抗生素PPT课件（英文精品）SURGICAL INFECTIONS .pptVIP

TETANUS Cl. Tetani, produce neurotoxin Penetrating wound ( rusty nail, thorn ) Usually wound healed when symptoms appear Incubation period: 7-10 days Trismus- first symptom, stiffness in neck back Anxious look with mouth drawn up ( risus sardonicus) Respiration swallowing progressively difficult Reflex convulsions along with tonic spasm Death by exhaustion, aspiration or asphyxiation TETANUS Treatment: wound debridement, penicillin Muscle relaxants, ventilatory support Nutritional support Prophylaxis: wound care, antibiotics Human TIG in high risk ( un-immunized ) Commence active immunization ( T toxoid) Previously immunized- booster 10 years needs a booster dose booster 10 years- no treatment in low risk wounds PSEUDOMEMBRANOUS COLITIS Cl. Difficile Overtakes normal flora in patients on antibiotics Watery diarrhea, abdominal pain, fever Sigmoidoscopy: membrane of exudates (pseudomembranes) Stool- culture and toxin assay Treatment : stop offending antibiotic oral vancomycin/ metronidazole rehydration, isolate patient Body Cavity Infection Primary peritonitis: Spontaneous Children, Ascitic Haematogenous/ lymphatic route Antibiotic Secondary peritonitis: Inflam./ rupture of viscera Polymicrobial Investigations: blood, radiological Treatment of original cause Prosthetic Device Related Infection Artificial valves and joints Peritoneal and haemodialysis catheters Vascular grafts Staphylococcus aureus Antibiotics, washing of prosthesis or removal Hospital Acquired Infection Occurring within 48 h of hospital admission, three days of discharge or 30 days following an operation 10% of patients admitted to hospitals Spent 2.5-times longer in hospital - UK Highest prevalence in ICU- Enterococcus, Pseudomonas spp.,E coli, Stap