Intro to Infection and Bacteria_student.pptx

Infection, and the use of antimicrobial agents MATTHEW MOEHL, PHARMD The Big Picture Microorganis ms Drug classes HTTPS://HEALTH.CLEVELANDCLINIC.ORG/WHAT-SHOULDYOU-DO-IF-YOU-HAVE-A-MRSA-INFECTION-5-TIPS/ Key points about each class Overview of Microorganisms Bacteria ◦ Single-celled microbes...

Infection, and the use of antimicrobial agents MATTHEW MOEHL, PHARMD The Big Picture Microorganis ms Drug classes HTTPS://HEALTH.CLEVELANDCLINIC.ORG/WHAT-SHOULDYOU-DO-IF-YOU-HAVE-A-MRSA-INFECTION-5-TIPS/ Key points about each class Overview of Microorganisms Bacteria ◦ Single-celled microbes. Reproduce by fission or splitting. Viruses ◦ Not “alive.” Survive only in living tissues. Fungi ◦ Plant-like microorganisms Parasites ◦ Infect a “host” HTTPS://SLIDEPLAYER.COM/SLIDE/5255492/ Normal FloraPathogens Normal Flora Main areas ◦ Upper respiratory tract ◦ Colon ◦ Skin Helpful effects ◦ Digestion ◦ Prevent pathogen growth Normal Flora can become pathogenic… ◦ Opportunistic pathogens HTTPS://EXPERIENCELIFE.COM/ARTICLE/GOOD-BACTERIAWELCOME/ Host Defense Mechanisms Intact skin Mucous membranes Phagocytic cells Immune & inflammatory processes Anti-infective secretions HTTPS://WWW.MICROSOFT.COM/EN-US/P/OSMOSIS-JONES/ 8D6KGWZL5ZMN?ACTIVETAB=PIVOT%3AOVERVIEWTAB Common Bacterial Pathogens GRAM-POSITIVE GRAM-NEGATIVE Staphylococci Bacteroides Streptococci Escherichia coli Enterococci Klebsiella Proteus Pseudomonas Serratia Salmonella Shigella Key points: Gram positive has thick cell wall on outside Gram negative has a lipid layer on the outside. HTTPS://WWW.REDBUBBLE.COM/ES/PEOPLE/STANLEYILLUST/WORKS/21341791-GRAMOPOSITIVO-FRENTE-A-BACTERIAS-GRAM-NEGATIVAS?P=ART-PRINT Bacteria card • • • • Gram + or – Key subspecies Normal flora? Common infection Image Staphylococci • Gram positive • Key subspecies • Staphylococcus aureus • Normal flora? • Skin and upper respiratory tract • Anterior nares • Common infection • Skin infections https://www.cdc.gov/hai/organisms/staph.html cluste rs MRSA • MethicillinResistant Staphyloccus aureus • High resistance • Beta-lactamase • Penicillin-bindingproteins (PBP’s) • MSSA https://www.healthvermont.gov/immunizations-infectious-disease/healthcare-associated-infections/mrsa Antibiotic Resistance http://modmedmicro.nsms.ox.ac.uk/learn-more-aboutantibiotic-resistance/ This is called “acquired” resistance Streptococci • Gram positive • Key subspecies • Streptococcus pneumoniae • Normal flora? • Throat • Common infection • Pneumonia https://www.cdc.gov/pneumococcal/about/photos.html Chains or pairs Enterococci • Gram positive • Key subspecies • Vancomycin Resistant Enterococci (VRE) • Normal flora? • Intestine • Common infections • Hospitalized patients https://biomeddiagnostics.com/prepared-culture-media/colorex-vre pairs Bacteroides • Gram negative • Key subspecies • Bacteroides fragilis • Anaerobic • Normal flora? • Colon https://afracturedreality.tumblr.com/post/41049944708/bacteroides-fragilis Escherichia coli • Gram negative • aka E. coli • Normal flora? • Intestinal tract • Common infection • Urinary tract infections (UTI) https://www.thepacker.com/article/cdc-says-another-e-coli-outbreak-linkedchipotle Klebsiella • Gram negative • Key subspecies • Klebsiella pneumoniae • Normal flora? • bowels • Common infections https://microbewiki.kenyon.edu/index.php/ Klebsiella_pneumoniae_pathogenesis • Pneumonia Proteus • Gram negative • Normal flora? • Intestinal tract • Common infection • Urinary tract infection (UTI) https://pixels.com/featured/5-proteus-vulgaris-bacteria-sem-thomasdeerinck-ncmir.html Pseudomonas • Gram negative • Key subspecies • Pseudomonas aeruginosa • Normal flora? • Intestines • Common infections • Wounds *resists many antibiotics* https://wickhamlabs.co.uk/technical-resource-centre/fact-sheetpseudomonas-aeruginosa/ Serratia • Gram negative https://fineartamerica.com/featured/1-serratia-marcescens-bacteria-semscimat.html?product=poster Salmonella • Gram negative • Common infections • Food poisoning https://www.webmd.com/food-recipes/food-poisoning/salmonella-faq Shigella • Gram negative • Common infection • Gastrointestinal problems https://www.cdc.gov/shigella/index.html Summary Key points ◦Staph aureus ◦ MRSA ◦S. pneumoniae ◦Enterococcus ◦ VRE ◦E. coli ◦Pseudomonas aeruginosa HTTPS://TENOR.COM/VIEW/SOUNDS-BAD-IKNOW-EGOGUARDIANS-OF-THE-GALAXY-GIF-13674107 Community vs. HospitalAcquired Infections Community acquired infections generally less severe than hospitalacquired Example: communityacquired pneumonia (CAP) vs. health care-associated pneumonia (HCAP) Superinfection HTTPS://MEDICALTERMINOLOGYBLOG.COM/NOSOCOMIALINFECTIONS-HAI/ Drug Therapy Empiric therapy Culture and sensitivity tests What is it? Lets find out… Give our “best guess” *susceptible (S) *intermediate (I) *resistant (R) Likely broad spectrum Targeted therapy Match the drug to the bug… Hopefully, narrow spectrum Case Study – Empiric therapy A client presents with general signs and symptoms of infection (fever, malaise, etc). The provider wants to start empiric therapy. Which type of antibiotics will be chosen? A) Active against only gram positive B) Active against only gram negative C) Active against gram positive & gram negative D) Antiviral medications **Culture and sensitivity tests are drawn at admission for eventual targeted therapy** Case Study – Targeted Therapy The client’s susceptibility report becomes available. Which drug is the organism susceptible to? A. Ampicillin B. Cefepime C. Ceftriaxone D. Piperacillin/Tazobactam Drug Therapy key terms Bactericidal ◦Kills the bacteria Bacteriostatic ◦ Inhibits bacteria growth Combination therapy ◦ More than one antibiotic ◦ Synergy Minimum inhibitory concentration (MIC) ◦ Lowest concentration of antibiotic that prevents microbial growth Nursing Considerations & Patient Education - Wash hands often and thoroughly - balanced diet, fluid intake, and exercise - Take ALL doses of an antibiotic prescription - report other drugs taken and allergies - antibiotics are not indicated for viral infections HTTPS://IMGUR.COM/R/SPONGEBOB/JYKRIEB The End