Superinfection, Sepsis/Septicaemia, Notifiable diseases

Question 1

Superinfection/Narrow-Broad spec antibiotics

Answer 1

Basc a infection on another infection.
EXAMPLE: PT has UTI - Get trimethoprim - then PT gets oral thrush - this is now a superinfection.

More common with broad spec bacteria as they decrease/kill good and bad bacteria = higher vulnerability of fungal infection/ABx associated colitis.

Knowing narrow specs makes its easier to know broad spec.

Acronym for narrow spec antibiotic: (most common only)
TV & PC
Teicoplanin
Vancomycin
Penicillin G (Benzyl)/ Pen V
Clindamycin

• Above list isn’t exhaustive

Broad spec antibiotics
Aminoglycosides
Macrolides (azithro, erythro etc)
Carbapenems (meropenem etc)
Cephalosporins
Tetracyclines
Quinolones
Ampicillin
Amoxicillin
Chloramphenicol

Question 2

Sepsis & Septicaemia

Answer 2

Septicaemia - Restricted to the blood.
- Caused by bacteria, fungi or virus

Sepsis - All organs can be affected.
- Life threatening, WHOLE body affected. Body reaction to severe infection
- Septicaemia can lead to sepsis. Sepsis more severe.

Sepsis symptoms (EXAM Q)
S - Shivering, fever or very cold
E - Extreme pain/general discomfort
P - Pale or discoloured skin
S - Sleepy, lethargic
I - “I feel like I might die”
S - SOB

Sepsis Symptoms in children (EXAM Q)
Very high/low temp
No urine in the last 12 hrs
Vomiting
Breathing fast
Non blanching rash (like meningitis)
Blue/Pale skin or lips (cyanosis)
Babies - High pitch cry/Lethargic

NON blanching = Rash dont disappear when glass is put on it.

Sepsis Treatment
Give broad spec ABx at MAX dose ideally within 1hr to reduce risk of severe illness/death for high risk PTs
Empirical IV treatment needed then use local formulary with national guidelines.
PRSC:
- IV Benzylpenicillin (Penicillin G) in community.
- IV Ceftriaxone in hospital

Monitor PTs at high risk latest every 30 mins

Septicaemia (community acquired)
- Broad spec antipseudomonal penicillin OR broad spec Cephalosporin
- MRSA sus + Vancomycin or Teicoplanin
- Anaerobic sus + Metronidazole to cephalosporin
- Other resistant microbe sus use more broad spec beta lactam (eg meropenem)

Broad spec antipseudomonal penicillin eg Piperacillin + tazobactam, Ticarcillin + Clavulanic acid
Broad Spec cephalosporin eg cefuroxime

Septicaemia (Hospital acquired)
AS ABOVE

Septicaemia with vascular Catheter
Vancomycin or Teicoplanin
- Gram -ve sus + Broad-spec antipseudomonal beta-lactam.

Meningococcal septicaemia
Single dose of Penicillin G B4 urgent hospital transfer as long as transfer not delayed
ALT cefotaxime ALT Chloramphenicol

To remove nose carriage - Cipro, Rifampicin or Ceftriaxone

Question 3

Notifiable diseases (EXAM Q)

Answer 3

Notifiable disease - A very contagious disease - need to notify some1 of it. So there’s a public health risk i.e. COVID

Notifiable diseases LIST EXTRA
Anthrax
Botulism
Brucellosis
Cholera
COVID-19
Diarrhoea (infectious bloody)
Diphtheria
Encephalitis (acute)
Food poisoning
Haemolytic uraemic syndrome (HUS)
Haemorrhagic fever (viral)
Hepatitis (acute infectious)
Legionnaires’ disease
Leprosy
Malaria
Measles
Meningitis (acute)
Meningococcal septicaemia
Mpox (monkeypox)
Mumps
Paratyphoid fever
Plague
Poliomyelitis (acute)
Rabies
Rubella
Severe acute respiratory syndrome (SARS)
Scarlet fever
Smallpox
Streptococcal disease (Group A, invasive)
Tetanus
Tuberculosis
Typhoid fever
Typhus
Whooping cough
Yellow fever