{"id":5214,"date":"2011-07-14T20:24:28","date_gmt":"2011-07-14T20:24:28","guid":{"rendered":"http:\/\/crashtext.org\/misc\/the-bugs.htm\/"},"modified":"2012-08-01T18:51:19","modified_gmt":"2012-08-01T22:51:19","slug":"the-bugs","status":"publish","type":"post","link":"https:\/\/crashingpatient.com\/medical-surgical\/infectious-disease\/the-bugs.htm\/","title":{"rendered":"The Bugs – Microbes and Such"},"content":{"rendered":"

<\/span>The Bugs<\/span><\/h2>\n

Enterococci<\/p>\n

E. Faecalis<\/p>\n

E. Faecium<\/p>\n

facultative anaerobes<\/p>\n

 <\/p>\n

Enterobacteriaceae<\/p>\n

E. Coli<\/p>\n

Protes<\/p>\n

Klebsiella<\/p>\n

Citrobacter<\/p>\n

Salmonella<\/p>\n

Shigella<\/p>\n

Yersinea<\/p>\n

Urine<\/p>\n

Morganella<\/p>\n

E. Aerogenes<\/p>\n

E. Cloacae<\/p>\n

 <\/p>\n

Anaerobes<\/p>\n

Clostridia<\/p>\n

 <\/p>\n

Non-Fermentative Gram Neg Rods<\/p>\n

Pseudomonas Aeruginosa<\/p>\n

A. Baumannii<\/p>\n

 <\/p>\n

Candida<\/p>\n

Albicans<\/p>\n

Krusei<\/p>\n

Glabrata<\/p>\n

 <\/p>\n

candida colonizes the gi tract<\/p>\n

any candida in the blood requires removal of all lines and treatment<\/p>\n

in the urine without other sites, remove catheter and reculture<\/p>\n

 <\/p>\n

treat:<\/p>\n

2 sites<\/p>\n

vascular cath tip<\/p>\n

c. tropicalis<\/p>\n

resistant funguria<\/p>\n

deep issue culture<\/p>\n

 <\/p>\n

fluconazole 400-800 mg\/day<\/p>\n

 <\/p>\n

early yeast infection: consider gastric perf<\/p>\n

 <\/p>\n

Group B strep is strep A galactiae<\/p>\n

 <\/p>\n


\n<\/em><\/p>\n

<\/span>S<\/span><\/h2>\n

UPER BUGS UNLEASHED IN YOUR EMERGENCY DEPARTMENT\u0097<\/p>\n

Peter DeBlieux, MD, Professor of Clinical Medicine, Louisiana<\/p>\n

State University School of Medicine, New Orleans<\/p>\n

Epidemiology:<\/p>\n

gram-positive sepsis has overtaken gram-negative<\/p>\n

sepsis; common gram-positive bacteria include<\/p>\n

Staphylococcus <\/em><\/p>\n

aureus,<\/p>\n

coagulase-negative staphylococci, enterococci,<\/p>\n

and streptococci; most common gram-negative pathogens are<\/p>\n

Escherichia coli<\/p>\n

, Klebsiella<\/em>, and Pseudomonas<\/em>; incidence of<\/p>\n

fungal sepsis has tripled due to transplant patients and those on<\/p>\n

immunosuppressive therapy (accounts for only 5% of all cases<\/p>\n

of sepsis); common sites of sepsis are 1) lungs, 2) bloodstream,<\/p>\n

3) abdomen, 4) urinary tract, 5) skin and soft tissue;<\/p>\n

pearl\u0097<\/p>\n

when source unknown, choose antibiotic that covers<\/p>\n

abdominal pathogens<\/p>\n

Origins of super bugs:<\/p>\n

selection of agents with broader spectrum<\/p>\n

than required; broad-spectrum antibiotics placed in animal<\/p>\n

feed (<\/p>\n

eg, <\/em>cows, sheep, chickens); patients not finishing<\/p>\n

their course of medication and giving leftover pills to friends<\/p>\n

or relatives; propensity of physicians to overuse antibiotics<\/p>\n

(medicate rather than educate); selection pressure number one<\/p>\n

etiology of resistance,<\/p>\n

ie, <\/em>sensitive organisms killed by antibiotic,<\/p>\n

resistant organisms multiply<\/p>\n

Case:<\/p>\n

3-yr-old presents with temperature of 39.5<\/p>\n","protected":false},"excerpt":{"rendered":"

Array<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[23],"tags":[],"yoast_head":"\nThe Bugs - Microbes and Such - Crashing Patient<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/crashingpatient.com\/medical-surgical\/infectious-disease\/the-bugs.htm\/\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"CrashMaster\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/crashingpatient.com\/medical-surgical\/infectious-disease\/the-bugs.htm\/\",\"url\":\"https:\/\/crashingpatient.com\/medical-surgical\/infectious-disease\/the-bugs.htm\/\",\"name\":\"The Bugs - 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