Infection Flashcards
What type of infection is acquired in the hospital?
Nosocomial Infection
Host characteristics that predispose individuals to infection include:
diabetes malnutrition obesity steroid usage immunocompromisation increased age
Local factors that increase risk of infection:
ischemia
presence of necrotic tissue
debris in wounds
chronic wounds
Contamination:
all wounds have non replicating bacteria and does not impede healing.
Colonization:
increased number of bacteria replicating in wound without host reaction, does not impede healing.
Critical colonization:
bacteria is multiplying in wounds with local signs causing delayed healing
Infection:
defined as 10 to the 4th or 10 to the 5th organisms per gram of tissue causing a systemic response.
Cellulitis:
- Acute inflammation of dermis and subcutaneous tissue.
- Presents in stocking pattern sometimes.
Lymphangitis:
- Inflammation of lymphatic channels due to infection at distal channel.
- Streaking following lymph vessels
Sepsis:
Body is overloaded with bacteria causing systemic inflammatory response and can lead to organ dysfunction.
Osteomyelitis:
Infection of the bone.
Streptococcus bacteria characteristics
Spherical
Divides in chains
Staphylococcus bacteria characteristics
Spherical
Divides in clusters
Pseudomonas aeruginosa characteristics
Gram negative
Found in moist environments
Aerobic, but easily survives in anaerobic conditions
Lab values for infection risk
Esr > 15
Platelets 100000
WBC > 13000
3 Risks of fungal infection:
Depressed immune system
Pt taking antibiotics
Moist, occluded areas
Tinea vs Candida
Tinea= affects nails and feet, red, scaling patches with fissuring and itching
Candida=yeast like; red, papular skin rashes with burning and itching.
Which of the following cultures is most applicable to healthcare professionals: tissue biopsy, needle aspiration, or swab culture?
Swab culture: although not the most accurate, identifies sensitivities and resistance to antibiotics, identifies colonization, taken after cleansing wound.
Describe the Levine culture technique.
Cleanse wound thoroughly Pat dry moisten swab with saline rotate swab over 1 cm viable tissue identifies sensitivities, resistance, and colonization with 80% accuracy.
A culture that is quantified as 1+ or 2+ would be quantified at what level of bacterial bioburden?
Colonization
A culture that is quantified as 3+ or 4+ would be quantified at what level of bacterial bioburden?
Critical colonization or infection.
May also indicate slowing of healing process
At what point in time in the healing process should you consider the possibility of infection with diminished response or possible fungal infection? (How many days?)
10-14 days
What type of patients are at greater risk for silent infections?
-Immunocompromised or have inadequate perfusion
Examples: abcess or patient with arterial insufficiency and gangrenous toe
Clinicians should look for systemic signs of infection if they suspect this type of infection.
A structured community of bacteria cells enclosed in a self produced polymetric matrix and adherent to a living surface is called a_______?
Biofilm
Biofilm provide a protected mode of growth from phagocytosis, antibodies, and antibiotics. Plantonic bacteria released from biofilm cause acute infection and dissemination in surrounding tissue.
Are biofilms more common in acute or chronic wounds?
Chronic.
How are biofilms treated?
Effective debridement followed by effective dressings with antibiotics, antimicrobials, or antiseptics.
Acticoat has been metioned in research as being effective
What type of agent destroys unicellular organisms?
Antimicrobials=used to treat infection or prophylactically.
Antibacterials are antimicrobials that are effective against bacteria.
What is the difference between bactericidal and bacteriostatic?
Bactericidal results in bacterial death.
Bacteriostatic results in inhibited bacterial growth.
What do antifungals target?
yeasts and molds
What are 2 prevalent strains of resistant microbes?
MRSA and vancomycin resistant enterococci (VRE)
What are 3 associated problems with MRSA?
Cellulitis, osteomyelitis, and abcesses
Bactoban has been shown to be effetive in treatment
2 common ways VRE is acquired?
Surgical wound and UTI
ampicillin-amoxicillin effective microbial
Differentiate between local and systemic adverse reactions from resistant antimicrobial strains.
Local: mild skin rash/reaction. Note whether redness rises from site of application.
Systemic: general rash, pruritis, ascending erythema, GI irritation, photosensitivity, fever
Another word for systemic antimicrobial therapy is _____?
antibiotics
prescribed for sepsis, signs of advancing infection, with or without topical anticrobials
May be given via IV
True or false: bacteria that is unable to grow in the presence of a certain antimicrobials is considered sensitive?
TRUE
Bacteria that continues to multiply in the presence of a drug is considered _______?
Resistant
May be natural or acquired
Premature cessation of antimicrobials or misuse/overuse of antibiotics increase possibility of resistance
