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41 Cards in this Set
- Front
- Back
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colonization
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the presence, growth, and multiplication of the organism without observable clinical symptoms or immune reaction.
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Infection
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refers to invasion of bacteria into tissue with replication of the organism. Infection is characterized by isolation of the organism accompanied by clinical signs of illness such as either fever, elevated white blood count, purulence (pus), pneumonia, inflammation (warmth, redness, swelling), etc
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contamination
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prophylaxis. Surgical wounds are classified by the degree of bacterial contamination (or microbial load) at the time of the procedure. Greater microbial loads result in increased infection risk. The CDC classifies wounds as clean, cleancontaminated, contaminated, or dirty in the NHSN patient safety component, SSI data collection
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Surgical Wound Classification
Clean |
- An uninfected operative wound in which no inflammation is encountered and there is no entry into the respiratory, alimentary, genital, or urinary tract
- Clean wounds are closed primarily and, if necessary, drained with closed drainage |
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Surgical Wound Classification
Clean-contaminated |
- Operative wounds in which the respiratory, alimentary, genital, or urinary tracts are entered under controlled conditions and without unusual contamination
- No evidence of infection is encountered or major break in technique occurs |
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Surgical Wound Classification
Contaminated |
- Open, fresh accidental wounds
- Operations with major breaks in sterile technique or gross spillage from the gastrointestinal tract - Incisions in which acute, non-purulent inflammation is encountered |
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Surgical Wound Classification
Dirty or infected |
-Old traumatic wounds with retained devitalized tissue
- Existing clinical infection or perforated viscera is encountered - This definition suggests that the organisms causing postoperative infection were present in the operative field prior to the procedure |
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Epidemiology (EPI)
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The study of the relationships of the various factors determining the frequency and distribution of disease in a human community.
• The field of medicine concerned with the determination of the specific causes of localized outbreaks of infection, such as hepatitis, or toxic disorders, such as lead poisoning, or any other disease of recognized etiology. |
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Normal Flora
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Anywhere our bodies contact the
environment, microorganisms have set up a niche/biocommunity that is in a dynamic state through their lifetimes and ours • We have thousands of bacteria that normally live on these surfaces (skin, GI, GU, lungs, oro-/naso-pharnyx) without causing disease |
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Respiratory Tract Normal Flora
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Alpha Streptococcus
Staph aureus Coagulase Neg Staph Neisseria Haemophilus Moraxella Corynebacterium Micrococcus Candida |
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(GU) Tract Normal Flora
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– Corynebacterium
– Lactobacillus – Staphylococcus – Neisseria – Enteric rods – Gardnerella – Enterococcus – Mycoplasma – Ureaplasma – Propionibacterium – Candida – Mixed anaerobes |
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Gastrointestinal (GI) Normal Flora
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– Lactobacillus
– Enterococcus – Enteric rods – Corynebacterium – Streptococcus – Staphylococcus – Propionibacterium – Candida – Mixed anaerobes |
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Skin, Ear, and Eye Normal Flora
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– Corynebacterium
– Staphylococcus – Micrococcus – Neisseria – Propionibacterium – Peptostreptococcus – Candida – Mucor – Absidia |
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John Huss
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15th
Bohemia (Czech) Influenced by Wycliff, emphasizing right living over the sacraments. Opposed veneration of images and indulgences. Was burned at the stake. Reformer of Catholic Church |
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Toxins
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• Endotoxins
– Gram negative cell wall – Not destroyed by boiling or autoclaving • Exotoxins – Secreted by gram positive – More susceptible to heat but variable – Neutralized by specific antibody |
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Endotoxins
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– Gram negative cell wall
– Not destroyed by boiling or autoclaving |
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Exotoxins
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– Secreted by gram positive
– More susceptible to heat but variable – Neutralized by specific antibody |
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Immunity
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The resistance of a host to a specific agent,
characterized by measurable and protective surface or humoral antibody and by cell-mediated immune responses... • Active – Naturally-acquired--resolved infection – Artificially induced--vaccination, immunization • Passive – Naturally-acquired--maternal antibodies – Artificially introduced--serum immune globulin |
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Active Immunity
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– Naturally-acquired--resolved infection
– Artificially induced--vaccination, immunization |
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Passive Immunity
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– Naturally-acquired--maternal antibodies
– Artificially introduced--serum immune globulin |
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Primary organs of
the immune system |
Tonsils & adenoids
Lymph nodes Thyamus Spleen Peyer's patches Appendix Bone Marrow Lymphatic vessels |
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Bacteria
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Gram positive
– Gram negative – Aerobes – Anaerobes – Chlamydiae, Mycoplasmae, Ureaplasmae and Ricketsiae – Spirochetes – Mycobacteria |
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Microorganisms Basic Groups
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Bacteria
Viruses Fungi Parasites Prions-”slow viruses |
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Microbiology Staining
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• The characteristics of
the bacterial cell wall is what determines the staining pattern • Knowing the staining pattern then tells us some basic characteristics of the organism that may allow empiric therapy |
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2 basic Gram stain reactions
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• Positive = Purple/Blue
• Negative = Red/Pink |
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3 basic shapes for bacteria
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• Cocci
• Baccili/Rods • Spiral-shaped |
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Why do we need the Gram
stain? |
• By knowing the shape and Gram staining
reaction of the organism, along with the site from which the specimen was obtained, we can make a reasonable guess as to a causative agent. • This reasonable guess, in the face of signs and symptoms of infection, will allow for the empiric selection of antibiotics immediately, while awaiting culture results |
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AFB stains
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Acid fast bacilli stains are predominantly the
mycobacteria, but are occasionally positive (or partially positive) for other bacteria (e.g. Nocardia sp.) |
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Techniques in ID of Organisms
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• Light Microscopy
• Electron Microscopy |
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Physical conditions required for growth
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–Nutrition (types of media)
– Temperature (pathogens 35°C) –Aerobe or anaerobe |
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Specimen preparation
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–Direct examination
–Differential fixed staining |
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Physical conditions required for growth
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–Nutrition (types of media)
– Temperature (pathogens 35°C) –Aerobe or anaerobe |
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Laboratory Culture Media
Blood agar |
broad array of bacteria
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Laboratory Culture Media
Chocolate agar |
Haemophilus, Neisseria
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Laboratory Culture Media
Lowenstein-Jensen |
Mycobacterium
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Laboratory Culture Media
MacConkey |
gram negative
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Laboratory Culture Media
Bile esculin |
group D Strep
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Laboratory Culture Media
Thayer-Martin |
N. gonorrhoeae
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Laboratory Culture Media
Charcoal yeast |
Legionella
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Laboratory Culture Media
Ziehl-Neelsen |
Mycobacterium (AFB)
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Fungal diagnosis
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morphologypresence
of hyphae, size of yeast, presence of capsule and form (branching or septations) |
