Microbiology Nuts & Bolts
  • Home
  • Basic Concepts
    • What is infection?
    • Normal flora
    • Diagnosing infection
  • Microbiology
    • Basic bacterial identification
    • Interpreting bacteriology results
    • Interpreting serology results
  • Infection Control
    • What is infection control?
    • Universal precautions
    • MRSA
    • Clostridium difficile
  • Clinical Scenarios
    • Respiratory infections
    • Urinary infections
    • GI infections >
      • D&V
      • CDAD
    • CNS infections
    • Skin & bone infections
    • Sepsis
  • Antibiotics
    • Antimicrobial Stewardship
    • How antibiotics work
    • How to choose an antibiotic?
    • Reviewing antibiotics
    • Antibiotic resistance
    • Testing antibiotic resistance
    • Penicillin allergy
    • Theraputic Drug Monitoring
  • Guidelines
  • Lectures & Lecture Notes
    • Medical Students
    • Curriculum for the Foundation Program
    • Foundation Year 1
    • Foundation Year 2
    • Other Lectures
  • The Bug Blog
  • Buy the book...
  • NEW Edition Updates
  • Peer Reviews
  • Want to know more?
  • Contact

Sepsis

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is sepsis with circulatory, cellular or metabolic dysfunction, and has a high mortality.
 
Sepsis and septic shock are clinical diagnoses not laboratory diagnoses:
  • Sepsis - infection with evidence of a systemic response to that infection e.g. hypoxia, oliguria, confusion
  • Septic shock - sepsis associated with organ dysfunction, hypoperfusion or hypotension
 
Sepsis and septic shock are medical emergencies and early recognition and treatment improve survival.
 
Risk Factors for Sepsis
  • Age <1 year or >75 years
  • Frailty or comorbidities e.g. diabetes, renal failure, liver failure
  • Trauma, surgery or other invasive procedure within 6 weeks
  • Immunosuppression
  • Intravascular device
  • Breaches to skin integrity e.g. cuts, burns, blisters
  • Current or recent pregnancy (within 6 weeks)
Sepsis Clinical Features
Sepsis SOFA Score
Sepsis Warning Septic Shock Vasopressors
Sepsis Hints & Tips qSOFA score
Causes
Common

• Staphylococcus aureus
• Enterobacteriaceae e.g. Escherichia coli, Klebsiella sp., Enterobacter sp.,
• Pseudomonas sp.
• Neisseria meningitidis
Investigations
​• Blood cultures
• Urine for microscopy, culture and sensitivity if able
• Do not unduly delay treatment as mortality increases
Treatment
Antibiotics should be given within 1 hour of the diagnosis of sepsis (see section – Emergencies, Adult Sepsis “Golden-Hour” Management Flowchart)
Sepsis Treatment Adults
In addition to antibiotics a source of sepsis should be identified and managed as soon as possible e.g. removal of infected CVC, drainage of abscess, repair of perforated abdominal viscus.
​
For Children (see section – Emergencies, Initial Management of Meningococcal Sepsis in Children)
Sepsis Treatment Children
Total Duration
7-10 days
Unless a causative microorganism or focus of infection requires longer treatment e.g. Staphylococcus aureus bacteraemia, listeriosis or meningitis (see section – Antibiotics, Adult Empirical Antibiotic Guidelines)

Dosing
See section - Antibiotics, Empirical Antibiotic Guidelines Emergencies.
Sepsis Warning Mortality
Adult Sepsis Golden Hour Flowchart
Microbiology Nuts & Bolts on Amazon
Topics in Clinical Scenarios - Emergencies:
  • How to Recognise the Sick Patient
  • National Early Warning Score (NEWS)
  • Paediatric Early Warning Score (PEWS)
  • Sepsis
  • Adult Sepsis “Golden-Hour” Management Flowchart
  • Neutropaenic Sepsis and Febrile Neutropaenia
  • Neutropaenic Sepsis Antibiotic Flowchart
  • Toxic Shock Syndrome (TSS)
  • Meningitis
  • Meningococcal Sepsis
  • Initial Management of Bacterial Meningitis and Meningococcal Sepsis in Adults
  • Initial Management of Bacterial Meningitis in Children
  • Initial Management of Meningococcal Sepsis in Children
  • Encephalitis
  • Epiglottitis
  • Spinal Epidural Abscess
  • Necrotising Fasciitis
  • Malaria
​​
​All these topics are covered in the book...Ready to buy your copy? Click here to buy your copy of "Microbiology Nuts & Bolts" Its updated and amazingly only slightly larger considering its got 1/3 more in it! (11cmx18cmx2.5cm).

Powered by Create your own unique website with customizable templates.