Bacterial infections of the blood Flashcards
What is bacteremia?
Bacterial infection of the blood
True or false: bacteremia is not uncommon, and can occur from trauma to a body site that has normal flora
True
What type of bacteremia results from dental extraction?
Transient–goes away quickly
What type of bacteremia results from pneumococcal pneumonia?
Intermittent
What type of bacteremia results from gram negative sepsis? What is the consequence of this?
Intermittent, but constantly there
Need to take multiple cultures to “catch” the bacteria
What type of bacteremia results from an intraabdominal abscess?
Intermittent, with disappearing amounts
What type of bacteremia results from infective endocarditis?
Continuous and low
What type of bacteremia results from catheter bacteremia?
Continuous
What are the three possible consequences of bactermia?
- Transient and benign
- Sepsis/shock
- Endocarditis
What is sepsis?
Systemic inflammatory response syndrome (SIRS) that has a proven or suspected microbial etiology
Is bacteremia required for sepsis?
No–microbial could release toxins into the blood
What are the signs that occur with SIRS/sepsis? How many of these signs are needed to make a diagnosis of sepsis?
Fever/hypothermia
Tachypnea
Tachycardia
Abnormal WBC
Need to have at least two of these
What is severe sepsis?
Sepsis with one more more signs of organ dysfunction
What is septic shock?
Severe sepsis + hypotension (systolic pressure <90 mmHg)
What is refractory septic shock?
Septic shock that lasts for >1 h and does not respond to fluid and pharmacological treatment
What is multiorgan failure?
Dysfunction of >1 organ, as well as disseminated intravascular coagulation
What are the inflammatory cytokines that result in sepsis?
IL-6
TNF-alpha
DIC
What causes the organ failure in sepsis?
DIC
What general type of microorganism is usually responsible for sepsis (viruses, bacteria, fungi, or parasites)?
Bacteria
True or false: bacteremia is required to have bacterial sepsis?
False–exotoxins can cause sepsis
What is the pathophysiology behind sepsis?
Gram Negative LPS (or other PAMPs) causes release of cytokines
How can gram positive bacteria cause septic shock?
Release of exotoxins or peptidoglycan
How do fungi cause sepsis?
PAMPs associated with yeast like teichoic acid
LPS binds to what?
CD14 and TLR4
Which major cytokines does TLR4 recruit that causes sepsis?
TNF-alpha
IL-1
IL-6
What is the gram stain, morphology of staph Aureus? Catalase?
Gram positive cocci in clusters
Catalase positive
What is TSST-1?
Superantigen from Staph. Aureus
Toxic shock syndrome is caused by what now?
Wound infections
How does strep pyogenes Toxic shock syndrome compare to staph toxic shock syndrome?
Most patients are bacteremic with strep, unlike staph Aureus intoxications
Most patients who develop strep toxic shock syndrome have what? What species of strep causes this?
Necrotizing fasciitis
Strep Pyogenes (GAS)
What are the pyrogenic exotoxins? What are the types that strep pyogenes has?
Superantigens that are produced by strep pyogenes (A, B, and C)