BLOOD INFECTION

Question 1

What is septicaemia?

Answer 1

• When bacteria enters the bloodstream
• It can become life-threatening quickly

Question 2

Is septicaemia the same as sepsis?

Answer 2

NO
* Septicaemia can progress to sepsis
* Sepsis is an extreme inflammatory response to an infection (e.g. septicemia). Can lead to organ failure

Question 3

What are the different types of
septicaemia?

Answer 3

1. Community-Acquired
2. Hospital-Acquired
3. Septicaemia related to vascular catheter
4. Meningococcal septicaemia

Question 4

How do you treat
Community-Acquired septicaemia?

Answer 4

1. Broad-spectrum Antipseudomonal penicillin
   - Piperacillin with tazobactam
   - OR Ticarcillin with clavulanic acid
   OR
2. Broad-spectrum cephalosporin
   - Cefuroxime

Question 5

What if MRSA is suspected in community acquired septicaemia?

Answer 5

1. Vancomycin
   OR
2. Teicoplanin

Question 6

What if an anaerobic infection is suspected in community acquired septicaemia?

Answer 6

Add: (to ONLY the Cephalosporin)
- Metronidazole

Question 7

What if other resistant micro-organisms are suspected in community acquired septicaemia?

Answer 7

Use a more broad spectrum beta-lactam antibacterial
- e.g. Meropenem

Question 8

How do you treat
Hospital-Acquired septicaemia?

Answer 8

With a broad-spectrum antipseudomonal beta-lactam antibacterial:
- Piperacillin with tazobactam
OR
- Ticarcillin with clavulanic acid
OR
- Ceftazidime
OR
- Imipenem with cilastatin
OR
- Meropenem

Question 9

What if MRSA is
suspected in hospital acquired septicaemia?

Answer 9

1. Vancomycin
   OR
2. Teicoplanin

Question 10

What if an anaerobic infection is suspected in Hospital acquired septicaemia?

Answer 10

Add: (to a broad-spectrum
Cephalosporin e.g
Cefuroxime. So not the antipsuedomonal penicillin)
- Metronidazole

Question 11

How do you treat
septicaemia related to vascular catheter?

Answer 11

Treat with:
- Vancomycin
OR
- Teicoplanin

Question 12

What if gram-negative organism suspected in septicaemia related to vascular catheter?

Answer 12

Add (to Vancomycin or Teicoplanin):
- Broad-spectrum antipseudomonal beta-lactam (e.g. penicillin, Cephalosporin, carbapenems etc.)
This is especially if patients are immunocompromised

Question 13

When would you consider removing the vascular catheter in septicaemia related to vascular catheter?

Answer 13

Consider removing vascular catheter, particularly if infection is caused by:
- Staphylococcus aureus
- Pseudomonas species
- Candida species

Question 14

How do you treat meningococcal septicaemia?

Answer 14

• Single dose
  Benzylpenicillin before urgent transfer to hospital

Question 15

What if patient is penicillin allergic and is suspected to have meningococcal septicaemia?

Answer 15

• Cefotaxime
• (or Ceftriaxone)

Question 16

What if patients with suspected meningococcal septicaemia have a history of immediate hypersensitivity
reaction to penicillin or to cephalosporin?

Answer 16

Give Chloramphenicol