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samenvatting vreemd lichaam infecties
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samenvatting over het ontstaan van infecties door een vreemd lichaam
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VREEMD LICHAAMCASUS 1
Man, 34 -> auto-ongeluk
Pneumothorax, fracturen rib, femur, schedel, elleboog
Dag 1 -> intubatie & ventilatie, bortdrainage, heupprotese
Dag 6 -> koorts & katheder lijkt ontstoken (rood, vuil, etter, bloedklonters)
VERDERE BEHANDELING
Katheder verwijderen
Bloedculturen
Emperische AB starten
Dag 8 -> gram + cocci groeien van bloed & kathederstalen (wijst op CLABSI)
! CLASBI: central line associated blood stream infection !
REDEN VOOR CLABSI
Huid beschadigen -> entry poort maken, huid kolonisators inbrengen
Vreemd lichaam -> productie biofilm, minder lokale immuniteit, geen AB werking
Intravasculair lichaam -> direct toegang systemische circulatie, verspreiding naar rest
Meest waarschijnlijk punt van intrede: ingangspunt, schakelstuk
STAPHYLOCOCCI
STAPHYLOCOCCI AUREUS
MSSA
MRSA
Veroorzaakt community & ziekenhuisinfecties
SSI, abcessen, CLABSI, endocarditis
COAGULASE NEGATIEVE STAPHYLOCOCCI (CNS)
Minder virulent
Epidermidis, saprofyticus, capitis, lugdunesis
Ziekenhuisinfecties
Kolonisatie & infectie van katheder & materiaal
ANDERE VERWEKKERS VAN CLABSI
Streptococci & entercocci
Pseudomonas aergunosa
Serratia & enterobacteriace
Candida
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