Infectious Diseases I: Background and antibiotics by drug class

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47 Terms

1

-signs and symptoms, including fever, elevated WBC count, and site specific symptoms (ex: dysuria with UTI)

-diagnostic findings, such as culture results, xrays, and markers of inflammation (procalcitonin)

the presence of infection is determined by: clinical evaluation and laboratory tests.

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2

-the infection site and likely organisms

-infection severity and risk of multidrug resistant (MDR) pathogens (ex: community vs hospital acquired infections)

-antibiotic characteristics (ability to penetrate site of infection)

-patient characteristics (age, weight, allergies, renal/hepatic function, comorbidities, recent abx use, pregnancy, etc)

-treatment guidelines

antibiotic selection is based on:

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3

streptococcus pneumoniae, neisseria meningitidis, haemophilus influenzae, Group B streptococcus/ E. coli, Listeria

Common pathogens that cause CNS/Meningitis infection

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4

streptococcus pyogenes, streptococcus pneumoniae, haemophilus influenzae, moraxella catarrhalis

Common pathogens that cause upper respiratory infections

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5

staphylococcus aureus (including MRSA), staphyloccus epidermidis, streptococci, enterococci

Common pathogens that cause heart/endocarditis infections.

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6

staphylococcus aureus, staphylococcus epidermidis, streptococcus pyogenes, pasteurella multocida, + aerobic/anaerobic GNR (in diabetes)

Common pathogens that cause skin and soft tissue infections.

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7

staphylococcus aureus, staphylococcus epidermidis, streptococci, neisseria gonorrhoeae, GNR (in specific situations)

Common pathogens that cause bone/joint infections.

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8

mouth flora (peptostreptococcus), anaerobic gram negative rods, (prevotella, others), Viridans group streptococci

Common pathogens that cause mouth infections.

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9

streptococcus pneumoniae, haemophilus influenzae, atypicals (legionella, mycoplasma, chlamydophila), enteric gram negative rods (alcohol use disorder)

Common pathogens that cause lower respiratory (community) infections

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10

staphylococcus areus (including MRSA), pseudomonas aeruginosa, acinetobacter baumannii, enteric gram negative rods (including ESBL +, Multi drug resistant), streptococcus pneumoniae

common pathogens that cause lower respiratory (hospital) infections

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11

enteric GNR, enterococci, streptococci, bacteroides species

Common pathogens causing intra-abdominal infections.

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12

E. coli, proteus, Klebsiella, staphylococcus saprolyticus, enterococci

Common pathogens causing urinary tract infections.

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13

Proteus, E coli, Klebsiella, enterobacter, serratia

enteric gram negative rods

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14

empiric treatment

usually broad spectrum (covers several types of bacteria) and can be guided by local resistance patterns (antibiogram)

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15

gram positive organisms

have a thick cell wall and stain dark purple or blue from the crystal violet stain

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16

gram negative organisms

have a thin cell wall and take up the safranin counterstain resulting in a pink color

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17

atypical organisms

do not have a cell wall and do not stain well

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18

staphylococcus spp (MSSA/MRSA)

gram positive cocci- clusters

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19

streptoccoccus pneumoniae (diplococci), streptococcus spp. (including strep pyogenes), enterococcus spp. (including VRE)

gram positive cocci- pairs and chains

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20

listeria, monocytogenes, corynebacterium spp.

gram positive rods

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21

peptostreptococcus, propionibacterium acnes, clostridium difficile, clostridium spp.

gram positive anaerobes

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22

neisseria spp.

gram negative cocci

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23

proteus mirabilis, E coli, klebsiella spp., serratia spp., enterobacter cloacae, citrobacter spp.

gram negative rods that colonize in the gut (enteric)

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24

H pylori, campylobacter spp. , treponema spp., borrelia spp., leptospira spp.

curved or spiral shaped gram negative rods

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25

pseudomonas aeruginosa, haemophilus influenzae, providencia spp

gram negative rods that do not colonize in the gut

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acinetobacter baumannii, bordetella pertussis, moraxella catarrhalis

gram negative coccobacilli

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27

bacteroides fragilis, prevotella spp.

gram negative anaerobes

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28

staph aureus

stahpylococcus species that is coagulase positive

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29

minimum inhibitory concentration

minimum concentration of each antibiotic that inhibits bacterial growth

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30

aminoglycosides + beta lactams: beta lactam breaks down cell wall and aminoglycoside reaches intracellular target at safe doses

synergistic treatment for certain invasive gram positive infections such as infective endocarditis

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31

intrinsic resistance

resistance is natural to the organism (E coli is resistant to vancomycin because this antibiotic is too large to penetrate the cell wall of E coli.)

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32

selection pressure

resistance occurs when antibiotics kill susceptible bacteria, leaving behind more resistant strains to multiply. (normal GI flora includes enterococcus; when abx eliminate susceptible enterococci, VRE can become predominant.)

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33

acquired resistance

bacterial DNA containing resistant genes can be transferred between species and/or picked up from dead bacterial fragments in the environment

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34

antibiotic degradation

bacterial enzymes break down the antibiotic (beta lactamases)

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35

Klebsiella pneumoniae (ESBL, CRE)

E coli (ESBL, CRE)

Aceinetobacter baumannii

Enterococcus faecalis, enterococcus faecium (VRE)

Staph aureus (MRSA)

Pseudomonas aeruginosa

*Kill Each And Every Strong Pathogen*

Common Resistant Pathogen

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36

clostridium difficile

when an antibiotic kills GI flora along with the targeted pathogen it can result in an overgrowth of _____________, which can produce toxins that inflame the GI mucosa

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37

mild (loose stools to abdominal cramping) to severe (pseudomonas colitis that can require a colectomy or be fatal) symptoms

symptoms of c. diff

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38

broad spectrum penicillins and cephalosporins, quinolones, carbapenems, and clindamycin

antibiotics with the highest risk of c.diff infection

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39

folic acid synthesis inhibitors

sulfonamides, trimethoprim (often combined with sulfamethoxazole to overcome resistance), dapsone

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40

cell wall inhibitors

beta lactams, monobactams (aztreonam), vancomycin, dalbavancin, telavancin, oritavancin

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41

protein synthesis inhibitors

aminoglycosides, macrolides, tetracyclines, clindamycin, linezolid, tedizolid

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42

cell membrane inhibitors

polymixins, daptomycin, televancin, oritavancin

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43

DNA/RNA inhibitors

quinolones (DNA gyrase, topoisomerase IV), metronidazole, tinidazole, rifampin)

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44

aminoglycosides, quinolones, daptomycin

concentration dependent abx

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45

vancomycin, macrolides, tetracyclines, polymyxins

exposure dependent abx

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46

beta lactams

time dependent abx

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47

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