Sepsis Flashcards

1
Q

What is sepsis?

A

blood poisoning causes by bacteria, overreaction of the immune system due to septicaemia

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2
Q

What are the symptoms of sepsis?

A

slurred speech or confusion
fever/loss of appetite
extreme shivering
passing no urine all day
severe breathlessness
skin mottles or discolouration
blue skin/ lethargy

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3
Q

Where does sepsis come from?

A

bacterial infection -> bacteraemia (gets into bloodstream and disseminates) -> sepsis

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4
Q

When should the first blood culture be taken?

A

post fever spike before antibiotics are administered
should be repaid every 24hrs until clear

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5
Q

What are the blood culture bottles for adults?

A
  • 1 FN Anaerobic blood bottle
  • 1FA Aerobic blood bottle
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6
Q

Which blood bottle is used for children?

A

1 x PF Plus blood culture bottle

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7
Q

Why shouldn’t blood culture bottles be refrigerated?

A

it can kill any bacteria that we needed to identify

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8
Q

Which machine is used to measure bacterial growth and what happens when it detects positive?

A

BacTec
immediately alerts the ward to a sportive culture -> BMS must process the positive within 2 hours

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9
Q

what tests are done after the BacTec tests positive?

A
  • add a drop to a blood agar plate and quadrant streak
  • add a drop to a fastidious anaerobe agar and quadrant agar and quadrant streak
  • incubate the plate
  • heat fix and gram stain
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10
Q

What happens after the gram stain is positive?

A
  • second blood agar plate with optochin disc is set up (using staph aureus select agar) -> zone of inhibition means positive result = may be strep pneumoniae
  • Tube coagulase test is done if there is a positive staph aureus result
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11
Q

What happens if the gram stain is negative?

A
  • chocolate agar = differentiates between meningitis and influenza
  • macConkey agar = differentiates between E. coli (lactose fermenter) and Salmonella (non lactose fermenter)
    -Neomycin plate= identifies anaerobic bacteria
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12
Q

Describe how Staph Aureus causes bacteraemia

A
  • enters bloodstream from infected site in the body
  • causes infected lesions in skin
  • causes abcesses in tissues or organs
  • infected joints
  • Pneumonia with S Aureus leads to septicaemia
  • S Aureus bacteraemia indicates source of infection elsewhere in the body
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13
Q

Which test can differentiate between different strep variations?

A

the lance field test: bacterial sample is mixed with specific antibodies that bind to group specific carbohydrate antigens, if antibodies bind to the bacteria this indicates a positive result for that group

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14
Q

Which lance field group is streptococcus pyogenes from?

A

group A

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15
Q

Which lance field group is streptococcus agalactiae from?

A

Group B

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16
Q

What conditions can E.Coli cause?

A

-UTI’s: mainly affects immunocompromised individuals such as the elderly

17
Q

What does the presence of Neisseria Meningitidis indicate?

A
  • septicaemia with the possibility of meningitis
  • has a serious and rapid clinical progression
    -requires aggressive antibiotic therapy
18
Q

What are the characteristics of Candida albicans?

A
  • fungal bacteraemia
  • common in immunocompromised individuals, elderly
  • BS antibiotics may predispose candida infections
    -cytotoxic therapy for cancer may damage gut mucosa and allow candida to move from bowel to bloodstream
  • some candida species are resistant to antifungals
19
Q

What is polymicrobial bacteraemia?

A
  • where 2 or more significant organisms are isolated
  • usually associated with serious underlying illnesses
20
Q

What can salmonella spp cause?

A

biliary sepsis in cases of severe food poisoning = enteric fever, needs rapid diagnosis and treatment

21
Q

what do all non lactose fermenting, oxidase negative, gram negative bacilli isolated bacterium need to be checked for?

A

salmonella spp

22
Q

Why is enterococcal septicaemia problematic to treat?

A

due to limited therapeutics