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Medical Microbiology > Bloodstream Infections > Flashcards

Bloodstream Infections Flashcards

1
Q

What is bacteraemia?

A

Presence of bacteria in the blood

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2
Q

How do microbes gain access?

A

Via portal of entry

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3
Q

What can bacteraemia lead to?

A

Systemic infection

Haematogenous disease

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4
Q

What haematogenous disease can bacteraemia lead to?

A

Endocarditis
Osteomyelitis
Organ infections
Meningitis

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5
Q

What is septicaemia?

A

Bacteraemia and symptoms of systemic infection

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6
Q

What are symptoms of systemic infection?

A 
Pyrexia
Chills
Rigors
Hypotension
Shock
Multiple organ failure
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7
Q

What is sepsis?

A

Life-threatening condition where body’s response to infection injures tissues and organs

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8
Q

What is sepsis assessed by?

A

Sepsis-related organ failure assessment (SOFA) score

Measures function of major organs

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9
Q

What is septic shock?

A

Subset of sepsis where underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality

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10
Q

What is the treatment of sepsis?

A

Give oxygen (94%)
Take blood cultures
Administer empiric IV antibiotics
Measure serum lactate and send full blood count
Start IV fluid resuscitation
Commence accurate measurement of urine output

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11
Q

What are the effects of cytokine storm?

A

Inflammation
Shock
Multiple organ dysfunction syndrome
Death

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12
Q

What is the mortality rate of sepsis?

A

35%

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13
Q

What is the primary cause of death from infection?

A

Sepsis

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14
Q

What percentage of worldwide communicable disease deaths is due to sepsis?

A

Approximately 50%

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15
Q

What are the negatives of antibiotic therapy?

A

Increases costs
Causes side effects
Complicates diagnosis

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16
Q

What are the leading causes of Sepsis?

A

Escherichia coli

Staphylococcus aureus

17
Q

How does E. coli infect a patient to lead to sepsis?

A

UTIs via catheters, intestinal lesions, biliary tract infections
Extra-intestinal diseases (extra-intestinal pathogenic E. coli ExPEC)

18
Q

How does staphylococcus aureus infect a patient to lead to sepsis?

A

Via abscesses, cellulitis, infected joints, post-operative

19
Q

What are some other causes of sepsis?

A

Streptococci (pneumonia, agalactiae, pyogenes)
Salmonella typhi (paratyphi)
Candida
Neisseria meningiditis

20
Q

How do bacteria survive in the bloodstream?

A

LPS - resist lysis via complement deposition
Haemolysins
Glycocalyx (capsule/slime layer)
Camouflage by binding IgG in ‘wrong’ orientation

21
Q

What does protein A in staphylococcus aureus do?

A

SpA impedes phagocytosis by binding the Fc component of immunoglobulin

22
Q

Mutants of S. aureus lacking SpA means what?

A

More efficient phagocytosis in-vitro
Diminished virulence
Lost cloak of invisibility

23
Q

What does fibronectin binding protein do?

A

Tethers the bacteria to the endothelium lining

24
Q

What is infectious endocarditis caused by?

A

Bacteraemia after medical/dental procedures and colonisation of damaged heart valves

25
Q

Where can infectious endocarditis spread to?

A

Brain, lungs, kidneys, or spleen once form clots that break off

26
Q

What bacteria is responsible for infectious endocarditis?

A

Viridans streptococci (oral flora) e.g. Streptococcus oralis
Staphylococcus aureus
HACEK group organisms

27
Q

What are the pathogenicity factors in endocarditis?

A 
Clumping factor (fibrinogen binding protein)
Fibronectin binding protein
28
Q

What are some conditions of immunocompromised patients?

A 
Transplant related immunosuppression
Cancer
AIDS
Congenital problems 
Splenectomised patients
29
Q

What bacteria commonly cause infections to immunocompromised patients?

A 
Low-virulence opportunistic pathogens
C-N streptococci
Listeria spp
Candida spp
Aspergillus spp
30
Q

Which drugs are used for effective eradication for immunocompromised patients?

A

Cidal antimicrobials

31
Q

How is antibiotic susceptibility testing carried out?

A

Give provisional result
Use media and incubation appropriate to target
Confirm with purified cultures

Medical Microbiology (7 decks)

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