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Flashcards in blood infections Deck (23)
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1

define a blood stream infection (BSI)

presence of microorganisms growing in blood cultures

2

what is the differences in a primary and secondary BSI

primary = unknown source of infection
secondary = has another infection (pneumonia, UTI, soft tissue...)

3

what is the appropriate empiric treatment for a gram positive BSI

empiric therapy is vancomycin
(better than like linezolid= static; vanc = cidal)

4

what is considered a community acquired BSI

occurs less than 48 hours after hospital admission without healthcare risk factors

5

what are healthcare risk factors for a BSI

1. hospitalization in an acute care hospital in past 90 days for longer than 1 day
2. resident in a nursing home or long term care facility
3. dialysis
4. IV home therapy
5. immunosuppressive medications
6. invasive device present

6

what are common causes of transient bacteremia

tooth brushing
biopsy

7

what is a common cause of intermittent bacteremia (when it goes away and comes back repeatedly)

abscess

8

what is a common cause of persistent/ sustained bacteremia

intravascular (endocarditis present)

9

what pathogens may be true pathogens or contaminants in a BSI

viridans streptococci
enterococci spp.

10

what species are usual contaminants (not pathogens) in a BSI

1. coagulase negative staph
2. bacillus
3. corynebacterium
4. propionibacterium acnes

11

what are the most frequently occurring inpatient bacteria in BSIs in order

1. S. aureus
2. e. choli
3. enterococcis
4. Coagulase negative staph
5. pseudomonas

12

what are the most frequently occurring out patient bacteria in BSIs in order

1. e. choli
2. S. aureus
3. enterococci
4. pseudomonas
5. Cooag negative staph

13

what organsims are more likely to disseminate in BSIs

candida and gram positive cocci are much more likely than gram negative rods

14

what are some host dependent factors that put people at risk for dissemination of BSIs

1. advanced age and arthritis
2. prosthetic material in place
3. immunosuppressed state

15

what are some frequent sites of dissemination

1. heart valves
2. bone and joints
3. intervertebral discs
4. eyes

16

What should be used to treat an MSSA BSI?

nafcillin

17

what should be used to treat an MRSA BSI

continue vancomycin

18

what should be used to treat an enterococcus BSI

ampicillin (can add gentamicin for cidal activity)

19

what should be used to treat an streptococcus BSI

beta-lactam

20

what organism gets static activity from vanc and ampicillin

enterococcus

21

what should be used to treat an vancomycin resistant enterococcus (VRE)

daptomycin

22

what is the minimum duration for a gram positive BSI

2 weeks after 1st negative culture

23

what gram positive BSI organism may be treated for a shorter duration?
for how long?

enterococcus
7-14 days