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Bacteremia & septicemia

Bacteremia & septicemia. Bacteremia. Bacteremia is the invasion of  bloodstream by bacteria. The blood is normally a  sterile, so detection of bacteria in the blood is always abnormal.

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Bacteremia & septicemia

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  1. Bacteremia & septicemia

  2. Bacteremia • Bacteremiais the invasion of bloodstream by bacteria. • The blood is normally a sterile, so detection of bacteria in the blood is always abnormal.

  3. Systemic inflammatory response syndrome (SIRS): Two or more of these: Fever, high or low WBCs count, tachycardia and tachypnea. • Septicemia (sepsis) : invasion of bloodstream by virulent microbe and its toxins which results in acute systemic illness (SIRS and culture-documented infection). • Septic shock: A medical emergency caused by decreased blood and oxygen supply to organs and tissues as a result of inflammatory response to blood sepsis. It may cause Multiorgan dysfunction syndromeand death.

  4. Bacteremia, Septicemia, and SIRS: • N

  5. N • Themortality rate from septic shock is approximately 25%-50%. • Clinical presentation of SIRS: • Rapid breathing (Respiratory rate > 20/min),  • fever > 38 Cᴼ, • Heart rate > 90 beats/min, • WBCs > 12000 cells/ µl.

  6. Microbial virulence and pathogenesis(Sepsis and septic shock): • The Gram negative lipopolysaccharide, crosslink soluble CD14 and attract neutrophil, monocytes & B lymphocytes. • Cytokines production in bloodstream; (IL-1, IL-8, IL-12, TNF). These cytokines promotes fever and capillary vasodilation leading to edema formation, hypotension and hypoperfusion, and increased smooth muscle contraction of respiratory tract.

  7. N

  8. Sources of Bacteremia: • Indwellingcatheters, dental procedures, UTI, respiratory tract infection, GIT infection, intravenous drug use, contaminated endoscopy or colonoscopy, post-operative infection. • Why should we know the source of infection? • To guess the type of bacteria and start treatment

  9. Bacterial Causes of Bacteremia & Sepsis: • Gastrointestinal infection: Typhoid fever (Salmonellosis), Malta fever (Brucellosis), Yersinia and Bacteroid fragilis. • Genitourinary tract infection: Staphylococcus aureus, E.coli, Klebsiella, citrobacter, enterobacter, pseudomonas species and Treponema pallidum.

  10. Respiratory tract infection: Neisseria meningitidis, H. influenza, Streptococcus pneumoniae, MRSA, vancomycin resistant enterococci (VRE), and Klebsiella pneumonia. • Skin infection: S.aureus.

  11. N Diagnosis of endocarditis and Bacteremia: Blood culture: • Withdraw 5-8 ml of blood for culture under aseptic conditions. • Specimens are better withdrawn during fever stage. • Inoculate blood culture bottles, and incubate them under aerobic and anaerobic conditions at 37C for up to 8 days. • a minimum of 2 sets of blood cultures should be cultured from different venipuncture sites spaced over 30 - 60 minutes.

  12. Blood culture procedure: N

  13. Blood culture growth indicators: • Turbidityof blood culture media. • Air bubbles formation in the media. • Hemolysisof cultivated blood.

  14. Identification of pyogenic Cocci isolated from Blood culture: n

  15. Staphylococcus species: DNasepostive Staphylococcus aureus Coagulase positive

  16. N Streptococcusviridansspecies are resistant to Optichin and insoluble in bile salt.

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