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phar 516_mc

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Subcategory
Species
Antibiotic of choice
R/V
Normal flora
Infection
MSSA   show 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  
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CA-MRSA   Staphylococcus Aureus Catalase +. Coagulase + Gram Positive Clusters, Cocci   show 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  
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show 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  
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MSSE   Staphylococcus Epidermidis Catalase+, Coagulase – Gram +. Cocci, cluster   show 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  
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MrSE   Staphylococcus Epidermidis Catalase+, Coagulase – Gram +. Cocci, cluster   show 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  
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Alpha hemolysis- partial RBC breakdown. Green   Streptococcus Pneumoniae Gram + Cocci, pairs/chains   show 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  
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show Streptococcus viridans Gram +. Cocci, pairs/chains   Penicillin (DOC)   n/a   upper respiratory track   Dental infections  
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Beta hemolytic, group A   Streptococcus Pyrogens Cocci, Gram +. Chains/pairs   -Penicillin (DOC) PANDAS- pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections   show upper respiratory track, and skin   -Strep throat -Skin and skin structure infections -FLESH EATTING SKIN BACTERIA (Necrotizing fasciitis  
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Beta hemolytic group B   Streptococcus Agalactiae Cocci, Gram +. Chains/pairs   Only treat during labor   n/a   intestinal track, and the vagina   show
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Gamma or alpha hemolytic Group D   Enterococcus Faecalis Gram +, cocci, pairs/chains   show Generally, not VRE   GI tract   Nosocomial UTI  
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Gamma or Alpha hemolytic group D   Enterococcus Faecium Gram +, cocci, pairs/chains   show Can have VRE 85% of the time, so usually linezolid or daptomycin   GI tract   Nosocomial UTI  
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Listeria   Gram +, Bacillus   Patients at risk are newborns, pregnant women, elderly, and immunocompromised   show Not normal flora   can cause gastroenteritis from eating contaminated food, leading to meningitis  
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Clostridium Spp Anaerobic   show n/a   n/a   n/a   n/a  
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B. Antracis-antrax   Gram +, bacillus   show n/a   n/a   Used for biowarfare  
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show Gram +, bacillus   n/a   n/a   n/a   Fried rice syndrome Can lead to diarrhea and vomiting  
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Escheria coli (E coli) Gram (-) Bacilli Rod   show -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  
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Klebsiella Gram (-) bacilli rod   Enterobacteralies family Lactose fermenters   Carbapenems with beta lactamase inhibitors   show GI tract   UTI  
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Protues Gram (-) Bacilli rod   Enterobacteralies family Lactose fermenters   n/a   show GI tract   UTI  
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show Enterobacterales family, ferments lactose   n/a   n/a   n/a   More common in health care associated infections  
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Shigella   Enterobacteralis family   n/a   n/a   show Gastroenteritis  
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Salmonella   Enterobacteralis family   n/a   show Not normal flora   Gastroenteritis -Typhoid fever  
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-Enterobacter cloacae -Klebsiella aerogenes Citrobacter Freundii   show n/a   n/a   n/a   n/a  
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Pseudomonas Rod (bacillus)   show 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)  
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Acinetobacter Rod (bacillus)   Gram (-) Pseudomonads/ non lactose fermenters   Colistin   Resistant often resistant to all antibiotics   show Common infections in immunosuppressed, pneumonia, wounds  
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Brukholderia Rod   show Similar to Pseudomonas   Nerds resistant     Nosocomial infections respiratory  
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Stenotrophomonas Rod   Gram (-) Pseudomonads/ non lactose fermenters   Bactrim-DOC   Nerds resistant   show Nosocomial infections respiratory  
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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   show    
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Neisseria meningitidis Diplococci (paired cocci)   Respiratory Gram Negatives and Gram-Negative Cocci     Virulent- contagious meningitis through respiratory droplets. Encapsulated   show Meningitis  
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Neisseria gonorrhoeae Diplococci   Respiratory Gram Negatives and Gram-Negative Cocci     Virulent- Through direct mucosal contact Encapsulated   show Gonorrhea  
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Moraxella S.PP Diplococci   Respiratory Gram Negatives and Gram-Negative Cocci       show Upper respiratory tract infections -Community acquired pneumonia  
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show Respiratory Gram Negatives and Gram-Negative Cocci     Type B encapsuled + virulent     -URTI -CAP -meningitis -Sepsis in unvaccinated children  
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Bordatella Pertussis Cocco-bacilli   Respiratory Gram Negatives and Gram-Negative Cocci   show     Whooping cough  
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show 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  
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Mycoplasma Pneumonia   Atypical Bacteria   -Fluroquinolones Ciprofloxacin, Levofloxacin, Delafloxacin -Macrolides Azithromycin, Clarithromycin -Tetracyclines Doxycycline, Minocycline     show Community acquired pneumonia (CAP  
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Legionella Pneumophila   Atypical Bacteria   -Fluroquinolones Ciprofloxacin, Levofloxacin, Delafloxacin -Macrolides Azithromycin, Clarithromycin -Tetracyclines Doxycycline, Minocycline     show Community acquired pneumonia (CAP  
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show Gram + anaerobes     virulent      
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C. Botulinum Botulism and botox   Gram + anaerobes   Antitoxin available through CDC   show   correlated to home canned food and honey Neurotoxin produces paralysis  
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C.Tetani- Tetanus   Gram + anaerobes         show
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show Gram + anaerobes         -Toxin cause tissue necrosis -Surgery necessary to stop rapid progression  
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Clostriodies Difficile (C.Diff)   show -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  
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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)     show -Intra abdominal -Genital infections -Wounds  
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show Gram Negative Anaerobes     Polymicrobial   oral cavity   Oral infections -trench mouth -Periodontitis  
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