Normal flora & Intra-abdominal Sepsis - Week 5

Question 1

Where are most organisms in the GI tract found?

Answer 1

Colon

Question 2

Which bacteria are common in the normal flora of the mouth?

Answer 2

Viridans strep, candida sp.

Question 3

Which bacteria are common in the normal flora of the bile ducts?

Answer 3

None - they should be sterile

Question 4

Which groups of bacteria are part of the normal flora of the colon?

Answer 4

Enterobacteriaceae, Enterococci, Millieri group streptococci

Question 5

What kind of bacteria are Enterobacteriaceae?

Answer 5

Gram negative rods

Question 6

What kind of bacteria are enterococci?

Answer 6

Gram negative cocci

Question 7

What is meant by colonisation?

Answer 7

the establishment of a microorganism on or within a host, may be short-lived

Question 8

What is meant by a pathogen?

Answer 8

Any microorganism that has the potential to cause disease

Question 9

What is meant by virulence?

Answer 9

Likelihood of the pathogen causing disease

Question 10

Which kind of infection is more likely in a patient with HIV?

Answer 10

Bacterial infection

Question 11

What is meant by primary peritonitis?

Answer 11

an infection that develops in the peritoneum

Question 12

What is meant by secondary peritonitis?

Answer 12

usually develops when an injury or infection in the abdominal cavity allows infectious organisms into the peritoneum

Question 13

Give some causes of secondary peritonitis.

Answer 13

Oesophagitis, gastritis, duodenitis, liver abscess, cholecystitis, cholangitis, pancreatitis, perineal abscess

Question 14

What are the 2 types of Enterobacteriaceae?

Answer 14

lactose fermenting or lactose non-fermenting

Question 15

Give examples of lactose-fermenting Enterobacteriaceae.

Answer 15

E. Coli, Klebsiella spp., Enterobacter spp.

Question 16

Give examples of non lactose-fermenting Enterobacteriaceae.

Answer 16

Salmonella spp., Shigella spp., Yersinia spp.

Question 17

Give examples of enterobacteriaceae which lack the H antigen (and flagella).

Answer 17

Shigella & Klebsiella

Question 18

Why do gram negative organisms cause sepsis?

Answer 18

Body’s immune system is hugely activated by LPS

Question 19

What is MacConkey agar used for?

Answer 19

lactose fermenters turn this pink

Question 20

Give a drawback of MALDI-TOF.

Answer 20

Amplifies all genetic material so shows organisms which are dead

Question 21

Give molecular testing which is useful if an organism cannot be cultured.

Answer 21

16s RNA or Whole genome sequencing

Question 22

What is serotyping used for?

Answer 22

Immunoreactivity of various antigens. For example, can tell you that it is a 0157 type of E. Coli.

Question 23

Give an example of a group of microorganisms which are strict anaerobes.

Answer 23

Bacteroides

Question 24

Intra-abdominal sepsis caused by perforated peptic ulcer is likely caused by which organisms?

Answer 24

Staph, Strep, anaerobes & E Coli

Question 25

Which gram positive cocci are most likely to pass into blood during sepsis?

Answer 25

E Faecalis/ E faecium

Question 26

For gram positive cocci (Enterococcus) in intra-abdominal sepsis, what are the first and second line antibiotics?

Answer 26

1. Amoxicillin 2. Vancomycin

Question 27

What is meant by sepsis?

Answer 27

life-threatening organ dysfunction caused by a dysregulated host response to infection

Question 28

What are the clinical findings necessary to diagnose sepsis?

Answer 28

NEWS > 5 & infection

Question 29

What must be completed if sepsis is suspected?

Answer 29

Sepsis 6 bundle

Question 30

Which acronym is used to remember the Sepsis 6 bundle?

Answer 30

BUFALO

Question 31

What does BUFALO stand for?

Answer 31

Blood cultures (+ related cultures of pus/wound)
Urine Output measurement
Fluid Resuscitation
Antibiotics IV – NOT oral
Lactate measurement
Oxygen – to correct hypoxia

Question 32

What is meant by septic shock?

Answer 32

Subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality. Not responding to resuscitation.

Question 33

Which antibiotics should be given for peritonitis/biliary tract infection/intra-abdominal infection?

Answer 33

IV Amoxillin + Metranidazole + Gentamicin

Question 34

Which antibiotic is used to cover gram negative bacteria?

Answer 34

1. Gentamin 2. Co-trimoxazole

Question 35

Which antibiotic is used to cover anaerobes?

Answer 35

Metranidazole

Question 36

Which antibiotic should be given in acute pancreatitis?

Answer 36

None - usually is not bacterial

Question 37

If an abscess is suspected/confirmed, what action should be taken?

Answer 37

Phone surgeon - will require surgical drainage