Diagnosis of bacterial infections Flashcards

1
Q

clinical signs of a bacterial disease

A

Inflammation
* purrulent discharge
* fever
* swelling/heat
* pain
* loss of function

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2
Q

clinicopathologic changes from bacterial disease

A
  • increased leukocytes (neutrophilia)
  • left shift
  • hyperfribrinogenemia
  • hyperglobulinemia
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3
Q

presumptive diagnosis

A

Diagnosis based on history and findings of physical examination (clinical signs)
Ok to do when:
* identifying bacteria would not change treatment
* pathognogmonic signs

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4
Q

empirical therapy

A

Administration of therapy based on previous experience
Either yours or someone else’s
indicated when:
* spectrum of care (cannot afford tests)
* high level of efficacy for recommended treatments
* waiting for results of testing

based on:
* Likely bacteria to cause this disease
* Likely antimicrobial sensitivity pattern of these bacteria
* Other factors (site of infection, cost of antibiotic, ease of administration etc)

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5
Q

definitive/artiological diagnosis

A

identifies the specific cause of disease; in our case also the specific bacteria
do this when:
* very young, old or seriously ill animal
* infection in a difficult to treat place (bone, joint, brain)
* suspected pathogens dont have a predictable bacterial pattern
* no responding to earlier therapy
* zoonootic/reportable disease
* outbreak in heard

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6
Q

ways to identify specific bacteria

A
  • collect sample and culture
  • PCR (DNA)
  • antibodies/antigens (serology)
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7
Q

When is the best time to collect a sample?

A
  • NOT while giving antimicrobials
  • in acute stage of infection
  • within 4 hours of death
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8
Q

is the draining tract the site of infection?

A

NO do not sample draining tract

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9
Q

collection from sterile site

A

collect sterily, easy to interpret (any bacteria is bad)

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10
Q

collect from site with normal flora

A

collect cleanly
interpret:
* pathogens that are not part of normal flora
* increased numbers of normal flora can cause disease

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11
Q

when would you use a swab to collect a sample?

A
  • mucus membranes
  • ears
  • uterine
  • conjuctiva
  • ears
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12
Q

Issues with swabs to collect sample?

A
  • mostly dont get enough bacteria
  • bacteria can adhere to them
  • dry out - therefore bacteria die
  • exposed to air (not good for anaerobes)
  • people stick them where they shouldn’t!!! e.g., open wounds or draining tracts
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13
Q

When to use FNA (fine needle aspirate)?

A
  • joint fluid
  • thoracic/abd fluid
  • blood
  • csf
  • pustule/abscess
  • tracheal absess
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14
Q

Issues/pros with FNA?

A

Not many, better than swabs
* Cheap and easy to use
* Preferred technique for sample collection if possible
* Easier for collecting sample using a sterile technique
* the better you do this the easier it is to interpret results
* Easier to get more material
* But bacteria don’t live in them forever; particularly anaerobes

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15
Q

when to use biopsy?

A
  • surgery (tissue)
  • sequestrum (dead bone)
  • deep skin infections (Punch biopsy)
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16
Q

issues/pros to using biopsy?

A

may be needed to by-pass normal flora e.g. draining tract
bacteria can survive “longer” in tissues
tissue may represent entire pathological process
but invasive and expensive!

17
Q

sampling surface of skin

A

not sterile
sticky tape test

18
Q

sampling superficial pyoderma (pustules)

A

sterile site= sterile technique
* Pick intact pustule
* Clean skin surface over pustule with alcohol and allow to dry
* Open pustule with fine needle
* Use swab to collect pus
* Place in transport media and send to diagnostic laboratory

19
Q

sample collection for deep pyoderma

A

Sterile site: so FNA or biopsy is preferred when when have deep pyoderma or open wounds

20
Q

Sampling the ear

A

swabs
try to collect from horisontal canal

21
Q

how do we sample the udder?

A

milk samples
* clean and dry teat
* clean with alcohol
* collect milk

22
Q

How to sample lungs?

A

horse: transtracheal aspirate
* make small hole in trachea or use endoscope with guarded catheter
* add fluid and aspirate
* NOT bronchoalveolar lavage

dog/cat: bronchoalveolar lavage or transtracheal aspirate

23
Q

how to sample urinary tract?

A
  1. cystocentesis (sterile)
  2. free catch (not sterile)
  3. catheterization (not sterile but less contamination)
24
Q

How to sample uterus?

A

Mares: guarded swab
bitch: FNA surgical sample, swab anterior uterus

25
Q

microscopic examination of sample
check for:

A

presense of inflammation
* inflammatory cells, or indirectly

presense of pathogen
* may be diagnostic based on distinctive morphology

look for mixed infection or not
contamination

26
Q

transporting the sample to a lab

A

Goals of Transportation of Sample
* get the sample to the lab in the “same state” as when it was collected
* same numbers of bacteria and same types of bacteria

Principles of Transportation
* use transportation media that supports survival but not growth of bacteria
* use appropriate media depending on suspected pathogen (e.g., anaerobes, Salmonella)
* transport as quickly as possible
* transport cool (refrigerator temp)

27
Q

4 point rule for sterile sites

A
  1. the sample must be collected from an appropriate fashion from the actual site
  2. evidence of inflammation
  3. good evidence of bacteria in sample
  4. bacteria that is isolated must have the opportunity to and be capable of causing this disease