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phar 516_mc
| Subcategory | Species | Antibiotic of choice | R/V | Normal flora | Infection |
|---|---|---|---|---|---|
| MSSA | Staphylococcus Aureus Catalase +. Coagulase + Gram Positive Clusters, Cocci | Oxacillin Nafcillin Dicloxacillin | Resistant & virulent -penicillinase inhibiting the use of Amoxicillin, Ampicillin, Pencillin -MRSA will carry mecA gene causing it to change the express on of its PBP into PBP2, causing all beta lactams to not work except ceftaroline | skin | n/a |
| CA-MRSA | Staphylococcus Aureus Catalase +. Coagulase + Gram Positive Clusters, Cocci | Vancomycin, Dalbavancin, Daptomycin Linezolid, Tedizolid Ceftaroline Bactrim CA- Doxycycline. Clindamycin. Minocycline | Resistant & virulent -penicillinase inhibiting the use of Amoxicillin, Ampicillin, Pencillin -MRSA will carry mecA gene causing it to change the express on of its PBP into PBP2, causing all beta lactams to not work except ceftaroline | skin | Skin infections, can cause an abscess, purulent cellulits Exotoxin is preCan |
| HA-MRSA | Staphylococcus Aureus Catalase +. Coagulase + Gram Positive Clusters, Cocci | Vancomycin, Dalbavancin, Daptomycin Linezolid, Tedizolid Ceftaroline Bactrim CA- Doxycycline. Clindamycin. Minocycline | Resistant & virulent -penicillinase inhibiting the use of Amoxicillin, Ampicillin, Pencillin -MRSA will carry mecA gene causing it to change the express on of its PBP into PBP2, causing all beta lactams to not work except ceftaroline | skin | infect any anatomical surface, no Exotoxin, generally more Resistant than CAsent |
| MSSE | Staphylococcus Epidermidis Catalase+, Coagulase – Gram +. Cocci, cluster | Oxacillin Nafcillin Dicloxacillin | Resistant- will produce penicillinase (never use amoxicillin, ampicillin or penicillin) MRSE- will carry the mecA gene | skin | Generally, not as infective as S. Aureus, however will cause infections in immunocompromised PT, or those with prosthetics can form biofilms |
| MrSE | Staphylococcus Epidermidis Catalase+, Coagulase – Gram +. Cocci, cluster | Vancomycin, Telbavancin Daptomycin Linezolid, Tedizolid Ceftaroline Bactrim | Resistant- will produce penicillinase (never use amoxicillin, ampicillin or penicillin) MRSE- will carry the mecA gene | skin | Generally, not as infective as S. Aureus, however will cause infections in immunocompromised PT, or those with prosthetics can form biofilms |
| Alpha hemolysis- partial RBC breakdown. Green | Streptococcus Pneumoniae Gram + Cocci, pairs/chains | -Ceftriaxone (empirically) -Vaccine available | Virulent can spread fast, not really resistant, however it is encapsuled by a polysaccharide capsule, most resistant species in the streptococcus family | upper respiratory track | -Bacterial Mengitiis -Community acquired pneumonia -Otitis Media -Sinusitis |
| Alpha hemolysis- green color | Streptococcus viridans Gram +. Cocci, pairs/chains | Penicillin (DOC) | n/a | upper respiratory track | Dental infections |
| Beta hemolytic, group A | Streptococcus Pyrogens Cocci, Gram +. Chains/pairs | -Penicillin (DOC) PANDAS- pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections | Virulent- Jock, some strains will produce toxins which causes tissue necrosis | upper respiratory track, and skin | -Strep throat -Skin and skin structure infections -FLESH EATTING SKIN BACTERIA (Necrotizing fasciitis |
| Beta hemolytic group B | Streptococcus Agalactiae Cocci, Gram +. Chains/pairs | Only treat during labor | n/a | intestinal track, and the vagina | -Neonatal sepsis -Neonatal meningitis -neonatal pneumonia |
| Gamma or alpha hemolytic Group D | Enterococcus Faecalis Gram +, cocci, pairs/chains | Treat with ampicillin if resistant treat with vancomycin if resistant treat with linezolid or Daptomycin | Generally, not VRE | GI tract | Nosocomial UTI |
| Gamma or Alpha hemolytic group D | Enterococcus Faecium Gram +, cocci, pairs/chains | Treat with ampicillin if resistant treat with vancomycin if resistant treat with linezolid or Daptomycin | Can have VRE 85% of the time, so usually linezolid or daptomycin | GI tract | Nosocomial UTI |
| Listeria | Gram +, Bacillus | Patients at risk are newborns, pregnant women, elderly, and immunocompromised | n/a | Not normal flora | can cause gastroenteritis from eating contaminated food, leading to meningitis |
| Clostridium Spp Anaerobic | Gram +, bacillus | n/a | n/a | n/a | n/a |
| B. Antracis-antrax | Gram +, bacillus | n/a | n/a | n/a | Used for biowarfare |
| B. Serious | Gram +, bacillus | n/a | n/a | n/a | Fried rice syndrome Can lead to diarrhea and vomiting |
| Escheria coli (E coli) Gram (-) Bacilli Rod | Enterobacteralies family Lactose fermenters | -Carbapenems with beta lactamase inhibitors | Potential carrier of Extended spectrum beta lactam resistant to penicillin, cephalosporins/ monobactam) - Resistance to all beta-lactams except the new beta lactam+ extended spectrum beta lactamase inhalators -May produce carbapenems (CRE) | GI track most common Aerobic gram (-) | UTI -Food born illness |
| Klebsiella Gram (-) bacilli rod | Enterobacteralies family Lactose fermenters | Carbapenems with beta lactamase inhibitors | Potential carrier of Extended spectrum beta lactam resistant to penicillin, cephalosporins/ monobactam) - Resistance to all beta-lactams except the new beta lactam+ extended spectrum beta lactamase inhalators -May produce carbapenems (CRE | GI tract | UTI |
| Protues Gram (-) Bacilli rod | Enterobacteralies family Lactose fermenters | n/a | Intrinsic resistance to polymyxins | GI tract | UTI |
| Enterobacter Serratia Citrobacter Providencia Morganella | Enterobacterales family, ferments lactose | n/a | n/a | n/a | More common in health care associated infections |
| Shigella | Enterobacteralis family | n/a | n/a | Not normal flora | Gastroenteritis |
| Salmonella | Enterobacteralis family | n/a | n/a | Not normal flora | Gastroenteritis -Typhoid fever |
| -Enterobacter cloacae -Klebsiella aerogenes Citrobacter Freundii | Potential producers of AMP-C beta lactamases, making them resistant to all the beta lactamase except for cefepime and carbapenems, De-escalation below cefepime is not recommended, more common in healthcare associated infections | n/a | n/a | n/a | n/a |
| Pseudomonas Rod (bacillus) | Gram (-) Pseudomonads/ non lactose fermenters | Pencilin- Piperacilin/Tazobacm Cephalosporin- Ceftazidim, Ceftolozone/avibactam, Cefepime, Cefiderocol Carbapenems- Meropenem, Imipenem, Doripenem Monobactam- Aztreonam Add on therapy | Virulent and resistant, considered the worst of all the pseudomonads family | Not normal flora found in soil and water | Common cause of nosocomial infections, Pneumonia (HAP/VAP) |
| Acinetobacter Rod (bacillus) | Gram (-) Pseudomonads/ non lactose fermenters | Colistin | Resistant often resistant to all antibiotics | Not normal flora found in soil and water | Common infections in immunosuppressed, pneumonia, wounds |
| Brukholderia Rod | Gram (-) Pseudomonads/ non lactose fermenters | Similar to Pseudomonas | Nerds resistant | Nosocomial infections respiratory | |
| Stenotrophomonas Rod | Gram (-) Pseudomonads/ non lactose fermenters | Bactrim-DOC | Nerds resistant | Nosocomial infections respiratory | |
| Gram negative rod empiric treatment for the critically ill ICU PT | Gram (-) Pseudomonads/ non lactose fermenters | 1st line + anti pseudomonal beta lactam De-scalation when subspecialties are known • 1st line narrow spectrum beta lactam, 2nd line- Non beta lactams | |||
| Neisseria meningitidis Diplococci (paired cocci) | Respiratory Gram Negatives and Gram-Negative Cocci | Virulent- contagious meningitis through respiratory droplets. Encapsulated | Meningitis | ||
| Neisseria gonorrhoeae Diplococci | Respiratory Gram Negatives and Gram-Negative Cocci | Virulent- Through direct mucosal contact Encapsulated | Gonorrhea | ||
| Moraxella S.PP Diplococci | Respiratory Gram Negatives and Gram-Negative Cocci | Upper respiratory tract infections -Community acquired pneumonia | |||
| Haemophilus influenzae Cocco-bacilli | Respiratory Gram Negatives and Gram-Negative Cocci | Type B encapsuled + virulent | -URTI -CAP -meningitis -Sepsis in unvaccinated children | ||
| Bordatella Pertussis Cocco-bacilli | Respiratory Gram Negatives and Gram-Negative Cocci | Whooping cough | |||
| Chlamydia Pneumoniae | Atypical Bacteria | -Fluroquinolones Ciprofloxacin, Levofloxacin, Delafloxacin -Macrolides Azithromycin, Clarithromycin -Tetracyclines Doxycycline, Minocycline | They do not grow on normal media or do not stain by gram stain | Community acquired pneumonia (CAP | |
| Mycoplasma Pneumonia | Atypical Bacteria | -Fluroquinolones Ciprofloxacin, Levofloxacin, Delafloxacin -Macrolides Azithromycin, Clarithromycin -Tetracyclines Doxycycline, Minocycline | They do not grow on normal media or do not stain by gram stain | Community acquired pneumonia (CAP | |
| Legionella Pneumophila | Atypical Bacteria | -Fluroquinolones Ciprofloxacin, Levofloxacin, Delafloxacin -Macrolides Azithromycin, Clarithromycin -Tetracyclines Doxycycline, Minocycline | They do not grow on normal media or do not stain by gram stain | Community acquired pneumonia (CAP | |
| Clostridium S.PP Gram positive bacilli, spore forming, toxin producing | Gram + anaerobes | virulent | |||
| C. Botulinum Botulism and botox | Gram + anaerobes | Antitoxin available through CDC | correlated to home canned food and honey Neurotoxin produces paralysis | ||
| C.Tetani- Tetanus | Gram + anaerobes | -Associated with puncture wounds -Toxin leads to muscle spasms and hyperreflexia -Muscles are chronically | |||
| C. perfringens -Gas gangrene | Gram + anaerobes | -Toxin cause tissue necrosis -Surgery necessary to stop rapid progression | |||
| Clostriodies Difficile (C.Diff) | Gram + anaerobes | -Antibiotic use biggest risk factors -Clindamycin> Fluroquinoles > 3rd/4th gen cephalosporins -Oral vancomycin (Not IV) -Fidaxomicin -Fecal transplant -Rebyota Bezlotoxumab- monoclonal antibody against the toxin, | -Active C. Difficile toxin cause intestinal tissue destruction- Leading to diarrhea | ||
| Bacteroides Fragilis | Gram Negative Anaerobes | -produces Penicillinase -worst case scenario -almost always polymicrobial Treatments -Metronidazole -Penicillin+ Beta lactamase inhibitors Cefoxitin/Cefotetan (TAN/FOX -Carbapenems+ beta lactamase inhibitor Tigecycline (Rarely used) | Most common bacteria in the GI track | -Intra abdominal -Genital infections -Wounds | |
| Prevotella s.PP | Gram Negative Anaerobes | Polymicrobial | oral cavity | Oral infections -trench mouth -Periodontitis |
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kero_d