“New(er)” gram-positive infecting agents.11– 14
| Organism . | Microbiologic Features . | Type of Infection . | Therapy . | Comments . |
|---|---|---|---|---|
| Abbreviations: ARDS, acute respiratory distress syndrome; CNS, central nervous system; gi, gastrointestinal; gu, genito-urinary | ||||
| viridans streptococci | from oral flora | bacteremia | Vancomycin until susceptibility is determined | associated with mucositis and use of certain prophylactic antibiotics |
| toxic shock-like syndrome with ARDS | increased resistance to penicillins and some cephalosporins | |||
| 6-30% mortality rates | ||||
| Enterococcus sp | from gi flora | bacteremia | no”best” therapy | associated with outbreaks |
| linezolid or quinopristin/dalfopristin may be useful | mortality rates >70% noted | |||
| Stomatococcus mucilaginous | slime producing encapsulated organism | catheter associated sepsis | vancomycin | infection may be slow to resolve or may recur even with appropriate treatment |
| from oral flora | CNS infection | |||
| bacteremia | ||||
| Bacillus cereus | slime producing bacillus | pneumonia | vancomycin | remove central line in presence of bacteremia |
| line-related sepsis | clindamycin | |||
| skin and soft tissue infection | ||||
| fasciitis | ||||
| meningitis | ||||
| Rhodococcus equi | pleiomorphic gram-positive bacillus | necrotizing pneumonia | macrolides | more commonly seen in AIDS |
| lung abscesses | vancomycin | |||
| empyema | ||||
| Corynebacterium sp | non-hemolytic, coccobacillus from skin, rectal flora | line-sepsis | vancomycin | remove central line in presence of bacteremia |
| endocarditis | ||||
| Leuconostoc sp | fastidious cocci may be mistaken for viridans streptococci | fever | clindamycin | combination therapy with penicillins + clindamycin may be best therapy |
| line sepsis | aminoglycoside | |||
| colitis | ||||
| Lactobacillus sp | bacillus from oral, gi, gu flora | bacteremia | penicillin plus aminoglycoside | mortality may be as high as 45% |
| endocarditis | ||||
| meningitis | ||||
| intrabdominal abscess | ||||
| pneumonia | ||||
| Organism . | Microbiologic Features . | Type of Infection . | Therapy . | Comments . |
|---|---|---|---|---|
| Abbreviations: ARDS, acute respiratory distress syndrome; CNS, central nervous system; gi, gastrointestinal; gu, genito-urinary | ||||
| viridans streptococci | from oral flora | bacteremia | Vancomycin until susceptibility is determined | associated with mucositis and use of certain prophylactic antibiotics |
| toxic shock-like syndrome with ARDS | increased resistance to penicillins and some cephalosporins | |||
| 6-30% mortality rates | ||||
| Enterococcus sp | from gi flora | bacteremia | no”best” therapy | associated with outbreaks |
| linezolid or quinopristin/dalfopristin may be useful | mortality rates >70% noted | |||
| Stomatococcus mucilaginous | slime producing encapsulated organism | catheter associated sepsis | vancomycin | infection may be slow to resolve or may recur even with appropriate treatment |
| from oral flora | CNS infection | |||
| bacteremia | ||||
| Bacillus cereus | slime producing bacillus | pneumonia | vancomycin | remove central line in presence of bacteremia |
| line-related sepsis | clindamycin | |||
| skin and soft tissue infection | ||||
| fasciitis | ||||
| meningitis | ||||
| Rhodococcus equi | pleiomorphic gram-positive bacillus | necrotizing pneumonia | macrolides | more commonly seen in AIDS |
| lung abscesses | vancomycin | |||
| empyema | ||||
| Corynebacterium sp | non-hemolytic, coccobacillus from skin, rectal flora | line-sepsis | vancomycin | remove central line in presence of bacteremia |
| endocarditis | ||||
| Leuconostoc sp | fastidious cocci may be mistaken for viridans streptococci | fever | clindamycin | combination therapy with penicillins + clindamycin may be best therapy |
| line sepsis | aminoglycoside | |||
| colitis | ||||
| Lactobacillus sp | bacillus from oral, gi, gu flora | bacteremia | penicillin plus aminoglycoside | mortality may be as high as 45% |
| endocarditis | ||||
| meningitis | ||||
| intrabdominal abscess | ||||
| pneumonia | ||||