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What is tetanus?

What is the organism that causes tetanus and why is it of concern in this situation?

Tetanus is referred as the bacterial infection which is mainly caused by the bacterium Clostridium tetani (NSW Government, 2020).

This bacterium can enter into the body by wound or any open injury and might make toxin into the patient’s body which causes the disease (health.gov.au, 2022). Moreover, it might cause other complications as well such as breathing problems that might become life-threatening as it might takes place from becoming the vocal cords tight as well as making the muscle rigid in the neck as well as abdomen, specifically amidst a generalized spasm. It might also result in pulmonary embolism which might be deadly. For that reason, Mary was given Tetanus as she had an open wound in right calf.

Discuss the rationale for giving Mary the tetanus booster. 

Tetanus booster dose is given in case the wound is fresh and clean and if the patient has not taken the tetanus booster since past 10 years. This booster is given for avoiding any consequences mentioned in the above section as this might boost the immunity of the body and keeps the body ready to prevent tetanus infection. Since, Mary has got a fresh cut on her right calf with substances that might cause tetanus to that area and had not taken tetanus for few years hence, the tetanus was given to her (Australian Technical Advisory Group on Immunisation, 2018).

For each of the three wound observations indicate, and provide a rationale, as to whether it is a sign or a symptom. (2 marks)

 Physiological basis of 3 wound observations can be:

  • Wound edges red and hot to touch – Sign of not healing.
  • Surrounding tissues swollen
  • Purulent And Odorous Discharge

Name and discuss the physiological basis of the first observation.  

The physiological aspects of redness of the wound region are normal because the blood is circulated to that area   for supplying nutrients as well as oxygen for healing process. From the physiologic aspect it can be stated that unhealthy granulation tissue might result in the redness of that area. An infectious disease or poor healing must be considered when granulation tissue seems "unhealthy" (Alhajj & Goyal, 2021).

Name and discuss the physiological basis of the second observation. 

Swelling and inflammation at the place where the needle penetrated the skin might develop after an injection. This is an allergic response to the needle or the drug administered. It might also be a response to both. Inflammatory stimuli may also cause a fast drop in interstitial fluid pressure, resulting in enhanced filtration as well as the production of oedema or swelling in the affected region (Chen et al., 2017).

Name and discuss the physiological basis of the third observation.

Despite the fact that it comes into touch with a variety of microorganisms and may be persistent on the skin, it is thought to be a very effective barrier against invasion as well as consequent bacterial illnesses. The most prevalent situations that might make a person more susceptible to bacterial skin infections occur when the skin barrier's integrity is compromised; hence, trauma such as abrasion, ulcerations, laceration, or maceration can leave the skin exposed.

Why is tetanus of concern in this situation?

How did Mary’s fever develop?

Mary might have been developed the fever because of the bacterial infection that took on her skin. It has been known from the laboratory test that Staphylococcus aureus might be the causative agent that caused the infection on that area. The infection of the skin after wound can be referred as

Cellulitis, which is a very common, as well as potentially severe skin infection by bacteria. The area of the skin which has been affected appears swollen as well as red and warm to the touch and consist pain because of the inflammation that might cause fever (nhs.uk, 2022).

Discuss two ways in which fever is beneficial.

Even though it is physically expensive, fever is an ultimately beneficial procedure for the host. Fever triggers the defences of the body, causing white blood cells as well as other "fighter" cells to rush to the infection's source to battle as well as eradicate it.  A mild fever suppresses the inflammatory reaction while increasing neutrophil as well as eosinophil that related to phagocytic activity which would destroy the bacteria (González Plaza et al., 2016).

Another benefit of fever might be it activates the T cells to produce more Hsp90 subunits when body temperatures rise. The cells flip their 4 fibronectins to an active phase when these molecules concentrate. They get sticky as an outcome. Each molecule of Hsp90 may also bind itself into the tail ends of 2, 4-integrin molecules. Hsp90 molecule play a vital role in cell survival, cell cycle control, hormone as well as other signaling pathways (Lin et al., 2019).

Name one endogenous source of contamination and discuss the mode of transmission from the source to the new host. 

Bacterial flora is made up of endogenous bacteria, which are bacteria that live in a closed environment spontaneously. When microbes from the typical bacterial flora invade a sterile part of the body, such as the nervous system or muscular, disease can result. This is what is known as an endogenous infection (Lee & Bishop, 2016). For example: Mycobacterium tuberculosis is one such bacteria that can cause tuberculosis in humans that can be an endogenous source.

The mode of transmission could be air, food, water, or living vectors. The major modes of transmission of bacterial infection are airborne, contact, vectors, droplet, as well as vehicular.

Name one exogenous source of contamination and discuss the mode of transmission from the source to the new host.  

Exogenous infections, in contrast, takes place when a microorganism invades the body of the patient from the outside. These illnesses can spread through contaminated equipment, medical personnel, contaminated surfaces, or other mediators. Undigested carbohydrates as well as proteins from the host diet are the main source of external energy for GIT bacteria. bile acids, Mucin, digestive enzymes, as well as epithelial cells are can be mentioned as examples of sources of endogenous energy (Lee & Bishop, 2016).

The exogenous microorganism can enter into the host’s body through air (aerosolized bacteria), by food (when someone ingest the contaminated foods), direct contact like sexual activity, or touching of a wound that consist the bacteria. 

Discuss the rationale for giving Mary the tetanus booster.

Appropriateness of Augmentin as the antibacterial agent prescribed to Mary 

Given the colonizing organism was Staphylococcus aureus, discuss why Augmentin is an appropriate prescription?

Augmentin or Amoxicillin found to be a secure, useful, as well as effective antibiotic that are often used in the treatment of infections of skin in hospital and general practice. His medication is often prescribed in bacterial infection as it is considered to be very effective when mixed infections occur like staphylococci as well as Streptococcus pyogenes occurs which are penicillin resistant (Yao et al., 2019). From the aspect of mechanism of action, it can be stated that Amoxicillin links to penicillin-binding proteins within the cell wall of the targeted bacteria as well as inhibits the synthesis of bacterial cell wall and prevent further growth of the bacteria like Staphylococcus aureus (Evans, Hannoodee & Wittler, 2019).

Describe the added benefits that Augmentin provides, with reference to the role of the major ingredients in Augmentin.

 Augmentin is more effective than amoxicillin against even a larger spectrum of germs. As a result, Augmentin may be regarded as a more powerful antibiotic than amoxicillin. The effectiveness of the antibiotic is determined by the infection as well as the bacteria that caused it. There is a specific composition, which is often followed by the manufacturer and the ingredients which is used to make this medication are mentioned below:

Each film-coated Augmentin tablet composed of amoxicillin trihydrate, which is equivalent to 500 mg amoxicillin as well as potassium clavulanate, which is equivalent to 125 mg clavulanic acid (Medicines.org.uk, 2022). The core of the Augmentin tablet is made up of Colloidal anhydrous silica, Magnesium stearate, Sodium starch glycolate, Type A as well as Microcrystalline cellulose. The film-coating of the tablet is composed of Titanium dioxide (E171), Macrogol (4000, 6000), Hypromellose as well as Dimeticone (Medicines.org.uk, 2022).

Presentation 

Referencing in-text and in reference list conforms to APA 7th ed. referencing style.

Critique supported by relevant literature as prescribed.

Correct sentence structure, paragraph, grammatical construction, spelling, punctuation, and coherent presentation. 

References 

Alhajj, M., & Goyal, A. (2021). Physiology, granulation tissue. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554402/

Australian Technical Advisory Group on Immunisation (ATAGI). (2018). Australian Immunisation Handbook. Australian Government Department of Health.https://immunisationhandbook.health.gov.au/

Chen, L., Deng, H., Cui, H., Fang, J., Zuo, Z., Deng, J., Li, Y., Wang, X., & Zhao, L. (2017). Inflammatory responses and inflammation-associated diseases in organs. Oncotarget, 9(6), 7204–7218. https://doi.org/10.18632/oncotarget.23208

Evans, J., Hannoodee, M., & Wittler, M. (2019). Amoxicillin Clavulanate. https://www.ncbi.nlm.nih.gov/books/NBK538164/

González Plaza, J. J., Hulak, N., Zhumadilov, Z., & Akilzhanova, A. (2016). Fever as an important resource for infectious diseases research. Intractable & rare diseases research, 5(2), 97–102. https://doi.org/10.5582/irdr.2016.01009

Lee, G., & Bishop, L. (2016). Microbiology and infection control for health professionals (6th ed.). Pearson Australia.

Lin, C., Zhang, Y., Zhang, K., Zheng, Y., Lu, L., Chang, H., ... & Chen, J. (2019). Fever promotes T lymphocyte trafficking via a thermal sensory pathway involving heat shock protein 90 and α4 integrins. Immunity, 50(1), 137-151. https://doi.org/10.1016/j.immuni.2018.11.013

Nhs.uk. (2022). Cellulitis. Retrieved from https://www.nhs.uk/conditions/cellulitis/

NSW Government. (2020). Communicable diseases factsheet: Tetanus.  https://www.health.nsw.gov.au/Infectious/factsheets/Factsheets/tetanus.PDF

Yao, Q., Gao, L., Xu, T., Chen, Y., Yang, X., Han, M., ... & Yang, Y. (2019). Amoxicillin administration regimen and resistance mechanisms of staphylococcus aureus established in tissue cage infection model. Frontiers in microbiology, 1638. https://doi.org/10.3389/fmicb.2019.01638

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[Accessed 01 March 2024].

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