Sepsis (4) Flashcards
Define infection:
presence of microorganisms in a normally sterile site
Define bacteremia:
Culturable bacteria in the bloodstream
What are the criteria for SIRS?
Need to have >2 of the following:
Temp >38 or 90
RR>20 or PaCo2 12,000 cells/ mm3 or 10% banc cells
What is sepsis?
systemic response to infection
What is severe sepsis?
Sepsis associated with dysfunction of organs distant from the site of infection, hypoprofusion or hypertension
What is septic shock?
Sepsis w/ hypotension that persists despite fluid resuscitation that requires vasopressor therapy
Perfusion abnormalities
SIRS is due to …
Procytokines and cytokines
Infectious or noninfectious insult
What plays a critical role in SIRS?
TLR4…it transmits the LPS recognition signal to the interior of the cell
What does TLR4 recognize?
LPS (gram - bacteria cell wall component)
What is gram negative shock?
Results from the massive cytokine storm that occurs after the release of LPS
What are some signs of sepsis?
Rapid breathing
changes in mental status
fever/ shaking chills
Decreased urination
Tachycardia
Nausea, vomiting, diarrhea
What is transient bacteremia?
Lasts for a few minutes or a few hours
Frequently occurs after manipulation of nonsterile body sites
What is intermittent bacteremia?
Bacteremia due to the same microorganism that is detected intermittently in the same patient (due to cycles of clearance and recurrence)
Associated with an undrained abscess
What is persistent bacteremia?
Characteristic of infective endocarditis and other intravascular infections
Also seen in early stages of systemic bacterial infection
Define primary BSI:
A BSI w/out documented primary source of infection and the source of teh organism is from an intravascular site
What organisms typically cause infective endocardits and who is susceptible?
Usually develops in individuals with underlying structural cardiac defect who develop bacteremia
S. aureas, Viridans, coag negative staph, and HACEK
What causes mycotic aneurysms?
Infectios cause inflammatory damage and weakening of arterial wall
What is supprative thrombophlebitis?
Venous thrombosis associated with inflammation in the setting of bacteria
Who does supprative thrombophlebitis usually occur in?
People with IV catheters or PIC lines
What is secondary (extravascular) BSI?
BSI in which there is a documented portal of bacterial entry and/or associated site of infection
How do you detect bacteremia?
3 sets of cultures over 24 hours.
Should take from different site
Detection rates for 1 set, 2 sets and 3 sets?
1 set: 80%
2 sets: 90%
3 sets: 99%
