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1

CoNS

Skin commensal
device associated infection inlcuding valve endocarditis
Rx- 50% flucloxacillin resistant
Regimen depends on sensitivies
Combinations including rifampicin often used

2

S. saprophyticus

UTI in young women
Rx: flucloxacillin or nitrofurantoin

3

MSSA

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

4

MRSA

Skin adn soft tissue infection
Endocarditis
Toxin-mediated diseases
Resistant to beta-lactam antibiotics
Rx: Vancomycin or linezolid

5

Enterococcus spp.

Commensal of Gi and GU
UTI
Endocarditis
Polymicrobial infection from GI perforation
Cephalosporin resistant
Rx: amoxicillin (E. faecalis) or vancomycin (E. faecium)
Can get vancomycin resistant enterococci (VRE)

6

Streptococcus pneumoniae

Draughtsman colonies
Pharyngeal commensal
CAP
Meningitis
Vaccines availble
Rx: Benzyl penicillin (IV) or amoxicillin (PO)
Can get peniciilin resistant

7

Viridans streptococci

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

8

Group A: Strep pyogenes

Pharyngitis
Skin and soft tissue infections inc. necrotising fasciitis
Rheumatic fever/scarlett fever
Puerperal sepsis
ASOT/DNAse B
Rx: Penicillin IV (pharyngitis)
Benzyl penicillin (IV) or amoxicillin (PO)

9

Group B: Strep agalactiae

Commensal of female GU tract
UTI
Neonatal sepsis and meningitis
Endocarditis and septic arthritis
Rx: Benzyl penicillin (IV) + gentamicin (severe) or amoxicillin (PO)

10

Group C: Strep equi, equisimilus, zooepiodemicus

Pharyngitis
Skin and soft tissue infections
Rx: Benzyl penicillin (IV) or amoxicillin (PO)

11

Group D: Enteroccus spp and S. Bovis

S. bovis - colon cance associated endocarditis
Rx: Benzyl penicllin (IV) or amoxicillin (PO)

12

Group F: Strep anginosus, constellatus, intermedius

'Milleri group'
Intra-abdominal abcesses, often polymicrobial
Rx: Beznyl penicillin (IV) or amoxicillin (PO_

13

Group G: Strep dysgalactiae

Skin and soft tissue infection
Rx: Benzyl penicillin (IV) or amoxicillin (PO)

14

Bacillus anthracis

Anthrax
3 toxins: edema factor, protective antigen and lethal factor
CUtaneous, inhalational, GI infection
Rx: benzyl penicillin or ciprofloxacin

15

Bacillus cereus

Emetic food poisoning
1-5 hours - rice
Diarrhoea and abdominal pain 8-16 hours
Usually self limiting

16

Clostridium botulinum

Botulism (classic food borne)
INfant botulinism- honey
Wound botulinism- IVDU
Rx: supportive and anti-toxin
would botulinism - debridement +/- penzyl pencillin or mtronidazole

17

Clostridium difficile

Antibiotic associated diarrhoea
Pseuomembranous colitis
Rx: oral metronidiazole or vancomycin

18

Clostridium perfringens

Food poisoning (self limiting)
'Pigbel'
Gas gangrene: Rx: debridement with benzyl peniciliin or metrondiazole

19

Clostridum tetani

Tetanus
Vaccines +/- HTIG in non-immune
Rx: supportive with HTIG plus metrondiazole

20

Corynebacterium spp. (diptheroids)

Club shaped
Commensal flora (non-diptheria strains)

21

C. diptheria

Some strains toxigenic
Resp tract diptheria
Cutaneous diptheria
Diptheria toxin vaccine (dT)
Rx: Horse diptheria antitoxin plus penicillin or erthrymycin

22

Actinomyces spp.

IUCD-related infections
Cervicofacial infection
Rx: Benzyl penicillin (IV) or amoxicillin (PO)

23

Nocardia spp.

Partially acid fast
Pulm, cutaneous and systemic infections including brain abcessess
Rx: co-trimoxazole

24

Propionibacterium spp.

Skin commensal
Slow growing
Acne
Rx: tetracyclines

25

Listeria monocytogenes

Tumbling motility
Beta-haemolytic
Food borne
Listeriosis in pregnancy
Neonatal listerioios
Listeria meningitis
Cephalosporin resistant
Rx: amoxicillin and gentamicin

26

Oral neisseria spp.

Commensal flora

27

Neisseria meningitidis

'Meningococcus'
Diplococcus
Capsular types include A, B, C, W135, Y
Meningitis and septicaemia
Notifiable
Rx: Benzyl penicillin (IV) or ceftriaxone
Chemoprophylaxis (rifampicin or cipfloxacin) to household contacts +/- vaccine

28

Neisseria gonorrhoeae

'Gonococcus'
Sexually transmitted
Opthalmia neonatorum
Rx: High rates of resistance
Depending on sensitivity pattern: pencillin (IM) or amoxicillin or ciprofloxacin or zithromycin or cefixime
Consider other STI

29

Haemophilus influenzae

Polysaccharide capsule (serotypes a-f)
Meningitis and epiglottitis
Hib vaccines
Non-capsular strains- ottitis media, sinusitis, exacerbations COPD
Rx: amoxicillin or ceftriaxone (meningitis)
5-10% beta-lactamase positive
Rx: co-amoxiclav or cefruoxime

30

Moraxella catarrhalis

Ottitis media
Sinusitis
Exacerbations COPD
Tributyrin positive
Rx: beta-lactamase psotive
Rx: co-amoxiclav or cefuroxime

31

Bordetella pertussi

Pertussis/whooping cough
Petrussis vaccine
Per-nasal swabs- Bordet Genhou agar
Rx: erthroymycin

32

Brucella spp

Zoonotic
B. melitensis goats, sheep
B. abortus - cattle
Slow growing
Urease positive
Rx: Gentamicin plus rifampicin

33

Escherichia coli

Commensal of GU/GI tract
UTI
Rx: co-amoxiclav or trimethorpim
Increasing rates of ESBL
Diarrhoea incl. HUS (0157)
Neonatal meningitis
Rx: ceftrioxone

34

Kleibsiella pneumoniae

Commensal of GI tract
UTI and LRTI
Amoxicillin resistant
Rx: co-amoxiclav or ciprofloxacin
Increasing rates of ESBL

35

Enterobacter cloacae

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

36

Bacteriodes fragilis

Commensal of GI tract
Polymicrobial intra-abdominal infection
Rx: metronidazole

37

Proteus mirabili

Commensal of Gu/GI tract
Urease positive
Swarming colonies
UTI
Nitrfurantoin resistant
Rx: Amoxicillin or cephtrioxone

38

Acinetobacter

Commensal of GU/GI
UTI and HCAI
Trimethoprim resistant
Rx: Amoxicillin or ciprofloxacin
Increasing rates of MDR

39

Salmonella spp.

Food borne
Diarrhoea and vomitting
Usually self limiting

40

Salmonella typhyi + parathypho

Bacteraemic illness
Rx: ciprpfloxacin or ceftriaxone

41

Helicobacter pylori

Oxidase positive
Strongly urease positive
Gastric ulcer disease

42

Camplyobacter spp.

Oxidase positive
Food borne illness
Bloody diarrhoea
Usually self limiting
Rx: erthromycin or ciprofloxacin if required

43

Vibrio cholera

Oxidase positive
Food borne illness
Watery diarrhoea
Cholera toxin
Rx: hydration and tetracyclin

44

Pseudomonas aeruginoa

Pyoverdin and pyocyanin - green
Enviormental
HCAI
Chronic colonisation in CF
Rx: ciprofloxacin, gentamicin or anti-psedomonal beta-lactamase (ceftazidim/tazocin/meropenem)
resistance problems

45

Burkholderia cepacia

Environmental
Chronic colonisation in CF
Colistin resistant
Rx: difficult
Ciprofloxacin, or anti-pseudomonal beta-lactam (ceftazidim/tazocin/meropenem)