Term
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Definition
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Term
leukopenia (immune exhaustion) |
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Definition
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Term
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Definition
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Term
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Definition
presence of bacteria in blood culture |
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Term
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Definition
presence of fungus in blood culture |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
elderly, open abdominal wounds, large burs, antipyretic or anti-inflam drugs, immuno suppressed |
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Term
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Definition
stroke, intracranial bleed, severe head trauma |
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Term
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Definition
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Term
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Definition
malignant hyperthermia, neuroleptic malignant syndrome, immune/ inflammatory reactions |
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Term
antimicrobial related fevers |
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Definition
b-lactams, sulfonamides, abacavir, amphotericin B |
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Term
antiepileptic related fevers |
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Definition
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Term
antiarrhythmic related fevers |
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Definition
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Term
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Definition
temporaty: peripheral venous catheter, midline catheter, higher risk of infection |
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Term
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Definition
non-tunneled lines, PICC, tunneled lines and totally implanted lines (less infection) |
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Term
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Definition
high infection rates, used for cardiac monitoring |
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Term
localized infections of catheter |
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Definition
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Term
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Definition
larger infection within 2cm of the catheter exit site |
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Term
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Definition
along the subcutaneous tract |
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Term
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Definition
subcutaneous pocket of an implanted device |
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Term
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Definition
can be with or without a local infection or visible manifestations |
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Term
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Definition
bacteria is living on the inside of the line |
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Term
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Definition
uncommon pharmacy specific problem: either contamination at compounding or contaminated stock solution |
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Term
pathogen of suspected infusate-related infections |
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Definition
cultures from both infusate and blood cultures to verify with sudden onset of symptoms soon after start of an infusion |
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Term
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Definition
blood culture contamination, low ratio of pos/neg blood cultures |
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Term
bacterial species of pseudobacteremia |
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Definition
coagulase-neg staph spp., bacillus spp., diphtheroids (corynebacteria) |
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Term
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Definition
most likely not pseudobacteremia, should consider that it's a true infection |
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Term
how do you know if it's a line infection |
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Definition
pull the line and culture the line |
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Term
"plate roll" line tip section rolled on agar plate |
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Definition
> or = to 15 colony forming units (CFU), sensitivity is 60% |
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Term
flushing, vortexing or sonicating in broth |
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Definition
sensitivity of this method is 80% but it's much more expensive, must have > or = to 100 CFU's |
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Term
pathogens of the line infection |
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Definition
gram pos cocci (staph aureus, coag neg staphylococcus), gram neg bacilli (pseudomonas, enterobacter) and candida spp (rare and more common with TPN) |
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Term
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Definition
staphylococcus aureus, Streptococcus |
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Term
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Definition
pseudomonas, enterobacter |
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Term
empiric treatment of line infections |
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Definition
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Term
alternative empiric treatment for line infections |
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Definition
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Term
vanco, daptomycin, linezolid |
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Definition
active against MRSA, coag-neg staph; choice depends on complications |
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Term
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Definition
good for endocarditis scenarios, not good for pulmonary |
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Term
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Definition
very good for osteomylitis, not good for endocarditis |
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Term
use Nafcillin or alternatively cefazolin for empiric line infection |
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Definition
local rate of MRSA low ***doesn't know where this is not high rates of MRSA |
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Term
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Definition
antipseudomonal b-lactam, antipseudomonal cabapenems and aminoglycosides |
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Term
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Definition
Ceftazidime, piperacillin-tazobactam, cefipime |
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Term
antipseudomonal cabapenems |
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Definition
Imipenem, meropenem, doripenem |
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Term
aminoglycosides (active agains psuedomonas) |
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Definition
gentamycin, tobramycin, amikacin |
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Term
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Definition
no pseudomonal activity, not appropriate for line infection suspected for pseudomonal |
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Term
amphoteracin B (lipasomal/ non-lip) |
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Definition
highly active against candida |
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Term
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Definition
more spendy but less toxicity |
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Term
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Definition
fluconazole and voriconazole, cost resistance common (can't switch) |
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Term
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Definition
when patient is trying to die |
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Term
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Definition
caspofungin, MICAfungin :), anidulafungin |
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Term
clinically stable candida spp line infection |
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Definition
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Term
clinically UNstable candida spp line infection |
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Definition
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Term
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Definition
mixed with normal saline or heparin, used to penetrate biofil and get good antibiotic circulation systemically |
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Term
heparin + vanco for Antibiotic lock therapy |
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Definition
must have high doses of heparin to prevent precipitation |
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Term
antibiotics used for antibiotic lock therapy |
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Definition
vanco, gent/amikacin, or cipro |
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Term
best outcomes for ALT(lck therapy) |
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Definition
coag neg staph spp and 10-14 days in addition to systemic Abx |
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Term
coag neg staph (staph epidermidis); UNcomplicated |
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Definition
many lines salvaged with systemic Abx + ALT for 10-14 days; line not retained shorten duration to 5-7 days |
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Term
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Definition
shorter duration only if catheter REMOVED, resolution of infection within 3 days, no prosthetic intravascular device, no metastatic infection, not diabetic and not immunosuppressed |
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Term
staph aureus abx duration |
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Definition
4-6 wks therapy because of metastatic infections (osteomylitis); line not salvageable most cases |
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Term
gram-neg bacilli (e. coli, klebsiella) |
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Definition
recommended to remove line, systemic abx 7-14 days; salvage with systemic + ALT for 10-14 days (no response remove line) |
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Term
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Definition
remove line and treat 14 days (14 days start once blood cultures are CLEAR of candida) |
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Term
febrile after day 3 or persistent bacteremia (2-4 days on abx) |
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Definition
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Term
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Definition
high bioavailability, clinically stable pt, NOT ok for endocarditis |
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Term
ventilator associated pneumonia |
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Definition
> 48-72 hours after intubations |
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Term
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Definition
chest radiograph with progressive infiltrate + two of the following: fever, leukocytosis or leukopenia, purulent sections |
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Term
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Definition
abx sesitive pathogens more likely <4 days of hospitalization better prognosis |
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Term
if at risk for multi-drug resistant pathogens (MDRP) |
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Definition
treat as if late onset VAP |
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Term
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Definition
strep pneumoniae, H. influ, staph aureaus, enteric gram neg bacilli |
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Term
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Definition
E. coli, klepsiella pneumoniae, enterobacter, proteus, serratia marcenscens |
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Term
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Definition
>/= 5 days of hospitalization, increased morbidity/ mortality and rate of multidrug resistant pathogens |
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Term
ceftriaxone or cefotaxime for VAP |
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Definition
no multi-drug resist bags for early onset VAP (covers all bugs) |
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Term
levofloxacin and moxifloxacin for VAP |
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Definition
anti-pneumococcal fluoroquinolones, good for strep pneumoniae |
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Term
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Definition
poor strep pneumo activity |
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Term
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Definition
check E. coli, only use if there is not suspected E. coli |
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Term
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Definition
usually restricted, used for resistant bugs |
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Term
Multi-drug resistant pathogens risk factors (one of the following) |
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Definition
antimicrobial therapy in past 90days, current hospitalization > 5 days, high feq. of local antibiotic resistance, immune suppressed and has risk factors for HCAP |
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Term
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Definition
prior hospitalization, nursing home or extended care facility, home infusion, dialysis, long term wound care, close contact with MDR pathogen |
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Term
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Definition
Aerobic gram-neg bacteria, resistant strains of gram pos cocci |
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