1. Discuss the magnitude of bacteremia and sepsis in hospitalized patients and the relationship between these two diagnoses. (5 points)
Septic shock is the leading cause of death for patients in intensive care units and is the final stage in a continuum of infectious and inflammatory processes. This continuum begins with bacteremia, which is the presence of bacteria in the blood. Normally the body’s immune system can fight off a localized infection caused by a small amount of bacteria in the blood and the person will remain asymptomatic. However, a hospitalized patient could be immunocompromised, have a…show more content… The systemic inflammatory response is the next step in the continuum and is a nonspecific inflammatory state that may be seen with an infection. Sepsis is the presence of the systemic inflammatory response syndrome (SIRS) with evidence of infection. As the bacteria invade the bloodstream, they release endotoxins that damage the endothelial cell lining and impair the vascular system, coagulation mechanism, and immune system. These endotoxins also trigger the immune and inflammatory responses, which results in the activation of macrophages and CD4 cells that release proinflammatory cytokines to create a systemic inflammatory response to the pathogen. Hospitalized patients may quickly progress from bacteremia to sepsis and finally to septic shock, even with treatment.
2. What are the risk factors for infection and development of septic shock? Identify those that applied to Mr. Roberts. (5 points)
Risk factors for infection can be anything that suppresses the ability of the host to resist the infectious pathogen, including the following: drugs, such as steroids and chemotherapy; disorders that affect the innate and adaptive immune responses, such as cancer, leukopenia, and HIV/AIDS; and a breakdown of the first line of defense, such a trauma, broken skin, or surgical wounds. Patients are at risk for developing sepsis and septic shock if they are very old or very young and have and inability to fight off the infection. Some other risk factors for the