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Test 1 IBI > B3.005 - Causes of Sepsis > Flashcards

B3.005 - Causes of Sepsis Flashcards

1
Q

How do bacteria get into the blood stream?

A 
Brushing your teeth
Trauma
Other infections
Indwelling devices
IV Drug use
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2
Q

Diagnosis of sepsis

A

2 of 4:

  1. Tachypnea
  2. Tachycardia
  3. Hyperpyrexia
  4. Leukocytosis
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3
Q

What is sepsis

A

overwhelming blood stream immune response to infection

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4
Q

What is an infection highway

A

blood stream

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5
Q

What is stage 1 sepsis

A

Have at least 2 of the following and confirmed infection

  1. Body temp above 101 or below 96.8
  2. Heart rate over 90
  3. RR over 20
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6
Q

Stage 2 sepsis

A

Severe sepsis

Everything in sepsis plus one sign of organ failure

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7
Q

What are signs of organ failure

A
  1. significantly decreased urine output
  2. Changes in mental status
  3. Decreased platelets
  4. Difficulty breathing
  5. Abnormal heart function
  6. Abdominal pain
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8
Q

what is stage 3 sepsis

A

Septic shock

Must have previous signs plus very low blood pressure that does not respond to fluid replacement

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9
Q

Patients hospitalized for septicemia or sepsis were how much more likely to die

A

8 times more likely to die during hospitalization

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10
Q

Risk factors of sepsis

A 
Older adults
Chronic medical condition 
Immunocompromised
Children less than 1 year
Invasive devices
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11
Q

Bacteria forming colonies/biofilms on biomaterials are recalcitrant to what

A

antibiotic therapy

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12
Q

What causes 76% of all orthopedic infections

A 
staph sp.
#1 staph aureus 
#2 staph epidermidis
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13
Q

what is standard treatment of orthopedic infections

A

removal of implant, temporary insertion of antibiotic impregnated spacer and replacement of implant

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14
Q

what are the top pathogens that can lead to sepsis infections

A

Staph aureus
CONS
E. Coli
Strep sp.

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15
Q

What are the features of staph

A 
Gram positive cocci
Non motile, non spore forming
Catalase +
Oxidase -
Facultative anaerobes
Major component of normal flora (skin, nares)
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16
Q

What are clinical syndromes that can be caused by staph

A 
Toxic shock syndrome
Endocarditis
Necrotizing pneumonia
Sepsis
Cellulitis
Necrotizing fasciitis
Pustolosis/Folliculitis
Brain abcess
Furuncle or carbuncle
Impetigo
Surgical wound
Epidural abcess
Device ass. infections
17
Q

Key virulence factors of staph

A

Cytolysins
Multiple bi component leukocidins
Phenol soluble modulins
Enterotoxins

18
Q

What are adherance factors of staph

A

Protein A
Fibronectin-binding proteins
Collagen binding proteins

19
Q

What is the pathophys of septic shock

A
  1. Innate immune system recognizes microbes
  2. Immune factors activate endothelial cells and additional leukocytes
  3. immune system over responds including secondary mediators
  4. systemic endothelial damage, vasodilation and capillary leakage
  5. multiple organ failure
  6. death
20
Q

what are microbial triggers of an immune response

A

gram negative bacteria - LPS
Gram positive bacteria - LTA, peptidoglycan, superantigens
General bacteria - flagellin
Viral nucleic acids

21
Q

PAMP recognition by

A

Toll like receptors

22
Q

What are super antigens

A

exotoxins that cross link TCR to class II MHC
Instead of activating 1 in 10,000 T cells as many as 1 in 5 T cells becomes stimulates
Leads to massive IFN gamma and IL-2 production
Acts on vascular endothelium to cause capillary leakage

23
Q

What are superantigens produced by

A

staph aureus and sterp pyogenes
Best known for causing Toxic shock syndrome
Some Sa toxins

24
Q

Treatment of sepsis

A

manage infection, identify infecting organism, antibiotics, catheter replacement, surgery

25
Q

how do you manage the shock

A

Oxygen and IV fluids

breathing machines or kidney dialysis

26
Q

what is the Accelerate PhenoTest BC

A

First test approved for identification and antibiotic susceptibility of organisms in blood stream infections

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