Infection

Question 1

What type of infection is acquired in the hospital?

Answer 1

Nosocomial Infection

Question 2

Host characteristics that predispose individuals to infection include:

Answer 2

diabetes
malnutrition
obesity
steroid usage
immunocompromisation
increased age

Question 3

Local factors that increase risk of infection:

Answer 3

ischemia
presence of necrotic tissue
debris in wounds
chronic wounds

Question 4

Contamination:

Answer 4

all wounds have non replicating bacteria and does not impede healing.

Question 5

Colonization:

Answer 5

increased number of bacteria replicating in wound without host reaction, does not impede healing.

Question 6

Critical colonization:

Answer 6

bacteria is multiplying in wounds with local signs causing delayed healing

Question 7

Infection:

Answer 7

defined as 10 to the 4th or 10 to the 5th organisms per gram of tissue causing a systemic response.

Question 8

Cellulitis:

Answer 8

• Acute inflammation of dermis and subcutaneous tissue.

- Presents in stocking pattern sometimes.

Question 9

Lymphangitis:

Answer 9

• Inflammation of lymphatic channels due to infection at distal channel.
• Streaking following lymph vessels

Question 10

Sepsis:

Answer 10

Body is overloaded with bacteria causing systemic inflammatory response and can lead to organ dysfunction.

Question 11

Osteomyelitis:

Answer 11

Infection of the bone.

Question 12

Streptococcus bacteria characteristics

Answer 12

Spherical

Divides in chains

Question 13

Staphylococcus bacteria characteristics

Answer 13

Spherical

Divides in clusters

Question 14

Pseudomonas aeruginosa characteristics

Answer 14

Gram negative
Found in moist environments
Aerobic, but easily survives in anaerobic conditions

Question 15

Lab values for infection risk

Answer 15

Esr > 15
Platelets 100000
WBC > 13000

Question 16

3 Risks of fungal infection:

Answer 16

Depressed immune system
Pt taking antibiotics
Moist, occluded areas

Question 17

Tinea vs Candida

Answer 17

Tinea= affects nails and feet, red, scaling patches with fissuring and itching

Candida=yeast like; red, papular skin rashes with burning and itching.

Question 18

Which of the following cultures is most applicable to healthcare professionals: tissue biopsy, needle aspiration, or swab culture?

Answer 18

Swab culture: although not the most accurate, identifies sensitivities and resistance to antibiotics, identifies colonization, taken after cleansing wound.

Question 19

Describe the Levine culture technique.

Answer 19

Cleanse wound thoroughly
Pat dry 
moisten swab with saline 
rotate swab over 1 cm viable tissue
identifies sensitivities, resistance, and colonization with 80% accuracy.

Question 20

A culture that is quantified as 1+ or 2+ would be quantified at what level of bacterial bioburden?

Answer 20

Colonization

Question 21

A culture that is quantified as 3+ or 4+ would be quantified at what level of bacterial bioburden?

Answer 21

Critical colonization or infection.

May also indicate slowing of healing process

Question 22

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?)

Answer 22

10-14 days

Question 23

What type of patients are at greater risk for silent infections?

Answer 23

-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.

Question 24

A structured community of bacteria cells enclosed in a self produced polymetric matrix and adherent to a living surface is called a_______?

Answer 24

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.

Question 25

Are biofilms more common in acute or chronic wounds?

Answer 25

Chronic.

Question 26

How are biofilms treated?

Answer 26

Effective debridement followed by effective dressings with antibiotics, antimicrobials, or antiseptics.
Acticoat has been metioned in research as being effective

Question 27

What type of agent destroys unicellular organisms?

Answer 27

Antimicrobials=used to treat infection or prophylactically.

Antibacterials are antimicrobials that are effective against bacteria.

Question 28

What is the difference between bactericidal and bacteriostatic?

Answer 28

Bactericidal results in bacterial death.

Bacteriostatic results in inhibited bacterial growth.

Question 29

What do antifungals target?

Answer 29

yeasts and molds

Question 30

What are 2 prevalent strains of resistant microbes?

Answer 30

MRSA and vancomycin resistant enterococci (VRE)

Question 31

What are 3 associated problems with MRSA?

Answer 31

Cellulitis, osteomyelitis, and abcesses

Bactoban has been shown to be effetive in treatment

Question 32

2 common ways VRE is acquired?

Answer 32

Surgical wound and UTI

ampicillin-amoxicillin effective microbial

Question 33

Differentiate between local and systemic adverse reactions from resistant antimicrobial strains.

Answer 33

Local: mild skin rash/reaction. Note whether redness rises from site of application.

Systemic: general rash, pruritis, ascending erythema, GI irritation, photosensitivity, fever

Question 34

Another word for systemic antimicrobial therapy is _____?

Answer 34

antibiotics
prescribed for sepsis, signs of advancing infection, with or without topical anticrobials
May be given via IV

Question 35

True or false: bacteria that is unable to grow in the presence of a certain antimicrobials is considered sensitive?

Answer 35

TRUE

Question 36

Bacteria that continues to multiply in the presence of a drug is considered _______?

Answer 36

Resistant
May be natural or acquired
Premature cessation of antimicrobials or misuse/overuse of antibiotics increase possibility of resistance