Monday MR with Melissa Itsara: GNR bacteremia


A middle aged man with stage IV HCC of unknown etiology who presented 2 weeks after biliary stent placement with confusion found to have E. Coli bacteremia.


**Learning point for Gram-negative bacteremia

-Treat presumptively with Zosyn – consider 2nd gram negative agent if: immunocompromised; high risk for P. aeruginosa, or unit antibiogram shows drug resistance > 20-25% for GNR pathogens

Risk factors for P. aeruginosa

-Current hospitalization or admission to an intensive care unit

-Recent P. aeruginosa infection

-Recent hospitalization


-Admission from along-term care facility

-Recent IV abx

-Recent chemo




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