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CLASP - SEPSIS > Gram Positives > Flashcards

Gram Positives Flashcards

1
Q

Give examples of Gm +ve cocci

A

Staph.

  • Aureus (MSSA/MRSA)
  • Epidermidis (+ other coag. -ve staph)

Strep.

Enterococci

  • faecalis
  • faceium
  • vancomycin resistant enterococci
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2
Q

Give examples of Gm +ve bacilli

A

Listeria

Clostridia

  • Difficile
  • Perfringens

Corynebacterium
- AKA diptheroids (not diptheria)

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3
Q

What antibiotic classes are Beta-lactams?

A
  • Penicillin (PLUS Flucloxacillin and Amoxicillin)
  • Cephalosporins
  • Piperacillin/tazobactam
  • Carbepenems
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4
Q

What is the difference between penicillin given IV and oral?

A 
IV = benzyl penicillin
Oral = phenoxymethylpenicillin
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5
Q

What is the Minimum Inhibitory Concentration? (MIC)

A

The concentration of drug required to kill 99.9% of organisms during the 18 to 24 hour period

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6
Q

In order to tackle infections effectively, we must remain above the MIC level. TRUE/FALSE?

A

TRUE

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7
Q

Name the monobactam which is used in Tayside

A

Aztreonam

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8
Q

Should gentamicin be allowed to linger in the body?

A
  • No can cause nephro/ototoxicity
  • Usually infused quickly to a peak and then out as quickly as possible
  • DONT give for longer than 3 days
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9
Q

What sites are hard for antibiotics to reach and how do we get round this?

A 
CNS 
Eyes
Prostate
** due to tight junctions **
Need higher doses of IV antibiotics to get to these places
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10
Q

What type of agar is used to show streptococcus haemolysis?

A

Blood agar

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11
Q

What is meant by streptococci being “facultative anaerobes”?

A

They grow in conditions with or without oxygen

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12
Q

Group A strep. follows what classification system?

A

Lancefield

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13
Q

Why is PCR better at classifying strep. than the Lancefield classification?

A

Some forms of strep. dont fit the criteria for a Lancefield group

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14
Q

What type of streptococci are in the Group B Lancefield classification?

A

Streptococcus agalactaiae

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15
Q

How many species of viridans strep. are there?

A

3 species (each with sub-species of its own)

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16
Q

What streptococcal infection has a link to colon cancer?

A

Streptococcus gallollyticus

17
Q

What stain is retained in the thick peptidoglycan layer of the Gm +ve cell wall?

A

Crystal violet

18
Q

Strep. pneumoniae usually causes what 3 infections?

A

Otitis
pneumonia
meningitis

19
Q

Why is it important to ask if a patient has travelled when you suspect they have Step. pneumoniae meningitis?

A

Some countries have strains of this which are resistant to penicillin

20
Q

Give examples of countries which have penicillin resistant strep. pneumoniae

A

Canada
USA
Mexico

Spain
Poland
Italy
Croatia
Greece
Turkey

Pakistan
China

21
Q

Name one important mechanism of antibiotic resistance in bacteria

A

Enzyme changes to inactivate drug

e.g. beta-lactamase can break down antibiotics containing beta-lactam ring

22
Q

Where are enterococci usually found and therefore where do they cause infection?

A

Found in gut
Responsible for peritonitis when gut perforates
OR biliary tract infection

23
Q

What is the chosen treatment for enterococci infection?

A

Amoxicillin IV

24
Q

If enterococci are resistant to amoxicillin what can be given instead?

A

Vancomycin IV

25
Q

What antibiotics can be used if treating Vancomycin resistant enterococci?

A

Linezolid
Daptomycin
Tigecycline

26
Q

SEPSIS caused by staph. aureus should be treated with what?

A

Flucloxacillin IV

Vancomycin IV in MRSA

27
Q

If there is a staph. aureus infection but no sepsis, and the patient cannot tolerate flucloxacillin, what antibiotics can be used?

A

Oral:

  • doxycycline
  • Cotrimoxazole
  • clindamycin
28
Q

Many staph. epidermidis are flucloxacillin resistant. TRUE/FALSE?

A

TRUE

29
Q

Listeria is a Gm +ve bacillus causing what kind of infection?

A

Gastroenteritis

30
Q

What infection is related to reheated/ left out rice?

A

Bacillus Cereus

31
Q

What antibiotic is used for a mild C-Diff infection and which is used for SEVERE?

A 
MILD = IV Metronidazole
SEVERE = oral vancomycin (treats topically)
32
Q

Why is there a lot of recurrence in C-Diff?

A

Due to spore formation

33
Q

What infection control precaution must you always remember in C-Diff?

A

WASH HANDS WITH SOAP AND WATER

alcohol gel allows spores to form

CLASP - SEPSIS (9 decks)

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