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I.Microbial InfectionMicroorganisms can be found internal or externalThey can be harmful or beneficialThey become harmful when conditions become altered in some wayUsually able to resist due to normal defenses Physical barriers- skin and mucosa membranesPhysiologic defenses- gastric acids, antibodiesPhagocytic cells- macorophagesA.BacteriaMorphology- can take a number of different shapes and is the main means of classificationMaybe grouped by other means such as gram stain1.Gram Positive – Stain purpleVery thick cell walls- peptidoglycanMay have thick outer capsule2.Gram Negative- stain redComplex cell wallsOuter capsule and peptidoglycan layerTwo membranes- outer and innerMore difficult to treat due to complex walls
B.InfectionResults from normal host cells defenses being compromised Invades multipliesoverwhelms defense systemclinically apparent S&SFever, chills, redness, sweat, pain, swelling, fatigue, weight loss, increase WBC, pusAntibiotics are often required to assist normal defenses but not always neededWhen a host is colonoized but shows no S&S treatment is not required but is often ddone anyways and results in antibiotic resistant microbes. 1.community associated infection- defined as an infection that acquired by a person who has not recently been hospitalized or had a medical procedure2.Health Care-associated infection-Previously known as nosocomial infectionthat a patient acquired during the course of receiving treatment for another condition in a health care facility.Occurs more than 48 hours after admissionMore difficult to treat cause organisms are often drug resistant and most virulentTop 10 leading cause of death in USMRSA; methicillin-resistantStaphylococcus aureus being the most commonEnterococcus, Klebsiella, Acinetobacter, Pseudomonas aeruginosaMost are UTI or post-op wound infections Areas most common for these type of infections; Critical Care, dialysis, oncology, transplant and burn units. – (due to immunocompromised pts)Prevention- 70% are preventable and most common transmission by direct contact HAND WASHING the single most important thing Disinfectant- able to kill organisms and is used only on nonlivingorganisms that may be present; cidal agents Antiseptics- generally only inhibits the growth of organisms, not necessarily kills them. Applied exclusively to living tissue; static agentsBactericidal- kills bacteriaBacteriostatic- inhibits growth of bacterial rather than killing them immediately; eventually leads to bacterial deathII.Pharmacology Overview - AntibioticsAntibiotics have three general uses:A.Empiric therapy-Treatment of an infection before specific culture information has been provided. The antibiotic selected is one that can best kill the microorganisms known to be the most common cause of the infection.