Infections On Surfaces - Clincal Questions Flashcards
If you suspect someone of having endocarditis, what would your plan of action be?
Confirm diagnosis: blood culture, ECHO (transoesophageal/ transthoracic)
What is the treatment for endocarditis?
Antibiotics
(If unresponsive to antibiotics) surgery: heart valve replacement or cleaning of valve
Give cardiac support (eg for BP)
What is the significance of having a bicuspid aortic valve?
Congenital abnormality of the valve, can increase ones risk of valve infection (vegetation growth) by affecting blood flow and turbulence can damage the valve (can cause leaflet perforation)
How might someone with poor dental hygiene end up with endocarditis
Streptococcus moved from mouth (where there was a break in the mucosal lining) where it is normally found into the blood and travelled to the heart valve.
What would drugs would you give to someone with endocarditis?
High dose if IV penicillin and gentamicin
What is the coagulate test?
Coagulase is an enzyme that causes a clot to form when bacteria are incubated with plasma.
The test is used to differentiate staphylococcus aureus (coagulate positive) from coagulase - negative staphylococci
Coagulase positive bacteria promote clotting of serum
What is the most common and important of the coagulase negative staphylococci?
Staph epidermidis
Where are coagulate negative staphylococci normally found?
Epidermis
Why does the biofilm promote persistence of a bacterial infection?
- Reduced entry of antimicrobial and natural antibodies
- Rescued metabolic rate (which means antibiotics that target specific metabolic processes cant work or have limited action)
- Reduced exposure to immune components ie complement, immune cells
How can infections on central venous lines be prevented?
Coat the CVL in silver
What does apryexial mean?
Without fever
What type of bacteria is E.coli?
Gram negative bacilli
