142 - Staphylococcal Infections

Question 1

What are the main staph infections?

Answer 1

aureus

CoNS (coagulase negative staph)

Question 2

Staph aureus can convert __ to __ using coagulase

Answer 2

fibrinogen

fibrin

Question 3

Name the main risk factors for SA infection: 5

Answer 3

insulin dependent diabetes
PMN disorder (chemo, CGD, Job/Chediak-Higashi syndrome, HIV, ESRD)
IVDU

Question 4

Part of the reason for endocarditis increased incidence is more __ __ devices being used

Answer 4

intra vascular

Question 5

Right endocarditis is related more to __

Answer 5

IVDU

Question 6

Left endocarditis is more common in __ valve of __ patients

Answer 6

native

older

Question 7

The most frequent areas CA-MRSA affect are the __ and __ tissue

Answer 7

skin

soft

Question 8

Life threatening CA-MRSA situations include: 4

Answer 8

necrotizing pneumonia
necrotizing fasciitis
sepsis + Waterhouse-Friderichsen syndrome

Question 9

Name 3 toxins mediated staph infections:

Answer 9

food poisonings
TSS
SSSS

Question 10

Food poisoning is caused by inoculation of staph __. The disease start after - hours from digestion and passes after -. symptoms include: 3

Answer 10

toxin
1-6
8-10
diarrhea
nausea/vomiting
hypotension/dehydration

Question 11

TSS start with __ like symptoms progressing to __, __ and __. The disease escalates quickly and __ may appear - weeks after.

Answer 11

flu
fever
hypotension
erythroderma 
skin scaling
1-2

Question 12

CoNS is __ than SA, but a common reason for __ infection, including __. The main strain is __

Answer 12

virulent
prosthetic
endocarditis
staph epidermidis

Question 13

When treating staph infection we must __ the collection or remove infected __ together with starting __ treatment, which should be lasting - weeks.

Answer 13

drain
prosthetic
Abx
4-6

Question 14

Higher complication rate is associated with: 4

Answer 14

acquiring positive blood cultures > 96 h
community acquisition
failure to quickly drain/remove to source of infection
presence of a significant infection

Question 15

Uncomplicated bacteremia of staph is when the source can be easily __, fast response for treatment (- days) w/o __/__/__. In these cases, treatment for _ weeks is sufficient.

Answer 15

removed
3-4
fever/positive cultures/prosthesis
2

Question 16

Penicillin sensitive staph should be treated with: 3

Answer 16

oxacillin/nafcillin
cephalosporins (1st)
carbapenem

Question 17

In cases of CA-MRSA treat with:

Answer 17

vancomycin

daptomycin

Question 18

What are the 3 staph resistances for vancomycin:

Answer 18

increased MIC
VISA- partial resistance (thicker cell wall)
VRSA- full resistance (derived from enterococci)

Question 19

Daptomycin is effective for __ and __ but not for __

Answer 19

skin infection
bacteremia
pulmonary infections

Question 20

Linezolid is a __ Abx with __ mechanism. Potential S/E include: 4. They are associated with prolonged use

Answer 20

bacteriostatic
protein synthesis (50s)
thrombocytopenia
neutropenia
lactic acidosis
optic/peripheral neuropathy

Question 21

Ceftaroline if a _ gen cephalosporin with a __ action. Approved for treating nosocomial __ and __

Answer 21

5
bacteriocidic
pneumonia
SSTI (Skin and soft tissue infections)

Question 22

When treating MRSA remember that old Abx such as __, __, and __ are also effective.

Answer 22

doxycycline
clindamycin
TMP-SMX

Question 23

Stubborn MRSA infection can be treated with mixes of __/__ + __ or __/__ + __. __/__ are also an option for a single drug therapy.

Answer 23

vancomycin/daptomycin + ceftaroline (beta lactam)
TMP-SFX/rifampin + daptomycin
linezolid/ceftaroline

Question 24

Decolonization, especially in ICU setting, can be achieved by using topical __ and/or __.

Answer 24

mupirocin

chlorhexidine