Pathogens
Most common pathogens (2)
Staphylococcus aureus
Streptococcus pyogenes
What type of SSTI is impetigo?
Superficial
Mild symptoms of cellulitis?
Localized pain
swelling
Redness
warmth
Gold standard of treatment
Surgery
Most likely pathogen?
MRSA
True or False: Cultures should always be obtained before antibioitc use
False, IDSA states cultures are recommended but treatment without cultures is also appropriate
Where is impetigo usually located?
Around mouth/nose/eyes in children
Most common pathogens for cellulitis?
Streptococci
Group A streptococcus
S. aureus
Empiric antibiotic regimen?
Vancomycin + Beta-lactam + Clindamycin
What are the main targets (pathogen wise) for initial empiric treatment?
aerobic gram-positive pathogens only (beta-haemolytic streptococci andStaphylococcus aureus including methicillin-resistant strains if indicated)
Most common pathogen in purulent SSTI's
MRSA
Topical treatment option for Impetigo? (include duration)
Mupirocin topical ointment BID for 5 days
Treatment duration for cellulitis?
5 - 7 days
can depend on severity and response to treatment
True or False:
These infections are likely to be polymicrobial
True
True or False:
Moderate to severe diabetic foot infections should have P. aeruginosa coverage
True, depending on patient risk factors and clinical evaluations
What mutation causes MRSA resistance?
mec gene
True or False: Impetigo is likely to be caused by MRSA
Falso, usually streptococci not MRSA
First line treatment option for purulent cellulitis?
Incision and Drainage
antibiotic therapy determined from there
Most likely pathogen? (3)
MRSA, Aeromonas hydrophila, or Vibrio vulnificus
Difference in severe vs 'super' severe diabetic foot infection
risk for anaerobic pathogens
Most common pathogen for anerobic infection in SSTI?
bacteroides fragilis
When do we escalate to oral antibiotics for impetigo?
When pustules occur in large amounts or are persistent despite treatment
SIRS criteria for addition/escalation of antibiotics (3)
Temperature > 100.4F
HR > 90 BPM
WBC >12,000 or < 4000
What is the benefit of Clindamycin in NF treatment regimen?
Suppresses streptococcal toxin production
What 'extra' step should be taken for patients with Diabetic Foot Infection versus patients with moderate cellulitis?
higher risk for OM causes inclination for probe-to-bone test, plain X-rays, and ESR, or CRP, orPCT as the initial studies to diagnose osteomyelitis of the foot