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15 Cards in this Set
- Front
- Back
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Definition of nosocomial septicemia
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-hospital acquired infections
-Approx. 15% of hosptitalized newborns (>48 h of stay in the NICU) may acquire an infection) |
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most common cause
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-->staplyococcus (s. aureus-coagulase +, and s. epidermidis-CONS, the most common)
-->enteric gram - and p. aeruginosa -->enterococci |
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transmission of bacteria
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indwelling central vascular catheters, thoracostomy tubes, or CNS shunts (staphylococcus- s. aureus and s. epideridis)
-environment -personnel |
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clinical manifestion
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same as septicemia
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therapy-antibiotic of choice
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penicillinase resistant (antistaphyloccal) penicillins (nafcillin or oxacillin- bactericidal)
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A.E. of penicillinase resistant penicillin (nafcillin or oxacillin)
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-hypersensitivity rxns- rash to anaphylactic events
-superinfection -gi -dermatologic effects:nonallergic rash |
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therapy-MRSA and gram pos.
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vancomycin (batericidal)
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serum PEAK conc. of vancomycin
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25-40 (toxicity)- not concentration dependent killing like AG
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serum TROUGH conc. of vancomycon
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5-15 (efficacy)-not concentration dependent killing like AG
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A.E. of vancomycin
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nephro, oto, red man syndrome (release of histamine=due to infusion)
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Therapy-vancomycon-intermediate or vancomycin resistant enterococcus faecium (VREF)=covers gram +
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Linezolid (IV)
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AE of linezolid
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GI: N/V/D
severe: lactic acidosis, neutropenia, thrombocytopenia, and anemia |
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Therapy: for persistant S. aureus infection (adjunctively) (covers gram +) works synergistically
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Rifampin
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a.e. of rifampin
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GI: N/V/D and cholestatic jaundice
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Empiric regimen
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Nafcillin/vancomycin+AG
-->once sensitivities return: MSSA=nafcillin MRSA=vancomycin +/- rifampin vancomycin-intermediate s. aureus or VRE=linezolid -->if p. aeruginos, requires double coverage (can add ceftazidime, ticarcillin, or piperacillin) |
