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Bacterial Sepsis

Bacterial Septicemia


Presentation

  • Bacterial infections present in many ways, depending on the part of the body affected.[sepsis.org]
  • Splanchnic blood flow is also affected and primarily shunted to other organs, especially once hypotension is present.[ncbi.nlm.nih.gov]
  • The present study showed that more than half of the patients hospitalized due to primary diagnosis of sepsis, actually had no sepsis.[ncbi.nlm.nih.gov]
  • University Hospital NHS Trust Full Title: Evaluation of Corticosteroid therapy in Childhood Severe Sepsis (Steroids in Paediatric Sepsis, StePS) - a randomised pilot study Medical condition: Children with severe sepsis requiring mechanical ventilation presenting[clinicaltrialsregister.eu]
Congestive Heart Failure
  • Comorbidities associated with morbidity and mortality in sepsis include active cancer, diabetes, chronic lung disease, congestive heart failure, renal insufficiency, and liver disease(cirrhosis).[ncbi.nlm.nih.gov]
Anemia
  • […] systems related to their condition in order of prevalence: Lungs manifesting as acute respiratory distress syndrome (ARDS), Cardiovascular as septic shock (hypotension) Kidneys as acute kidney injury (AKI) Brain as septic encephalopathy Bone marrow as anemia[ncbi.nlm.nih.gov]
Wound Infection
  • [PCR detection of PER & amp; VEB & amp; SHV and TEM β-lactamases in multidrug resistant P. aeruginoasa isolated from wound infections in two hospitals of Tehran]. Iran J Med Microbiol. 2008; 1 (4):21–7. [ Google Scholar ] 15.[ncbi.nlm.nih.gov]
Tachypnea
  • SIRS SIRS includes 2 or more of the following: Temperature greater than 38 C or less than 36 C Heart rate greater than 90 beats per minute Tachypnea greater than 20 breaths per minute or PaCO2 less than 32 mm Hg White blood cell (WBC) count greater than[ncbi.nlm.nih.gov]
Hypotension
  • Splanchnic blood flow is also affected and primarily shunted to other organs, especially once hypotension is present.[ncbi.nlm.nih.gov]
Dental Abscess
  • Other types of bacterial infections include urinary tract infections (including bladder and kidney infections) and dental abscesses, as well as infections caused by MRSA, Group B Streptococcus, and C. Difficile.[sepsis.org]
Withdrawn
  • This was not the case as it was withdrawn from the market after further studies were published showing no benefit and potentially worse outcomes.[ncbi.nlm.nih.gov]
Stroke
  • With low preload and afterload, cardiac output (CO) must increase to compensate, typically with increased heart rate (CO Stroke Volume x Heart Rate).[ncbi.nlm.nih.gov]
Oliguria
  • Sepsis SIRS as the result of an infection Severe Sepsis Sepsis associated with organ dysfunction (1 or more), hypo-perfusion abnormality, or sepsis-induced hypotension Hypo-perfusion abnormalities may include but are not limited to lactic acidosis, oliguria[ncbi.nlm.nih.gov]
Cloudy Urine
  • urine – it may contain blood Fever The common element with most bacterial infections are: Fever Chills Pain or discomfort in the affected area But if the infection is in a joint, that joint and the surrounding area will likely hurt; if you have a sinus[sepsis.org]

Workup

  • […] dysfunction Chest x-ray and urinalysis Either can be ordered to investigate for possible sources of infection Blood Cultures with or without other potential source cultures At least 2 blood cultures are recommended, before administering antibiotics Optional workup[ncbi.nlm.nih.gov]
Staphylococcus Aureus
  • The most common isolated microorganisms were: Staphylococcus aureus (16/35, 45.7%), Escherichia coli (10/35, 28.5%), Klebsiella pneumonia (4/35, 11.4%), Pseudomonas aeruginosa (8/35, 22.8%), and coagulase-negative staphylococci ( S. epidermidis and S.[ncbi.nlm.nih.gov]

Treatment

  • Treatment of sepsis in the ICU as in the internal ward was inappropriate, whereas in the infectious diseases ward, the treatment was mostly appropriate (12/61, 19.7% vs. 61/98, 62.2%).[ncbi.nlm.nih.gov]
  • Treatment Most often, treatment for a bacterial infection is with antibiotics. They could be taken orally (by pill, liquid or capsule), injection, drops, topical (cream or ointment), or intravenously (by IV).[sepsis.org]
  • The Surviving Sepsis Campaign (SSC) and its accompanying treatment bundle were developed with the intention of rapid identification and treatment of septic patients.[ncbi.nlm.nih.gov]
  • Trial results: (No results available) EudraCT Number: 2017-000717-24 Sponsor Protocol Number: 230390 Start Date * : 2017-08-24 Sponsor Name: Aarhus University Hospital Full Title: Concentration of piperacillin in plasma and subcutis in patients on crrt treatment[clinicaltrialsregister.eu]
  • The mortality rate for septic shock is high, therefore early diagnosis and treatment are extremely important. Premature infants and the elderly are particularly susceptible to sepsis.[sysmex.co.jp]

Prognosis

  • It is therefore a biomarker with high clinical value and is expected to contribute to the earlier diagnosis of bacterial sepsis and help achieve a more accurate prognosis. * Since January 1, 2014, the presepsin test has been covered by health insurance[sysmex.co.jp]
  • Important markers for disease severity and prognostic implications, such as the SIRS or qSOFA criterion, have been able to provide some framework for treatment as well as insight into prognosis for affected patients.[ncbi.nlm.nih.gov]
  • Prognosis of sepsis depends on several factors such as the underlying diseases, immune status, and early appropriate empirical treatment with effective antibiotics ( 8 ).[ncbi.nlm.nih.gov]

Etiology

  • Intensive care unit-acquired urinary tract infections in patients admitted with sepsis: etiology, risk factors, and patterns of antimicrobial resistance.[ncbi.nlm.nih.gov]
  • Etiology The inflammatory response that leads to clinical syndromes such as sepsis is triggered by conditions that threaten the functional integrity of the host, in this case, microbial invasion.[ncbi.nlm.nih.gov]

Epidemiology

  • Vital Signs: Epidemiology of Sepsis: Prevalence of Health Care Factors and Opportunities for Prevention. MMWR Morb. Mortal. Wkly. Rep. 2016 Aug 26; 65 (33):864-9. [ PubMed : 27559759 ] 12. Dantes RB, Epstein L.[ncbi.nlm.nih.gov]
  • Sepsis: definition, epidemiology, and diagnosis. BMJ. 2007; 335 (7625):879–83. doi: 10.1136/bmj.39346.495880.AE. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ] 21. McGowan JE., Jr..[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • It was not until the further widespread use of antibiotics and the discovery of endotoxin that suggested the pathophysiology of sepsis was far more complex. [3] [4] Despite the increased understanding of this complex disease process, mortality from sepsis[ncbi.nlm.nih.gov]

Prevention

  • Prevention Not all infections can be prevented, but the chances of spreading bacterial infections can be greatly reduced by following these tips: Wash your hands often, particularly if you are in a healthcare facility. Keep wounds clean and covered.[sepsis.org]
  • Vital Signs: Epidemiology of Sepsis: Prevalence of Health Care Factors and Opportunities for Prevention. MMWR Morb. Mortal. Wkly. Rep. 2016 Aug 26; 65 (33):864-9. [ PubMed : 27559759 ] 12. Dantes RB, Epstein L.[ncbi.nlm.nih.gov]
  • This finding is in agreement with most published studies ( 16, 17, 20 ). considering this issue when dealing with sepsis may help in administration of proper antibiotics and prevention of treatment failure.[ncbi.nlm.nih.gov]

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