Infection, Immunity, and Antimicrobial Stewardship

Comprehensive vocabulary flashcards covering principles of immunity, stages of infection, transmission-based precautions, communicable pathogens, and antimicrobial pharmacology.

Innate Immunity

The body's natural, immediate physical and chemical barriers (such as skin, mucus, and stomach acid) that provide short-term, nonspecific defense against pathogens.

Natural Active Immunity

A form of long-lasting immunity produced by an individual's own immune system after exposure to and recovery from an infection.

Artificial Active Immunity

A form of long-lasting immunity stimulated deliberately within an individual through vaccination.

Natural Passive Immunity

Immediate, short-term protection acquired naturally from a mother through maternal antibodies.

Artificial Passive Immunity

Immediate, short-term protection provided by introducing antibodies from an external source, such as antivenom or immune globulin.

Local Infection

An infectious process confined to a specific anatomical area, characterized by heat, redness, pain or tenderness, swelling, and purulent drainage.

Systemic Infection

An infection that impacts the entire body, manifested by fever, malaise, weakness, and laboratory alterations such as elevated WBCs, Erythrocyte Sedimentation Rate (ESR), and C-reactive Protein (CRP).

Incubation Stage

The initial period of an acute infection from pathogen exposure to the appearance of the first symptoms, during which the pathogen enters and multiplies without recognizable clinical symptoms.

Prodromal Stage

The early phase of illness where pathogen replication continues and the immune system activates, manifesting as early, nonspecific symptoms like malaise, fatigue, low fever, and general discomfort.

Illness Stage

The peak stage of an acute infection where the pathogen burden and tissue effects are greatest, producing the most severe, characteristic signs and symptoms of the disease.

Decline Stage

The resolution phase of an infection where the pathogen burden falls as a result of immune control and/or treatment, causing clinical symptoms to lessen.

Convalescence Stage

The final recovery phase of an infectious disease where the pathogen is controlled or eliminated and the patient regains strength and baseline normal function.

Chain of Infection

A six-component cycle of disease transmission consisting of an infectious agent, reservoir, portal of exit, means of transmission, portal of entry, and susceptible host.

Reservoir

The natural habitat or environment where an infectious agent lives, grows, and multiplies, including people, equipment, and water.

Standard Precautions

The foundational infection-prevention practices applied to all patients in all healthcare settings, based on point-of-care risk assessment, hand hygiene, PPE use, aseptic technique, and environmental cleaning.

Contact Precautions

Transmission-based precautions required for pathogens spread through direct or indirect contact (e.g., MRSA, VRE, C. difficile, and RSV), requiring gloves and gowns upon room entry and dedicated or disposable equipment.

Droplet Precautions

Transmission-based precautions used for pathogens spread by large respiratory droplets (e.g., pertussis, influenza, mumps, rubella, and N. meningitidis), requiring full eye, nose, and mouth coverage before room entry.

Airborne Precautions

Transmission-based precautions for infectious agents spread by airborne droplet nuclei (e.g., COVID-19, measles, varicella, and tuberculosis), requiring an airborne isolation room with the door kept closed and a fit-tested N95 or higher respirator.

PPE Donning Sequence

The correct order for putting on personal protective equipment before patient contact: gown first, followed by mask or respirator, goggles or face shield, and gloves.

PPE Doffing Sequence

The deliberate procedure for removing contaminated protective gear: gloves first, followed by goggles or face shield, gown, and mask or respirator (removed outside the room), finished immediately with hand hygiene.

Diagnostic Stewardship

The practice of optimizing diagnostic testing, such as ensuring clinical cultures are collected properly before initiating antibiotic therapy, to guide appropriate antimicrobial treatment.

Norovirus

The leading cause of vomiting and diarrhea in the United States, typically causing acute symptoms within $12\text{--}48\text{ hours}$ after exposure and lasting $1\text{--}3\text{ days}$, carrying a major risk for dehydration.

Campylobacter

The most common bacterial cause of diarrheal illness in the United States, frequently contracted from raw or undercooked poultry, causing diarrhea, fever, and cramps that typically resolve within $7\text{ days}$.

Shigella

A bacterial diarrheal infection characterized by fever, an urge to pass stool even when the bowel is empty (tenesmus), and potentially bloody diarrhea.

Shiga Toxin-Producing E. coli (STEC)

A bacterial pathogen that causes bloody diarrhea and can progress to hemolytic uremic syndrome (kidney injury).

Primary Syphilis

The first clinical stage of Treponema pallidum infection, painless chancre at the infection site. Lesions may resolve without treatment.

Secondary Syphilis

Treponema pallidum produces rash, fever, malaise, and generalized lymphadenopathy.

Benzathine Penicillin G

The intramuscular antibiotic used to treat syphilis, administered as a single dose for early/early latent disease or in three weekly doses for late or unknown latent disease.

Vancomycin

A bactericidal glycopeptide antibiotic given IV for resistant staph infections and orally for C. diff; monitored via peak and trough levels and associated with nephrotoxicity, ototoxicity, thrombophlebitis, and 'Red man Syndrome'.

Gentamicin

An aminoglycoside bactericidal antibiotic effective against gram-negative bacteria; requires monitoring of peak and trough levels, can cross the placenta to cause fetal deafness, and damages the 8th cranial nerve (ototoxicity) and kidneys (nephrotoxicity).

Ertapenem

A broad-spectrum bactericidal carbapenem antibiotic that inhibits cell membrane synthesis; contraindicated with Depakote or antivirals due to seizure risk and shares cross-sensitivity with beta-lactams.

Ciprofloxacin

A fluoroquinolone bacteriostatic antibiotic that inhibits DNA replication; carries boxed warnings for tendon rupture, aortic rupture, and CNS effects, and is contraindicated with drugs that prolong the QT interval.

Trimethoprim–Sulfamethoxazole

A bactericidal sulfonamide combination that is the drug of choice for Pneumocystis jirovecii pneumonia and UTIs; potential adverse effects include nephrotoxicity, hepatotoxicity, hyperkalemia, and folate deficiency.

Tetracycline

A bacteriostatic antibiotic that inhibits protein synthesis in the bacterial cell wall; it is teratogenic, causes photosensitivity, and should be taken on an empty stomach with water, avoiding milk, iron, and antacids.

Clindamycin

A lincosamide class antibiotic used for Staph and Strep infections; must be administered with a full glass of water to avoid esophageal ulceration.

Oseltamivir

An antiviral medication active against influenza A and B that is most clinically effective when initiated within $48\text{ hours}$ of symptom onset.

Fluconazole

An oral azole antifungal excreted renally that requires monitoring of creatinine clearance ($CrCl$) and should be administered after dialysis.

RECOMMENDED VACCINES: children at birth

HEPATITIS B

RECOMMENDED VACCINES: children at 2-6 mo

Rotavirus, influenza (6 mo), DTaP, Hib, pneumococcal conjugate, and polio.

RECOMMENDED VACCINES: children at 12-18 mo

MMR, varicella, and hepatitis A

RECOMMENDED VACCINES: children 4-6 yo

DTaP, polio, MMR, and varicella

RECOMMENDED VACCINES: children 11-12 yo

Start the HPV series, begins at 11–12 and may start at age 9. Give the first meningococcal ACWY dose.

RECOMMENDED VACCINES: 16 yo

boosters

RECOMMENDED VACCINES: through 18, adults

boosters, yearly vaccines, review history and expiration dates

RECOMMENDED VACCINES: 50 to 74

Two-dose shingles series beginning at age 50, Routine pneumococcal vaccination from age 50, more at risk for RSV

RECOMMENDED VACCINES: 75+ pregnancy

Tdap during each pregnancy; seasonal maternal RSV

vaccination when eligible, RSV routinely at age 75+; remain

current on pneumococcal and zoster vaccines.

Tertiary Syphilis

Progressive inflammation may damage multiple organs, including the aorta and

CNS

Latent Syphilis

No signs or symptoms. Secondary retsymptoms may recur.

Cervical infection of gonorrhea and chlamydia

Often asymptomatic. Findings may include mucopurulent cervicitis or urinary and vaginal symptoms.

urethral infection of gonorrhea and chlamydia

Burning with urination and penile discharge may occur. Some patients have no symptoms.

complications that gonorrhea and chlamydia can cause to the upper genital tract

Either infection may cause pelvic inflammatory disease, endometritis, ectopic pregnancy or infertility.

STI that can can cause arthritis or bloodstream infection in any sex.

Gonorrhea

Common adverse effects of antibiotics

GI UPSET, SKIN RASH, YEAST INFECTIONS, DIZZINESS

Breathing difficulty or face/throat swelling needs emergency care. Severe diarrhea needs prompt review for possible C. difficile.