Bugs and drugs Flashcards by Marc Huttman

MSSA
3d
2a

Skin and soft tissue infection
Endocarditis
Toxin-mediated diseases
Rx: flucloxacillin or erythromycin

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MRSA
3d
2a
1r

Skin and soft tissue infection
Endocarditis
Toxin-mediated diseases
Rx: vancomycin or linezolid (resistant to beta lactams)

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Staphylococcus epidermidis
commensal
1d
1a
1r

Skin commensal
Device associated infections (prosthetic valve endocarditis)
Rx: 50% flucloxicillin resistant. regimen depends on sensitivity. Combinations include rifampicin

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Staphylococcus saprophyticus
1d
2a

UTI in young women

Rx: Flucloxacillin or nitrofurantoin

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Enterococcus
commensal
3d
2a
2r

Commensal of GI and GU
UTI
Endocarditis
Polymicrobial infection after perforation
Rx: Amoxicillin (B. faecalis) or vancomycin (B. faecium)
(resistent to cephalosporin, with some vancomycin resistant enterococci, too)

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Strep pneumoniae
appearance?
commensal
2d
2a
1r
vaccine?

Draughtsman colonies
pharyngeal commensals
CAP
Meningitis
Vaccines available
Rx: Benzyl penicillin (IV) or amoxicillin (penicillin resistent)

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Strep viridans
commensal
4 types
1d
2a

Pharyngeal commensals
Includes S.mitis, S.oralis, S,salivarius, S.mutans
Native valve endocarditis
Rx: Benzyl penicillin (IV) with synergistic gentamicin

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Group A strep
6d
Recent infection marker?
3a

Strep pyogenes
pharyngitis/strep throat
skin and soft tissue infections (necrotising fasciitis)
rheumatic/scarlet fever
puerpural sepsis
ASOT/DNAse B suggests recent infection
Rx: penicillin (V) for pharyngitis, benzyl pen (IV) or amoxicillin

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Group B strep
commensal
5d
3a

Strep agalactiae
commensal of female GU tract
UTI
Neonatal sepsis/meningitis
endocarditis
septic arthritis 
Rx: Benzyl pen (IV) + gent if severe or amoxicillin

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Group C strep
3 types
2d
2a

S. equi, S. equisimilus, S.zooepiodemicus.
Pharyngitis
skin and soft tissue infections
Rx: Benzyl pen (IV) or amoxicillin

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Group D
2 types
2d
2a

enterococcus and Strep bovis (endocarditis + associated with colon cancer)
Rx: Benzyl pen (IV) or amoxicillin

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Group F
3 types + special name
1d
2a

“milleri group”
S.anginosus, S.constellatus, S.intermedius.
intra-abdominal abscess, often polymicrobial.
Rx: Benzyl pen (IV) or amoxicillin

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Group G
1d
2a

S.dysgalactiae
Skin and soft tissue infections
Rx: Benzyl pen (IV) or amoxicillin

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Nocardia
1s
4d
1a

Partially acid fast
pulmonary, cutaneous and systemic infections including brain abscesses
Rx: Co-trimoxazole

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Actinomyces
2d
2a

IUCD-related infections
Cervicofacial infections
Rx: Benzyl pen (IV) or amoxicillin

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bacillus anthracis
1d
3 toxins
2a

anthrax
3 toxins: oedema factor (EF), protective antigen (PA), lethal factor (LF). PA+EF = oedema toxin, PA+LF = necrosis toxin.
Rx: Benzyl pen or ciprofloxacin

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bacillus cereus
1d
timeline?

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food poisoning
1-5 hours after eating rice
D&V that lasts 8-16 hours and is self-limiting

clostridium botulism
transmission?
2d
4a

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classically food borne
infant botulism from honey
wound botulism from IVDU
Rx: anti-toxin
in wound botulism need debridement +/- benzyl pen or metronidazole

clostridium difficile
2d
2a

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antibiotic associated diarrhoea
pseudomembranous colitis
Rx: metronidazole or vancomycin

Clostridium perfringens
3d
3a

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self-limiting food poisoning
pigbel necrotising enteritis
gas gangrene
Rx: debridement + benzyl pen or metronidazole

clostridium tetani
appearance?
1d
vaccine?
2a

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resembles drumsticks
tetanus = spasms and resp failure
vaccinate children
Rx: HTIG + metronidazole

corynebacterium 
shape
commensal
1d
vaccine?
3a

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club shaped
non-diphtheria strains are commensal
C. diphtheria causes diphtheria (respiratory [grey plaque on throat] or cutaneous lesion)
diphtheria toxin vaccine
Rx: horse diphtheria antitoxin plus penicillin or erythromycin

Listeria monocytogenes
motile?
positive for?
source?
3d
2a
1r

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tumbling motility
beta haemolytic
food-borne
listeriosis in pregnancy
neonatal listeriosis
listeria meningitis
Rx: amoxicillin and gentamicin (cephalosporin resistant)

helicobacter pylori
positive for 2 things?
1d
2 lines of treatment

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oxidase positive
strongly urease positive
gastric ulcer disease
1st line = PPI, clarithromycin, amoxicillin
2nd line = PPI, bismuth, tetracycline, metronidazole

``` campylobacter positive for? source? 1d 3a ```

oxidase positive food borne illness bloody diarrhoea Rx: usually self limiting but can use erythromycin or ciprofloxacin if needed

``` Vibrio cholera positive for? source 1d 2a ```

``` oxidase positive food borne illness watery diarrhoea cholera toxin Rx: hydration and tetracycline ```

``` Brucella source goats sheep cattle positive for? 2a ```

``` Zoonotic B.melitensis = goats/sheep B.abortus = cattle slow growing urease positive Rx: gentamicin plus rifampicin ```

Bortadella pertussis 1d diagnosis 1a

whooping cough/pertussis pertussis routine vaccine per-nasal swabs & grow on Bordet gengou agar Rx: erythromycin

Moraxella catarrhalis 3d positive for what 2 things? 2a

``` otitis media sinusitis exacerbaiton COPD Tributyrin positive Rx: co-amoxiclav or cefuroxime (beta-lactamase positive) ```

``` Haemophilus influenzae require what to grow capsule? vaccine? 5d 4a 1r ```

``` Requires X (haemin) and V (NAD) for in vitro growth Polysaccharide capsule (serotypes A-F) - Meningitis, Epiglottitis, Hib vaccine ``` non-capsular strains - otitis media, sinusitis, COPD exacerbation Rx: amoxicillin or ceftriaxone (meningitis) 5-10% beta lactamase positive - coamoxiclav or cefuroxime

``` Neisseria meningitidis shape capsule 2d notify? 5a ```

``` "meningococcus" diplococcus Capsular types A, B, C, W135, Y. meningitis and septicaemia notifiable disease Rx: benzyl pen (IV) or ceftriaxone chemoprophylaxis (rifampicin or ciprofloxacin) to household contacts + vaccine ```

neisseria gonorrhoeae transmission 2d

"gonococcus" sexually transmitted ophthalmia neonatorum (conjunctivitis during delivery)

oral neisseria | commensal?

commensal flora

bactericides fragilis commensal? 1d 1a

commensal of GI Polymicrobial intra-abdominal infection Rx: Metronidazole

``` Psudomonas aeuriginosa culture? source? 2d 5a ```

blue-green colour on culture (procyanin & pyoverdin) environmental HCAI Chronic colonisation in CF Rx: ciprofloxacin, gentamicin or pseudomonal beta lactam (ceftazidime, tazocin, meropenem) resistence problematic

Burkholderia cepacia source 1r 4a

environmental chronic colonisation in CF colistin resistant Rx: ciprofloxacin or pseudomonal beta lactam (ceftazidime, tazocin, meropenem)

E. coli commensal? 3d 3a

``` Commensal of GU/GI tract UTI, diarrhoea, HUS (O157) Rx: UTI = co-amoxiclav or trimethoprim (increasing rates of ESBL) Rx other = cefotaxime ```

``` Klebsiella pneumoniae commensal? 2d 2a 1r ```

commensal GI UTI and LRTI Rx: co-amoxiclav or ciprofloxacin (amoxicillin resistent - increasing ESBL)

Enterobacter cloacae commensal 2d 3a

commensal of GI/GU UTI and LRTI Rx: amoxicillin, trimethoprim, ciprofloxacin

``` proteus mirabilis commensal positive for? culture? 1d 1a 1r ```

``` commensal of GU/GI tract urease positive swarming colonies UTI (staghorn?) Rx: amoxicillin (nitrofurantoin resistant) ```

acinetobacter spp commensal 2d 2a

commensal of GU/GI UTI HCAI Rx: amoxicillin or ciprofloxacin (increasing rates of MDR)

``` salmonella source 3 types 2d 3a ```

food borne diseases D&V Rx: usually self limiting S.typhi and S.paratyphi: bacteraemic illness Rx: ciprofloxacin or ceftriaxone

Bugs and drugs Flashcards

(42 cards)