Infection Flashcards
An infection acquired while in the hospital is called
a nosocomial infection
Factors that predispose individuals with open wounds to infection
- host characteristics
- local factors
List host characteristics
- diabetes
- malnutrition
- obesity
- steroid usage
- immunocompromisation
- increased age
List local factors
- ischemia
- presence of necrotic tissue or debris in wound
- chronic wounds
Signs of infection
- Induration
- Fever - calor
- Erythema - rubor
- Edema - tumor
- Odor (even after irrigation)
- Infection vs. Inflammation
- Purulence
- Increased pain - dolor
- Friable tissue
- Change in color
- Increased glucose levels in pts with diabetes
Bacterial bioburden - contamination
all wounds have non-replicating bacteria and does not impede healing
Bacterial bioburden - colonization
increased number of bacteria replicating in wound without host reaction, does not impede healing
Bacterial bioburden - critical colonization
bacteria is multiplying in wound with local signs causing delayed healing
Bacterial bioburden - infection
10^4 or 10^5 organisms per gram of tissue causing a systemic response
Other types of infection besides bacterial
- cellulitis
- lymphangitis
- sepsis
- osteomyelitis
What is cellulitis?
- acute infection of dermis and subcutaneous tissue
- presents in stocking pattern sometimes
What is lymphangitis?
- inflammation of lymphatic channels due to infection at distal channel
- streaking following lymph vessels
What is sepsis?
body is overloaded with bacteria causing systemic inflammatory response and can lead to organ dysfunction
What is osteomyelitis?
infection of the bone
What is streaking?
. . .
Fungi
- Tinea
- Candida
What is Tinea? What does it affect?
- red, scaling patches with fissuring and itching
- nails/feet
What is candida?
- red, papular skin rashes with burning, itching
- yeast-like
Lab tests for infection
- sedimentation rate
- platelets
- WBC
What culture technique identifies colonization, resistances, and sensitivities with 80% accuracy?
Levine Technique
What is the big deal with the Levine Technique?
identifies colonization, resistances, and sensitivities with 80% accuracy
Describe the Levine Technique
- cleanse wound thoroughly
- pat dry
- moisten swab with saline
- rotate swab over 1 cm viable tissue attempting to express wound fluid
What should you do if a wound has not shown progress in 10-14 days?
reconsider the possibility of infection with diminished response
Who is at greater risk of silent infections?
pts who are immunocompromised or have inadequate perfusion
Examples of silent infections
- abscess
- pt with arterial insufficiency
- gangrenous toe
If suspecting a silent infection, what should clinicians look for?
systemic signs of infection
Define bacterial biofilm
structured community of bacteria cells enclosed in a self produced polymetric matrix and adherent to a living or inert surface
Biofilms provide a ____________ mode of growth from _____________, _____________, and ______________.
protected mode; phagocytosis; antibodies; antibiotics
What should you do if there is a biofilm?
- must be removed by effective debridement techniques
- once removed, prevent reformation by applying effective dressings, antibiotics, antimicrobials, or antiseptics
Antimicrobial agent
destroys unicellular organisms
Antibacterial agents
antimicrobials that are effective against bacteria
2 types of antibacterial agents
- bactericidal
- bacteriostatic
Bactericidal
resulting in bacterial death
Bacteriostatic
inhibits bacterial growth
Dressing techniques
- clean technique
- sterile technique
Sterile technique
hold hands with palms facing your face so you can see them and know where they are (avoid bumping into anything or touching anything without thinking)
Clean technique
wearing gloves, touch package of dressing, place dressing on pt
