Chapter 10: Hospital-Acquired Gram-Negatives Flashcards Preview

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Flashcards in Chapter 10: Hospital-Acquired Gram-Negatives Deck (14):
1

What are the Hospital-acquired infections?

4 W's
Wind: Penumonia - ventilation, intubation
Water: UTI - Foley
Wound: Surgery
Wires: bloodstream infection - intravenous

2

What are the 4 often highly resistant gram-negative bacteria?

Pseudomonas, Acinetobacter, Stenotrophomonas and Burkholderia

3

Pseudomonas aeruginosa

obligate aerobic (non-lactose fermenter)
Gram-negative rod
Motile: virulence
Produces pyoverdin (green pigment) and pyocyanin (blue pigment)
Grape-like scent
Weak invasive
Exotoxin A: like diphtheria toxin

4

What are the Pseudomonas aeruginosa infections?

BE PSEUDO
Burns
Endocarditis
Pneumonia
Sepsis
External Malignant otitis media
UTI
Diabetic osteomyelitis

5

Most ______ pts have their lungs colonized with Pseduomonas aeruginosa. What do these pts develop?
Who is highly susceptible to peumonia caused by Pseduo aeruginosa?

Cystic fibrosis

Chronic pneumonia which progressively destroys their lungs

Immunocompromised pts

6

Who have an increased risk of osteomyelitis (related to wounds) due to Pseudomonas aeruginosa?

Diabetic pts: Foot ulcers infected, infection penetrates into bone
IV drug abusers: vertebrae or clavicle
Children: puncture wounds to foot wearing tennis shoe

7

How does Pseudomonas aeruginosa lead to sepsis?

Infected "wires" or catheters, or from burn-wounds, water, wind etc

8

What are frequent causes of right heart valve endocarditis in IV drug abusers?

Staphylococcus aureus
Pseudomonas aeruginosa

9

Malignant external otitis

Pseudomonas external ear canal infection burrows into the mastoid bone
Primarily in elderly diabetic pts

10

Burkholderia cepacia

Oxidase-positive aerobic gram-negative bacillus
Virulence: Extremely antibiotic resistant
Grow in water, soil, plants, animals
Infection in burn and ventilated pts

11

Who has the greatest risk for Burkholderia cepacia?

Cystic fibrosis
Asymptomatic carriage, bronchiectasis (dilated infected airways) or rapidly progressive pneumonia with bacteremia

12

Stentotrophomonas maltophilia

Colonizer
Part of normal respiratory flora
Can cause pneumonia, line-related bacteremia
Virulence: extremely antibiotic resistant

13

Acinetobacter

Virulence: multiple acquired mechanisms of antibiotic resistance
Aerobic gram-negative bacteria
Soil and water

14

Acinetobacter baumanni

Survive on environmental surfaces: increase transmission in healthcare settings
Cause: HAP, line-related bactermias, burn infections, foley UTI,

May appear gram-positive or look like Neisseria : can be coccobacillary (short rods) or coccal in appearance, or diplococci on solid media