Lecture 40 - Post-Op Complications

Question 1

Biofilm?

Answer 1

microbial community of cells that bind to a substrate or an interface or each other, embedded in a matrix of extracellular polymeric matrix

Question 2

Bacterial factors?

Answer 2

electrostatic forces, adhesion proteins (MSCRAMMS), polysaccharide intracellular adhesion

Question 3

Device factors?

Answer 3

device material (PVC, Teflon), source of material (synthetic), surface of device (textured, irregular), shape of device (tube>mesh)

Question 4

Problems w biofilm-associated bacteria?

Answer 4

harder antibiotic targets, change in genes, changes in surface (resistance), slower growth rate (resistance), persister cells, difficult to determine resistance

Question 5

Prevention? IMPORTANT

Answer 5

reconsider device requirement, handwashing, place under aseptic conditions (avoid femoral region), monitoring, remove unnecessary devices

Question 6

C. Difficile - people most at risk?

Answer 6

hospital patients recieving antibiotics, people in hospital 1+ wk, treatments disrupting colonic flora

Question 7

C. Difficile - colonisation?

Answer 7

C. Difficile survives as endospores despite sensitivity to antibiotics, as non-endospore bacteria die C. Difficile becomes prominent to release toxins

Question 8

Endospores?

Answer 8

dormant forms of bacteria w better survival but no reporoduction, killed by heat (autoclaving) and chemicals, resistant to antibiotics, pasteurization

Question 9

C. Difficile - action?

Answer 9

1. attachment, 2. endocytosis, 3. acidification and release (inflammation and ulceration), 4. G-protein glucosylation, 5. Actin depolymerisation

Question 10

C. Difficile - treatment?

Answer 10

discontinue current antibiotic, treat with metronizadole (IV) or vancomycin (oral), treat symptoms, probiotics

Question 11

Pseudomembranous collitus?

Answer 11

toxin A and B causes apoptosis of submucosa cells leading to severe inflammation, loss of barrier integrity and toxic megacolon