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BDS2 BAMS > microbes in blood > Flashcards

microbes in blood Flashcards

1
Q

is blood sterile

A

normal blood is sterile (no pathogens)

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2
Q

bloodstream infections caused by?

A

bacteria - s aureus
fungi - c. albicans
viruses - herpes simplex

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3
Q

name of blood stream infection caused by fungi?

A

fungaemia

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4
Q

name of blood stream infection caused by virus

A

viraemia

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5
Q

how does pathogens enter the bloodstream?

A

broken skin - cellulitis

mucous membranes - mucositis

dental abscess - collection of pus

GIT infections

viral reactivation - herpes zoster

direct inoculation - into vascular system, could be a cannula

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6
Q
A
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7
Q

what factors affect the mortality rate of a microbe bloodstream infection

A

the source
the type of microbe
host immune system

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8
Q

do bloodstream infections have high mortality rate?

A

yes

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9
Q

how long can microbes last in the blood?

A
  1. transient ie several minutes bacteraemia
  2. intermittent ie undrained abscess or infected biofilm
  3. continuous ie severe infection that has overwhelmed host defences eg IE
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10
Q

what can a bacteremia be caused by?

A

manipulation or surgical procedure involving infected tissues, TRANSIENT presence of bacteraemia

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11
Q

signs of IE

A

splinter hemorrhages
(microemboli in nailbed)
Roths Spots in retina
fever
tachycardia

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12
Q

2 most common microbes in blood stream infections?

A
  1. ECB = e coli bacteraemia
  2. SAB = s. aureus bacteraemia
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13
Q

3 most common reasons for e coli bacteraemia?

A
  1. lower urinary tract infection
  2. catheter associated urinary tract infection
  3. hepatobilliary infection
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14
Q

what % of all SAB cases are MRSA and MSSA? which one is “better” in terms of treatment?

A

MSSA = 97%
MRSA = 3%

better that most are MSSA because can use flucloxacillin.

vancomycin is used for MRSA, harder to administer, only can IV

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15
Q

antibiotic for MRSA

A

VANCOMYCIN

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16
Q

antibiotic for MSSA

A

flucloxicillin

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17
Q

fatality rate for ECB

A

14%

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18
Q

fatality rate for SAB

A

40 for SAB IE

19
Q

3 most common reasons for SAB?

A

skin and soft tissue infections
vascular access devices
unable to determine by team

20
Q

what bacteremia do we worry about in pregnant women?

A

listeria monocytogenes

21
Q

what bacteremia do we worry about in neonates?

A

group B strept
e coli

22
Q

what bacteremia do we worry about in children?

A

pneumococci
group A strept
meningococci

23
Q

group A strept aka?

A

Strept. pyogenes

24
Q

what bacteremia do we worry about in immunocompromised patients?

A

gram negative
- e coli
- pseudomonas aeruginosa

both associated with severe sepsis and high mortality rate

25
Q

what is the wcc level to be classed as immunocompromised?

A

wcc less than 0.5 x 10^9 /L

26
Q

how do we detect bacteraemia in blood? prob dont need to know much about this

A

BAcTec

molecular methods

27
Q

why is molecular methods better than BacTech system?

A

1h turn around time compared to 48h for BacTec

this is a great improvement for patients

28
Q

what is IE?

A

infection of the heart valves or other areas of the endocardium

29
Q

what other diseases could predispose you to have IE

A

congenital heart disease

rhematic valvular disease

mitral valve prolapse with murmur

degenerative heart disease

30
Q

what species causes IE

A

70% steptococcal

25% staphylococcal - more aggressive

31
Q

there is no such thing as streptococcus viridans. there are 8 groups of streptococci. which causes IE?

A

all can cause IE. most common is streptococcus mitis.

32
Q
A
33
Q

which bacteria falls under Lancefield group D and why is it important?

A

Enterococcus bacteria. (which is a species under S. pyogenic)

it causes IE

34
Q

is streptococci only found in the oral cavity?

A

no, it can be found in the oral cavity, GIT, hepatobilliary system etc

35
Q

can u find staphylococcus aureus in the oral cavity?

A

yes

36
Q

name a species of s.aureus in oral cavity

A

staphylococcus epidermis

37
Q

name the bacteria that causes recurrent endodontic infections

A

Coagulase negative staphylococci can colonise and infect the oral cavity , causing recurrent endo infections

38
Q

what are some characteristics of native valve endocarditis in sub type intravenous drug users?

A
  • younger age group
  • s.aureus more predominant
  • mostly affects right side heart valves
  • lead to multiple lung abscesses
39
Q

types of IE

A

NVE native valve endocarditis
PVE prosthetic valve endocarditis

40
Q

bacteria in NVE

A

s. aureus

41
Q

bacteria in PVE

A

coagulase negative staphylococci (CNS)

S.aureus

Gram negative bacilli

42
Q

is antibiotic prophylaxis successful and effective for preventing IE?

A

little evidence,

AB for dental tx in patients at risk of IE is NOT routinely recommended except for 3 special groups

43
Q

possible reason for increase in IE?

A

restriction in Antibiotic prophylaxis?

not all microbes causing IE are susceptible to amoxicillin that is prescribed

44
Q

is it acceptable to prescribe Antibiotic prophylaxis for a patient with prosthetic joint?

A

no

just maintain good OH

BDS2 BAMS (27 decks)

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