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Definitions in Infection Definition Colonisation Presence or multiplication of microorganisms on a wound/mucosal surface, not invading the underlying tissue and not causing inflammation Infection Microorganisms invading viable tissue, and/or the presence of organisms in a normally sterile site. This is usually, but not necessarily, accompanied by an inflammatory host response Bacteraemia Bacteria present in blood, as confirmed by culture, may be transient Septicaemia Same as bacteraemia, but implies greater severity SIRS (Systemic inflammatory response syndrome) The systemic inflammatory response to a variety of clinical conditions, both infectious or non infectious (e.g. burns, pancreatitis) as manifest by TWO OR MORE of the following: Sepsis SIRS caused by infection Sepsis Syndrome Sepsis plus evidence of altered organ perfusion with at least one of the following: Hypoxemia, elevated lactate, oliguria, altered mentation Hypotension A systolic blood pressure of <90 mmHg or a reduction of >40 mmHg from baseline in the absence of other causes of hypotension Severe Sepsis Sepsis associated with organ dysfunction, hypoperfusion, or hypotension. Hypoperfusion and perfusion abnormalities may include, but are not limited to, lactic acidosis, oliguria, or an acute alteration in mental status Septic Shock Sepsis with hypotension despite adequate fluid resuscitation along with the presence of perfusion abnormalities that may include, but are not limited to, lactic acidosis, oliguria, or an acute alteration in mental status. Patients who are on inotropic or vasopressor agents may not be hypotensive at the time that perfusion abnormalities are measured Refractory Septic Shock Septic shock that lasts for more than 1 hour and does not respond to fluid administration or pharmacologic intervention Temperature >380C or <360C Heart rate >90 beats/minute Respiratory rate >20 breaths/min or PaCO2 <32 mmHg (<4.3 kPa) WBC >12,000 cells/mm, <4000 cells/mm, or >10% immature (band) forms The Department of Microbiology, 28/07/05
