Anti-Infectives: Quick Microbiology Review (Nursing)

00:01 Okay, let's do a quick micro review. Now, don't break out in a sweat.

00:05 This is not going to be a full blown microbiology course.

00:08 I know my class was really tough when I took that in undergrad.

00:11 So I know that requires a lot of study, but it's going to pay off for you here.

00:14 I just want to go over some really basic foundational concepts.

00:18 Okay, so, the bugs, the bacteria, are usually grouped into 3 categories and they classify them by shape. See? That's not so hard. They're classified by shape.

00:28 The first one is cocci, so which is kind of round.

00:32 Then there's bacillus, which is kind of like a rod.

00:35 And then there's a spirochete, which is like a kind of a spiral shape thing.

00:39 So why are we looking at this because I don't know any nurses that, like, look at something under a microscope? Because you're going to see this on the reports and things that we review.

00:50 And I just want you to remember that part of understanding what the bacteria is, when you see these terms on the reports and things that we do review, you'll know what they're talking about.

01:00 Let's take a look at a culture report.

01:02 What you're going to see in a culture report, and hey, this is meant for nurses.

01:07 You don't want to be the kind of nurse that just follows along and doesn't actively engage in the process of helping your patient get better.

01:15 So we're going to teach you, in this video and a couple of the other videos, how do you look at lab work reports and what do you know what to do about them? Well, for treating infections, culture reports are really important.

01:26 So, whatever infection your patient has, if they have a pneumonia, we'll do a sputum, which is my least favorite one to collect.

01:35 But you'll do a sputum specimen and send that to the lab.

01:38 If we're worried about how their kidneys are doing or if they have a urinary tract infection, we'll take a urine sample.

01:44 Now, some really bad infections could be you have a infection in your bloodstream and it might even be working towards septic, then we'll draw a lab sample from the blood.

01:54 We can also culture any drainage from the body.

01:58 So that's what we do with cultures.

02:00 Now, what you're going to see on the culture report tells you whether it's gram-positive or gram-negative, it tells you the shape. Remember, we just talked about those 3 shapes of bacteria, and the name of the bacteria. So that's the first step.

02:14 We know if it's gram positive or negative, we know the shape of the bacteria, and we know the name of the bacteria from the culture report.

02:22 Now the next step is a sensitivity report.

02:25 Now that tells you which antibiotics will actually treat the bacteria.

02:29 Now, I want you to take a look in your notes and see -- You've got a list of -- on the left, you should have a list of the antibiotics by name.

02:37 And then you'll see -- if you follow that all the way over, you'll see the letters R or S.

02:43 R means that that bug is resistant to that medication, meaning don't use that for your patient.

02:51 S means that bug is sensitive to that drug.

02:55 That would be a drug that you want to use.

02:58 So, really important, as a nurse, when you know your patient has a pending culture and sensitivity report, you want to make sure that you review that, look at the results, and compare that to the antibiotics that have been ordered for the patient.

03:11 Because it's our role to make sure, along with the healthcare provider, that that patient is on an antibiotic that will actually do the job we want it to do.

03:21 Are they on the right antibiotic that the bug is sensitive to, so it will kill that infection? That's what we're looking for.

03:29 So, don't be overwhelmed by those lab reports.

03:31 They're really fun as you start to get in there and really do some comparing the results and taking a look with the treatment plan, that's when it's really fun to be a nurse, and when you're really making a difference for your patients.

03:43 Okay, we talked about positive and negative. I want to go back and review that.

03:48 Initially, we talked about the shapes, then we talked about the culture and sensitivity reports.

03:53 Now I want to talk about what is gram positive? Well, gram positives stain a purple color. That's how they get their name.

04:00 They're gram positive. When I first started learning this and thinking about it, I think about gram-positive bacteria as like Forrest Gump.

04:09 They're kind of kinder, gentler kind of bugs.

04:13 They are easier to work with. Their cell walls are thicker, they're peptidoglycan, they're a thicker outer cell, capsule.

04:22 They're just like that character in the movie, Forrest Gump.

04:26 They're kinder, gentler bugs, and they're easier for us to take care of.

04:30 Now, the other end of the spectrum are Gram stain negative, and I think of these guys as more sinister, like, you know, that Hannibal Lecter guy from Silence of the Lambs.

04:41 These guys stain a red color.

04:44 They're way more complex than our friends, Forrest Gump.

04:47 They are smaller outer capsule, they have this weird layer.

04:50 They have got 2 cell membranes, an outer and an inner.

04:53 They are more difficult to treat than gram positive, and drugs just have a harder time penetrating them.

05:00 So, if I were you, if you got to pick, which you really shouldn't, but if you could get a Gram negative or a gram positive type of infection, you would definitely want a gram positive one, because it's just easier to treat.

05:13 So, before we move on, let's think about what we talk through.

05:17 The different shapes, what they mean; the nurse's role in looking at a culture and sensitivity report, and the difference between gram positive and gram negative, particularly remembering that gram negative are the harder, more difficult infections to treat.

05:33 Thank you for watching our video today, an Introduction to Antibiotic Therapy.