Lecture 2 - Infection Flashcards
What is contamination?
normal non-replicating resident bacterial and fungi on/in skin and GI tract
count of 10^3 of microbes
What is colonization?
When microflora adhere to the body’s surface and replicate but do not adversely affect the individual or cause a host response
What is critical colonization?
increasing wound bioburden reaches critical point and begins to adversely affect host; however the person’s body does not mount a defense
What is infection?
Microorganisms multiply and invade viable body tissues, body should mount a defense
At what point is there so much bacteria that there is a decline in wound status?
Critical colonization
What may be the only indication of infection?
Decline in wound status with no other explanation
How will drainage change with infection?
Increase - look for need to change to more absorptive dressing OR more frequent changes
What is the texture and color of infection drainage?
Purulent (thicker) drainage
Yellow, white, green or blue
What infection has an ammonia-like smell?
Proseus
What infection has a “sickly sweet” smell sometimes accompanied by a bluish wound bed?
Pseudomonas
What is biofilm?
Polymicrobial with diverse species in thick slimy barrier made of proteins and sugars that make and secrete protective matrix that attaches to the wound base
attaches during critical colonization
Signs of infection
Rubor - redness
Calor - heat
Tumor - swelling
Dolor - pain
Functio Lasea - loss of function
When is biofilm most likely to happen?
Decreased immunity, poor circulation/tissue ischemia, poor nutrition
T/F Antibiotics help to decrease biofilm.
False, they don’t work.
Biofilm leads to increased inflammation which leads to _____
Increased exudate and slough = more neutrophils, macrophages, and MMPs in the wound bed
T or F, the only indication of an infection could potentially be a decline in wound status with no other explanation
T
During an infection, drainage may change to _______ thicker drainage that is _____ (what color)
purulent
yellow/white/green/blue
What is the gold standard for wound culturing?
Tissue biopsy
What is the benefit of a swab culture?
Less painful
Can be done bedside
What is the disadvantage of a swab culture?
Can only tell you what is on the surface
What are the 2 types of swab cultures?
- Aerobic
- Anaerobic
T or F : Odor and drainage is a sign of infection
F
Which swab culture is more common?
Aerobic bacteria are more common, anaerobic are typically in undermining or sinus tracts (because of lack of O2)
What’s the difference between antibiotic and antimicrobial?
Antibiotic - use more systemic (IV or oral)
Antimicrobial - use more local (topicals or dressings)
How will infection affect drainage?
Most likely will increase drainage
What is biofilm?
Bacteria forms thick slimey barrier that attaches to wound base and affects healing
When does biofilm happen?
During critical colonization
most likely happens with decreased immunity, poor circulation, tissue ischemia, poor nutrition
Biofilm causes an increase in ____________ which increases exudate and ________
This calls more neutrophils, macrophages, and MMPs to the wound bed. These end up __________ the wound bed more
Inflammation
Slough
Damaging
What is a caution with antiseptics?
They are cytotoxic = good at killing microbes in wound BUT also kill keratinocytes and other cells needed to heal
T or F: you can test for a biofilm with a culture and use antibiotics to help it
False
WASH YOUR HANDS
10-15 seconds
anti-microbial soap
wrist, hands, fingers, nails
wash before and after treatments
PREVENT NOSOCOMIAL INFECTION
How to remove biofilm?
Debridement
Apply antimicrobial treatment
What is the gold standard for wound culturing?
What kind of wound culture only tells you whats on the surface, but is les painful?
Tissue biopsy
Swab Culture
Aerobic vs anaerobic swab culture
when should you use each?
aerobic- swabbing an area exposed to air
anerobic- swabbing areas not exposed to air (different bacteria grow here)
All wounds - Aerobic
Anaeorbic - Inside of undermining and sinus tracts
What are the pros and cons of using antiseptics in wounds?
Effective at killing microbes
but also kill keratinocytes and other cells needed to heal
They’re being used less frequently in woundcare, but still have a place and time for use
Handwashing guidelines?
Wash hands atleast 10-15 seconds using antimicrobial soap, include wrist, hands, fingers, nails
or use alcohol hand rub before and after treatments
What is a nosocomial infection
An infection from the hospital/developed at the hospital
note: depending on severity can be a sentinel event (serious injury or harm)
PAYMENT MAY BE WITHHELD FROM INSURANCE FOR THESE :(
Standard woundcare precautions
Universal precautions
Handwashing + PPE
Gloves worn entire treatment, change gloves between different procedures on the same patient
Knock knock
Steven is here to say you’re doing great!
Sterile technique
Meticulously make sure u dont touch anything that isnt sterile besides the wound
signficant prep and set up required
discard all contaminated items
Research shows that sterile technique doesnt make a big difference unless dealing with burns
