Presentation is loading. Please wait.

Presentation is loading. Please wait.

Gram-positive bacteria: Staphylococci

Similar presentations


Presentation on theme: "Gram-positive bacteria: Staphylococci"— Presentation transcript:

1 Gram-positive bacteria: Staphylococci

2 Staphylococcus aureus
Staphylococcus aureus causes a variety of suppurative (pus-forming) infections and toxinoses in humans. It causes superficial skin lesions such as boils, styes and furunculosis; more serious infections such as pneumonia, mastitis, phlebitis, meningitis, and urinary tract infections; and deep-seated infections, such as osteomyelitis and endocarditis. S. aureus is a major cause of hospital acquired (nosocomial) infection of surgical wounds and infections associated with indwelling medical devices. S. aureus causes food poisoning by releasing enterotoxins into food, and toxic shock syndrome by release of superantigens into the blood stream.

3 Staphylococcus aureus

4 Superantigens

5

6 Treatment of Infections Caused by Staphylococcus aureus
Antistaphylococcal penicillins: Nafcillin, oxacillin First Generation cephalosporins: Cefazolin Second Generation Cephalosporins: Cefurxime Third-generation cephalosporins: Ceftriaxone, cefotaxime, ceftizoxime B-Lactam/b-lactamase inhibitor combinations: Ampicillin-sulbactam, piperacillin-tazobactam, ticarcillin-clavulanate Carbapenems: Imipenem, meropenem

7 Treatment of Methicillin-resistant Staphylococcus aureus
Vancomycin Linezolid Streptogramins (Quinupristin-dalfopristin) Daptomycin Tigecycline

8 Gram-positive pathogens: Streptococcus pneumoniae

9 Streptococcus pneumoniae

10 Treatment of Streptococcus pneumoniae
Penicillin G Aminopenicillins: Ampicillin

11 Treatment of Penicillin-resistant Streptococcus pneumoniae
Second Generation Cephalosoporins: Cefuroxime Third Generation Cephalosporins: Cefotaxime, Ceftriaxone Quinolones: Moxifloxacin, Levofloxacin Vancomycin Macrolides/ketolines: Telithromycin

12 Streptococcus pyogenes

13 Streptococcus pyogenes

14 Treatment of Streptococcus pyogenes
Penicillin G Aminopenicillins: Ampicillin Aminoglycosides are sometimes added for synergy: Gentamicin Clindamycin is added for severe invasive Streptococcus pyogenes infections

15 Treatment for Penicillin-resistant Streptococcus pyogenes (and other penicillin resistant Streptococcus) Vancomycin Second-generation cephalosporins: Cefuroxime Third-generation cephalosporins: cefotaxime, ceftriaxone

16 Enterococci

17 Enterococcus

18 Enterococcus Resistance Mechanisms

19 Treatment of Infections Caused by Enterococcus
Penicillin G Aminopenicillins: Ampicillin Extended-spectrum Penicillins: Piperacillin Carbapenems: Imipenem, meropenem For serious infections, add an aminoglycoside for synergy: Gentamicin

20 Treatment for Infections Caused by Penicillin-resistant Enterococci
Vancomycin

21 Treatment for Vancomycin Resistant Enterococci (VRE)
Linezolid Tetracycline-like: Tigecycline Sometimes also active: Daptomycin Quinupristin/dalfopristin

22 Gram-positive Bacteria: Listeria Monocytogenes

23 Listeria monocytogenes

24 Treatment of Infections Caused by Listeria monocytogenes
Ampicillin + Gentamicin If penicillin allergic: Trimethoprim-sulfamethoxazole

25 Bacillus anthracis

26 Bacillus anthracis

27 Bacillus anthracis

28 Treatment of Infections Caused by Bacillus anthracis
Quinolones: Ciprofloxacin Tetracycline: Doxycycline

29 Treatment of Infections Caused by Bacillus anthracis
For Inhalation Anthrax, a Second Agent Should be Added from the Following List: Rifampin Vancomycin Penicillin G Ampicillin Chloramphenicol Carbapenem: Imipenem Clindamycin Macrolide: Clarithromycin

30 Gram-negative Bacteria: Enterobacteriaceae

31 Escherichia coli

32 Klebsiella

33 Proteus

34 Escherichia coli.

35 Treatment of Infections Caused by: E. coli., K. pneumoniae, Proteus
Aminopenicillins: Ampicillin First Generation Cephalosporins: Cefazolin Sulfa drugs: Trimethoprim-sulfamethoxazole Quinolones: Ciprofloxacin, levofloxacin, moxifloxacin

36 Treatment of Resistant Infections Caused by: E. coli. , K
Treatment of Resistant Infections Caused by: E. coli., K. pneumoniae, Proteus Third Generation Cephalosporins: Cefoxaxime, ceftriaxone, ceftizoxime Monobactam: Aztreonam Extended Spectrum penicillins + b-lactamase inhibitor: Piperacillin-tazobactam, ticarcillin-clavulanate Carbapenems: Imipenem, meropenem, ertapenem Carbapenem + aminoglycoside in serious infections: Add Gentamicin, Tobramycin, amikacin

37 Treatment of Infections Caused by: Enterobacter, Serratia, Citrobacter, Providencia, and Morganella Spp. Carbapenems: Imipenem, meropenem, ertapenem Sulfa Drugs: Trimethoprim-sulfamethoxazole Quinolones: Ciprofloxacin, levofloxacin Fourth Generation Cephalosporins: Cefepime + aminoglycoside: Gentamicin, tobramycin, amikacin

38 Treatment of Infections Caused by: Salmonella enterica, Shigella spp.
Quinolones: Ciprofloxacin Third-generation cephalosporins: Cefotaxime, ceftriaxone, ceftizoxime Macrolides: Azithromycin

39 Treatment of Infections Caused by: Yersinia spp.
Aminoglycosides: Gentamicin, streptomycin Tetracyclines: Doxycycline Quinolones: Ciprofloxacin Sulfa drugs

40 Gram-negative Bacteria: Pseudomonas

41 Pseudomonas

42 Resistance of Pseudomonas

43 Treatment of Infections caused by Pseudomonas aeruginosa
Extended spectrum penicillins: Piperacillin, Ticarcillin Third Generation Cephalosporins: Ceftazidime Fourth-generation Cephalosporins: Cefepime Carbapenems: Imipenem, meropenem Monobactams: Aztreonam Quinolones: Ciprofloxacin, Levofloxacin Aminoglycosides: Gentamicin, tobramycin, amikacin

44 Treatment of Serious Infections Caused by Pseudomonas aeruginosa
Antipseudomonal b-lactam + aminoclycoside: Ceftazidime + Tobramycin Extended-spectrum penicillin + antipseudomonal quinolone: Piperacillin + Ciprofloxacin

45 Neisseria

46 Neisseria meningitidis

47 Neisseria gonorrhoeae

48 Treatment of Infections Caused by Neisseria meningitidis
Penicillin G Third generation cephalosporins: Ceftriaxone, cefotaxime

49 Treatment of Infections Caused by Neisseria Gonorrhoeae
Third Generation Cephalosporins: Ceftriaxone, cefixime

50 Curved Gram Negative Bacilli
Includes: Campylobacter jejuni, Helicobacter pylori, Vibrio cholerae

51 Campylobacter jejuni

52 Campylobacter jejuni

53 Treatment of Infection Caused by Campylobacter jejuni
Macrolides: Erythromycin, azithromycin, clarithromycin Quinolones: Ciprofloxacin

54 Helicobacteri pylori

55 Helicobacter pylori

56 Helicobacter pylori

57 Duodenal Peptic Ulceration Caused by Helicobacter pylori

58 Treatment of Infection Caused by Helicobacter pylori
Amoxicillin + clarithromycin + proton pump inhibitor Metronidazole + clarithromycin + proton pump inhibitor Bismuth subsalicylate + metronidazole + tetracycline + proton pump inhibitor

59 Vibrio cholerae

60 Vibrio cholerae

61 Treatment of Infection Caused by Vibrio cholerae
Tetracyclines: tetracycline, doxycycline Sulfa drugs: Trimethoprim-sulfamethoxazole Quinolones: Ciprofloxacin Macrolides: Erythromycin, Azithromycin

62 Haemophilus influenzae

63 Haemophilus influenzae

64 Haemophilus influenzae

65 Treatment of Infections Caused by Haemophilus influenzae
Aminopenicillins + b-lactamase inhibitor: Amoxicillin/clavulanate Ampicillin/sulbactam Second-generation cephalosporin Cefuroxime Third-generation cephalosporin Ceftriaxone Cefotaxime

66 Bordetalla pertussis

67 Bordetella pertussis

68 Treatment of Infection Caused by Bordetella pertussis
Macrolides: Azithromycin, Clarithromycin, Erythromycin

69 Moraxella catarrhalis
Causes otitis media, pneumonia, and sinusitis Usually produces b-lactamase

70 Treatment of Infections Caused by Moraxella catarrhalis
Extended spectrum penicillins: piperacillin, ticarcillin B-lactam/b-lactamase inhibitor combinations: piperacillin/tazobactam, ticarcillin/clavulanate Second and third-generation cephalosporins

71 Acinetobacter Recent outbreak among soldiers in Iraq
Second leading cause of infection among troops during the Vietnam conflict

72 Acinetobacter

73 Treatment of Infection Caused by Acinetobacter
Sulbactam Carbapenems Quinolones

74 Anaerobic Bacteria Gram positive: Clostridia spp.

75 Clostridium tetani Clostridium tetani is the etiologic agent of tetanus Characterized by persistent tonic spasm, usually involving the masseter muscles (lockjaw) Usually caused by deep wound becoming infected with C. tetani spores.

76 Clostridium botulinum
Clostridium botulinum is usually acquired by ingestion of food contaminated with C. botulinum spores Botulinum toxin leads to cranial neuroopathies and weakness rather than muscular spasm.

77

78 Treatment of Infections Caused by Clostridium spp.
Penicillin G Metronidazole (may be associated with better outcomes

79 Clostridium difficile

80 Clostridium difficile

81 Treatment of Infections Caused by Clostridium difficile
Oral metronidazole Oral vancomycin

82 Clostridium perfringens is the cause of gas gangrene

83 Treatment of Infections Caused by Clostridium perfringens
Penicillin + one of the following: Clindamycin Tetracycline Metronidazole

84 Anaerobic Gram-negative Bacteria

85 Common Anaerobic Gram-negative Pathogens
Bacteroides fragilis Usually produces b-lactamase Prevotella Porphyromonas

86 Treatment of Anaerobic Gram-negative Infections
b-lactam/b-lactamase inhibitor combinations Ampicillin-sulbactam Piperacillin-tazobactam Ticarcillin-clavulanate Carbapenems: Imipenem, Meropenem, Ertapenem Metronidazole

87 Atypical Bacteria: Chlamydia

88 Chlamydia trachomatis
One of the most common sexually transmitted diseases Also a leading cause of blindness in some parts of the world

89 Chlamydia trachomatis
Chlamydia is a bacterial infection of the genital tract spread through sexual contact. If untreated, it can result in various medical complications, including damage to the reproductive organs. The disease affects both women and men, although reported cases for women greatly exceed those for men. Chlamydia affects people in all age groups, but it is particularly prevalent among teenagers and young adults. According to the U.S. Centers for Disease Control and Prevention (CDC), the infection is most prevalent among women aged 20 to 25.

90 Chlamydia trachomatis
Some signs and symptoms that may be present in people infected with chlamydia are: Abnormal discharge from the penis or vagina Burning sensation during urination Lower abdominal or back pain Nausea Fever Pain during intercourse Burning or itching around the head of the penis Swollen or tender testicles Bleeding between menstrual cycles Proctitis (inflammation of the rectum)

91 Treatment of Infections Caused by Chlamydia trachomatis
Tetracyclines Tetracycline Doxycycline Macrolides Azithromycin Erythromycin Telithromycin Quinolones Ofloxacin Moxifloxacin Gemifloxacin

92 Mycoplasma pneumoniae

93 Mycoplasma pneumoniae

94 Treatment of Infections Caused by Mycoplasma pneumoniae
Macrolides: Azithromycin, clarithromycin, erythromycin telithromycin Tetracyclines: Tetracycline, doxycycline Quinolones: Levofloxacin, moxifloxacin, gemifloxacin

95 Atypical Bacteria: Legionella
Legionella pneumophila is the most common species, and is the causative agent of Legionaires’ disease Once in the lung, Legionella organisms are taken up by macrophages and multiply within them.

96 Legionalla pneumophila

97 Treatment of Infections Caused by Legionella pneumophila
Macrolides: Azithromycin Quinolones: Levofloxacin, moxifloxacin

98 Brucella Brucellosis is a disease of animals, that is occasionally transmitted to humans Contact with animals and/or ingestion of unpasteurized milk or cheese are risk factors

99 Brucella

100 Brucella

101 Treatment of Infections Caused by Brucella spp.
Doxycycline + rifampin Dixycycline + gentamicin Doxycycline + streptomycin

102 Francisella tularensis

103 Francisella tularensis

104 Treatment of Infections Caused by Francisella tularensis
Aminoglycosides: Streptomycin, Gentamicin Tetracyclines: Tetracycline, doxycycline

105 Rickettsia spp

106 Rickettsia rickettsii
Rocky Mountain spotted fever is the most severe and most frequently reported rickettsial illness in the United States. The disease is caused by Rickettsia rickettsii, a species of bacteria that is spread to humans by ixodid (hard) ticks.

107 Treatment of Infections Caused by Rickettsia spp.
Tetracyclines Doxycycline Tetracycline

108 Spirochetes: Treponema pallidum

109 Treponema pallidum

110 Treponema pallidum

111 Treponema pallidum

112 Treatment of Infections Caused by Treponema pallidum
Penicillin G (including benzathine penicillin) Tetracyclines Third Generation Cephalosporins

113 Penicillin G benzathine

114 Procaine penicillin G

115 Borrelia borgdorferi

116 Borrelia burgdorferi

117 Borrelia burgdorferi is the causative agent of Lyme Disease

118 Treatment of Infections Caused by Borrelia burgdorferi
Tetracyclines: Doxycycline Aminopenicillins: Amoxicillin

119 Leptospira interrogans

120 Leptospira interrogans

121 Treatment of Infection Caused by Leptospira interrogans
Tetracyclines: Doxycycline Aminopenicillins: Amoxicillin Severe Disease can be treated with Penicillin G, Ampicillin, or Ceftriaxone

122 Mycobacteria Mycobacterium tuberculosis Mycobacterium avium complex
Mycobacterium leprae

123 Mycobacterium tuberculosis

124 Mycobacterium tuberculosis

125 Mycobacterium tuberculosis

126 Treatment of Infections Caused by Mycobacterium tuberculosis
Active Disease Isoniazid + Rifampin + Pyrazinamide + Ethambutol for two months Followed by: Isoniazid + Rifampin for Four months Latent Disease Isoniazid for 9 months

127 Mycobacterium avium complex

128 Mycobacterium avium complex

129 Treatment of Infections Caused by Mycobacterium avium complex (MAC)
Clarithromycin + ethambutol + rifabutin

130 Mycobacterium leprae

131 Mycobacterium leprae

132 Leprosy

133 Treatment of Infections Caused by Mycobacterium leprae
Dapsone + rifampin + clofazimine


Download ppt "Gram-positive bacteria: Staphylococci"

Similar presentations


Ads by Google