Chap 36-BOOK (Part 1)

Question 1

Presence of viable bacteria in the blood stream

Answer 1

Bacteremia

Question 2

Bacteremia is often associated with

Answer 2

Hospitalization
Insertion of foreign bodies such as catheter into blood vessels

Question 3

Blood cultures may also be positive as a result of contamination of blood samples during phlebotomy, leading to false-positive results, a phenomenon termed

Answer 3

Pseudobacteremia

Question 4

Contamination is most often caused by skin commensals

Answer 4

CONS (Coagulase negative staphylococci)

Question 5

A blood culture reflects a true-positive result, bacteremia may not be associated with any physical signs or symptoms of severe infection, a condition known

Answer 5

Occult (unsuspected) bacteremia.

Question 6

occult (unsuspected) bacteremia is most often caused by

Answer 6

Strep. pneumoniae

Question 7

indicate bacteremia plus a clinical presentation of physical signs and symptoms of bacterial invasion and toxin production

Answer 7

Septicemia

Question 8

Comprises a spectrum of increasingly severe conditions ranging from noninfectious inflammatory response to sepsis

Answer 8

Systemic inflammatory response syndrome (SIRS)

Question 9

Sepsis accompanied by refractory hypotension

Answer 9

Septic shock

Question 10

Site of origin of Primary bacteremia

Answer 10

Endovascular source (Infected cardiac valve or IV catheter)

Question 11

Secondary bacteremia occurs in

Answer 11

Infected extravascular souce (Lung in patients with pneumonia)

Question 12

Gram-positive bacteremia is caused by organisms

Answer 12

Streptococcus pneumoniae
Staphylococcus aureus
Enterococcus faecium

Question 13

Gram-negative bacteremia is caused by

Answer 13

Escherichia coli or Pseudomonas aeruginosa

Question 14

Anaerobic bacteremia is caused by

Answer 14

B. fragilis

Question 15

Type of bacteremia that is caused by mixture of organisms

Answer 15

Polymicrobial bacteremia

Question 16

usually occurs after a procedural manipulation of a particular body site

Answer 16

Transient bacteria

Question 17

Occur because of the presence of abscesses somewhere in the body or as a clinical manifestation of certain types of infections, such as meningococcemia, gonococcemia, or pneumonia.

Answer 17

Intermittent bacteremia

Question 18

Occurs when the organisms are coming from an intravascular source and are consistently present in the bloodstream

Answer 18

Continuous bacteremia

Question 19

Most common clinical manifestation associated with continuous bacteremia

Answer 19

Infective endocarditis

Question 20

The agent of first case of bacteremia in 1899

Answer 20

Pseudomonas aeruginosa

Question 21

Factors associated with an unfavorable outcome in bacteremia

Answer 21

• Age older than 70 years
• Polymicrobial bacteremia
• Presence of malignancy
• Acquired immunodeficiency syndrome (AIDS), or renal failure
• Origin of the bacteremia in the respiratory tract or bowel
• Unknown origin of bacteremia
• Inappropriate antimicrobial therapy.

Question 22

Risk factors of bacteremia

Answer 22

• Decreased immune competency of selected patient populations
• Increased use of invasive procedures
• Age of the px
• Antimicrobial resistance
• Diagnostic criteria and coding practice

Question 23

Bacteremias are more frequent among persons with

Answer 23

1. Neoplasia (abnormal growth of new cells that maybe benigh or malignant)
2. Chronic underlying dse
3. Receiving immunosuppresive therapy)
4. HIV

Question 24

58% of S. aureus isolates in the United States were resistant to

Answer 24

Methicillin (Oxacillin)

Question 25

30% of Enterococcus was resistant to

Answer 25

Vancomycin

Question 26

15% of Klebsiella spp. were extended-spectrum

Answer 26

β-lactamases (ESBL) producers

Question 27

9% of E. coli isolates were resistant

Answer 27

Ciprofloxacin

Question 28

Bacterial invasion of the bloodstream, cases attributable to fungal invasion of the bloodstream (fungemia) caused by organisms such as

Answer 28

C. albicans

Question 29

The predisposing factors in polymicrobial bacteremia include

Answer 29

IV drug use, burns, and GI tract sources

Question 30

May lead to bacteremia via local inflammation, edema, and tissue destruction that disrupts nearby vascular structures and allows bloodstream invasion.

Answer 30

Focal bacterial infection

Question 31

Two major complications may ensue:

Answer 31

Metastatic infection and septic shock

Question 32

S. aureus bacteremia may lead to

Answer 32

Endocarditis, osteomyelitis, septic arthritis, hepatic abscess, or pyomyositis.

Question 33

A bacterial membrane component (lipopolysaccharide [LPS], also known as endotoxin, in gram- negative organisms; lipoteichoic acid and peptidoglycan in gram- positive organisms) interacts with macrophages

Answer 33

causes release of tumor necrosis factor, IL1, IL6 and other proinflammatory cytokines

Question 34

Catheters exquisitely vulnerable to colonization and biofilm formation by gram-positive organism

Answer 34

CoNS, S. aureus, and Enterococcus

Question 35

May serve as a ligand during initial surface adhesion and colonization, or it may be produced after the organism has established a focal presence by adhering to the surface

Answer 35

Biofilm

Question 36

Organisms associated with such infusion-associated bacteremias are typically gram-negative organisms such as

Answer 36

P. aeruginosa and Enterobacter cloacae.

Question 37

Bloodstream infections caused by nontuberculous mycobacteria associated with intravascular catheters by

Answer 37

Mycobacterium aviumintracellularae complex HIV-positive individuals

Question 38

Most common cause of bacteremia in UTI

Answer 38

E. coli

Question 39

Most common organisms in pneumonia that produce a concurrent bacteremia

Answer 39

S. pneumoniae, H. influenzae, S. aureus, P. aeruginosa, and E. aerogenes.

Question 40

Primary peritonitis, which frequently occurs in patients with cirrhosis is caused by

Answer 40

E. coli, K. pneumoniae, and enterococci

Question 41

Secondary peritonitis is caused by

Answer 41

E. coli, anaerobes, and enterococci.

Question 42

Cellulitis caused by

Answer 42

S. aureus, Streptococcus pyogenes, or Streptococcus agalactiae

Question 43

Skin breakdown in bedridden patients (bed sores) or peripheral vascular disease can be caused by

Answer 43

Proteus mirabilis, E. coli, S. aureus, B. fragilis, Pseudomonas spp., Clostridium spp., and Peptostreptococcus

Question 44

Organisms associated with acute, sudden- onset endocarditis include virulent bacteria such as

Answer 44

S. aureus and S. pneumoniae

Question 45

Progressing subacute endocarditis is commonly caused by less virulent bacteria

Answer 45

iridans streptococci, nutritionally variant streptococci (Abiotrophia and Granulicatella, and CoNS)

Question 46

Acute osteomyelitis is often associated with transient bacteremia caused by

Answer 46

S. aureus

Question 47

Prosthetic joints, particularly those implanted in the hip, can be hematogenously seeded by organisms such as

Answer 47

S. aureus and CONs

Question 48

Prosthetic joint infection with virulent organisms such as S. aureus or group A β-hemolytic streptococci can lead to

Answer 48

florid sepsis and death

Question 49

Acute bacterial meningitis is generally the result of transient bacteremia caused by

Answer 49

S. pneumoniae or Neisseria meningitidis

Question 50

Meningitis is caused by bacteremia resulting from sinusitis or otitis caused by

Answer 50

S. pneumoniae

Question 51

abnormal rapid breathing

Answer 51

Tachypnea

Question 52

A central necrotic area surrounded by an erythematous base, is typically associated with Pseudomonas bacteremia.

Answer 52

Ecthyma gangrenosum

Question 53

A central necrotic area surrounded by an erythematous base, is typically associated with Pseudomonas bacteremia.

Answer 53

Ecthyma gangrenosum