Page 149 Complete Your CE Test Online - Click Here allow bacteria to enter the pulp of the tooth, which houses blood vessels, nerves, and connective tissue. Subsequently, a dental abscess forms and bacteria can move out of the tooth to the bone and tissue. Infections can occur after any dental work when bacteria are introduced to a scrape or cut in the mouth following such procedures as cleanings, fillings, root canals, or tooth extractions. Patients who are more likely to develop infections during dental work include those with a joint replacement and cardiac issues. These patients are typically give a prophylactic antibiotic to prevent development of infection. Diabetes: Patients with diabetes are at risk for developing sepsis because of the tendency to have wounds and scrapes that take longer to heal and are a port of entry for bacteria. Ebola: Ebola is a virus that originated in animals and was first seen in humans in West Africa in 1976. Since that time, it has spread and has recently become a concern for travelers worldwide. As the body tries to fight the Ebola virus, sepsis often sets in, followed by septic shock. Those who die from Ebola die from complications of septic shock (Bente, Gren, Strong, & Feldmann, 2009). Gallstones: Gallstones are hard deposits that form from a collection of cholesterol or bilirubin in the gallbladder. The gallbladder stores bile from the liver to aid in digestion. Gallstones can cause the gallbladder to become inflamed and block the flow of bile, which can lead to infection. Sometimes surgery, another risk for infection, is necessary to remove the gallbladder because of gallstones that are persistent and painful. Gastrointestinal perforation: The gastrointestinal tract may become perforated by any number of conditions leading to leaking of gastrointestinal contents and causing a subsequent infection. These conditions include the following: ● ● Appendicitis. ● ● Diverticulitis. ● ● Ulcerative colitis. ● ● Toxic megacolon. ● ● Strangulated hernia. ● ● Peptic ulcer disease. ● ● Forceful vomiting. In addition, the GI tract can be perforated by a traumatic injury to the abdomen, such as a knife or gunshot wound or swallowing a corrosive or foreign object. If the contents of the GI tract leak into the abdomen, peritonitis may occur. If the perforation is in the bowel, the condition is known as perforated bowel. Group B streptococcus: Group B Streptococcus is found in the GI tract. Typically, most healthy people do not develop infections from this bacterium. Newborns are most at risk for developing an infection from group B Streptococcus, but patients who are older or immunocompromised may develop an infection from Streptococcus B in their bloodstream, lungs (as pneumonia), skin or soft tissue, or bones or joints. Health care-associated infections (HAIs): Health care-associated infections (also known as nosocomial infections) can arise from any health care setting. HAIs are common in those who are elderly, young, or immunocompromised through an exposure to a concentrated number of germs from invasive procedures. Following are the most common types of invasive procedures associated with HAIs: ● ● Central intravenous catheters (central lines): Central lines are placed in the chest, groin, or neck in large veins to administer specific treatments that cannot be given via smaller veins. There is an increased risk for infection to spread rapidly in these lines because the access to the heart is more direct. ● ● Urinary catheters: Indwelling catheters that drain urine from hospitalized patients account for nearly 75% of all urinary tract infections in the hospital. It is the most common HAI. ● ● Surgical site infection: Surgical sites, as with any breakdown in skin integrity, can be a site for bacteria to enter the body. After a patient undergoes surgery, he is at risk for developing HAIs. ● ● Ventilator-associated pneumonia (VAP): Patients mechanically ventilated are at an increased risk of bacteria entering the lungs via the endotracheal tube used to assist breathing. Common bacteria that cause HAIs include methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C. diff.), and vancomycin-resistant Enterococcus (VRE). The norovirus can also be a cause. HIV/AIDS: Sepsis is the most common cause of death in patients with HIV/AIDS. Patients with HIV/AIDS are more at risk than other patient populations are for HAIs because of weakened immune response, frequent antibiotic use, and surgical procedures. Immunocompromised: Those patients with impaired immune system functioning are obviously more susceptible to infection. Patients receiving treatment for cancer, who have had a splenectomy, or who have received an organ transplant are at high risk for developing sepsis. Patients on certain medications that may suppress the immune response—such as corticosteroids, prednisone, and tubular necrosis factor (TNF) inhibitors–are also considered at greater risk for developing infections. Infection: The invasion of normally sterile tissue with a pathogen. Influenza: Influenza is a respiratory viral infection that can lead to sepsis when the body attempts to clear the infection. It can also lead to sepsis if secondary infections, such as pneumonia, occur as a complication of the flu. Kidney stones: Kidney stones are hard deposits of calcium, uric acid crystals, cysteine, or struvite that form a stone-like structure that can block the ureter and lead to an infection in the kidney, known as pyelonephritis. Liver disease: Cirrhosis of the liver is a chronic liver disease in which healthy liver tissue begins to break down and is replaced by scar tissue that impairs blood flow. It is most commonly caused by alcoholism and hepatitis C in North America. Other causes of cirrhosis include hepatitis B and nonalcoholic fatty liver disease. Cirrhosis caused by hepatitis carries the highest risk for bacteremic infections (Azzopardi, Fenech, & Piscopo, 2012). Malaria: Malaria is transmitted via mosquito bites and is considered a parasitic disease, as a parasite infects the mosquito that then bites a person who is infected with malaria. Meningitis: Meningitis is inflammation of the meninges that surround the spinal cord and brain. It is caused by a bacterium, a virus, a fungus, or a parasite. ● ● Bacterial meningitis: The most severe type of meningitis caused by one of the following bacteria—Haemophilus influenza, Streptococcus pneumoniae, group B Streptococcus, Listeria monocytogenes (in newborns), and Neisseria meningitidis. ● ● Viral meningitis: The most common cause of meningitis caused by either the flu virus or the mumps virus. Viral meningitis usually affects children under 5 or those with a weakened immune system and typically resolves on its own. ● ● Fungal meningitis: Caused by a fungus and is the rarest type of meningitis. It is usually found only in those who are immunocompromised. Methicillin-resistant Staphylococcus aureus (MRSA): MRSA is a bacterium found in hospitals and the community and is resistant to various antibiotics. It is sometimes found on the skin. It is not