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Flashcards in blood infections 2 Deck (17)
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1

what are the risk factors for pseudomonas

1. admission to an ICU
2. recent pseudomonas infection
3. recent hospitalization
4. dialysis
5. nursing home
6. recent IV antibiotics
7. recent chemotherapy

2

how is pseudomonas treated in a BSI

double coverage with 2 drugs with 2 different mechanisms of action.

3

what are 4 drug classes with the same type of MOA that should not be used together to treat pseudomonal infections

1. antipseudomonal PCNs (Zosyn, ticar/clav)
2. cephalosporins
3. monobactams
4. carbapenems

4

what class of drugs works for pseudomonas by inhibiting protein synthesis

aminoglycosides

5

what class of drugs works for pseudomonas by targeting DNA and replication

fluoroquinolones

6

what should be done to treat ESBL (gram -) blood infections

carbapenems:
imipenem/ cilastatin
meropenem
doripenem
ertapenem

7

what should be used to treat someone with both an ESBL and pseudomonas infection

1. an carbapenem (imipenem, meropenem, doripenem)
+ aminoglycoside OR fluoroquinolone

8

what carbapenem should not be used for pseudomonas

ertapenem; does not work for pseudomonas

9

how long should a gram negative BSI be treated

7-14 days after 1st negative blood culture

10

what are two most common fungal BSI's

C. albicans
C. glabrata (fluconazole resistant)

11

what is the treatment duration for fungal BSIs

14 days after the 1st negative culture

12

what is the standard approach if a CLABSI is suspected (Central Line Associated BSI)

1. pull central line and culture tip
2. obtain blood cultures
3. establish a peripheral IV
4. follow either short term or long term algorithms

13

what is considered short term central line placement

less than 14 days

14

what are the complicated cases of CLABSI

1. thrombophlebitis
1. endocarditis
3. osteomyelitis

15

if there is a complicated case of CLABSI, what must always be done

remove catheter

16

what is the only type of short term catheter infection where catheter can be salvaged

coag negative staphylococcus

17

what are the only 3 long term central venous catheter infections where catheter may be salvaged and not removed

coag negative staphylococcus
enterococcus
gram negative bacilli