Sepsis

Question 1

When taking blood cultures, when do you receive the results?

Answer 1

A first interim report is within 2-3 days

A final report within 4-5 days

Note: blood cultures are low sensitivity because bacteraemias are most often transient or intermittent, and don’t give a positive result upon testing

Question 2

What are the most common multidrug resistant bacterias?

Answer 2

Carbapenamase-producing enterobacteria CPE
Methicillin-resistant staphylococcus aureus MRSA
Vancomycin-resistant enterococci VRE
Klebsiella pneumoniae carbapenamase KPC-producing gram negative bacteria
Multidrug resistant tuberculosis

All of these are more commonly found in the hospital because of the concentration of ill people and the rate of antibiotic use

Question 3

Which test is useful for distinguishing a fungal organism from other kinds?

Answer 3

A beta-D glucan test:

Tests for the panfungal cell wall component released in to the blood in invasive fungal infections.

Question 4

What are the investigations necessary in suspected sepsis?

Answer 4

Blood gas - respiratory failure or acid/alkalosis

Lactate - tissue perfusion measure (cardiorespiratory effectiveness)

Glucose, FBC, WCC

CRP (produced by liver!)

U+E’s (AKI is likely in sepsis)

Clotting screen (Coagulation is likely in sepsis)