Small Group: Anaerobic Bacterial Infections Flashcards
- Name the organism (genus and species) that is the most common cause of gas gangrene.
Clostridium perfringens
- Define and explain the terms debridement and crepitation. Note: crepitus and crepitation are interchangeable.
debridement: removal of devitalized tissue
crepitation: build up of gas in subcutaneous tissues usually due to C. perfingens
grating, crackling or popping sounds and sensations experienced under the skin and joints or a crackling sensation due to the presence of air in the subcutaneous tissue.
- Discuss the microbiological and physiological predisposing factors for the development of gas gangrene.
poorly controlled diabetes (circulatory damage and nerophahy)
high blood pressure can effect PMN function
previous infection or colonization
open infection (culture medium)
increased age
hygiene
- Explain the rationale of antibiotic treatment in the containment of gas gangrene and the reasons that containment is difficult.
poor circulation to site of infection because of tissue damage
devitalized tissue may serve as a reservoir of infection if not removed
- Discuss and evaluate the role of debridement in the treatment of gas gangrene.
very important in removing devitalized tissue (anaerobic culture) and organism burden (decrease bug, decrease a toxin)
- Explain the role of clinical findings and laboratory testing to diagnose cases of gangrene.
can be important in syndrome recognition, testing may be time consuming and organism may be difficult to grow
- Explain the importance of appropriate specimen collection and handling when anaerobes are suspected.
transport with an anaerobic chamber with reducing agents and anaerobic transport media, may be fastidious to grow
- List the clinical signs of gas gangrene.
crepitus, dishwater discharge, early onset of pain, rapid evolution of damage, cyanosis
- Name the organism (genus and species) most commonly associated with antibiotic associated diarrhea.
Clostridium dificile
- Explain why this organism is problematic as a hospital-acquired pathogen, how it is transmitted and what preventative strategies can be used to reduce rates.
can be spread by very hardy spores (shed in feces) that are not killed by certain cleaning products
requires practitioners to wash their hands with soap and water and also for rooms to be cleaned with a chlorine solution
can be transmitted on hands, equipment, bedding etc.
- Describe the disease spectrum seen with this organisms.
patients can be asymptomatic or they can have membranous colitis, require colectomy or die (Septicemia or antibiotic resistance), most common can be mild-severe diarrhea that is persistent (strains that do not produce the a toxin is not pathogenic, cannot tell without PCR)
- Discuss therapeutic strategies that can be used to treat this disease.
limit antibiotic use, private rooms (continue precaution until diarrhea stops
tx: oral vancomycin or or oral metronidazole, fidaxomicin ($$ less relapse)
probiotics or fecal transplant
IV IgG from donor antibodies to help against C. diff toxin
shorten hospital time, reduce GI surgery (advanced age is also a risk factor)
- Discuss reasons why recurrences are common for this disease.
relapse (spores remain in gut) or reinfection
patient may not develop antibodies to the toxin
- Name the most common genera of normal anaerobic and facultative gut microflora (bacteria.)
Bacteriodes fagilus
- Explain the biphasic development of peritonitis as it relates to aerobes or facultative anaerobes v. strictly anaerobic bacteria.
anaerobe infection creates devitalized tissue infection that allows for the growth of anaerobic organisms
Phase I occurs in peritoneal fluid and phase 2 at localized sites
- Name the common genera of microflora found in the oral cavity.
Provetella Fusiform Peptostreptococci Bacterioides Streptococci Lactobaccilli Staphylococci
- Define the term “aspiration pneumonia.”
foods, liquids or saliva from the mouth enter into the respiratory system and cause an inflammatory (infection)
possible complications include empyema
- List and discus the major conditions predisposing a patient to aspiration pneumonia and relate each to the host defenses that are defeated.
alcohol, smoking, poor dentition, esophageal motility, stroke, Epilepsy, drug use, GERD, head and neck cancers, MS, ALS, nasogastric tube
inhalation of fluids blocks airway (vomitus or other liquid)
- Identify the most common bacterial agents (to genus) involved in aspiration pneumonia.
Provatella
Fusiform
Peptostreptococcus
+ anything living in the mouth
use clindamycin or ampicillin/sulbactam to treat
- List and describe those conditions within the lung that can lead to development of an anaerobic microenvironment.
obstruction of the alveoli (COPD, foreign body etc.)
disruption of blood flow (ie. PE)
