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characteristics of methicillin resistant staph aureus MRSA?
normal bacterial flora in humans, most common site of colonization is anterior nares, 30% of people are colonized with it but only 2% are infected by it; coated with fibrin wall that resists phagocytosis → MRSA direct result of abx overuse
what types of abx is MRSA resistant to?
all beta-lactam abx → penicillins, cephalosporins, carbapenems
what are the symptoms of s aureus infection (different from MRSA)?
minor skin infections including pimples, abscesses, styes, impetigo
s/s of MRSA infection?
serious infections like PNA, skin and soft tissue infections, bloodstream infections → causes complications of contracting other infections with high mortality rates
characteristics of vancomycin resistant enterococci VRE?
bacteria that normally live in GI tract and female genital tract (also found in soil, water, and food) → organism prefers aerobic environment but can change to anaerobic → can spread by contact with hands or from dirty equipment; very hard to control outbreaks
what are the types of abx that VRE are resistant to?
beta-lactams and aminoglycosides
what is the best way to control VRE outbreaks?
prevention
s/s of VRE?
commonly cause UTIs, peritonitis, pelvis wound infections, bacteremia symptoms → UTIs: back pain, dysuria, sensation of needing to urinate, fever; wound infections: red, hot, purulent drainage; bacteremia: tachycardia, hypotension, fever
what are some complications of VRE?
has a growing list of resistance to antimicrobial agents, prolonged hospital stays, higher mortality rate than other enterococci bacteremias, gene has transferred to s aureus isolates, most common cause of infective endocarditis
characteristics of c diff?
spore-forming gram positive anaerobic bacillus, spores resistant to many diff types of disinfectants, heat, etc → primary source of spread is via hands of healthcare workers; symptom is mild-moderate diarrhea with a distinct odor
what are some risk factors for getting c diff?
abx exposure, 65 and older, recent stay at hospital/nursing home, weakened immune system, previous hx of c diff
what are some complications of a c diff infection?
incr length of hospital stay, incr costs, can lead to more severe complications (mortality is lower than MRSA or VRE)
characteristics of acinetobacter baumannii?
resistant to more than 3 classes of abx, rarely occurs outside of the hospital with highest instances in ICU → risk factors: recent surgery, central venous catheter, tracheostomy ventilation, enteral feedings
what is the most common way of acinetobacter baumannii transmission?
vascular catheter and respiratory tract; (also unclean hands of healthcare workers)
s/s of acinetobacter baumannii?
can colonize many body sites but typically respiratory tract, blood, pleural fluid, peritoneum, urinary tract, surgical wounds, CNS, eyes, skin → most frequent infections found in ventilator-associated PNA and bloodstream infections
characteristics of carbapenem resistance enterobacteriaceae CRE?
normally found in intestines but if spread outside of intestines can cause serious infections, high mortality rate (50%), spread via direct contact specifically with wounds or stool
s/s of carbapenem resistant enterobacteriaceae CRE?
depend on location → commonly fever, chills and signs of sepsis
complications of CRE?
infection is dangerous and difficult as it’s resistant to nearly all abx, incr risk for patients with indwelling devices
medications to tx MRSA?
vancomycin → requires through level blood test & weekly BUN/creatinine test
medications to tx VRE?
susceptibility testing recommended and may require multiple abx
medications to tx c diff?
stop causative agent and use vanc as first drug of choice, also probiotics & fecal microbial transplant → in 20% of patients the infection will self resolve in 2-3 days