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1. CP - Core Microbiology > (7b) Infection, Prevention and Control > Flashcards

(7b) Infection, Prevention and Control Flashcards

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1
Q

What is the prevalence of healthcare-associated infection (HCAI) and how much does it cost?

A

7.6% in 2006

5,000 UK HCAI deaths per annum

£2,917 per HAI

Annual cost to NHS = £930.6 million

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2
Q

What are the stages in the chain of infection?

A
  1. pathogenic organism
  2. reservoir
  3. exit
  4. transmission
  5. entry
  6. susceptible host (non-immune)
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3
Q

What must a pathogenic organism have in order to cause disease?

A

It must be of sufficient virulence and be in adequate numbers to cause disease

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4
Q

What does the ‘reservoir’ stage in the chain of infection mean?

A

Reservoir or source that allows the organism to survive and multiply

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5
Q

What is infection prevention and control (IPC)

A

Activities undertaken with the aim of breaking the chain of infection

  • eliminate pathogenic organism
  • remove source/reservoir
  • minimise transmission
  • eliminate exit and entry
  • reduce susceptibility to infection
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6
Q

In what ways can the pathogenic organism be eliminated (part of IPC)?

A
  • environmental cleaning and decontamination
  • equipment decontamination
  • antisepsis
  • antibiotic prophylaxis
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7
Q

Environmental cleaning and decontamination helps to eliminate the pathogenic organism. Give examples of this

A
  • H2O2 room decontamination
  • spillage management
  • laundry
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8
Q

Equipment decontamination can help to eliminate the pathogenic organism. Give examples of this

A
  • sterilisation

- disinfection

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9
Q

Antisepsis can help to eliminate the pathogenic organism. Give examples of this

A
  • surgical skin prep

- MRSA decolonisation

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10
Q

Antibiotic prophylaxis can help to eliminate the pathogenic organism. Give examples of this

A
  • perioperative

- post-exposure

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11
Q

What is involved in removing the source/reservoir (part of IPC)?

A
  • hand hygiene

- environmental cleaning and decontamination

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12
Q

What can be done to minimise transmission (part of IPC)?

A
  • hand hygiene
  • personal protective equipment (PPE - aprons, gloves, masks)
  • equipment decontamination (surgical instruments, stethoscopes etc)
  • source and protective isolation
  • use of disposable equipment (syringes, needles etc)
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13
Q

What can be done to eliminate entry (and exit) -part of IPC?

A
  • antisepsis (surgical skin prep)
  • asepsis (insertion and management of invasive devices)
  • air handling
  • sharps management
  • patient management (minimise use and duration of invasive devices)
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14
Q

Air handling can help to eliminate entry of micro-organism as part of IPC. What is involved in this?

A
  • air filtration and laminar flow

- positive pressure ventilated lobby (PPVL) rooms

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15
Q

What can be done to reduce susceptibility to infection? (part of IPC)

A
  • antibiotic stewardship “start smart - then focus” (reduce susceptibility to C. diff infection, reduce chance of colonisation with multi-resistant organisms)
  • immunisation
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16
Q

What is surveillance?

A

Process of gathering information to ensure that disease outbreaks are pre-empted or identified early?

  • alert organisms (organisms with the propensity to cause outbreaks)
  • alert conditions (conditions caused by such organisms)
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17
Q

The IPC team in hospitals is involved in both passive and active surveillance. What is involved in passive surveillance?

A

Clinical reporting and laboratory records

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18
Q

The IPC team in hospitals is involved in both passive and active surveillance. What is involved in active surveillance?

A

Seeking out trouble eg. surgical site infection surveillance (SSIS) programmes

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19
Q

How is the community involved in surveillance?

A

Legislation of reportable/notifiable diseases

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20
Q

What are sterilisation, disinfection and antisepsis?

A

Decontamination methods used with the aim of reducing the burden of potentially pathogenic organisms from medical equipment and human tissue

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21
Q

What stages of the chain of infection to sterilisation, disinfection and antisepsis interrupt?

A
  • eliminate pathogenic organism
  • remove source/reservoir
  • minimise transmission
  • eliminate exit and entry
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22
Q

What is sterilisation?

A

Complete killing or removal of all types of microorganisms

  • bacteria (vegetative, spores)
  • viruses
  • fungi
  • mycobacteria
23
Q

Give some sterilisation methods

A
  • heat (moist, dry)
  • chemical (gas, liquid)
  • filtration
  • ionising radiation (used for single use disposable equipment)
24
Q

Sterilisation by heat can be moist heat or dry heat. How is moist heat sterilisation achieved?

A

Autoclave

  • delivery of steam under high pressure
  • specific pressure and temperature cycles
25
Q

Sterilisation by heat can be moist heat or dry heat. How is dry heat sterilisation achieved?

A

Oven

  • controlled temperature cycles (160c for 2 hours or 170c for 1 hour)
26
Q

What is disinfection?

A

Removal or destruction of sufficient numbers of potentially harmful microorganisms to make an item safe to use

27
Q

What is antisepsis?

A

Disinfection applied to damaged skin or living tissues (requires a disinfectant with minimal toxicity)

28
Q

How is disinfection achieved?

A

Almost always by use of chemical disinfectants

29
Q

What are the properties to consider in chemical disinfectants?

A
  • effects on microorganisms
  • chemical properties
  • physical effects
  • harmful effects
30
Q

Effects on microorganisms is a property to consider in chemical disinfectants. What does this mean?

A
  • antimicrobial spectrum

- sporicidality

31
Q

Chemical properties should be considered when choosing a chemical disinfectant. What does this involve?

A
  • shelf life
  • in-use concentration
  • compatibility with other chemicals
32
Q

Physical effects should be considered when choosing a chemical disinfectant. What does this involve?

A
  • corrosiveness
33
Q

Harmful effects should be considered when choosing a chemical disinfectant. What does this involve?

A
  • irritant potential

- toxicity

34
Q

Which is the least hazardous method of sterilisation/disinfection/antisepsis (decontamination)?

A

Heat - should be used where possible

35
Q

Chemical disinfection is largely limited to what?

A
  • environmental decontamination (surfaces, spills etc)
  • antisepsis
  • heat-sensitive items
36
Q

What is the risk of infection in surgical instrument reprocessing?

A

High

37
Q

What are the physical properties of surgical instruments?

A
  • metal construction

- paper/cloth packaging

38
Q

What is the decontamination level in surgical instrument reprocessing?

A

Sterilisation

39
Q

What is the decontamination method in surgical instrument reprocessing?

A

Moist heat

40
Q

What is the risk of infection in flexible endoscope usage?

A

High

41
Q

What are the physical properties of the flexible endoscope?

A
  • metal/plastic construction

- fragile, sensitive parts

42
Q

What is the decontamination level for flexible endoscope?

A

“High-level” disinfection

43
Q

What is the decontamination method for flexible endoscope?

A

Chemical - several alternative methods, delivered via “washer-disinfector”

44
Q

What is the risk of infection for the syringe needle?

A

High

45
Q

What are the physical properties of the syringe needle?

A
  • plastic/metal construction

- paper packaging

46
Q

What is the decontamination level for syringe needle?

A

Sterilisation

47
Q

What is the decontamination method for syringe needle?

A
  • y-irraditation pre-use

- disposal after use

48
Q

What are the physical properties of central venous catheter (CVC) insertion site?

A
  • living tissue
49
Q

What is the decontamination level for CVC insertion site?

A

Disinfection (antisepsis)

50
Q

What is the decontamination method for CVC insertion site?

A

Chemical - 2% chlorhexidine in 70% isopropyl alcohol

51
Q

What are the physical properties of the surgeon’s hands?

A
  • living tissue
52
Q

What is the decontamination level of the surgeon’s hands?

A

Washing

53
Q

What is the decontamination method for the surgeon’s hands?

A

Surgical scrub

1. CP - Core Microbiology (8 decks)

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