152.2 📚 國考版

152.2.0.1 必背 — 鑑別

• Gram + cocci in clusters = Staphylococcus
• Coagulase + = S. aureus
• Catalase + vs Strep -
• Bile soluble - vs Pneumococcus +

152.2.0.2 必背 — 主要疾病

• SSTI (cellulitis, abscess, impetigo, SSSS)
• Bacteremia + IE (高死亡, ID consult, TEE, 重複血培養)
• 骨髓炎 + 化膿性關節炎 (#1 cause)
• 肺炎 (post-influenza, CA-MRSA PVL +)
• TSS (menstrual + non-menstrual)
• Food poisoning (enterotoxin, 2-6 hr)

152.2.0.3 必背 — Empirical Antibiotics

Condition	Empirical
SSTI mild	TMP-SMX or doxycycline (CA-MRSA)
SSTI moderate	Cefazolin (if no MRSA risk) or vanco
Bacteremia	Vanco (until MSSA confirmed → cefazolin/nafcillin)
IE	Vanco + cefepime/genta (HACEK 也 cover)
Pneumonia (severe)	Vanco + cefepime ± azithro
TSS	Vanco + clinda (toxin suppression) ± IVIG

152.2.0.4 必背 — CoNS

• S. epidermidis: prosthetic device (biofilm)
• S. saprophyticus: UTI young female
• S. lugdunensis: aggressive IE (treat 像 S. aureus)

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