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Flashcards in Blood Stream Infections Deck (38)
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1

what is the mortality rate of severe sepsis?

28-50%

2

why is the incidence of severe sepsis anticipated to increase?

due to the disproportionate growth of elderly americans and the high incidence of sepsis in these patients

3

how do infection and colonization differ?

infection is microorganisms in a normally sterile site while colonization is on an epithelial surface

4

what is the difference between bacteremia and sepsis?

bacteremia only implies that there is bacteria in the blood stream. it may be of no consequence

5

what is the classification for systemic inflammatory response syndrome?

must have two or more of the following:
temperature over 38 or under 36C, tachycardia, tachypnea (over 20 or CO2 less than 32 mmHg), and WBC over 12k or under 4k (may also have >10% bands)

6

what is sepsis?

SIRS associated with proven or clinically suspected infection

7

define hypotension

systolic bp of 40 mmHg from baseline

8

what is severe sepsis?

sepsis associated with dysfunction of organs distant from the site of infection, hypoperfusion or hypotension. Hypotension is reversible by administering fluids

9

what abnormalities are typically included in severe sepsis?

lactic acidosis, oliguria, altered mental status, thrombocytopenia and acute lung injury.

10

define septic shock.

sepsis with hypotension that does not respond to fluid resuscitation and requires vasopressor therapy. There are perfusion abnormalities also seen in severe sepsis

11

what does refractory septic shock describe?

septic shock that lasts for greater than one hour and does not respond to vasopressor admin

12

what causes SIRS?

the body's response to an inciting event (not the direct effect of the event)- cytokines and dysregulation of inflammation

13

what is the cause of mortality with sepsis?

multiple organ dysfunction syndrome

14

how is septic shock initiated?

LPS of gram negative bacteria is recognized by TLR4. This activates the cell and promotes the production of inflammatory mediators

15

other than the immune system, what else is dysregulated in SIRS and sepsis?

the coagulation system

16

what molecule can be tracked to identify and watch the progression of sepsis?

procalcitonin level is elevated in sepsis. it is stimulated by endotoxin

17

what is transient bacteremia? what causes it, typically?

it lasts for minutes or a few hours, often when manipulating a nonsterile body part or at the onset of acute bacterial infections

18

what is intermittent bacteremia?

bacteremia of the same microorganism that goes through cycles of clearance and recurrence

19

what is the cause of intermittent bacteremia?

associated with undrained, closed space infections (abscesses) or focal infections

20

how is persistent bacteremia categorized?

bacteremia that is detectable over a long period of time

21

what are some infections that cause persistent bacteremia?

infective endocarditis and other intravascular infections. Also occurs during early stages of systemic bacterial infections

22

what is a primary blood stream infection?

a BSI without a documented primary source of infection (the source is intravascular)

23

what organisms are associated with endocarditis?

staph aureus, streptococci and coagulase negative staph. among several others

24

who is at risk for developing infective endocarditis?

IV drug abusers and individuals who have heart valve damage

25

what is a mycotic aneurysm?

damage to endothelial cells by inflammatory reaction to infection. results from an infection by staph, strep or salmonella, of the aortic wall

26

what is suppurative thrombophlebitis? where does it occur most frequently?

venous thrombosis associated with bacteremia and inflammation. occurs most frequently with IV catheter or PICC lines

27

what do catheter associated bloodstream infections colonize?

colonize dwelling catheters that provide more accessible long term venous access for blood testing and treatment.

28

what is a secondary blood stream infection?

a BSI that has a documented portal of bacterial entry or a known associated site of infection

29

what two infections of the elderly may lead to a bsi?

UTIS and bacterial pneumonias

30

how is bacteremia detected?

by culturing blood (most sensitive method) prior to initiation of antimicrobials