Where all your ID needs are met! Sort of.
If you get nothing from this, just remember: TMP-SMX, fluroquinolones, minocycline. These tend to be good antibiotic options for this bug. Also, make sure if you isolate this from a trach or a endotracheal tube that there are signs of infection before you proceed with treatment as this can colonize plastic! Stenotrophomonas maltophilia is a
Staphylococcus aureus bacteremia is a cause of severe morbidity and mortality, especially when it is complicated by infective endocarditis. The mortality of Staphylococcus aureus bacteremia is 20% (1) and that of infective endocarditis due to Staph aureus is much higher. Guidelines for the treatment of MRSA SAB (2) recommends the use of echocardiography, with TEE
This is a difficult post to go over since there is so much data to comb through that will likely change as the years go by (as with any topic I write about, but more so about therapy for influenza). Stay tuned as the flu season comes upon us, as this post may be updated
Enterococcal infections and bacteremia incidence have been increasing over the past decades, with enterococcal endocarditis representing 10% of all cases of infective endocarditis (1). This makes it the third most common organism implicated in IE, after Staphylococcus and streptococcus, and it is more prevalent in patients who are not drug abusers. Enterococcal bacteremia by itself
Beta-Lactamases make my head hurt. They are so many of them and they impact the therapeutic options for a lot of the infections that we treat. Due to this resistance mechanism, there has been an influx of new beta-lactam/beta-lactamase combinations (ceftazidime-avibactam, meropenem-vaborbactam, etc) to overcome this phenomena. So first, this is a beta-lactam: The penicillin-binding
I have a confession to make. I like fluroquinolones. I know. They’re broad spectrum, especially levofloxacin and moxifloxacin. They have pretty good bioavailability (almost 100%), and they cover pseudomonas (ciprofloxacin and levofloxacin) making them good PO stepdown therapy for severe pseudomonas bacteremia. Having said that, if you have spent any time in the internet you
Staphylococcus Aureus is a tough disease to treat, but luckily for MSSA we have pretty good antibiotics to treat this beast. The choice is usually between cefazolin, a first-generation cephalosporin, and Nafcillin, an anti-staphylococcal penicillin. My experience has been that cefazolin is usually the go to antibiotic for MSSA bacteremia, with nafcillin having a niche
Gram negative bacteremia tends to complicate a variety of infections, including urinary tract infections/pyelonephritis, and intra-abdominal infections. Further, a lot of these patients tend to have severe presentations leading to perhaps overtreatment with IV antibiotic therapy. Until recently, there had been little data to guide uncomplicated gram negative rod bacteremia but there has been a
Pulmonary tuberculosis is a global disease that tends to burden underdeveloped countries disproportionally as well people living with HIV. It is a difficult disease to diagnose in the microbiology lab, and as such, there have been various methods deployed in an attempt to diagnose it. While culture is the gold standard, it can take anywhere
Procalcitonin is a precursor of the hormone calcitonin and is released into systemic circulation within 4 hours of inoculation of bacterial endotoxin, In general, cytokines enhance procalcitonin release while interferons, which are released in context of viral infections. Because of this, there has been a push towards using PCT to differentiate bacterial from viral infections
Dr. Germophile 