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33 Cards in this Set

  • Front
  • Back
Name the bio-film associated infections?
IV catheter infections, Urinary catheter infections, Device Infections (Pacemakers, Prosthetic Joints)
What is an "Antimicrobial Biofilm?
Sophisticated communities of matrix-encased surface attached bacteria with hydrated structures with water channels to allow nutrients and oxygen diffusion
What are the contents of a biofilm?
1) Non-microbial host-derived components (platelets)
2) Cell-to-cell communication molecules
3) Dense matrix of polysaccharides
4) Bacterial Proteins (adhesins) and virulence factors
What different routes can antimicrobials be delivered to the site of infection?
1) Oral therapy
2) IV therapy
3) Material design (embedding/coating a device with antimicrobials)
4) Localized therapy
What are the targets for antimicrobials?
1) Cell wall synthesis
2) Protein synthesis
3) DNA synthesis
4) Anti-metabolites
What are the clinical implications of bacterial biofilms?
1) Attachment and growth of bacterial communities
2) Involved in prosthetic and catheter relation infections
3) Common in Staphylococci and many others
4) Much less susceptible (10-1000x) to antimicrobials
What are common organisms found in clinical biofilms?
1) Coagulase-neg Staphylococcus spp
2) Staph aureus
3) Gram - bacilli
4) Candida spp

Note: Almost any organism will form biofilms under the right condition!
What is a "Peripheral Venous Catheter"?
Device usually into the veins of the forearm or the hand; most common used short-term intravascular device
What is a "Peripheral Arterial Catheter?"
For short-term use, common used to monitor hemodynamic status and to determine blood gas levels of critical ill patients. Risk of infection may approach that of CVCs
What is a "Midline Catheter"?
Peripheral catheter is inserted via the antecubital fossa into the proximal basilic or cephalic veins, but it does not enter central veins; it is associated with lower rates of infection compared to CVCs
What is a "Short-term CVC"?
Most common used CVC, accounts for the majority of all catheter-related bloodstream infections
What is a CVC?
Central Venous Catheter
What is a "Pulmonary Artery Catheter?"
A device inserted through a teflon introducer and typically remains in place for an average duration of 3 days
What is a "Pressure-Monitoring System"?
Used in conjunction with arterial catheter, associted with both epidemic and endemic nosocomial bloodstream infections
What are the main focus of preventive strategies of catheter-related infections?
1) Catheter Hubs
2) Catheter insertion site
What are the 2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections?
1) Educating and training health-care providers who insert and maintain caths
2) Using max sterile barrier precautions during CVC insertion
3) Using a 2% chlorhexidine prep for skin antisepsis
4) Avoid routine replacement of CVCs as a strategy to prevent infection
5) Use antiseptic/biotic impregnated short-term CVS if rate of infection is high despite adherence to other strategies
What drug is used to treat methicillin-resistant Staphylococcus aureus (MRSA)?
How should treatment for gram negative bacilli be based?
Empirical coverage should be based on local antimicrobial susceptibility data and the severity of the disease
What should not be used for empirical therapy (i.e. used when a patient is suspected, but not proven, to have an infection)?
What other coverage, aside from gram-positive pathogens, should be included involving suspected CRBSI involving femoral caths in critically ill patients?
Coverage for gram-neg bacilli and Candida species
What is an "Antibiotic Lock"?
Technique used for catheter salvage, but if this cannot be used revert so systemic antibiotics administered through the colonized cath
What is the formulation of an antibiotic lock solution?
1) EtOH
2) Anticoagulants
3) Dose (Often multiple times higher than MIC)
4) Dwell time and stability
5) Prep practicality for pharmacy
What are the pros of antimicrobial-coated catheters?
1) Reduced risk of infection
2) Short term bridge for treatment
What are the cons of antimicrobial-coated catheters?
1) Increased costs
2) Local reactions
3) Lack of long term success
What are some examples of antimicrobial-coated catheters?
1) Chlorhexidine/Silver sulfadiazine
2) Minocycline/Rifampin
3) Plantinum/Silver
4) Silver cuffs
What is the most common type of healthcare-associted infection?
Catheter Associated Urinary Tract Infections (CAUTI)
What is the comprehensive strategy for CA-UTI prophylaxis?
1) High priority recommendations for urinary catheter use
2) Aseptic insertion
3) Maintenance
4) Routine use of systemic microbials is not recommended
What type of CA-UTI prophylaxis should be used in recurrent diseases?
Antimicrobial coated catheters
What are the CDCs steps to prevent resistance?
1) Vaccinate
2) Remove caths
3) Target pathogen
4) Access experts
5) Antimicrobial control
6) Use local data
7) Treat infection not contamination
8) Know when to say no
9) Stop treatment
10) Isolate pathogen
11) Break chain of contagion
What are the risk factors for prostethic joint infections?
1) Prior surgery at site
2) Rheumatoid arthritis
3) Immunocompromised states
4) Diabetes mellitus
5) Poor nutritional status
6) Obesity
7) Psoriasis
8) Extremely advanced age
What is the use of antibiotic spaces/beards/cement?
To treat or prevent local infection of bone and soft tissue
What are the advantages of antibiotic spaces/beads/cement?
1) Delivers direct local therapy at high concentrations
2) Fills dead space from debridement
3) Low system effects
What antibiotics are used in local therapy?
1) Vancomycin
2) Gentamicin
3) Daptomycin
4) Silver and SSD
5) Rifampin
6) Amikacin
7) Amphotericin