* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Staphylococcus aureus
Survey
Document related concepts
Hygiene hypothesis wikipedia , lookup
Neglected tropical diseases wikipedia , lookup
Common cold wikipedia , lookup
Traveler's diarrhea wikipedia , lookup
Childhood immunizations in the United States wikipedia , lookup
Infection control wikipedia , lookup
Gastroenteritis wikipedia , lookup
Staphylococcus aureus wikipedia , lookup
Immunosuppressive drug wikipedia , lookup
Clostridium difficile infection wikipedia , lookup
African trypanosomiasis wikipedia , lookup
Urinary tract infection wikipedia , lookup
Neonatal infection wikipedia , lookup
Transcript
Gram-positive bacteria: Staphylococci Staphylococcus aureus Staphylococcus aureus causes a variety of suppurative (pus-forming) infections and toxinoses in humans. It causes superficial skin lesions such as boils, styes and furunculosis; more serious infections such as pneumonia, mastitis, phlebitis, meningitis, and urinary tract infections; and deep-seated infections, such as osteomyelitis and endocarditis. S. aureus is a major cause of hospital acquired (nosocomial) infection of surgical wounds and infections associated with indwelling medical devices. S. aureus causes food poisoning by releasing enterotoxins into food, and toxic shock syndrome by release of superantigens into the blood stream. Staphylococcus aureus • http://www.visualdxhealth.com/pdfs/MRSA %20Handout.pdf Superantigens • http://highered.mcgrawhill.com/sites/0072556781/student_view0/ chapter32/animation_quiz_4.html Treatment of Infections Caused by Staphylococcus aureus • Antistaphylococcal penicillins: Nafcillin, oxacillin • First Generation cephalosporins: Cefazolin • Second Generation Cephalosporins: Cefurxime • Third-generation cephalosporins: Ceftriaxone, cefotaxime, ceftizoxime • B-Lactam/b-lactamase inhibitor combinations: Ampicillin-sulbactam, piperacillin-tazobactam, ticarcillin-clavulanate • Carbapenems: Imipenem, meropenem Treatment of Methicillin-resistant Staphylococcus aureus • • • • • Vancomycin Linezolid Streptogramins (Quinupristin-dalfopristin) Daptomycin Tigecycline Gram-positive pathogens: Streptococcus pneumoniae Streptococcus pneumoniae Treatment of Streptococcus pneumoniae • Penicillin G • Aminopenicillins: Ampicillin Treatment of Penicillin-resistant Streptococcus pneumoniae • Second Generation Cephalosoporins: Cefuroxime • Third Generation Cephalosporins: Cefotaxime, Ceftriaxone • Quinolones: Moxifloxacin, Levofloxacin • Vancomycin • Macrolides/ketolines: Telithromycin Streptococcus pyogenes Streptococcus pyogenes Treatment of Streptococcus pyogenes • Penicillin G • Aminopenicillins: Ampicillin • Aminoglycosides are sometimes added for synergy: Gentamicin • Clindamycin is added for severe invasive Streptococcus pyogenes infections Treatment for Penicillin-resistant Streptococcus pyogenes (and other penicillin resistant Streptococcus) • Vancomycin • Second-generation cephalosporins: Cefuroxime • Third-generation cephalosporins: cefotaxime, ceftriaxone Enterococci Enterococcus Enterococcus Resistance Mechanisms Treatment of Infections Caused by Enterococcus • • • • • Penicillin G Aminopenicillins: Ampicillin Extended-spectrum Penicillins: Piperacillin Carbapenems: Imipenem, meropenem For serious infections, add an aminoglycoside for synergy: Gentamicin Treatment for Infections Caused by Penicillin-resistant Enterococci • Vancomycin Treatment for Vancomycin Resistant Enterococci (VRE) • Linezolid • Tetracycline-like: Tigecycline • Sometimes also active: – Daptomycin – Quinupristin/dalfopristin Gram-positive Bacteria: Listeria Monocytogenes Listeria monocytogenes • http://www.nature.com/nrmicro/animation/i mp_animation/index.html Treatment of Infections Caused by Listeria monocytogenes • Ampicillin + Gentamicin • If penicillin allergic: – Trimethoprim-sulfamethoxazole Bacillus anthracis Bacillus anthracis Bacillus anthracis Treatment of Infections Caused by Bacillus anthracis • Quinolones: Ciprofloxacin • Tetracycline: Doxycycline Treatment of Infections Caused by Bacillus anthracis • For Inhalation Anthrax, a Second Agent Should be Added from the Following List: – – – – – – – – Rifampin Vancomycin Penicillin G Ampicillin Chloramphenicol Carbapenem: Imipenem Clindamycin Macrolide: Clarithromycin Gram-negative Bacteria: Enterobacteriaceae Escherichia coli Klebsiella Proteus Escherichia coli. • http://www.hhmi.org/biointeractive/media/e coli-lg.mov • http://www.drkoop.com/animation/93/43.ht ml Treatment of Infections Caused by: E. coli., K. pneumoniae, Proteus • Aminopenicillins: Ampicillin • First Generation Cephalosporins: Cefazolin • Sulfa drugs: Trimethoprimsulfamethoxazole • Quinolones: Ciprofloxacin, levofloxacin, moxifloxacin Treatment of Resistant Infections Caused by: E. coli., K. pneumoniae, Proteus • Third Generation Cephalosporins: Cefoxaxime, ceftriaxone, ceftizoxime • Monobactam: Aztreonam • Extended Spectrum penicillins + blactamase inhibitor: Piperacillintazobactam, ticarcillin-clavulanate • Carbapenems: Imipenem, meropenem, ertapenem • Carbapenem + aminoglycoside in serious infections: Add Gentamicin, Tobramycin, amikacin Treatment of Infections Caused by: Enterobacter, Serratia, Citrobacter, Providencia, and Morganella Spp. • Carbapenems: Imipenem, meropenem, ertapenem • Sulfa Drugs: Trimethoprimsulfamethoxazole • Quinolones: Ciprofloxacin, levofloxacin • Fourth Generation Cephalosporins: Cefepime • + aminoglycoside: Gentamicin, tobramycin, amikacin Treatment of Infections Caused by: Salmonella enterica, Shigella spp. • Quinolones: Ciprofloxacin • Third-generation cephalosporins: Cefotaxime, ceftriaxone, ceftizoxime • Macrolides: Azithromycin Treatment of Infections Caused by: Yersinia spp. • Aminoglycosides: Gentamicin, streptomycin • Tetracyclines: Doxycycline • Quinolones: Ciprofloxacin • Sulfa drugs Gram-negative Bacteria: Pseudomonas Pseudomonas Resistance of Pseudomonas Treatment of Infections caused by Pseudomonas aeruginosa • Extended spectrum penicillins: Piperacillin, Ticarcillin • Third Generation Cephalosporins: Ceftazidime • Fourth-generation Cephalosporins: Cefepime • Carbapenems: Imipenem, meropenem • Monobactams: Aztreonam • Quinolones: Ciprofloxacin, Levofloxacin • Aminoglycosides: Gentamicin, tobramycin, amikacin Treatment of Serious Infections Caused by Pseudomonas aeruginosa • Antipseudomonal b-lactam + aminoclycoside: Ceftazidime + Tobramycin • Extended-spectrum penicillin + antipseudomonal quinolone: Piperacillin + Ciprofloxacin Neisseria Neisseria meningitidis Neisseria gonorrhoeae Treatment of Infections Caused by Neisseria meningitidis • Penicillin G • Third generation cephalosporins: Ceftriaxone, cefotaxime Treatment of Infections Caused by Neisseria Gonorrhoeae • Third Generation Cephalosporins: Ceftriaxone, cefixime Curved Gram Negative Bacilli • Includes: – Campylobacter jejuni, – Helicobacter pylori, – Vibrio cholerae Campylobacter jejuni Campylobacter jejuni Treatment of Infection Caused by Campylobacter jejuni • Macrolides: Erythromycin, azithromycin, clarithromycin • Quinolones: Ciprofloxacin Helicobacteri pylori Helicobacter pylori Helicobacter pylori Duodenal Peptic Ulceration Caused by Helicobacter pylori Treatment of Infection Caused by Helicobacter pylori • Amoxicillin + clarithromycin + proton pump inhibitor • Metronidazole + clarithromycin + proton pump inhibitor • Bismuth subsalicylate + metronidazole + tetracycline + proton pump inhibitor Vibrio cholerae Vibrio cholerae Treatment of Infection Caused by Vibrio cholerae • Tetracyclines: tetracycline, doxycycline • Sulfa drugs: Trimethoprimsulfamethoxazole • Quinolones: Ciprofloxacin • Macrolides: Erythromycin, Azithromycin Haemophilus influenzae Haemophilus influenzae Haemophilus influenzae Treatment of Infections Caused by Haemophilus influenzae • Aminopenicillins + b-lactamase inhibitor: – Amoxicillin/clavulanate – Ampicillin/sulbactam • Second-generation cephalosporin – Cefuroxime • Third-generation cephalosporin – Ceftriaxone – Cefotaxime Bordetalla pertussis Bordetella pertussis Treatment of Infection Caused by Bordetella pertussis • Macrolides: Azithromycin, Clarithromycin, Erythromycin Moraxella catarrhalis • Causes otitis media, pneumonia, and sinusitis • Usually produces b-lactamase Treatment of Infections Caused by Moraxella catarrhalis • Extended spectrum penicillins: piperacillin, ticarcillin • B-lactam/b-lactamase inhibitor combinations: piperacillin/tazobactam, ticarcillin/clavulanate • Second and third-generation cephalosporins Acinetobacter • Recent outbreak among soldiers in Iraq • Second leading cause of infection among troops during the Vietnam conflict Acinetobacter Treatment of Infection Caused by Acinetobacter • Sulbactam • Carbapenems • Quinolones Anaerobic Bacteria Gram positive: Clostridia spp. Clostridium tetani • Clostridium tetani is the etiologic agent of tetanus • Characterized by persistent tonic spasm, usually involving the masseter muscles (lockjaw) • Usually caused by deep wound becoming infected with C. tetani spores. Clostridium botulinum • Clostridium botulinum is usually acquired by ingestion of food contaminated with C. botulinum spores • Botulinum toxin leads to cranial neuroopathies and weakness rather than muscular spasm. Treatment of Infections Caused by Clostridium spp. • Penicillin G • Metronidazole (may be associated with better outcomes Clostridium difficile Clostridium difficile Treatment of Infections Caused by Clostridium difficile • Oral metronidazole • Oral vancomycin Clostridium perfringens is the cause of gas gangrene Treatment of Infections Caused by Clostridium perfringens • Penicillin + one of the following: – Clindamycin – Tetracycline – Metronidazole Anaerobic Gram-negative Bacteria Common Anaerobic Gram-negative Pathogens • Bacteroides fragilis – Usually produces b-lactamase • Prevotella • Porphyromonas Treatment of Anaerobic Gramnegative Infections b-lactam/b-lactamase inhibitor combinations – Ampicillin-sulbactam – Piperacillin-tazobactam – Ticarcillin-clavulanate • Carbapenems: Imipenem, Meropenem, Ertapenem • Metronidazole Atypical Bacteria: Chlamydia Chlamydia trachomatis • One of the most common sexually transmitted diseases • Also a leading cause of blindness in some parts of the world Chlamydia trachomatis Chlamydia is a bacterial infection of the genital tract spread through sexual contact. If untreated, it can result in various medical complications, including damage to the reproductive organs. The disease affects both women and men, although reported cases for women greatly exceed those for men. Chlamydia affects people in all age groups, but it is particularly prevalent among teenagers and young adults. According to the U.S. Centers for Disease Control and Prevention (CDC), the infection is most prevalent among women aged 20 to 25. Chlamydia trachomatis Some signs and symptoms that may be present in people infected with chlamydia are: • • • • • • • • • • Abnormal discharge from the penis or vagina Burning sensation during urination Lower abdominal or back pain Nausea Fever Pain during intercourse Burning or itching around the head of the penis Swollen or tender testicles Bleeding between menstrual cycles Proctitis (inflammation of the rectum) Treatment of Infections Caused by Chlamydia trachomatis • Tetracyclines – Tetracycline – Doxycycline • Macrolides – Azithromycin – Erythromycin – Telithromycin • Quinolones – Ofloxacin – Moxifloxacin – Gemifloxacin Mycoplasma pneumoniae Mycoplasma pneumoniae Treatment of Infections Caused by Mycoplasma pneumoniae • Macrolides: Azithromycin, clarithromycin, erythromycin telithromycin • Tetracyclines: Tetracycline, doxycycline • Quinolones: Levofloxacin, moxifloxacin, gemifloxacin Atypical Bacteria: Legionella • Legionella pneumophila is the most common species, and is the causative agent of Legionaires’ disease • Once in the lung, Legionella organisms are taken up by macrophages and multiply within them. Legionalla pneumophila • http://www.natur e.com/nrmicro/a nimation/imp_an imation/index.ht ml Treatment of Infections Caused by Legionella pneumophila • Macrolides: Azithromycin • Quinolones: Levofloxacin, moxifloxacin Brucella • Brucellosis is a disease of animals, that is occasionally transmitted to humans • Contact with animals and/or ingestion of unpasteurized milk or cheese are risk factors Brucella Brucella Treatment of Infections Caused by Brucella spp. • Doxycycline + rifampin • Dixycycline + gentamicin • Doxycycline + streptomycin Francisella tularensis Francisella tularensis Treatment of Infections Caused by Francisella tularensis • Aminoglycosides: Streptomycin, Gentamicin • Tetracyclines: Tetracycline, doxycycline Rickettsia spp Rickettsia rickettsii Rocky Mountain spotted fever is the most severe and most frequently reported rickettsial illness in the United States. The disease is caused by Rickettsia rickettsii, a species of bacteria that is spread to humans by ixodid (hard) ticks. Treatment of Infections Caused by Rickettsia spp. • Tetracyclines – Doxycycline – Tetracycline Spirochetes: Treponema pallidum Treponema pallidum Treponema pallidum Treponema pallidum Treatment of Infections Caused by Treponema pallidum • Penicillin G (including benzathine penicillin) • Tetracyclines • Third Generation Cephalosporins Penicillin G benzathine Procaine penicillin G http://www.chemblink.com/products/54-35-3.htm Borrelia borgdorferi Borrelia burgdorferi Borrelia burgdorferi is the causative agent of Lyme Disease Treatment of Infections Caused by Borrelia burgdorferi • Tetracyclines: Doxycycline • Aminopenicillins: Amoxicillin Leptospira interrogans Leptospira interrogans Treatment of Infection Caused by Leptospira interrogans • Tetracyclines: Doxycycline • Aminopenicillins: Amoxicillin • Severe Disease can be treated with Penicillin G, Ampicillin, or Ceftriaxone Mycobacteria • Mycobacterium tuberculosis • Mycobacterium avium complex • Mycobacterium leprae Mycobacterium tuberculosis Mycobacterium tuberculosis Mycobacterium tuberculosis Treatment of Infections Caused by Mycobacterium tuberculosis • Active Disease – Isoniazid + Rifampin + Pyrazinamide + Ethambutol for two months – Followed by: Isoniazid + Rifampin for Four months • Latent Disease – Isoniazid for 9 months Mycobacterium avium complex Mycobacterium avium complex Treatment of Infections Caused by Mycobacterium avium complex (MAC) • Clarithromycin + ethambutol + rifabutin Mycobacterium leprae Mycobacterium leprae Leprosy Treatment of Infections Caused by Mycobacterium leprae • Dapsone + rifampin + clofazimine