Sepsis

Question 1

What is sepsis?

Answer 1

blood poisoning causes by bacteria

Question 2

What are the symptoms of sepsis?

Answer 2

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

Question 3

When should the first blood culture be taken?

Answer 3

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

Question 4

What are the blood culture bottles for adults?

Answer 4

• 1 FN Anaerobic blood bottle
• 1FA Aerobic blood bottle

Question 5

Which blood bottle is used for children?

Answer 5

1 x PF Plus blood culture bottle

Question 6

Why shouldn’t blood culture bottles be refrigerated?

Answer 6

it can kill any bacteria that we needed to identify

Question 7

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

Answer 7

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

Question 8

what tests are done after the BacTec tests positive?

Answer 8

• 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

Question 9

What happens after the gram stain is positive?

Answer 9

• 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

Question 10

What happens if the gram stain is negative?

Answer 10

• 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

Question 11

Describe how Staph Aureus causes infection

Answer 11

• enters bloodstream from infected site in the body
• causes infected lesions in skin
• infected joints
• Pneumonia with S Aureus leads to septicaemia
• S Aureus bacteraemia indicates source of infection elsewhere in the body

Question 12

Which test can differentiate between different strep variations?

Answer 12

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

Question 13

Which lance field group is streptococcus pyogenes from?

Answer 13

group A

Question 14

Which lance field group is streptococcus agalactiae from?

Answer 14

Group B

Question 15

What conditions can E.Coli cause?

Answer 15

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

Question 16

What does the presence of Neisseria Meningitidis indicate?

Answer 16

• septicaemia with the possibility of meningitis
• has a serious and rapid clinical progression

Question 17

What are the characteristics of Candida albicans?

Answer 17

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

Question 18

What is polymicrobial bacteraemia?

Answer 18

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