Staph Infections Flashcards
(27 cards)
What do we have to concerned with coag-negative stpah?
Less virulent but often on prosthetic devices (also a huge source of contamination)
Staphlococci gram staining
Gram positive, catalase positive
How many are colonized by s. aureus?
25-50%
Increased incidence of s. aureus colonization?
- DM
- HIV
- Dialysis
- Skin damage (psoriasis, eczema, etc)
What type of congenital IDs that lead to increased S. aureus infection
- Neutropenia
- CGD
- Job’s, Chediak-Higashi syndrome
When does MRSA begin to proliferate?
Late 1990’s
What are toxins produced by s. aureus?
- Cytotoxin
- Superantigens
• Enterotoxin (food poisoning)
• Toxic shock - Exfoliative toxin (scalded skin syndrome)
Symptoms for toxic shock syndrome?
• Fever over 102 • Hypotension • Funny rash (diffuse macular erythorderma) • Desquamation of skin after 1-2 weeks • IG upset • Pains • Renal problems • Hepatic problems • Low platelets • CNS distortions *******this is a very vague presentation and is hard to diagnose
Less common s. aureus infections?
- Respiratory
2. Urinary (often due to indwelling cath)
Rare s. aureus infections?
- CNS symptoms
2. GI symptoms
4 COMMON s. aureus infections?
- Skin and soft tissue
- Bacteremia
- Septic arthritis and osteomyelitis
- Prosthetic joint and device infiltration
What is impetigo?
Dermal infection of s. aureus, mostly seen in children
How can you decolonize s. aureus?
- Effective cleaning
- Nasal decolonization with mupirocin (not very effective)
- Bleach baths twice weekly 3-4 months
If you don’t know how Staph got in to the blood, what do we need to be more concerned with?
Metastatic process (it could be hiding out in other pockets like a joint or bone)
What do you want to do with blood work for a s. aureus, bacteremic patient?
You want to get repeat blood cultures every day to make sure the infection is clearing
Where is a common non-skin site of abscesses for s. aureus infection?
Psoas abscess
If you have a right sided s. aureus endocarditis, what do you have to think about?
The infection can seed the lungs and show as small nodules (might change your treatment choices)
If you have one set of blood cultures thats positive and one thats negative, what might this imply?
That one bottle was simply contaminated
What is the safest central line insertion site (according to Dr. Meyers)?
Subclavian
Why is enterococcus in the blood stream an odd bug?
It can cause endocarditis and there aren’t a lot of good options for treatment
Whats the main difference between sepsis and SIRS?
SIRS is from an inflammatory process that isn’t infectious
What is a problem with candida blood infections?
It doesn’t always grow in cultures and can be hard to diagnose.
What is the leading cause of bacteremia?
Staph
What measure in the ICU could help reduce S. aureus infections?
Daily chlorhexidine baths
