
2. Gastroduodenal perforatiosn >24 hours old
3. Intraoperative findings of purulent peritoneal fluid
4. Extension beyond the primary focus of infection. |
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Term
| Why does it matter if you are treating for prophylaxis or treatment? |
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Definition
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Term
| The main reason for treatment failure? |
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Definition
1. source control failure - did not fix a GI leak
2. MDR organisms
3. inadequate microbial therapy. |
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Term
| When should you start antifungal therapy? |
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Definition
When the patient is really sick.
Ex: injury to GI tract, septic, hypotensive, WBC 20 |
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Term
| How long would you treat Primary Peritonitis due to dialysis? |
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Definition
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