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WOUND INFECTION IDENTIFICATION

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WOUND INFECTION IDENTIFICATION Powered By Docstoc
					 Hassan Mohammad Eisa.
BSc,CLS(NCA ), MSc In Clinical Microbiology
        Department Of Microbiology
            College of Medicine
      King Faisal University,Dammam
         Kingdome Of Saudi Arabia
                 Dammam
       WOUND INFECTION
          IDENTIFICATION
Definition
          Superfical incisional infection
          Surgical site infections
           Deep inciaional infections
          Organ space infections
                   Terminology

Wound contamination: The presence of bacteria
 within a wound without any host reaction.
Wound colonization: The presence of bacteria within
 the wound which do multiply or initiate a host reaction.
Critical colonization: Multiplication of bacteria causing
 a delay in wound healing, usually associated with an
 exacerbation of pain not previously reported but still with
 no overt host reaction.
Wound infection: The deposition and multiplication of
 bacteria in tissue with an associated host reaction.
          PREDISPOSING FACTOR

General factors (age,malnutrition,hypoxia,anaemia,maligant
   disease,immunosupression.)

Local factors (necrotic tissue,foreign bodies,tissue
   ischaemia,haematoma formation and poor surgical technique)

Microbiological contamination
(Type, virulence, size,direct contact,self-contamination, antibiotic resistance of
   organism and airborne dispersal )
           WOUND PATHOGENS

Potential wound pathogens
 Bacteria :
 Gram-positive cocci (GAS,GDSand staph-aurus/MRSA)*
 Gram-negative aerobic ( p- pseruginosa).
 Gram-negative facultative.
  (Enterobacter sps,E-coli,k-sps and Prot-sps)
 Anaerobes( Bacteroides and cl).
 Fungi: (Yeast and Aspergillus).
 Protozoa and Viruses.
         SPECIMEM COLLECTION

The proper collection of specimen for
 culture is possibly the most important step:
 It must be from the actural site with a sterile syring or
    swab.
    Optimal times for collection.
    Sufficient amount of sp.
    Appropriate collection devices.
   Obtain culture before antibiotics.
    Labeling.
WOUND CULTURE IDENTIFICATION         and




 When and how to take or collect the specimen?
 Types of specimens:
    Purulent discharge.
    Biopsy.
    Needle aspiration.
    Dry sterile filter paper.
 PROCEDURE:
 Inculation on different types of culture plates.
 Incubation at 37C for 1-2days (Bacteria). and 3-5days ,in case a
  mold or yeast .
 Vitek.
 Microscan System.
 Gas – Liquid Chromatography (GLC)
            GRAM--STAIN

Preparation & Fixation of the smear.
Procedure of the stain:
Crystal violet. (primary staining)
Iodine solution
Decolorization (destaining) by ethanol.
Counter-staining by Safranin.
Wash with water, blot and dry the slide.
Exam microscopically.
Gram Positive COCCI
Gram Negative Rods
                      PREVENTION
•   The prevetion of wound infection should be a primary management
    objective for all healthcare practitioners.
Exogenous
            sterilisation of instruments.
            postive pressure ventilation of operating theatres.
             laminar air flow in high risk areas.
             exclusion of staff with infections.
             hand washing.
             proper way of using gloves.
Endogenous
            skin preparation.
            mechanical bowel preparation.
            antibiotic prophylaxis.
            good surgical technique .
             CONCLUSIONS

 Infections of the surgical wound are the most
  common hospital acquired infections causing
  morbidity and mortality.
 Decontamination first is important, using gloves
   and aseptic technique in handing and collecting
  cultural samples.
 The initial step is Gram-stain appearance.
 Infection rate can be reduced with antibiotic
  prophylaxis.

				
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posted:9/27/2012
language:English
pages:13