Infection Flashcards
Proximal small bowel bacteria
10^5 bacteria
GPC
Bacteria in stomach
Almost sterile
Some GPC
Some yeast
Distal small bowel bacteria
10^7 bacteria
GPC, GNR, GPR
Colon bacteria
10^11 bacteria
Mostly anaerobes
Some GNR, GPC
Most common anaerobe in the colon (anaerobic)
Bacteroides fragilis
Anaerobe
Most common bacteria in the colon aerobic
E. Coli
Most common cause of gram negative sepsis
E. Coli
Reason for gram negative sepsis
Endotoxin (lipopolysaccharide A) is released
Causes release of TNF alpha
Activates compliment and coag cascade
Types of wound infections
Clean- hernia
Clean contaminated- elective colon w/prep
Contaminated- Gsw to colon w/repair
Gross contaminated- abscess
Most common organism in surgical wounds
Staph aureus
Coagulase positive
Most common GNR - E. Coli
Most common anaerobe - bacteroides fragilis->recovery from tissue indicates necrosis
(Staph epidermidis- coagulase negative)
Bacteria amount needed for infection
> 10^5
Less needed if foreign body present
Surgical infection within 48hours of procedure
1) injury to bowel with leak
2) invasive soft tissue: Clostridium Perfringes or beta hemolytic strep (gp a strep)
Most common nonsurgical infection
UTI - E. Coli
Leading cause of infectious death after sx
Nosocomial PNA
Most common in ICU PNA: S. Aureus #2 pseudomonas
MRSA resistant infections treated with…..
Linezolid (zyvox) protein synthesis inhibitors
Good for gram +
Resistant skin infections
Number 1 organism in line infections
Staph epidermidis #2 staph aureus #3 yeast
Culture- need >15 colony forming units
Bacteria in necrotizing skin infections
Beta hemolytic group a strep
Clostridium Perfringes
Most common bug in line infections
Staph epidermidis - biofilm: exoslime = resistant to abx
#2 -s.aureus #3- yeast
Most common cause of infected AAA
Salmonella
S.aureus
Most common cause of acute lymphangitis
Group A strep (streaking)
Chronic- s.schenckii
Tx: PCN
Clostridium Perfringes infections
Necrotic tissue decreases oxidation redux potential Has alpha toxin Pain out of prop to exam Gas gangrene & myonecrosis Farming injury Tx: debride, PCN
Sbp- spontaneous bacterial peritonitis
Protein < 1g/dl in peritoneal fluid Monobacterial- 50%ecoli Many fluid Cx negative PMNS > 500 cells/cc Tx: ceftrisxone or 3rd gen cephalo Need to r/o intra-abd cause Flouroquino- short term prophylaxis
Secondary bacterial peritonitis
Due to intra abdominal source- transmucosal migration or perforated viscous
Polymycrobial - most common Bacteroides fragilis, ecoli, enterococcus
Tx: need laparotomy to find source
Brown recluse spider bites treatment
Dapsone
May need resection and skin graft if large area
Acute septic arthritis is due to…..
Gonococcus
Staph
H. Influenza
Strep
Tx: 3rd generation cephalosporin and vanco
Cat/dog/human bites organism
Human: eikenella
Cat/dog: pasturella multocida
Tx: broad spect abx- augmentin
Components of SIRS - systemic inflammatory response syndrome
Tachycardia
Tachypnea
Fever
Wbc elevated
SIRS to Sepsis
Meet all SIRS criteria + source of infection