p.1
Clinical Presentation of NTM Diseases
What are the most prevalent Nontuberculous Mycobacteria (NTM) causing pulmonary disease?
MAC, M. kansasii, M. abscessus (in order of prevalence).
p.5
Treatment Guidelines for NTM Lung Disease
What is the preferred treatment option for TB infection?
INH/Rifapentine x 3 months (3HP) with once weekly DOT.
p.8
Antibiotic Resistance Mechanisms in Mycobacteria
What are the two ways bacteria with the AmpC gene can come?
1. Chromosomal and Inducible; 2. On plasmid; constitutive.
p.16
In Vitro Susceptibilities and Treatment Responses
What are the side effects of Rifampicin?
Thrombocytopenia within 1-2 weeks; reintroduction is not advisable.
p.13
Diagnostic Criteria for NTM Pulmonary Disease
What is the role of factor G in the coagulation cascade?
It is activated by 1,3 ß D glucan in the coagulation cascade of horseshoe crabs.
p.18
Clinical Presentation of NTM Diseases
What are some complications associated with scrub typhus?
Encephalitis, seizure, myocarditis, pneumonia, and eschar.
p.8
Treatment Guidelines for NTM Lung Disease
What is the typical treatment for Trichomonas vaginitis?
Metronidazole, 500 mg orally twice daily for one week.
p.6
Initiation of ART in patients with HIV/TB
What is the recommended timing for initiating ART in patients with CD4 counts ≥50 cells/mm³?
Within 8 weeks of starting TB treatment.
p.6
Microbiologic Criteria for NTM Diagnosis
Which species are positive for modified acid-fast stain?
Nocardia, Rhodococcus, Gordonia, Tsukamurella, Dietzia, and some Corynebacterium species.
p.9
In Vitro Susceptibilities and Treatment Responses
Which antibiotics are recommended for respiratory pathogens?
Levofloxacin, Delafloxacin, and Moxifloxacin.
p.16
Treatment Guidelines for NTM Lung Disease
What are the first-line choices for MRSA bacteraemia?
Vancomycin, Daptomycin, and Linezolid.
p.11
Antibiotic Resistance Mechanisms in Mycobacteria
What are the main toxicities associated with aminoglycosides?
Cochleotoxicity, vestibulotoxicity, and nephrotoxicity.
p.5
Treatment Guidelines for NTM Lung Disease
What is the recommended duration for Rifampin treatment?
4 months, daily (10 mg/kg: 600 mg max).
p.1
Clinical Presentation of NTM Diseases
What NTM are associated with disseminated disease in HIV patients?
M. haemophilum and M. kansasii.
p.19
Treatment Guidelines for NTM Lung Disease
What is the treatment for the induction phase of Strongyloides stercoralis?
Ceftriaxone or Penicillin G for 2 - 4 weeks.
p.7
Antibiotic Resistance Mechanisms in Mycobacteria
What does the mecA gene confer resistance to?
All available β-lactams except ceftaroline.
p.1
Diagnostic Criteria for NTM Pulmonary Disease
What radiologic findings are indicative of NTM lung disease?
Nodular or cavitary opacities on CXR or bronchiectasis with multiple small nodules on HRCT.
p.13
Diagnostic Criteria for NTM Pulmonary Disease
What is the significance of 1,3 ß D glucan in fungal diagnostics?
It is a polysaccharide present in the cell wall of fungi and indicates invasive fungal infection.
p.6
Active TB Treatment Principles
What is the principle for treating active TB in HIV-infected patients?
Follow the same principles as for persons without HIV infection, starting with 4 drugs.
p.8
Chronic Lung Diseases Associated with NTM
How does Dirofilaria immitis typically present in humans?
As a solitary nodule in the lung.
p.4
Clinical Presentation of NTM Diseases
What are common symptoms associated with bladder instillation of BCG?
Fever and sterile pyuria.
p.14
Emerging Antifungal and Antimicrobial Therapies
What is Rezafungin and when was it approved?
Rezafungin is a long-acting echinocandin approved in summer 2023, with a half-life of approximately 152 hours.
p.3
In Vitro Susceptibilities and Treatment Responses
What is the role of macrolides in treating M. abscessus lung disease?
Their value is questionable, but they may serve as immune modulators.
p.1
Management of Disseminated NTM Infections
What should be done if NTM are recovered that are infrequently encountered?
Obtain expert consultation.
p.17
In Vitro Susceptibilities and Treatment Responses
What is a black box warning associated with Telavancin?
Nephrotoxicity for CICr ≤ 50 ml/min.
p.2
In Vitro Susceptibilities and Treatment Responses
What is the correlation between treatment response and in vitro macrolide MIC for MAC disease?
Treatment success correlates with in vitro macrolide MIC; susceptible ≤ 8 μg/ml, resistant ≥ 32 μg/ml.
p.5
Treatment Guidelines for NTM Lung Disease
What is the initiation phase of therapy for drug-susceptible TB?
INH, Rifampin, EMB, and PZA for 2 months.
p.18
Clinical Presentation of NTM Diseases
What essential feature distinguishes scrub typhus from other endemic diseases?
The presence of an eschar at the site of the chigger bite.
p.1
Diagnostic Criteria for NTM Pulmonary Disease
What clinical symptoms are required for diagnosing NTM lung disease?
Pulmonary or systemic symptoms.
p.9
Clinical Presentation of NTM Diseases
What does tetanus produce instead of progressive paralysis?
Severe and painful muscle spasms.
p.10
Microbiologic Criteria for NTM Diagnosis
What is a phenotypic marker for the production of ESBLases in GNB?
In vitro resistance of GNB.
p.16
In Vitro Susceptibilities and Treatment Responses
What is a potential risk when using Linezolid?
Serotonin syndrome, especially when used with SSRIs or MAO inhibitors.
p.19
Clinical Presentation of NTM Diseases
What are the non-specific clinical features of Babesiosis?
Malaise, fatigue, myalgia, nausea, and fever.
p.9
In Vitro Susceptibilities and Treatment Responses
What are the pros of using broad-spectrum antibiotics?
Broad spectrum of activity, large volume of distribution, high oral bioavailability.
p.19
In Vitro Susceptibilities and Treatment Responses
What combination of drugs is used for managing Babesiosis?
Atovaquone + azithromycin OR Clindamycin + quinine.
p.2
Treatment Guidelines for NTM Lung Disease
What is the treatment approach for cavitary MAC disease?
Macrolide (azithromycin preferred), EMB, rifamycin ± injectable (amikacin).
p.4
Management of Disseminated NTM Infections
What factors influence the decision to test/treat for NTM?
Likelihood of infection and likelihood of progression.
p.5
Diagnostic Criteria for NTM Pulmonary Disease
What is the recommended test for TB infection in individuals ≥ 5 years old with low or moderate risk?
IGRAs (Interferon Gamma Release Assays).
p.8
In Vitro Susceptibilities and Treatment Responses
Which antibiotics are considered oral carbapenem-sparing for ESBL producing bacteria causing cystitis?
Fosfomycin, Augmentin, Nitrofurantoin.
p.13
In Vitro Susceptibilities and Treatment Responses
What is the loading dose for Anidulafungin?
200 mg loading dose followed by 100 mg daily IV.
p.5
Treatment Guidelines for NTM Lung Disease
What is emphasized in the new guidelines for TB treatment?
Daily dosing over intermittent dosing.
p.12
Clinical Presentation of NTM Diseases
What is the primary difference between cellulitis and erysipelas?
Cellulitis involves deeper dermis and subcutaneous fat, while erysipelas involves the upper dermis and superficial lymphatics.
p.5
Treatment Guidelines for NTM Lung Disease
What is the continuation phase of therapy for drug-susceptible TB?
INH and Rifampin for 4-7 months.
p.8
Chronic Lung Diseases Associated with NTM
What does Strongyloides larvae migration through the lung cause?
Patchy pulmonary infiltrates or diffuse infiltrate in hyperinfection syndrome.
p.14
Emerging Antifungal and Antimicrobial Therapies
For what conditions is Rezafungin approved?
Approved for candidemia and invasive candidiasis in patients with limited antifungal options.
p.5
Management of Disseminated NTM Infections
What is the contraindication for INH/rifapentine in HIV patients?
Contraindicated in patients on any antiretrovirals except Efavirenz, Raltegravir, or Dolutegravir.
p.1
Microbiologic Criteria for NTM Diagnosis
What is the significance of a single positive culture from an expectorated sputum specimen?
It is regarded as indeterminate for diagnosis of NTM lung disease.
p.17
In Vitro Susceptibilities and Treatment Responses
What is a common side effect of Ceftaroline?
Rash and usual cephalosporin reactions.
p.19
Microbiologic Criteria for NTM Diagnosis
What is the classic appearance of Babesia merozoites?
Tetrads with a Maltese cross appearance.
p.4
Diagnostic Criteria for NTM Pulmonary Disease
What are the advantages of newer generation IGRAs over TST?
They do not cross-react with BCG or NTM and are preferred for BCG vaccinated individuals.
p.15
Diagnostic Criteria for NTM Pulmonary Disease
What is the sensitivity and specificity of T2Candida testing?
Sensitivity: 90-94%, Specificity: >99%.
p.16
Treatment Guidelines for NTM Lung Disease
What is the recommended dosage for Vancomycin?
30-60 mg/kg/d in 2-3 divided doses.
p.11
Antibiotic Resistance Mechanisms in Mycobacteria
Which cephalosporins have a higher risk of causing seizures?
Cefazolin, ceftazidime, and cefepime.
p.10
In Vitro Susceptibilities and Treatment Responses
What is the combination used to treat GNB co-producing ESBL and metallo-carbapenemase?
Ceftazidime-avibactam + Aztreonam.
p.4
In Vitro Susceptibilities and Treatment Responses
What is the resistance profile of M. bovis?
Resistant to PZA, susceptible to INH, rifampin, and EMB.
p.12
Clinical Presentation of NTM Diseases
How do the borders of cellulitis lesions typically appear?
Indistinct borders that are not raised.
p.7
Microbiologic Criteria for NTM Diagnosis
What is the significance of the Carba NP test?
It tests for carbapenemase production.
p.10
Management of Disseminated NTM Infections
What is associated with acute kidney injury (AKI) when using Vancomycin?
Trough concentration >15 mg/L.
p.12
Microbiologic Criteria for NTM Diagnosis
What are diphtheroid bacilli?
Gram-positive bacilli, club-shaped, non-spore forming, with a palisade arrangement.
p.14
Emerging Antifungal and Antimicrobial Therapies
What is Fosmanogepix and what does it target?
Fosmanogepix is a prodrug of manogepix that targets inositol acyltransferase (Gwt1) and inhibits protein synthesis.
p.17
In Vitro Susceptibilities and Treatment Responses
How does Dalbavancin differ in dosing?
It can be given as a single dose or 2 doses a week apart.
p.17
Treatment Guidelines for NTM Lung Disease
What is the indication for Oritavancin?
SSTI, with a one-time dose.
p.13
Diagnostic Criteria for NTM Pulmonary Disease
Which fungi are exceptions for the presence of 1,3 ß D glucan?
Cryptococcus, mucoraeceous molds, and Blastomyces (yeast phase).
p.8
Management of Disseminated NTM Infections
What is hyperammonemia syndrome and its association with lung transplant recipients?
A rare but sometimes fatal complication linked to Ureaplasma spp and M. hominis pulmonary infection.
p.11
Antibiotic Resistance Mechanisms in Mycobacteria
What is a potential side effect of metronidazole?
Metronidazole-induced encephalopathy.
p.3
In Vitro Susceptibilities and Treatment Responses
Which antibiotics are used for treating macrolide-resistant MAC?
Rifabutin, Ethambutol, and Linezolid.
p.16
Chronic Lung Diseases Associated with NTM
What is the significance of GATA2 deficiency?
It is associated with cytopenia and can lead to disseminated NTM.
p.7
Diagnostic Criteria for NTM Pulmonary Disease
What tests confirm susceptibility to oxacillin in serious infections?
PBP2a testing or NAAT to detect mecA and mecC.
p.3
Management of Disseminated NTM Infections
What is the prophylaxis recommendation for adults with AIDS and CD4 < 50?
Azithromycin 1200 mg/week or clarithromycin 500 mg BID.
p.14
Emerging Antifungal and Antimicrobial Therapies
What type of antifungal is Ibrexafungerp and what does it inhibit?
Ibrexafungerp is a triterpenoid antifungal that inhibits glucan synthase to prevent fungal cell wall formation.
p.2
Antibiotic Resistance Mechanisms in Mycobacteria
What is the mechanism of macrolide resistance?
Selection of isolates with mutations inhibiting macrolide ribosomal binding (erm gene).
p.7
In Vitro Susceptibilities and Treatment Responses
Which generation of cephalosporins has antipseudomonal activity?
4th generation (Ceftazidime and Cefepime).
p.19
Management of Disseminated NTM Infections
What should be monitored in immunocompetent patients with Babesiosis?
Parasitemia using peripheral blood smears.
p.2
Treatment Guidelines for NTM Lung Disease
What is the duration of therapy for severe or previously treated MAC disease?
12 months of sputum culture negativity while on therapy.
p.17
Clinical Presentation of NTM Diseases
What is a must-know tick-borne infection?
Ehrlichiosis, Anaplasmosis, Rickettsiosis, Q fever.
p.15
Diagnostic Criteria for NTM Pulmonary Disease
What diagnostic method is used for T2Candida?
Magnetic resonance-based diagnostic using nanoparticle technology.
p.13
In Vitro Susceptibilities and Treatment Responses
What are the first-line echinocandins for treating Candida infections?
Anidulafungin, Caspofungin, Micafungin, and Rezafungin.
p.11
Antibiotic Resistance Mechanisms in Mycobacteria
Which antibiotics are associated with ototoxicity?
Vancomycin, macrolides, and minocycline.
p.6
Active TB Treatment Principles
What is strongly recommended for TB treatment?
Directly observed therapy.
p.1
Diagnostic Criteria for NTM Pulmonary Disease
What are the microbiologic criteria for diagnosing NTM pulmonary disease?
At least one positive culture from 2 separate sputum samples, one bronchial wash, or a biopsy with mycobacterial features.
p.9
Clinical Presentation of NTM Diseases
What type of paralysis is associated with Guillain-Barré syndrome?
Ascending paralytic disease.
p.3
In Vitro Susceptibilities and Treatment Responses
What is the recommended treatment for M. abscessus lung disease?
Amikacin, Tigecycline, and Linezolid.
p.6
Initiation of ART in patients with HIV/TB
What caution should be taken when initiating ART in patients with tuberculous meningitis?
High rates of adverse events and deaths have been reported.
p.8
Clinical Presentation of NTM Diseases
What has been the trend in wound botulism cases in the United States?
Dramatic increase, often associated with injection drug users.
p.16
Management of Disseminated NTM Infections
What are the implications of immune reconstitution syndromes?
They can lead to lymphadenitis and granulomatous hepatitis.
p.6
Chronic Lung Diseases Associated with NTM
What are the two forms of Strongyloides stercoralis larvae?
Rhabditiform (in stool) and filariform.
p.1
Diagnostic Criteria for NTM Pulmonary Disease
What factors influence the diagnostic evaluation of NTM?
The virulence of the isolated NTM, the host's immune status, and the clinical source of the organism.
p.9
Antibiotic Resistance Mechanisms in Mycobacteria
What are the major families of Carbapenemases?
Non-metallo (serine at active site), Metallo (Zinc at active site), OXA (oxacillinase).
p.18
Diagnostic Criteria for NTM Pulmonary Disease
What neuroimaging findings are associated with CNS Whipple's disease?
MRI T2 hyperintense patches with variable contrast enhancement.
p.2
Chronic Lung Diseases Associated with NTM
What is 'hot tub' lung usually associated with?
MACs (Mycobacterium avium complex).
p.15
Management of Disseminated NTM Infections
What is a positive epidemiological risk factor for disseminated NTM?
Travel history related to dimorphic fungi (histoblastococci).
p.13
Diagnostic Criteria for NTM Pulmonary Disease
What are the primary diagnostic methods for Candida spp. infections?
Blood cultures, antigen assays, and antibody assays.
p.5
Diagnostic Criteria for NTM Pulmonary Disease
When are IGRAs considered better tests?
When TST administration is suspect, in BCG vaccinated populations, and in populations with a poor rate of return.
p.16
Chronic Lung Diseases Associated with NTM
What are some acquired defects that can lead to disseminated NTM?
Immunodeficiencies or autoimmunity.
p.2
Diagnostic Criteria for NTM Pulmonary Disease
What are the criteria for a positive diagnosis of NTM?
Positive culture from a BAL or bronch wash, or positive culture from a lung biopsy with consistent histopathology.
p.12
Microbiologic Criteria for NTM Diagnosis
What type of bacteria most commonly causes cellulitis?
β-haemolytic streptococci, sometimes S. aureus.
p.18
Clinical Presentation of NTM Diseases
What does the eschar represent in scrub typhus?
Tissue reaction at the chigger bite site and local proliferation of O. Tsutsugamushi.
p.8
Clinical Presentation of NTM Diseases
What is the typical cause of botulism in adults?
Ingestion of preformed toxin in contaminated food or infection of a wound with Clostridium botulinum.
p.12
Clinical Presentation of NTM Diseases
What is the characteristic appearance of erysipelas lesions?
Brightly red, indurated, well-demarcated.
p.7
In Vitro Susceptibilities and Treatment Responses
What are the risk factors for CMV antiviral resistance?
Prolonged drug exposure and being a lung transplant recipient.
p.11
Antibiotic Resistance Mechanisms in Mycobacteria
What are common pathogens in intravascular catheter-related infections?
Coagulase-negative staphylococcus, Staphylococcus aureus, and Corynebacterium jeikeium.
p.14
Antibiotic Resistance Mechanisms in Mycobacteria
What are the common mechanisms of antibiotic resistance in Acinetobacter?
Efflux, porins, inactivation, target site alteration, and bypass of target.
p.15
In Vitro Susceptibilities and Treatment Responses
What is avibactam?
A new β-lactamase inhibitor with activity against ampC.
p.7
In Vitro Susceptibilities and Treatment Responses
What type of bacteria does 6th generation cephalosporins target?
ESBL producing GNBs and has antipseudomonal activity.
p.7
In Vitro Susceptibilities and Treatment Responses
What is the activity of 8th generation cephalosporins?
Effective against serine/metallo carbapenemase producing Enterobacterales and non-fermenters, but not useful against Gram-positive and anaerobic bacteria.
p.15
Clinical Presentation of NTM Diseases
What is neuroretinitis and its common cause?
Acute visual loss from optic nerve edema associated with macular edema, commonly caused by Bartonella henselae.
p.13
Treatment Guidelines for NTM Lung Disease
What is the recommended approach for managing a fungal infection?
Remove focus of infection, decrease immunosuppression, restore immune function, and begin antifungal therapy early.
p.3
Treatment Guidelines for NTM Lung Disease
What is the primary concern regarding treatment for NTM lung disease?
The decision to treat is based on a risk/benefit analysis.
p.3
Treatment Guidelines for NTM Lung Disease
What factors influence the decision to treat NTM lung disease?
Diagnosis confidence, radiographic extent, and whether the disease is cavitary.
p.3
Chronic Lung Diseases Associated with NTM
What are common chronic lung diseases associated with NTM infections?
Bronchiectasis, Cystic Fibrosis, and Chronic Obstructive Lung Disease.
p.19
Treatment Guidelines for NTM Lung Disease
What is the maintenance phase treatment for Strongyloides stercoralis?
Septrin (treatment dose) for 1 year.
p.4
Clinical Presentation of NTM Diseases
What are the characteristic skin lesions of M. leprae?
Scaly skin lesions that are hyper- or hypopigmented.
p.11
Antibiotic Resistance Mechanisms in Mycobacteria
What is the risk of using aminoglycosides in myasthenia gravis (MG)?
They should be avoided due to neuromuscular effects.
p.18
Diagnostic Criteria for NTM Pulmonary Disease
What laboratory techniques are used for diagnosing scrub typhus from an eschar?
Immunohistochemistry (IHC) and nested DNA PCR assay.
p.3
Clinical Presentation of NTM Diseases
What organisms can cause infections from tattooing using contaminated water?
M. fortuitum, M. chelonae, M. abscessus.
p.15
In Vitro Susceptibilities and Treatment Responses
How does ceftazidime compare to other β-lactams regarding ampC induction?
Ceftazidime induces ampC less than other β-lactams.
p.15
In Vitro Susceptibilities and Treatment Responses
What is the effect of imipenem-relebactam on ampC?
Relebactam inhibits ampC and is poorly effluxed.
p.17
Clinical Presentation of NTM Diseases
What is the natural reservoir for scrub typhus?
Rodents, maintained by transovarian transmission of Trombicula mites.
p.4
Treatment Guidelines for NTM Lung Disease
When can treatment be discontinued for patients with CD4 counts?
Once CD4 >100 for more than 3 months.
p.4
Nontuberculous Mycobacteria (NTM) Overview
What are the risk factors associated with M. bovis?
Unpasteurized milk products, travel, gifts from foreign places.
p.6
Initiation of ART in patients with HIV/TB
When should ART be initiated in patients with CD4 counts <50 cells/mm³?
As soon as possible, but within 2 weeks of starting TB treatment.
p.11
Antibiotic Resistance Mechanisms in Mycobacteria
What causes peripheral neuropathy in certain antibiotics?
Inhibition of protein synthesis and nerve tissue injury.
p.16
In Vitro Susceptibilities and Treatment Responses
What should be monitored when using Daptomycin?
Therapeutic drug monitoring due to potential emergence of resistance.
p.2
Antibiotic Resistance Mechanisms in Mycobacteria
What is the significance of the erm gene in M. fortuitum?
It confers inducible macrolide resistance.
p.1
Microbiologic Criteria for NTM Diagnosis
Which NTM species are known to be frequent contaminants?
M. gordonae, M. terrae complex, M. mucogenicum.
p.9
In Vitro Susceptibilities and Treatment Responses
What are the cons of broad-spectrum antibiotics?
Increased resistance, serious adverse effects (C. diff), many drug-drug interactions.
p.10
Management of Disseminated NTM Infections
Which antibiotics are considered less nephrotoxic alternatives?
Cefoperazone, ceftriaxone, clindamycin, macrolides, doxycycline, minocycline, ciprofloxacin.
p.12
Antibiotic Resistance Mechanisms in Mycobacteria
What is a significant concern regarding antibiotic resistance in Corynebacterium?
Daptomycin resistance can develop during treatment due to the pgsA2 gene.
p.9
Antibiotic Resistance Mechanisms in Mycobacteria
What is the activity of Ceftazidime-avibactam against OXA-48?
Active (Avibactam binds OXA-48).
p.17
Clinical Presentation of NTM Diseases
What causes scrub typhus?
Orientia tsutsugamushi, an obligate intracellular gram-negative coccobacillus.
p.13
Treatment Guidelines for NTM Lung Disease
When should echinocandins be recommended as first-line treatment?
If there is prior azole exposure or infection due to C. glabrata, C. krusei, or C. auris.
p.7
Antibiotic Resistance Mechanisms in Mycobacteria
What is the mechanism of methicillin resistance in Staphylococcus aureus?
Mediated by the mecA gene, which alters the PBP target to PBP2a.
p.11
Antibiotic Resistance Mechanisms in Mycobacteria
Which antibiotic is associated with idiopathic intracranial hypertension?
Tetracycline, especially doxycycline.
p.19
Management of Disseminated NTM Infections
How often should CSF PCR be repeated to evaluate treatment response?
Every 2 - 3 months until negative.
p.18
Clinical Presentation of NTM Diseases
What is the typical appearance of an eschar in scrub typhus?
A brownish-black crusted necrotic ulcer with an erythematous halo, resembling a 'cigarette burn'.
p.6
Management of Disseminated NTM Infections
What prophylaxis is recommended for Burkholderia pseudomallei?
Septrin/Doxycycline/Augmentin.
p.19
Diagnostic Criteria for NTM Pulmonary Disease
How is Babesiosis diagnosed?
By intraerythrocytic ring forms on peripheral blood smear examination.
p.7
In Vitro Susceptibilities and Treatment Responses
What is the activity spectrum of 1st generation cephalosporins?
Effective against MSSA, E. coli, and Klebsiella sp., but no activity against enterococci.
p.4
Diagnostic Criteria for NTM Pulmonary Disease
What is the significance of a 5 mm tuberculin skin test result?
It is positive in high-risk individuals.
p.18
Clinical Presentation of NTM Diseases
What are the clinical presentations of classical Whipple's disease?
Arthralgia, weight loss, abdominal pain, and diarrhea.
p.17
In Vitro Susceptibilities and Treatment Responses
What are preferred oral agents for MSSA bacteremia?
Linezolid, Septrin, FQ + rifampin, clindamycin.
p.15
Clinical Presentation of NTM Diseases
What typically causes infectious diarrheal disease to last more than 2 weeks?
Giardia, Cyclospora, Amoeba, or Cryptosporidium.
p.4
Diagnostic Criteria for NTM Pulmonary Disease
How is M. leprae diagnosed?
By pathology showing invasion of nerve cells by AFB or foamy macrophages.
p.10
Management of Disseminated NTM Infections
What are the three mechanisms of nephrotoxicity associated with Vancomycin?
Immune mediated (AIN), mitochondrial inhibition and oxidative damage (ATN), cast formation (ATN).
p.12
Management of Disseminated NTM Infections
What are common infections associated with non-diphtheriae Corynebacterium?
Pneumonia, CRBSI, endocarditis, implant-associated infections, wound infections, and UTIs.
p.12
Treatment Guidelines for NTM Lung Disease
What is the treatment approach for infections caused by lipophilic Corynebacterium?
Combination of antibiotics, steroids, drainage, and surgery, with susceptibility testing for lipophilic antibiotics.
p.12
Management of Disseminated NTM Infections
What is a common complication in managing infections caused by Corynebacterium?
Recurrent episodes often requiring multiple image-guided drainage or incisional drainage.
p.14
Emerging Antifungal and Antimicrobial Therapies
What recent advances have been made in anti-Pseudomonas antibiotics?
Ceftolozane-tazobactam and cefiderocol, designed to penetrate the outer membrane and resist hydrolysis.
p.12
Diagnostic Criteria for NTM Pulmonary Disease
What factors should be considered when diagnosing infections caused by Corynebacterium?
Patient/clinical and microbiological factors, along with additional microbiological investigations.
p.9
Antibiotic Resistance Mechanisms in Mycobacteria
What is the risk associated with Meropenem and Ceftolozane/tazobactam?
Risk of inducible AmpC production.
p.4
Treatment Guidelines for NTM Lung Disease
What is the treatment regimen for multibacillary forms of M. leprae?
Dapsone daily, rifampin monthly, clofazimine daily.
p.14
Management of Disseminated NTM Infections
What is the suggested treatment approach for moderate to severe CRAB infections according to IDSA guidelines 2022?
Combination therapy with at least 2 agents with in vitro activity is suggested.
p.10
Management of Disseminated NTM Infections
Which antibiotics are associated with DRESS syndrome?
Anti-TB antibiotics, glycopeptides (vancomycin, teicoplanin), and sulphonamides.
p.15
Clinical Presentation of NTM Diseases
How long does cryptosporidiosis typically last in healthy individuals?
1 to 2 weeks, but can sometimes last several weeks.
p.18
Diagnostic Criteria for NTM Pulmonary Disease
What is the sensitivity and specificity of IHC on the eschar for diagnosing scrub typhus?
100% sensitivity and specificity.
p.2
Treatment Guidelines for NTM Lung Disease
What is the recommended therapy for nodular/bronchiectatic MAC disease?
Macrolide/EMB/rifamycin intermittently (3x/week).
p.7
In Vitro Susceptibilities and Treatment Responses
What is the activity of 5th generation cephalosporins?
Similar to ceftriaxone with MRSA activity, but no activity against enterococci.
p.19
Management of Disseminated NTM Infections
What is the recommendation for testing after symptoms have resolved in immunocompetent patients?
Recommend against testing once symptoms have resolved.
p.17
Clinical Presentation of NTM Diseases
What are common signs and symptoms of scrub typhus?
Fever, chills, headache, generalized lymphadenopathy, and eschar at the bite site.
