Flashcards in Sepsis Deck (21)
What is sepsis?
systemic inflammatory response syndrome + confirmed or suspect infection process
What is the definition of systemic inflammatory response syndrome?
A non-specific clinical response including >2 of the following:
Temperature >38oC or 90 beats/minute
Respiratory rate >20/minute
White blood cell count >12,000/mm3 or 10% immature neutrophils
What is severe sepsis?
Acute organ dysfunction secondary to sepsis
What is evidence of organ dysfunction?
Brain - confusion
Lungs – Adult respiratory distress syndrome/acute lung injury
Heart - hypotension
Liver – dysfunction/acute liver injury
Kidney – acute kidney injury
Clotting cascade – disseminated intravascular coagulpathy
Acid base balance – metabolic acidosis
What action is taken to manage a patient with sepsis?
Full blood count and lactate
Measure urine output
What are community acquired causes of bacteraemia?
Escherichia coli (and other coliforms)
What are hospital acquired causes of bacteraemia?
E. Coli (and other coliforms)
Coagulase negative Staph.
What are coliforms?
E. coli and similar organisms that inhabit the large bowel,
Serratia sp. etc.
What is the definition of strict aerobes?
organisms that require oxygen for growth, such as Pseudomonas sp.
What is the definition of aerobic organisms?
Organisms that grow better with oxygen, but can also grow without it, e.g. Staphylococci, Streptococci, Enterococci and Coliforms (i.e.the majority of human pathogens)
What are normal bacteria found in the mouth?
Strep. “viridans”, Neisseria sp., anaerobes
Candida sp. (few), Staphylococci
What are normal bacteria found in the stomach and duodenum?
Few Candida sp. & Staphylococci may survive
What are normal bacteria found in the bile ducts?
These are usually sterile
What are normal bacteria found in the jejunum?
Small numbers of coliforms and anaerobes
What are normal bacteria found in the colon?
Large numbers of coliforms (106 per gram), anaerobes (109 per gram) and Enterococcus faecalis
What antibiotics are used for intra-abdominal infection with gram positive aerobes e.g. streptococci and enterococci?
What antibiotics are used for intra-abdominal infection with coliforms e.g. E coli?
What antibiotics are used for intra abdominal infection with anaerobes e.g. bacteroides?
What type of antibiotics is gentamicin?
How long should the time on gentamicin be minimised to?
Then review the patients condition and microbiology results