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1、SURGICALINFECTIONS&ANTIBIOTICSMKALAMMS,FRCSProf.&ConsultantSurgeonCollegeofMedicine&RCHOBJECTIVESDefinitions.Pathogenesis.Clinicalfeatures.Surgicalmicrobiology.Commoninfections.Antibioticsuse.INFECTIONInvasionofthebodybypathogenicmicroorganismsandreact
2、ionofthehosttoorganismsandtheirtoxinsSURGICALINFECTIONSInfectionsthatrequiresurgicalinterventionasatreatmentordevelopasaresultofsurgicalprocedure.SurgicalInfectionAmajorchallengeAccountsfor1/3ofsurgicalpatientsMorbidityMortalityIncreasedcosttohealthcar
3、eFactorscontributingtoinfectionsMicroorganismrelatedfactors:-Adequatedose-VirulenceofmicroorganismsHostrelatedfactors:-Suitableenvironment(closedspace)-SusceptiblehostPathogenicityofbacteriaExotoxins:specific,solubleproteins,remotecytotoxiceffectCl.Tet
4、ani,Strep.pyogenesEndotoxins:partofgram-negativebacterialwall,lipopolysaccharidese.g.,EcoliResistphagocytosis:ProtectivecapsuleKlebsielaandStrep.pneumoniaeHostResistanceIntactskin/mucousmembrane.(surgery/trauma-causesbreach)Immunity:Cellular(phagocytes
5、)AntibodiesClinicalfeaturesLocal-pain,heat,redness,swelling,lossoffunction.(apparentinsuperficialinfections)Systemic-fever,tachycardia,chillsPrinciplesofsurgicaltreatmentDebridement-necrotic,injuredtissueDrainage-abscess,infectedfluidRemoval-infections
6、ource,foreignbodySupportivemeasures:immobilizationelevationantibioticsSTREPTOCOCCIGrampositive,aerobe/anaerobeFloraofthemouthandpharynx,(bowel)Streptococcuspyogenes–(βhemolytic)90%ofinfectionse.g.,lymphangitis,cellulitis,rheumaticfeverStrep.viridens-en
7、docarditis,urinaryinfectionStrep.fecalis–urinaryinfection,pyogenicinfectionStrep.pneumonae–pneumonia,meningitisSTAPHYLOCOCCIInhabitantsofskin,GrampositiveInfectioncharacterizedbysuppurationStaph.aureus-SSI,nosocomial,superficialinfectionsStaph.epidermi
8、dis-opportunistic(wound,endocarditis)CLOSTRIDIAGrampositive,anaerobeRodshapedmicroorganismsLiveinbowel&soilProduceexotoxinforpathogenicityImportantmembers:Cl.Perfringens,Cl.Septicum(gasgangrene)Cl.Tetani(tetanus)Cl.Difficile(pseudomembr
