Intro

Question 1

Presentation:
BP 80/60
Temperature 39 degrees
HR 120/min
This presentation is signs of ______→ can lead to ______
Bacteria that are responsible for this presentation: typically ______ bugs eg. klebsiella pneumonia & ecoli
Bacteria component that is responsible: ______

Answer 1

This presentation is signs of septic shock → can lead to death
Bacteria that are responsible for this presentation: typically gram -ve bugs eg. klebsiella pneumonia & ecoli
Bacteria component that is responsible: Lipopolysaccharide

Question 2

What is a biofilm

Answer 2

Biofilm is produced by bacteria as a protective mechanism; a layer of slime that protects bacteria so that they are not killed by the immune system.

Question 3

what is the impact of biofilm on patient treatment

Answer 3

When the bacteria reach a certain concentration → can lead to infections

Question 4

Culture: to ____ an organism

Eg. :

Answer 4

grow

Aerobic culture
Anaerobic culture
Fungal culture
Viral culture

Question 5

Serology: To detect the ____ present following exposure to the organism

Eg.

Answer 5

antibodies

Eg. Blood test

Question 6

Microscopy: to _____

Eg.

Answer 6

visualise the organism

Gram stain
Fungal microscopy
Acid-fast stain
Immuno-fluorescence
Parasitology aka OCP

Question 7

Molecular testing: to _______

Mostly for detecting ____ or pathogens that cannot be ____.
Or when you need an answer ____.

Eg

Answer 7

detect nucleic acids

Mostly for detecting viruses or
Pathogens that cannot be cultured
You need an answer FAST

Eg. PCR

Question 8

Sterile vs non sterile sites

Answer 8

Sterile: “inside” body
Eg. blood, CBF, vitreous fluid, joint

Non-sterile: “outside”
Eg. skin, drains, anus, intestines, respiratory organs, stomach, etc

Question 9

Examples of wound swabs in infection

Answer 9

Staphylococcus aureus, group A streptococcus

Question 10

Examples of urine culture in colonization

Answer 10

Bacteria growth from indwelling catheters

Question 11

Examples of urine culture in infection

Answer 11

E coli, klebsielle pneumoniae (pure & high viable count with clinical signs)

Question 12

The 5 moments of hand hygiene

Answer 12

1. Before patient contact
2. Before aseptic task
3. After body fluid exposure risk
4. After patient contact
5. After contact with patient surrounding

Question 13

Swab: avoid swabbing an area that is ______

Answer 13

completely dry

Question 14

A more representative sample is a swab taken before/during/after wound cleansing

Answer 14

AFTER

Question 15

Screening swabs generally detect only a SPECIFIC organism eg. ____

Answer 15

MRSA

Question 16

Rayon bud (Tip) is for identifying

Answer 16

bacteria

Question 17

Aerobic culture
Anaerobic culture
MRSA screen
Gram-stain

They suit what kind of swab?

Answer 17

Rayon bud (Tip)

Question 18

Rayon bud (Tip) is not suitable for

Answer 18

Viral PCR

Viral culture

Question 19

Labels found in Rayon bud (Tip)

Answer 19

‘Aerobes and anaerobes’

Question 20

Swab in UTM/VTM is for

Answer 20

Viral & PCR testing

Question 21

Viral culture
Viral antigen
Viral PCR (eg. influenza)
Chlamydial PCR

They suit what kind of swab?

Answer 21

Swab in UTM/VTM

Question 22

Swab in UTM/VTM is not suitable for

Answer 22

Aerobic & anaerobic culture

Question 23

Label found in swabs in UTM/VTM

Answer 23

‘UTM-RT’

Question 24

eSwab media is used for

Answer 24

better detection of bacteria compared to Rayon bud

Question 25

Aerobic culture Anaerobic culture Bacterial PCR They suit what kind of swab?

Answer 25

eSwab media

Question 26

eSwab media is not suitable for

Answer 26

viral testing

Question 27

What is the default urine sample to send? And why?

Answer 27

Mid-stream urine. Because urethra is a non-sterile site Best method as the 1st bit of urine that pass may be contaiminated with bacteria from skin (reduce contamination from urethra & perineal region)

Question 28

In-out catheter urine: if required, clamp the tubing ______ to the sampling port

Answer 28

a few cm distal

Question 29

In-out catheter urine--- Best way to get good quality urine sample: sample from the ______ (______)

Answer 29

sample from the sampling port (needle-less)

Question 30

Good specimens of culture: low/high viable count

Answer 30

high

Question 31

Disadvantages of long term urinary catheter

Answer 31

- ↑ risk of UTI (esp elderly) - ↑ risk of getting infection caused than > 1 bug - Colonization of the catheter with various organisms - Patients will almost always have +ve urine cultures

Question 32

Collect sputum in the _____ to avoid _______ with food particles

Answer 32

morning; contamination

Question 33

Broncho-alveolar lavage is only used in ____, for ____ patients

Answer 33

ICU; sedated

Question 34

Presence of epithelial cells in a respiratory sample = specimen from upper respiratory tract which means

Answer 34

POOR QUALITY SAMPLE as it is highly contaminated with other flora

Question 35

What is a BAL sample? How is it obtained?

Answer 35

It helps diagnose and treat certain lung diseases. Collected by washing the airways with a saline solution and capturing fluid during the process.

Question 36

What is a ETT sample? How is it obtained?

Answer 36

A flexible plastic tube is placed through the nose or mouth into the trachea, or windpipe, to help a patient breathe. Can be obtained from instinctively ventilated covid patients through catheter from an endotracheal tube or from tracheotomised patients by directly tracheal suction

Question 37

Effect of endotoxin found in gram -ve bacteria

Answer 37

- Endotoxin are chemicals (found in cell wall of gram -ve bacteria) that can cause body reaction - Even when the bacteria is dead (correct antibiotic is given), this chemical will still be released into the bloodstream and tissues - It initiates a host inflammatory response which contributes to the severity of symptoms during infection (Eg. fever, septic shock) - Effects: histamine release, WBCs release and vessel dilation - Vessels dilate (blood supply to organs are compromised, blood pressure drops) capillaries become permeable, fluid leaks out - Can affect clotting system (thrombin formation) → blocked blood vessels - Can cause: sepsis → organ failure - Must be treated early

Question 38

What is commensal bacteria? Are they usually harmful?

Answer 38

- bacteria that are normally found on the human body - usually not harmful - may contribute beneficial effects

Question 39

Colonization increases in these type of patients:

Answer 39

- Hospitalised patients - Patients with medical conditions - Patients given antibiotics

Question 40

Lipopolysaccharide is found within ____. | Ability:

Answer 40

- Found within the cell wall | - Ability to produce antibiotics → hypotensive, tachycardic & pyrexic

Question 41

Where do you find biofilms?

Answer 41

ETT tubes, urine catheters