sep

Question 1

define colonisation

Answer 1

the presence of a microbe in the human body WITHOUT an inflammatory response

Question 2

infection definition

Answer 2

= inflammation due to a microbe

Question 3

bacteraemia definition

Answer 3

presence of VIABLE bacteria in the blood

Question 4

sepsis definition

Answer 4

the DYSREGULATED host response to infection

Question 5

septic shock

Answer 5

sepsis with hypotension refractory to adequate fluid resuscitation

Sepsis AND both of –
o Persistent hypotension requiring vasopressors to maintain Mean Arterial Pressure (MAP) greater than or equal to 65mmHg AND
o Lactate greater than or equal to 2mmol/l

-> (Despite adequate volume resuscitation)

Question 6

progression of infection to death

Answer 6

infection->SIRS->sepsis->shock->death

SIRS = systemic inflammatory response syndrome

Question 7

systemic inflammatory response syndrome (SIRS)

Answer 7

a non-specific clinical response including >=2 of the following
- temp >38 or <36
- HR >90
- RR >20
- WBC >12 or <4 or >10 immature neutrophils

Question 8

NEWs score + frequency of monitoring

Answer 8

1-4 = 4-6hrly

3 in a single parameter = min 1hrly

5 or more = min 1hrly (urgent response threshold)

7 or more = continous (emergency response threshold)

Question 9

contamination

Answer 9

the introduction of microorganism into a sample that are not causing disease or present in the body site

Question 10

CRP count in bacterial vs viral infection

Answer 10

CRP goes up in bacterial

goes down in viral

Question 11

atypical

Answer 11

mycoplasma pneumoniae

Question 12

MALDI-TOF

Answer 12

can be used to identify organisms on a positive culture
- uses mass spectrometry - identifies peaks assoc with particular organism
- does not give sensitivity but can guide tests

bacteria identified in 6hrs

Question 13

BacT-alert

Answer 13

machine which hold + processes blood cultures

-> flags positive blood cultures for further analysis

Question 14

susceptibility/sensitivity testing

Answer 14

• disc diffusion - zone size give a sensitive or resistant result for each
• an E-test
• vitek

Question 15

E-test

Answer 15

uses scale of increasing conc of one antibiotic on a plate wit the organism

determines min inhibitory concentration (MIC)
-> lowest conc at which the antibiotic inhibits growth of the organism

Question 16

gold standard method for measuring minimum inhibitory concentration of antibiotics (MIC)

Answer 16

broth dilution method

Question 17

vitek

Answer 17

machine that contains various concentration of antibiotics of antibiotics + will automatically give MICs for each

can also recognise patterns of resistance + recommend confirmatory tests

Question 18

sensitivity

Answer 18

probability a test is positive if the disease is present

Question 19

specificity

Answer 19

probability a test is negative if the disease is absent

Question 20

when should urinalysis not be used?

Answer 20

DO NOT use in over 65s or those with urinary catheters
- likely to have positive dip as detects bacteriuria, not infection
- go off clinical features

no symptoms = no infection

Question 21

in which infections might IV antibiotics make it worse?

Answer 21

c.diff - worsen + increase risk of recurrence

E.coli0157 - haemolytic uraemic syndrome

Question 22

organisms that are spirochaetes

Answer 22

borrelia burgdorferi
- causative agent of lymes disease

treponema pallidum
- causative agent of syphilis