Professional Documents
Culture Documents
Location eyes, genitals, lungs lungs lungs lung genitals genitals genitals (tiny colony)
Mycoplasma
smallest bac Mycoplasma pneumoniae no cell wall Mycoplasma genitalium Mycoplasma hominis Ureaplasma urealyticum Pos clusters Staph aureus Staph epidermidis Staph saprophyticus
skin bladder
Streptococci
Strep pyogenes (A)- Large B zone strep agalactiae (B) - small B zone GI, upper resp infants Strep pneumoniae- lancet Viridans Strep mouth and gut
Clostridium
GI tract from rust/splinter Soil, canned food, honey GI spores Nosocomial Spread gut
Gram Negatives Peptostreptococci Non-spore Neisseria Negative diplococci Aerobes Bacteroides Fragilis N. Meningitidis N. Gonnorhea mouth, GI, vagina GI tract, Vagina Brain In your Vajay/Schlong
Enterobacteriaceae anaerobes
Neg Pathovars
All rods E.coli- (indole producing) EPEC- Enteropathogenic EHEC- Enterohemorrhagic ETEC - Enterotoxiicgenic EIEC- Enteroinvasive EAEC- Enteroaggregative DAEC- Diffusely Adherent UPEC- Uropathogenic NMEC- Neonatal Meningitis Shigella S.dysenteriae S.flexneri S.boydii S.sonnei Klebsiella K.pneumoniae K.oxytoca K. granulatis
All GI small bowel Large bowel small bowel Large bowel Large Bowel Small bowel blood stream, bladder, kid bloodstream identical to E.coli
M-SPICE
S E C
S.paratyphi nontyphoidal Non-Enterobacterace Urease -ve Urease +ve Campylobacter Jejuni Heliobacter pylori Animals --> our gut Stomach Intestinal Tract Commensal in Pharynx Genitals
Oxidase +ve Vibrio Cholerae Haemophilus Negative H. Influenzae Coccobascilis H. Ducreyi Aerobe Legionella Pneumophilia Bordotella Pertussis Pseudomonas aerobic Neg rod curved P.aeruginosa
colon
Plasmodium
Non-Bacteria Protozoa
parasite
Giardia intestinalis
Fungi opportunistic
yeast, Pos
Candida
mouth, eso, vagina, skin Mucosal & Cutaneous Deep-seeded Candidemia usually inhaled as spores
mold
Aspergillus A.fumigatus
A.flavus A. niger yeast-encap. Cryptococcus C.neoformans var neoformans (birds) var gattii no pseudohyphae! effects immunocomp. effects all
Diseases A,B,C- trachoma (blindness), D-K- conjunctivitis, infant pneu, cerviciti, PID, urethritis, L- LGV walking pneumonia birds walking pneumonia (with target rash or stevens-johnson syndrome)
Skin and soft tissue infections, osteo, endocard, and septic arthritis Mainly found coating heart valves and prosthetics, biofilm UTI's
Pharyngitis (cobblestone), Scarlet fever, glomerulonephritis, rheumatic fever, necrotizing fasc. UTI, endometritis, bacteremia, skin and soft tissue infections, early/late onset disease in infants pulmonary infections and a million others Endocarditis
tetanus blocks Gaba and causes rigid paralysis Floppy paralysis, Ach blockage caused by endospores Food poisoning, soft tissue infection (necro fasci, uterine infection) Diarrhea caused by antibiotics #1 disease is UTI. Also causes bacteremia, endocarditis, meningitis, skin and soft tissue endocarditis most common
sinusitis, stomach lung and brain abscesses, post partum endometriosis Surgery, trauma, chronic disease leads to this commensal causing pneumonia and pleural abscesses Pili for adhesion, LPS for epithelial cell damage, and MENINGITIS DUH. Urethritis, Cervicits. Ophthalmic problems in neonates
UTI, blood, peritoneum, resp tract infections all common diarrheal outbreaks in neonates hemorrhagic colitis and HUS- Shiga toxin- bloody diarrhea travelers diarrhea illness similar to shigella travelers diarrhea diarrhea in developing nations UTI
UTI sometimes resp infections severe UTI with possible stone formation - swarming motility
typhoid fever
typhoid fever gastroenteritis - foodborne outbreaks gastroenteritis leading to guilamme barre due to enterotoxins urease allows it to survive in stomach acid. Causes stomach and duodenal ulcers Enterotoxin A and B causes secretion of fluid to gut. Firehose Diarrhea = 20L. 1-3L/day Capsule and IgA protease. Meningitis, pneumonia in COPD and alcoholics Chancroid ulcer
Legionaires disease and Pontiac fever. Whooping cough (cough of 100 days) Low grade fever progresses to vomitting and cyanosis Hot tub Folliculitis, smells like grapes Bacteremia, acute pneumonia, chronic resp infections (in CF), bone and joint, swimmers ear, eye, UTI
beaver fever
Thrush and Esophagitis (nystatin not effective here), Vaginitis (no statin) & Diaper rash, intertrigo (skin folds) CNS, endocarditis, osteomyelitis, septic arthritis, blood stream -> can disemminate to organs
Invasive pulmonary and sinus infection - in immunosupp. Pulmonary aspergilloma (fungus ball)- TB cavity required
cefazolin (ceph), cloxacillin (penicillin), Erythromycin (macrolide), Clindmycin, sulfa, and vanco (for MRSA)
Penicillin, Erythromycin Penicillin, Vancomycin Penicillin, Erythromycin - pneumococcal conjugate vaccine Penicillin-gentamycin
Clean wound, Tetanus Ig, benzo's, tetanus vaccine series on discharge Penicillin for wound infection, Horse made anti-toxin Pen G + Clindamycin Remove antibiotic, metranidazole, fluids. Avoid anti-motility agents! All have intrinsic and extrinsic resistance - to B-lactams and Aminoglycosides Use ampicillin + gentamicin for synergy, vanco + genta if allergic Linezolid for VRE
penicillin or clindamycin Metronidazole, drain abscess Penicillin, 3rd Gen Ceph. Quinolone given prophylactically to close contacts Erythromycin eye drops to EVERY baby. Doxycycline or azithromycin
ALL can use peniciilin, most cephalosporin, ALL quin, ALL sulfa B-lactams use depends on: 1) AB in contact with target 2) affinity of AB for target 3) production of B-lactamases Resistance: 1) porin channel mutations 2) Efflux system mutations (more AB pumped out) 3) PBP mutations 4) B-lactamase production (MOST COMMON)
ONLY 4th gen cephalosporins and Carbapenems can used used on M-SPICE have AmpC cephalosporinases therefore can't use 1,2,or 3 gen
Treat between 2-50, immunocompromised and very severe cases macrolides or quinolones, replenish fluids OAC = Omeprazole, Amoxicillin, Clarithromycin. Check for cure with urease breath test Replenish fluids like a mofo, Doxycycline, Quinolone Vaccinate, Macrolide, 2/3 gen ceph, Rifampin to close contacts Quinolone, 3rd gen ceph, macrolide
Macrolides or quinolone. Pip/tazo would probs also be a good choice IMO Erythromycin or macrolides for patient and contacts.
Chloroquine (but has resistance), Doxycycline (not in kids), Primaquine (no G6PD) Mefloquine (good drug)
metronidazole
topical nystatin (fungicidal-attacks cell mem) or oral fluconazole (fungistatic) CNS treated with IV AF fluconazole or newer gen voriconazole
CT shows "halo sign" or "air-cresent" infiltrates - use Amphotericin B or voriconazole surgery to remove fungus ball
All Catalase All have capsule All have C protein (antigenic component)
All ferment glucose, all reduce nitrate to nitrite All catalase +, All oxidase - (except pseudo) Do not prescribe AB, will cause HUS
Extra Extras
Staph Aureus #1 cause of endocarditis in IVDU 1) Disable IS- coagulase, leukocidins, penicillinase, PBP 2 (meth) 2) Tissue destroying enzymes- protease, lipase, 3) Exotoxins- exfoliation (scalded skin syndrome), Heat stable (food poisoning), TSST-1
Has M protein (rheumatic and superantigen TSS) Has M and F antigen, produces A hemolytic colonies
Microbe Chlamydia
Species Chlamydia trachomatis Chamydophila pneumonia Chamydophila psittacci Mycoplasma pneumoniae Mycoplasma genitalium Mycoplasma hominis Ureaplasma urealyticum Staph aureus Staph epidermidis Staph saprophyticus
Where to Find Them eyes, genitals, lungs lungs lungs lung genitals genitals genitals (tiny colony) skin/joints/diabetic foot skin bladder
Mycoplasma
Streptococci Strep pyogenes (A)- Large B zone strep agalactiae (B) - small B zone Strep pneumoniae- lancet Viridans Strep Clostridium C. Tetani C. Botulinum C. Perfringens C. Diff Enterococcus anaerobe (like strep) pairs or short chains E.faecalis E.faecium GI tract from rust/splinter Soil, canned food, honey GI spores Nosocomial Spread Throat GI, upper resp infants, Genitals Brain, Lungs mouth, gut, heart
Gut Gut
Gram Negatives Peptostreptococci Bacteroides Fragilis Neisseria N. Meningitidis N. Gonnorhea mouth, GI, vagina GI tract, Vagina Brain Urinary tract
Enterobacteriaceae anaerobes
All rods E.coli- (indole producing) EPEC- Enteropathogenic EHEC- Enterohemorrhagic ETEC - Enterotoxiicgenic EIEC- Enteroinvasive EAEC- Enteroaggregative DAEC- Diffusely Adherent UPEC- Uropathogenic NMEC- Neonatal Meningitis Shigella S.dysenteriae S.flexneri S.boydii S.sonnei Klebsiella K.pneumoniae K.oxytoca K. granulatis
All GI small bowel Large bowel small bowel Large bowel Large Bowel Small bowel blood stream, bladder, kid bloodstream GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI GI
M-SPICE
S.paratyphi nontyphoidal Non-Enterobacterace Campylobacter Jejuni Heliobacter pylori Vibrio Cholerae Haemophilus H. Influenzae H. Ducreyi
GI GI Animals --> our gut Stomach Intestinal Tract Commensal in Pharynx Genitals
Resp, Urinary, Gi
Giardia intestinalis
Fungi opportunistic
Candida
mouth, eso, vagina, skin Mucosal & Cutaneous Deep-seeded Candidemia usually inhaled as spores
Aspergillus A.fumigatus
A.flavus A. niger Cryptococcus C.neoformans var neoformans (birds) var gattii Respiratory tract effects immunocomp. effects all
Microbe Chlamydia
Species Chlamydia trachomatis Chamydophila pneumonia Chamydophila psittacci Mycoplasma pneumoniae Mycoplasma genitalium Mycoplasma hominis Ureaplasma urealyticum Staph aureus Staph epidermidis Staph saprophyticus
Mycoplasma
Streptococci Strep pyogenes (A)- Large B zone strep agalactiae (B) - small B zone Strep pneumoniae- lancet Viridans Strep Clostridium C. Tetani C. Botulinum C. Perfringens C. Diff Enterococcus anaerobe (like strep) pairs or short chains E.faecalis E.faecium
Enterobacteriaceae anaerobes
All rods E.coli- (indole producing) EPEC- Enteropathogenic EHEC- Enterohemorrhagic ETEC - Enterotoxiicgenic EIEC- Enteroinvasive EAEC- Enteroaggregative DAEC- Diffusely Adherent UPEC- Uropathogenic NMEC- Neonatal Meningitis Shigella S.dysenteriae S.flexneri S.boydii S.sonnei Klebsiella K.pneumoniae K.oxytoca K. granulatis
M-SPICE
S.paratyphi nontyphoidal Non-Enterobacterace Campylobacter Jejuni Heliobacter pylori Vibrio Cholerae Haemophilus H. Influenzae H. Ducreyi
Giardia intestinalis
Fungi opportunistic
Candida
Aspergillus A.fumigatus
Treatments Azithromycin. Erythromycin given to babies Doxycycline Doxycycline Macrolides or Quinolones azithromycin or doxycycline. Maybe Quinolone in resistance azithromycin or doxycycline azithromycin or doxycycline Cloxacillin Vancomycin (MRSA vanco as well) Penicillin
Penicillin, Erythromycin Penicillin, Vancomycin Penicillin, Erythromycin - pneumococcal conjugate vaccine Penicillin-gentamycin
Clean wound, Tetanus Ig, benzo's, tetanus vaccine series on discharge Penicillin for wound infection, Horse made anti-toxin Pen G + Clindamycin Remove antibiotic, metranidazole, fluids. Avoid anti-motility agents! All have intrinsic and extrinsic resistance - to B-lactams and Aminoglycosides Use ampicillin + gentamicin for synergy, vanco + genta if allergic Linezolid for VRE
penicillin or clindamycin Metronidazole, drain abscess Penicillin, 3rd Gen Ceph. Quinolone given prophylactically to close contacts Erythromycin eye drops to EVERY baby. Doxycycline or azithromycin
ALL can use peniciilin, most cephalosporin, ALL quin, ALL sulfa B-lactams use depends on: 1) AB in contact with target 2) affinity of AB for target 3) production of B-lactamases
ONLY 4th gen cephalosporins and Carbapenems can used used on M-SPICE have AmpC cephalosporinases therefore can't use 1,2,or 3 gen
Treat between 2-50, immunocompromised and very severe cases macrolides or quinolones, replenish fluids OAC = Omeprazole, Amoxicillin, Clarithromycin. Check for cure with urease breath test Replenish fluids like a mofo, Doxycycline, Quinolone Vaccinate, Macrolide, 2/3 gen ceph, Rifampin to close contacts Quinolone, 3rd gen ceph, macrolide
Macrolides or quinolone. Pip/tazo would probs also be a good choice IMO Erythromycin or macrolides for patient and contacts.
Chloroquine (but has resistance), Doxycycline (not in kids), Primaquine (no G6PD) Mefloquine (good drug)
Metranidazole
topical nystatin (fungicidal-attacks cell mem) or oral fluconazole (fungistatic) CNS treated with IV AF fluconazole or newer gen voriconazole
CT shows "halo sign" or "air-cresent" infiltrates - use Amphotericin B or voriconazole surgery to remove fungus ball
Resistance: 1) porin channel mutations 2) Efflux system mutations (more AB pumped out) 3) PBP mutations 4) B-lactamase production (MOST COMMON)