Bacteremia and CNS Infections Flashcards
(51 cards)
What is a syndrome
a collection of symptoms associated with a condition
What is bacteremia?
the presence of viable bacteria in the blood, as determined by growth in a blood culture
What are the three major types of bacteremia?
transient, intermittent, and persistent
Where is transient bacteremia found?
tooth brushing, biopsy
Where is intermittent bacteremia found?
abscess
Where is persistent or sustained bacteremia found?
intravascular
How long does transient bacteremia last?
a few seconds or minutes
How long does intermittent bacteremia last?
culture is positive at intermittent times of taking it
How long does persistent/sustained bacteremia last?
usually you see a positive culture everytime you take culture from patient
What can bacteremia result from?
ordinary activities like tooth brushing and difficult bowel movement; injection drug use, dental procedures, phlebotomy, medical procedures and infections (resp., urinary., GI, skin, CNS, and intravascular)
What can bacteremia lead to?
sepsis (not always though)
What are common sites of infection that lead to sepsis?
unknown (50% of cases), lungs, gastrointestinal, and urinary tract
What is sepsis?
a syndrome of life-threatening organ dysfunction caused by a dysregulated host response to infection
What are the steps involved in sepsis?
1) infection/trauma
2) sepsis
3) severe sepsis
What is Systemic Inflammatory Response Syndrome (SIRS)?
systemic inflammatory response can be triggered by a variety of infectious and noninfectious conditions (such as trauma, burns, and pancreatitis) – not always involved in sepsis
What are the stages of sepsis?
1) early sepsis: infection bacteremia
2) sepsis: life-threatening organ dysfunction
3) septic shock: circulatory, cellular, and metabolic abnormalities
What organs may fail in sepsis/septic shock?
lungs, heart, kidneys, vessels, liver, digestive system, and brain
What are some types of sepsis and their involved symptoms?
pulmonary - arterial hypoxemia
cardiovascular - troponin increase and hypertension
kidney - creatinine increase and acute oliguria
hematologic - coagulation abnormalities and thrombocytopenia
hepatic - hyperbilirubinemia
GI - ileus
neurologic - confusion and loss of consciousness
What are the risk factors for sepsis?
ICU admission, bacteremia, advanced age (>65), immunosuppression, diabetes and obesity, cancer, and community-acquired pneumonia (CAP)
What organisms is sepsis most common with?
it is found commonly with gram positive organisms
What are common sources of infection for nosocomial and community-onset bloodstream infections (BSIs)?
catheters, genitourinary tract, GI or biliary tract, respiratory tract, and SSTI
What do we need to keep in mind when considering the signs and symptoms of sepsis?
they are often nonspecific and it can be hard to diagnosis
What are the signs and symptoms of sepsis?
specific to infectious source: cough and dyspnea, pain and exudate in a surgical wound
general parameters: fever (core > 38.3 C), hypothermia (core <36 C), heart rate >90 bpm, altered mental status, and significant edema or positive fluid balance
hemodynamic parameters: arterial hypotension, or systolic blood pressure decrease
organ dysfunctions symptoms (as before mentioned)
inflammatory parameters: leukocytosis, leukopenia, normal white blood cell count with >10% immature forms, plasma C reactive protein, plasma procalcitonin and hyperglycemia
tissue perfusion parameter: hyperlactatemia
What is the management for patients with suspected sepsis in the first 3 hours?
within first 3 hours
1) measure lactate level
2) obtain blood cultures prior to administration of antibiotics
3) administer broad spectrum antibiotics
4) administer 30ml/kg crystalloid for hypotension or high lactate levels
