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You are here: Home / 09. Medical/Surgical / infectious disease / The Bugs – Microbes and Such

The Bugs – Microbes and Such

July 14, 2011 by CrashMaster

The Bugs

Enterococci

E. Faecalis

E. Faecium

facultative anaerobes

 

Enterobacteriaceae

E. Coli

Protes

Klebsiella

Citrobacter

Salmonella

Shigella

Yersinea

Urine

Morganella

E. Aerogenes

E. Cloacae

 

Anaerobes

Clostridia

 

Non-Fermentative Gram Neg Rods

Pseudomonas Aeruginosa

A. Baumannii

 

Candida

Albicans

Krusei

Glabrata

 

candida colonizes the gi tract

any candida in the blood requires removal of all lines and treatment

in the urine without other sites, remove catheter and reculture

 

treat:

2 sites

vascular cath tip

c. tropicalis

resistant funguria

deep issue culture

 

fluconazole 400-800 mg/day

 

early yeast infection: consider gastric perf

 

Group B strep is strep A galactiae

 


S

UPER BUGS UNLEASHED IN YOUR EMERGENCY DEPARTMENT—

Peter DeBlieux, MD, Professor of Clinical Medicine, Louisiana

State University School of Medicine, New Orleans

Epidemiology:

gram-positive sepsis has overtaken gram-negative

sepsis; common gram-positive bacteria include

Staphylococcus

aureus,

coagulase-negative staphylococci, enterococci,

and streptococci; most common gram-negative pathogens are

Escherichia coli

, Klebsiella, and Pseudomonas; incidence of

fungal sepsis has tripled due to transplant patients and those on

immunosuppressive therapy (accounts for only 5% of all cases

of sepsis); common sites of sepsis are 1) lungs, 2) bloodstream,

3) abdomen, 4) urinary tract, 5) skin and soft tissue;

pearl—

when source unknown, choose antibiotic that covers

abdominal pathogens

Origins of super bugs:

selection of agents with broader spectrum

than required; broad-spectrum antibiotics placed in animal

feed (

eg, cows, sheep, chickens); patients not finishing

their course of medication and giving leftover pills to friends

or relatives; propensity of physicians to overuse antibiotics

(medicate rather than educate); selection pressure number one

etiology of resistance,

ie, sensitive organisms killed by antibiotic,

resistant organisms multiply

Case:

3-yr-old presents with temperature of 39.5

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