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Invasive Bacterial Diseases: The Basics. What are Invasive Bacterial Diseases ?. Invasive bacterial diseases include: Neisseria Meningitidis Haemophilus Influenzae Streptococcus Pneumoniae Group B Streptococcus G roup A Streptococcus. Sterile Site:. Blood Cerebrospinal fluid
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What are Invasive Bacterial Diseases ? Invasive bacterial diseases include: Neisseria Meningitidis Haemophilus Influenzae Streptococcus Pneumoniae Group B Streptococcus Group A Streptococcus
Sterile Site: • Blood • Cerebrospinal fluid • Pleural fluid • Peritoneal fluid • Pericardial fluid • Surgical aspirate, bone, or joint fluid • Amniotic fluid • Surgically obtained tissue
Non-Sterile Site: Normal flora: • Respiratory Tract • Ear, Eye, Mouth • Skin ( Wound & Abscess) • Urine (Including Mid-Stream) • Feces
Reporting To the local health department in the patient’s county of residence within 24 hours of diagnosis: • Haemophilus influenzae, Invasive Disease • Meningococcal Disease, Invasive (Neisseria meningitidis)
Reporting To the local health department in the patient’s county of residence within 1 week of diagnosis: • Streptococcal Disease, Group A Invasive and/or Streptococcal Toxic Shock Syndrome (S. pyogenes) • Streptococcal Disease, Invasive Group B • Streptococcus pneumoniae, invasive disease --include antibiotic susceptibility patterns
What is Colonization ? Presence of an agent in a host without causing a specific immune response or infection. “Asymptomatic colonization” “Carrier State”
Carrier State Appearance of an organism of relatively high pathogenicity in the normal flora without causing disease. Examples: • 5% to 20% of the general population carry the meningococcal bacteria in the nose and throat in a relatively harmless state.
Carrier State Examples: • Group B Strep is a bacterium found in the lower intestine of healthy adults and also in the vagina of approximately 10-33% of all healthy adult women. • One of every four or five pregnant women carries GBS in the rectum or vagina without becoming ill. • Nasopharyngeal carriage with encapsulated type b strains for H. Flu ranges from 3%-5%. • As high as 50% in "closed" populations of young children, such as child care centers….CDC
Invasive Bacterial Diseases Pathogenesis Colonization of the Nose or throat, e.g. • Meningococcus • H. Influenza • S Pneumoniae • Group A Strep • Group B Strep Invasion into the bloodstream (bacteremia) Solid organ “Abscess” Pericardial fluid “Pericarditis” “Seeding” of distant sites Cerebrospinal fluid “Meningitis” Bone “Osteomyelitis” Pleural fluid “Septic pleural effusion” Synovial fluid “Septic arthritis” CDC
Bacteremia Bacteremia is an invasion of the bloodstream by bacteria. • May cause no symptoms and resolve without treatment, or • May produce fever and other symptoms of infection including septic shock.
Meningitis Meningitis is an illness in which there is inflammation of the tissues that cover the brain and spinal cord. Bacterial Meningitis: Meningitis with laboratory evidence of positive bacterial cultures from normally sterile site. CSF Pleocytosis > 5 WBC Viral Meningitis: Meningitis with no laboratory evidence of bacterial or fungal Culture from CSF. CSF Pleocytosis > 5 WBC
Meningitis Bacterial Viral Severe Less Severe Quite severe and may result in brain damage, hearing loss, or learning disability Resolves without specific treatment
Serogrouping / Serotyping Meningococcal Diseases – Serogrouping H. Influnezae – Serotyping - H. Flu Serotype b (Hib) Strep Pneumoniae – Serotyping (Capsular) Importance: • Determine if circulating strains are vaccine preventable, and • Assist with outbreak management, if necessary.
