CBC needs to be checked weekly to avoid bone marrow suppression, neutropenia, thrombocytopenia, and anemia. Linezolid is an option if a patient is allergic to vancomycin. Vancomycin requires renal dosing with trough levels between 15 to 20. Vancomycin, linezolid, daptomycin, and tigecycline cover moderate to severe community and hospital-acquired MRSA. Trimethoprim/sulfamethoxazole, clindamycin, and doxycycline are oral antibiotics used for mild to moderate MRSA infections. It is important to note that trimethoprim/sulfamethoxazole increases warfarin levels leading to increased INR. Carbapenems cover gram-positives, gram negatives, and anaerobes. Anti-pseudomonal penicillins include piperacillin and ticarcillin effective against gram-positive, gram-negative, pseudomonas, and anaerobes. The penicillinase-resistant organisms (nafcillin, oxacillin, cloxacillin, dicloxacillin) cover Staph (MSSA) and Strep. Penicillin does not cover Staph or Enterococcus but used mainly streptococcal infections. Penicillin was the first antibiotic ever introduced during World War II by Alexander Fleming in 1928. Listeria can cause neonatal meningitis, meningitis in immunocompromised patients, gastroenteritis, and septicemia. Listeria monocytogenes is a gram-positive rod acquired by the ingestion of cold deli meats and unpasteurized dairy products or by vaginal transmission during birth. Symptoms include nausea, vomiting, and watery non-bloody diarrhea.Ĭorynebacterium diphtheria is a gram-positive club-shaped rod that can cause pseudomembranous pharyngitis, myocarditis, and arrhythmias. Bacillus cereus is a gram-positive rod that can be acquired from spores surviving under-cooked or reheated rice. Treatment involves primarily with oral vancomycin.īacillus anthracis is a gram-positive spore-forming rod that produces anthrax toxin resulting in an ulcer with a black eschar. difficile is often secondary to antibiotic use (clindamycin/ampicillin), PPI use, and recent hospitalization. Vancomycin-resistant enterococci (VRE) are an important cause of nosocomial infections.Ĭlostridia is a gram-positive spore-forming rod consisting of C. Pregnant women need screening for Group-B Strep (GBS) at 35 to 37 weeks of gestation.Įnterococci is a gram-positive group D cocci found mainly in the colonic flora and can cause biliary tract infections and UTIs. Streptococcus agalactiae is a gram-positive group B cocci that colonize the vagina and is found mainly in babies. Streptococcus pyogenes is a gram-positive group A cocci that can cause pyogenic infections (pharyngitis, cellulitis, impetigo, erysipelas), toxigenic infections (scarlet fever, necrotizing fasciitis), and immunologic infections (glomerulonephritis and rheumatic fever). mutans and Strep mitis found in the normal flora of the oropharynx commonly cause dental carries and subacute bacterial endocarditis (Strep. Streptococcus pneumoniae is a gram-positive, encapsulated, lancet-shaped diplococci, most commonly causing otitis media, pneumonia, sinusitis, and meningitis. ![]() saprophyticus accounts for the second most common cause of uncomplicated urinary tract infection (UTI). Staphylococcus saprophyticus is novobiocin resistant and is a normal flora of the genital tract and perineum. epidermidis commonly infects prosthetic devices and IV catheters producing biofilms. Staphylococcus epidermidis is a gram-positive, catalase-positive, coagulase-negative cocci in clusters and is novobiocin sensitive. aureus can also cause toxic shock syndrome (TSST-1), scalded skin syndrome (exfoliative toxin, and food poisoning (enterotoxin). aureus can cause inflammatory diseases, including skin infections, pneumonia, endocarditis, septic arthritis, osteomyelitis, and abscesses. Staphylococcus aureus is a gram-positive, catalase-positive, coagulase-positive cocci in clusters. It is a 20 to 80 nm thick polymer while the peptidoglycan layer of the gram-negative cell wall is 2 to 3 nm thick and covered with an outer lipid bilayer membrane. Gram-positive organisms have a thicker peptidoglycan cell wall compared with gram-negative bacteria. Also, the branching filament rods encompass Nocardia and actinomyces. Spore-forming rods that produce spores can survive in environments for many years. Bacillus and Clostridia are spore-forming rods while Listeria and Corynebacterium are not. Gram-positive bacilli (rods) subdivide according to their ability to produce spores. agalactiae (Group B), enterococci (Group D), Strep viridans, and Strep pneumonia. Streptococcus bacteria subdivide into Strep. Gram-positive cocci include Staphylococcus (catalase-positive), which grows clusters, and Streptococcus (catalase-negative), which grows in chains. The staphylococci further subdivide into coagulase-positive ( S.
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