Week 2 Infections Flashcards
Chain of Infection
Infectious Agent
Reservoirs
Portal of Exit
Means of Transmission
Portal of Entry
Susceptible Host
Colonization
Describes microbes present without host inference or interaction
Infection
Indicates host interaction with the organism
Disease
The infected host displays a decline in wellness caused by the infection
Information Resouces
WHO
CDC
OSHA
Local Agencies
Hospital and facility infection control specialists and facility policies and procedures
Isolation Precautions
Guidelines to prevent the transmission of microbes in hospitals
Standard precautions in all patients
Primary strategy for preventing HAIs
Transmission- Based Precautions are for Pt with known infections diseases spread by airborne, droplet or contact routes
Elements of Standard Precautions
Hand hygiene
Use of gloves and other barriers
Needle sticks
Proper handling of patient care equipment and linen
Environmental control
Patient Placement
Organisms of HAI Infection Potential
C diff
MRSA
VRE
Multi Drug resistant gram negative organisms
CAUTI
CLABSI
VAP
Airborne Precautions
Hospitalized patient should be in negative pressure with the door closed, hcp should wear N95 resp mask at all times in the room
Droplet Precautions
Wear a face mask but door remain open, transmission limited to close contact
Contact Precautions
Use of barriers to prevent transmission, emphasize cautious technique because organisms are easily transmitted by contact between health worker and the PT
Prevention of Infection
HAI bloodstream infections
Community acquired infections
- Community acquired pneumonia is treated with different antibiotics than hospital acquired pneumonia
Vaccination programs
Planning for pandemic
Diarrheal Diseases
Transmission
Causes
Bacterial
Viral
Parasitic
STIs Infections
Syphilis
Chlamydia Trachomatis
Neisseria Gonnorhea
HIV
Trichomoniasis
Herpes
HPV
Nursing Process The Care of the Patient c STI Assessment
Protecting privacy and confidentiality
Communication needs to be culturally and emotionally sensitive and clarification is necessary
Patient Knowledge
Physical exam includes: rashes, lesions, drainage, inguinal nodes, genitalis, rectal, mouth and throat, women need abdominal and uterine exam
Collaborative Problems and Potential Complications
Increased risk for ectopic pregnancy
Infertility
Transmission of infection
Neurosyphillis
Gennoccal Memingitis
Gonoccal Arthritis
Syphillis Aortitis
HIV related complications
Interventions
Education about STDs and the spread of infection
Reducing Anxiety
Encourage to discuss anxieties and fears
Provide factual information and individualized education
Assistance in planning discussion with partners
Referral to social worker
Increasing Compliance
PT education
Referral to appropriate agencies
Emerging Infectious Agents
West Nile
Legionnaires
Pertussis
Ebola
E. Coli
Hantavirus Pulmonary Syndrome
Principles of Antimicrobial
Goal of therapy
Prevent and treat infection caused by pathogenic organisms
Drug Selection
Depends on organism causing infection
Severity of infection
Other Factors
Beta Lactam Antibacterials
Penicillins
Cephalosporins
Carbapenems
Monobactams
Penicillin
Safe, effective, widely used ATB
First ATB developed
- Had to be given parenterally
Destroyed by gastric acid
Injections were painful
Extensive use produced drug- resistant stains of Staphy
Penicillin
Take on empty stomach 1 hour before or 2 hour before except Amoxicillin taken with meals
Indications for use
BActrial infections caused by susceptible organisms
More effective in gram + than gram - infections
Skin/ soft tissue, resp. GI, and GU infections
Incidents of resistance continue to increase
Contraindications
Hypersensitivity/ allergic reaction to any penecillin preparation
Potential exists for cross allergenicity with cephalosporins and carbapenems use to be avoided
Penecillin Resistant Penicillins
Dicloxicillin
Naficillin
Oxacillin
Aminopenecillins
Ampicillin
Amoxicillin
Pepercillin
Penicillin Beta Lactamase Inhibitor Combinations
Ampillicin Sulbactam
Pipercillin tazobactam
Cephalosporins
Derived from fungus
Broad spectrum ATB goes against gram + and gram -
Widely distributed into most body fluids and tissues
Max conct in liver and kidneys
Clinical Use
Surgical Prophylaxis
Infections
Resp. Tract and urinary tract
Skin, soft tissues
Bones, joints
Brain, spinal cord
Contra in
Previous anaphylatic reactions
Cephalsporin allergy
Cefazolin
1st gen
2nd Generation
Cefotetan
Cefoxitin
Cefuroxime
Ceftazidime
3rd Generation
Cetriaxone
4th Generation
Cefepime
5th Gen
Certaroline
Carbapenems
Broad Spectrum, bactericidal beta lactam anti microbials
Inhibit synthesis of bacterial cell walls by binding with penicillin binding proteins
Imipenem
Doripenem
Ertapenem
Meropenem
All are Carbapenems
Monobactams are active against bacteria
Gram -
active against many strains that are antibody resistant
Does NOT cause kidney damage or hearing loss
Indications use for
Urinary Tract, lower Respiratory, intra abdominal and gynecologic infections, septicemia
Examples of Monobactams
Aztreonam
Glycopeptide Antibiotic
Vancomycin
Treats C diff
Side effects of Vancomycin
Hypotension
SOB
Dizziness
Headache
Chills
Fever
Chest Pain
Red Man Syndrome c IV use
Introduction to Fungi
Include Yeasts and Molds
Widely dispersed in environment
Saprophytic: Feed on dead organic matter
Parasitic- Feed on living organisms
Larger and more complex than bacteria
Multicellular Organisms that form fuzzy coating on various surfaces can produce spores, which can persist indefinitely in the environment
Molds
Yeasts
Unicellular organisms
Dermatophytes
Pathogens exist in
Soil, decaying plants
Other environmental habitats
Normal Flora ( candida albicans)
Skin, mouth, GI tract, vagina
Dematophytes
Mild and Superficial
Skin, hair, and nails: obtain nourishment from keratin
Tinea Pedis- Athletes foot
Tinea Captis- Ringworm
What are Mycoses?
Life threatening and systemic
Mainly in immunosuppressed hosts
More severe and invasive in immunocompromised
Why are serious fungal infections increasing?
HIV
Use of immonosupressants
Cancer, organ transplant patients
Use of Indwelling caths
Central Lines
Prosthetic Devices
Overuse of broad spectrum antibiotics
Name selected Fungal Infections
Aspergillosis
Blastomycosis
Candidasis
Coccidiodmycosis
Crytocossis
Histoplasmosis
Pneumocytosis
Sporotrichosis
Fungal cells are similar to
Human cells
Make sit difficult to develop effective antifungals
Where do antifungal medications target?
The cell membrane
- Produce potentially serious toxicities and drug interactions
Disrupt Structure and function of cell components
Polyenes
Azoles
Echinocandins
Polyenes
Amphotericin B
Nephrotoxic
IV administered
Nystatin
Mycostatin
Cream
powder
Ointment
Suspension/Tablets
oral thrush- candidasis
What is used for vaginal candidasis?
Fluconazole
Name the Azoles
Used PO, single dose, Parenteral
Itraconazole
Ketconzaloe
Posaconazole
Voriconazole
Echocandins include ?
Caspofungin
Anidulafungin
Micafungin
Used IV
Other fungals include :
Griseofulvin
Terbinafine
Pyrimidine
Viral STDs
HIV HPV Herpes Hepatitis
Bacterial STDs
Syphilis
Gonnorhea
Chlymadia
Protozoal STD
Trichomonasis, crabs, pubic lice, scabies
Education on STDs
Decreasing the spread
Safe Sex practices
Abstinence
Active infection- Have partner to be treated
Covid 19 Risk Factors
Age
Obesity
CV: HTN, CHF, CAD, cardiomyopathies
Diabetes
CKD
COPD/TB/ Asthma
Chronic Liver disease
Cystic Fibrosis
HIV/ Cancer/
Certain Meds ex ACEs and ARBs
Diagnostics
Labs
Lymphophenia
Neutrophillia
Elevated AST and ALT
Elevated Lactate
Elevated CRP
Elevated Ferritin
Elevated D Dimer
Elevated Prolactin
Chest X ray and Chest CT
-Unremarkable early in disease
Bilateral air space consolidation
Chest Radiographs
Ground Glass Opacities
See Xrays
Management and Treatment
Severe Clinical Presentation
Present:
Pneumonia
ARDs
Resp. Failure (Hypoxemic)
Sepsis
Septic Shock
Cardiomyopathy and Arrythmias
AKI
Secondary Bacterial Infections HAIs
-Due to prolonged hospital admission
Treatment:
Experimental corticosteroid use
Supportive care includes:
Treatment of PNA
Trx hypoxemic respiratory failure/ ARDs
-Mechanical Ventilation
- Sepsis/ Shock/ Multiorgan failure
- Affects of HAIs
- Thromboembolism
