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Soft tissue infections (3).ppt
- 1. Soft tissue infections Doneby : Abdulhadi T. Gelaidan Supervised by ; Dr.Majed Mansouri
- 2. Content of lecture: •Antibiotics use
- 3. Content of lecture: •Antibiotics use • Relation between infection and body.
- 4. Content of lecture: •Antibiotics use • Relation between infection and body. • Important bacteria in General surgery.
- 5. Content of lecture: •Antibiotics use • Relation between infection and body. • Important bacteria in General surgery. • Important antibiotics in G.S.
- 6. Content of lecture: •Antibiotics use • Relation between infection and body. • Important bacteria in General surgery. • Important antibiotics in G.S. • Types of soft tissue infections
- 7. Antibiotics use • Prophylaxis: indications - Increase in risk of infect. -Wound classes. -Infection = Disaster e.g : infected heart valve
- 8. What are therisk of infection?
- 9. • Wound classes •Immune deficiency • Medications steroids • Chronic illness • Nutritions • Old Age What are the risk of infection?
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- 12. Wound classifications • Cleanwounds • Clean-contaminated
- 13. Wound classifications • Cleanwounds • Clean-contaminated • Contaminated
- 14. Wound classifications • Cleanwounds • Clean-contaminated • Contaminated • Dirty
- 15. Risk of infection •Wound classes • Immune deficiency • Medications steroids • Chronic illness • Nutritions • Old Age
- 16. Risk of infection 1-Host: -Diet – vit.C . -Extreme age. -Chronic illness. -D.M, CLD, CRF -Medications: Steroid -Impaired immunity: HIV 2-Infection agent : 3-Battle ground wound : -Ischemia -Necrosis -Gangreneous -Decrease WBC ,Abs -Virulence -Numbers
- 17. 1-Host : -Diet –vit.C . -Extreme age. -Chronic illness. -D.M, CLD, CRF -Medications: Steroid -Impaired immunity: HIV Risk of infection 2-Infection agent : 3-Battle ground wound : -Ischemia -Necrosis -Gangreneous -Decrease WBC ,Abs -Virulence -Numbers
- 18. Risk of infection 1-Host: -Diet – vit.C . -Extreme age. -Chronic illness. -D.M, CLD, CRF -Medications: Steroid -Impaired immunity: HIV 2-Infection agent : 3-Battle ground wound : -Ischemia -Necrosis -Gangreneous -Decrease WBC ,Abs -Virulence -Numbers
- 19. Risk of infection 1-Host: -Diet – vit.C . -Extreme age. -Chronic illness. -D.M, CLD, CRF -Medications: Steroid -Impaired immunity: HIV 2-Infection agent : 3-Battle ground wound : -Ischemia -Necrosis -Gangreneous -Decrease WBC ,Abs -Virulence -Numbers
- 20. Important Bacteria inG.S COCCi BACILLI Gram + ve : Gram – ve : Gram + ve : Gram – ve :
- 21. Important Bacteria inG.S COCCi BACILLI Gram + ve : Gram – ve : Gram + ve : Gram – ve : Gram + ve : - Stapylococci -Streptcocci -Enterococcus -Peptostreptococcus
- 22. Important Bacteria inG.S COCCi BACILLI Gram + ve : Gram + ve : Gram – ve : Gram + ve : - Stapylococci -Streptcocci -Enterococcus -Peptostreptococcus Gram – ve : -Acinetobacter -Moraxella -Neisseria
- 23. Important Bacteria inG.S COCCi BACILLI Gram + ve : Gram – ve : Gram + ve : - Stapylococci -Streptcocci -Enterococcus -Peptostreptococcus Gram – ve : -Acinetobacter -Moraxella -Neisseria Gram + ve : -bacillus -clostridium -corynebacterium -lactobacillus -Listeria -Propinobacterium
- 24. Important Bacteria inG.S COCCi BACILLI Gram + ve : - Stapylococci -Streptcocci -Enterococcus -Peptostreptococcus Gram – ve : -Acinetobacter -Moraxella -Neisseria Gram – ve : -Pseudomonas -E.coli -Shigella -Salmonella -Klebsilla -Bacteroids -Helicobacter -Campylobactur -Fusobacterium -Proteus -Prevottella -Providencia -Serratia -Vibrio -Yersinia -Bartonella -Bordetella -Brucella -Francisella -Hemophilus -Legionella -Pasteurella Gram + ve : -bacillus -clostridium -corynebacterium -lactobacillus -Listeria -Propinobacterium
- 25. Important Bacteria inG.S G+ve Anaerobic - Clostridium tetani - Clostridium perfringes - Clostridium defficuili - Clostridium botulinium -Bacteroides -Fusobacterium -Prevotella G-ve Anaerobic
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- 27. Penecillins • Bacteria coverage: Gram (+) Cocci, C.perfringens. • Used in: cellulites & carbuncle Synthetic & combined
- 28. But what arethe problem with PENECILLINS ?
- 29. But what arethe problem with PENECILLINS ? • Limited spectrum
- 30. But what arethe problem with PENECILLINS ? • Limited spectrum • Resistance
- 31. Cephalosporine Action: cell wallinhibitors. Cephalosporines 1st generation 2nd gene. PC-TRX 3rd gene. Any cef. Out of PC-TRX 4th gene. Cefazoline Cephalexin cefadroxil Cefprozil PO Cefaclor Cefotetan Cefuroxime I.M-I.V Cefoxitin Ceftazidime which Pass through BBB Cefepime Mainly Gram + G-,G+,Anaerobic Mainly Gram - G-,Anaerobic Pseudomonus, Anaerobic
- 32. Aminoglycosides • Bacteria coverage: G (+)cocci & G ( - )bacilli • Sub group : Gentamicin, Tobramycin ,Amikacin ,Neomycin ,Streptomycin • Execreted by: kidney • Side effects: Renal toxicity and Ototoxicity
- 33. Nalidixic acid,Ciprofloxacine, Norfloxacin, Ofloxacin,Moxifloxacin ,Levofloxacin • G(- ve) • Most active against pseudomonas Subtypes: Azithromycine, Erythromycine , Clarithromycin ,Telithromycin Bacteria coverage : G (+)cocci & G ( - )bacilli Macrolides Fluoroquinolones
- 34. Bacteria coverage :Broad spectrum Subtypes: merupenum - imipenem Contra indication: panceriatitis-seizure – not allowed to given by doctors less than R5 Carbapenems
- 35. Clindamycine Bacteria coverage: Anaerobic& G +ve cocci
- 36. Vancomycine • Bacteria coverage: MRSA,G + ve. • Used in: prosthetic valve ,dialysis catheter
- 37. Augmantin combination antibiotic containingamoxicillin trihydrate, a β- lactam antibiotic, with potassium clavulanate, a β- lactamase inhibitor. This combination results in an antibiotic with an increased spectrum of action and restored efficacy against amoxicillin-resistant bacteria that produce β-lactamase.
- 38. Bactrim (septrin) • combinationof trimethoprim and sulfamethoxazole
- 39. Tazocin • Piperacillin isan extended spectrum beta-lactam antibiotic of the ureidopenicillin class. • It is normally used together with a beta-lactamase inhibitor such as tazobactam. The combination drug of piperacillin and tazobactam • Its main uses are in intensive care medicine (pneumonia, peritonitis), some diabetes-related foot infections and empirical therapy in febrile neutropenia (e.g. after chemotherapy).
- 40. Soft tissue infections Superficial(skin and subcutanous) :- -Boils -Folliculitis -Impetigo -Erysipelas -Cellulitis -Abcess -Carbuncle Deep ( Fascia & Muscle) :- -Necrotizing Fasciitis -Gas gangrene Organs :- -Cholecystitis -Appendicitis
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- 42. Superficial (skin and subcutanous) 1-Boils : it is infection of single hair follicle 2- Folliculitis Folliculitis is a infection of group of hair follicles;
- 43. Impetigo 3- Impetigo : staphylococcus, streptoccus infection which presented with honey crust skin after blisters rupture. Rx : by direct washing, topical Abcs , oral Abcs
- 44. Erysipelas 4 –(localized cellulitis)sharply demarcated streptcoccal infection of lymphatic vessels, usually associated with broken skin on face, erythema, Oedema do --- C/S Rx : broad spectrum Abcs
- 45. 5-Cellulitis - Is adiffuse inflammation of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin. Cellulitis can be caused by normal skin flora or by exogenous bacteria, and often occurs where the skin has previously been broken.
- 46. 6-Skin Abcess - Isa collection of pus (dead neutrophils) that has accumulated in a cavity formed by the tissue in which the pus resides on the basis of an infectious process (usually caused by bacteria or parasites)
- 47. 7-Carbuncle - Is anabscess larger than a boil, usually with one or more openings draining pus onto the skin.
- 48. Deep ( Muscle& Fascia) 1- Necrotizing fasciitis : Flesh-eating disease or Flesh-eating bacteria syndrome, is a infection of the deeper layers of skin and subcutaneous tissues, easily spreading across the fascial plane within the subcutaneous tissue
- 49. 2 – Gasgangrene : is a bacterial infection that produces gas tissues in gangrene. It is a deadly form of gangrene usually caused by anaerobic bacteria. It is a medical emergency. Deep ( Muscle & Fascia)
- 51. Deep organs - Appendicitis. -Acute cholecystitis