B3.005 Causes of Sepsis

Question 1

what are some ways bacteria get into the blood stream?

Answer 1

brushing teeth
trauma
infections
indwelling devices
IV drug use

Question 2

what 4 types of infection are often linked with sepsis

Answer 2

lungs
UTI
skin
gut

Question 3

what is the bloodstream?

Answer 3

an infection superhighway

Question 4

what is sepsis?

Answer 4

an overwhelming blood stream immune response to infection

Question 5

signs of organ failure associated with severe sepsis

Answer 5

decreased urine output
changes in mental status
decreased platelets
difficulty breathing
abnormal heart function
abdominal pain

Question 6

risk factors for sepsis

Answer 6

older adults
chronic medical conditions
immunocompromised
children less than 1 yo
invasive devices

Question 7

what is the result of biofilm formation on biomaterials?

Answer 7

recalcitrant to antibiotic therapy
unable to be cured by the immune system
chronic

Question 8

what bacteria causes 76% of orthopedic infections?

Answer 8

staphylococcus

1. aureus
2. epidermis

Question 9

standard treatment of biofilm infection

Answer 9

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

Question 10

what are the top pathogens that can lead to sepsis

Answer 10

staphylococcus
#1 CONS
#2 S.aureus
E. coli
Streptococcus

Question 11

features of staphylococci

Answer 11

gram + cocci
clusters
non motile, non spore forming
catalase positive and oxidase negative
facultative anaerobes
major component of normal flora

Question 12

most medically significant species of staph

Answer 12

aureus
epidermis
saprophyticus

Question 13

key virulence factors of staph

Answer 13

cytolysins
multiple bi-component leukocidins
phenol-soluble modulins
enterotoxins
adherence factors
other secreted proteins (proteases, nucleases, hyaluronidase, coagulase)

Question 14

pathophysiology of septic shock

Answer 14

innate immune system recognizes microbes
immune factors activate endothelial cells and additional leukocytes
immune system over-responds including secondary mediators
systemic endothelial damage, vasodilation, and capillary leakage
multiple organ failure
death

Question 15

microbial triggers leading to immune response

Answer 15

gram - bacteria: LPS
gram + bacteria: lipoteichoic acid (LTA), peptidoglycan, superantigens
general bacteria : flagella
viral nucleic acids

Question 16

when were super antigens first recognized?

Answer 16

toxic shock syndrome associated with tampons

Question 17

what are super antigens?

Answer 17

exotoxins that cross link TCR to class 2 MHC

Question 18

what is the result of a super antigen?

Answer 18

activate 1 in 5 T cells instead of 1 in 10000
massive IFN-gamma and IL-2 production
acts on vascular endothelium to cause capillary leakage
results in hypotension, shock, and death

Question 19

bacteria most likely to produce super antigens

Answer 19

staph- 21

strep - 12

Question 20

treatment of septic shock

Answer 20

1. manage infection
2. manage shock
   currently no drugs to specifically target the immune response

Question 21

treatment of septic shock under consideration

Answer 21

anti inflamm
drugs targeting cytokines
anticoagulants
plasma exchange
vitamin/corticosteroids
NSAIDS

Question 22

accelerated PhenoTestBC

Answer 22

identification in 90 min and susceptibility in 7 hrs