Infection 3 - AB resistance + Sepsis + HCAIs Flashcards Preview

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Flashcards in Infection 3 - AB resistance + Sepsis + HCAIs Deck (21):
1

Are most antibiotic resistance genes carried on a chromosome or plasmid?

Plasmid

2

What are the 3 mechanisms of antibiotic resistance?

1) Drug altering enzyme
2) Altered target
3) Altered uptake

3

How may bacteria acquire antibiotic resistance?

- Vertical gene transfer
- Conjugation
- Transformation
- Tranduction

4

What is the test to find out whether a bacteria contains antibiotic resistance?

Disc sensitivity testing

5

What are the main impacts of antibiotic resistance?

- More expensive medications required
- Longer duration of illness and treatment
- Higher healthcare costs
- More danger associated with surgery/chemotherapy

6

How can we reduce antibiotic resistance?

- Improve cleaning and hygiene (prevent infections)
- Only take AB's when prescribed, and finish course
- Encourage different treatment options, and more preventions ie vaccines
- Reduce use in animals and plants
- Antimicrobial stewardship (promoting and monitoring of judicious use)

7

Who is at a higher risk of developing sepsis?

- Very young or old
- Low body weight
- Asplenic
- Immuno-naive/compromised
- Co-morbidities
- Invasive medical device
- Recent infection/transplant/surgery/steroid use
- Long term antibiotic use

8

Define septic shock:

Persisting hypotension requiring treatment to maintain blood pressure, despite fluid resuscitation

9

What are the red flags of acute sepsis?

- RR > 25/min
- SpO2 < 91%
- Systolic BP < 91 mmHg
- HR > 130/min
- No urine output for 18 hrs
- Responds only to voice/pain/unresponsive
- Non-blanching rash/mottled/ashen/cyanotic
- Neutropenia or chemotherapy < 6 wks ago

10

At decision to start Sepsis 6 management, what is the expected lifespan of the patient?

1 hr

11

What is the Sepsis 6 management?

1) Give high flow O2
2) Take blood cultures
3) Give IV antibiotics (Meropenem unless meningitis suspected = Ceftriaxone)
4) Start fluid challenge
5) Measure lactate
6) Measure urine output

12

Why is it important to measure lactate during acute sepsis?

Marker of tissue perfusion
- shock causes poor tissue perfusion, causing lactic acidosis

13

At what point does a high resp rate become a red flag of sepsis?

RR > 25/min
`

14

How do microorganisms cause septic shock?

- Microorganism produces endotoxin, which binds to macrophages
- Macrophages locally release cytokines: alpha-TNF + IL-1, which stimulate wound repair and RAAS
- Systemic release of cytokines stimulate GF, macrophages, and platelets
= Mass vasodilation = Normovolaemic shock

15

What is the first organ which loses blood supply during sepsis?

Skin

16

List some possible complications of acute sepsis:

- DIC
- Endocarditis
- Empyema
- Pulmonary embolism
- Death

17

Define a hospital-acquired infection when contracted by a patient:

Infection not present or incubating at time of admission (onset after 48hrs of admission)

18

Name some viruses which are commonly acquired in hospitals:

- Norovirus
- Influenza
- Cheickenpox
- Hepatitis B/C (bloodborne)
- HIV (bloodborne)

19

Name some bacteria which are commonly acquired in hospitals:

- Staph. aureus (incl. MRSA)
- C. difficile
- E. coli
- Klebsiella spp.
- Pseudomonas spp.
- Myco. tuberculosis

20

Name some fungi which are commonly acquired in hospitals:

- C. albicans
- Aspergillus spp.

21

What is PPE?

Personal Protective Equipment:
- gloves
- goggles
- clothing
- face shields
- respirators