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3- Hospital Acquired Infection Flashcards

1
Q

What is meant by a reservoir?

A

reservoir of an infectious agent = the habitat in which the agent normally grows and multiplies

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2
Q

Give some examples of diseases without intermediaries

A

STDs, measles, mumps, streptococcal infection

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3
Q

Why was smallpox eradicated after the last human case was identified and isolated?

A

humans were the only reservoir for the smallpox virus

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4
Q

What is the difference between a carrier and a vector?

A

a carrier is infected even if asymptomatic
a vector is not infected even if they have it on them

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5
Q

What are the three different types of Carriers?

A

incubatory: transmit during incubation period before illness begins

convalescent: recovered from illness but can still transmit

chronic: continue to harbour causative agent for weeks/months after initial infection

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6
Q

what is zoonosis?

A

infectious disease transmissible under natural conditions from vertebrae animals to humans

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7
Q

Give five ways in which a pathogen can leave a host

A

respiratory tract
urine
faeces
crossing placenta from mother to foetus
cuts or needles in skin

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8
Q

Describe and explain the two modes of Direct Transmission

A

direct contact: skin to skin, kissing, sex
droplet spread: sneezing, coughing, talking

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9
Q

Describe the three modes of Indirect Transmission

A

airborne: carried by dust/droplet nuclei in air

vehicles: food, water, blood, fomites (inanimate objects)

vectors: mosquitoes, fleas, ticks

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10
Q

Give 3 examples of non-specific factors that defend against infection

A

skin, mucous membrane, gastric acidity

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11
Q

How could Vehicleborne transmissions be reduced?

A

elimination/decontamination of vehicle

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12
Q

How could airborne transmissions be reduced?

A

modifying ventilation or air pressure
filtering/treating the air

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13
Q

How could vectorborne transmission be reduced?

A

controlling vector popn

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14
Q

Give 2 examples of interventions that aim to increase a host’s defence

A

vaccinations: promote development of specific antibodies

prophylactic use of antimalarial drugs: prevents infection from taking root

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15
Q

What kind of intervention might prevent a pathogen from encountering a susceptible host?

A

herd immunity: if high proportion of popn are resistant, those who aren’t will be protected since pathogen will be unlikely to find the few susceptible individuals

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16
Q

Where might HAIs become more of a problem in outpatient settings?

A

limited capacity for infection control compared to acute care setting

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17
Q

What are the 4 main risk factors of HAI?

A

POM B

Patient characteristics
Organisational factors
Medical procedures and antibiotic uses
Behaviour of healthcare staff

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18
Q
  • List some ways in which HAIs can be prevented
A

Best practices: increase compliance amongst healthcare workers
Catheters: careful insertion, maintenance and prompt removal
Prevention: explore new approaches

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19
Q

What is a bacterial cell wall made of?

A

lipid bilayer membrane
peptidoglycan matrix

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20
Q

What are the differences in cell walls between gram negative and gram positive bacteria?

A

gram positive: thick peptidoglycan sheath around a single membrane

gram negative: thin layer of peptidoglycan between 2 lipopolysaccharide membranes

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21
Q

What colour is Gram negative and Gram positive bacteria respectively?

A

negative = red/pink
positive = purple

22
Q

If someone has an infection, what are their WBC count, CRP level and respiratory rate?

23
Q

What are the components of a single molecule of peptidoglycan?

A

2 sugars, short chain of amino acids, peptide bridge

24
Q

How is the peptidoglycan matrix formed?

A

peptidoglycan molecules bind to one another forming chains
chains are crosslinked by the peptide bridges

25
How does Penicillin obstruct bacteria?
peptidoglycan production prevented cell bursts due to osmotic pressure
26
What is D-alanyl-D-alanine carboxypeptidase transpeptidase also known as and what is its function?
penicillin binding protein assists with peptidoglycan matrix assembling by creating crosslinks between chains
27
Describe the mechanism by which Penicillin prevents peptidoglycan production?
penicillin's beta-lactam ring binds to key serine on the penicillin-binding protein's active site this inactivates enzyme and prevents formation of peptidoglycan matrix
28
How does altered target site antibiotic resistance work?
acquisition of alternative gene or gene that encodes a target modifying enzyme alters structural conformation of protein that antibiotic targets
29
How does MRSA (strain of S. aureus) evade beta-lactam-containing antibiotics?
expresses penicillin binding protein 2a with an altered active site that does. not bind to the beta-lactam ring in these antibiotics
30
Explain how antibiotics can be inactivated?
enzyme degradtion or alteration rendering antibiotic inffective
31
How else can bacteria evade beta-lactam-containing antibiotics?
express a beta-lactamase enzyme which breaks beta-lactam of antibiotic, rendering the antibiotic useless
32
What is a Beta-lactamase inhibitor?
medication used to inhibit the activity of beta-lactam ntibioticss to work prroperly
33
Giving an example, how can antibiotics overcome bacteria that produce beta-lactamase?
ampicillin and clavulaanic acid have beta lactamaase inhibitors, allowing antibiotic toinhibit penicllin-binding protein freely
34
What is Co-amoxiclav?
antibiotic consisting of both amoxicillin and clavulanic acid
35
What is meant by horizontal gene transfer?
process in which organism transfers genetic material (plasmids) to another organism that isn't offspring
36
what is vertical gene transfer?
tranfer of geneticc info, inc aany mutations, from parent to offspring
37
How can antibiotic resistance within one population of bacteria spread to another population?
horizontal gene transfer from species with resistance to species without resistance involves transfer of plasmids vertical gene transfer of plasmids from one generation in species that previously didn't have resistance, to next generation
38
When does antibiotic resistance occur?
when germs like fungi and bacteria develop the ability to defeat the drugs designed to kill them germs aren't killed and continue to grow
39
What are antimicrobials?
drugs which treat infection and disease caused by microbes
40
what are the 2 types of microbes?
bacteria- use antibiotics fungal- use antifungals
41
Where do you typically find antibiotic resistant DNA in bacteria?
plasmids (small pieces of DNAA that carry genetic instructions from one germ to another
42
What gram of bacteria have an outer layer that protects from their antibiotic drugs?
gram negative
43
How do germs get rid of antibiotics?
use pumps in their cell walls to remove antibiotic drugs that enter the cell
44
What other resistance mechanisms can bacteria use?
change antibiotic target: drug can no longer fit bypass effects of antibiotic: develop new cell processes that avoid using the antibiotic's target change/destroy antibiotic using enzyme
45
What is sepsis?
body's extreme response to infection can rapidly lead to tissue damage, organ failure, death
46
What is meant by a shock?
imbalance in supply and demand
47
what's the sequence of a septic shock?
hypotension (high BP) -->tachycardia (high heart ra=ate) --> tachypnoea (high resp rate)
48
what form of penicillin is suitable for oral use?
penicillin V
49
how can an altered metabolism profile lead to antibiotic evasion>
inc production of enzyme substrate can out compete antibiotic inhibitor or bacteria can switch to another metabolic pathway
50
What 2 HAIs did the Healthcare Associated Infections Objectives for Healthy People 2020 address?
MRSA- cau ses life threatening bloodstream infections, pneumonia and surgical site infections CLABSI (central line associated bloodstream infections)- gems enter bloodstream thru central line

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