Flashcards in Bacterial Infections Deck (101)
What is the definition of colonization?
presence of bacteria on a body surface (ex: skin, mouth, intestines, airways, etc), but the presence of bacteria does not cause disease in a person
What is the definition of infection/sepsis?
result of bacteria causing an illness, the s/s of infx depend on where the infx is
What is the definition of septicemia?
a serious, life threatening problem caused by a bacterial organism in the blood
What is the incidence of bacterial infections in the newborn?
1-8:1000 live births
What is the mortality rate for neonatal bacterial infx?
as high as 40% for preterm infant (early onset)
The significant mortality of neonatal sepsis necessitates what action by the provider?
early detection and treatment of sepsis to optimize the prognosis
What are common risk factors for neonatal bacterial infx?
PPROM, PROM >18h, PTL, chorioamnionitis, recent maternal infx, maternal fever in the perinatal period, maternal GU tract infx (including UTI and STD), perinatal asphyxia and invasive procedures
What is chorioamnionitis?
dx made by constellation of clinical symptoms including: maternal temp >100.4, maternal HR >100bpm, fetal HR >160bpm, uterine fundal tenderness, foul smelling amniotic or vaginal discharge, purulent appearing amniotic fluid
How does perinatal asphyxia increase an infant's risk for bacterial infx?
increased especially with PROM >18h, during asphyxial event, baby may gasp and deeply inhale infected amniotic fluid
What invasive procedures increase an infant's risk for bacterial infx?
procedures prior to del that interfere with the integrity of the amniotic cavity- CVS, amnio; or during delivery- fetal scalp electrode, vacuum assistance; or after delivery- PIV insertion, central lines, intubation
What is Gram staining?
the first step in identifying an organism, allows for differentiations of bacteria into 1 of 2 categories; G+ appear purple/blue (retain the stain) and G- appear pink
What are some common seen Gram positive bacterial organisms in the NICU population?
coagulase-negative staphylococcus, staphylocccus aureus, listeria monocytogenes, streptococcus pneumoniae and group A streptococcus
What are some common seen Gram negative bacterial organisms in the NICU population?
neisseria meningitdies, haemophilus influenza, klebsiella pneumoniae, pseudomonoas aeruginosa, acinetobacter species, citrobacter species, enterobacter species, serratia marcescens and proteus species
What is early onset sepsis?
within the first 72 h of life; can begin in utero as resul of swallowing or inhaling infected amniotic fluid; usually present within the first 24-48h
What is late onset sepsis?
after the first 72h of life
What are commonly presenting signs of bacterial infx in neonates?
respiratory distress, temperature instability, feeding intolerance, cardiovascular signs, abnormal neurologic status and abnormal skin findings * many of these signs may also be present with other concurrent illnesses
What clinical presentation of the respiratory system would indicate bacterial infx?
tachypnes, G/F/R, apeana, cyanosis, development/increased supplemental O2 requirement, respiratory support
What clinical presentation of temperature would indicate bacterial infx?
more commonly hypothermia, could be hyperthermia; temperature lability
What clinical presentation of feeding intolerance would indicate bacterial infx?
increased gastric residuals, poor feeding patterns, vomiting
What clinical presentation of the cardiovascular system would indicate bacterial infx?
tachycardia, bradycardia, mottling, hypotension, pale or grey skin color
What clinical presentation of the neuro system would indicate bacterial infx?
irritable, lethargy, sleepiness, sz and hypotonia
What clinical presentation of the integumentary system would indicate bacterial infx?
omphalitis, blisters on the skin, swelling or redness of the soft tissue, cellulitis, necrotic skin lesions
What is a WBC?
fx to protect the body from infx; produced in the bone marrow along with RBCs and platelets
What are the 5 different types of WBCs?
Neutrophils, eosinophils, basophils, lymphocytes and monocytes
What are neutrophils primarily responsible for?
killing and digesting bacteria
What are mature neutrophils called?
segmented neutrophils- segs (has a segmented nucleus), polymorphonuclear (PMNs), neuts, polys
What are immature neutrophils called?
bands, juveniles and stabs
How does a neutrophil mature?
in the bone marrow from a myeloblast into a segmented neutrophil
What comprises the neutrophil storage pool?
in the bone marrow the metamylocytes, bands and segmented neutrophils