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Medicine - Year 1 > Fractures & Dislocations - Microbiology > Flashcards

Fractures & Dislocations - Microbiology Flashcards

1
Q

What is prophylaxis?

A

Treatment given, or action taken to prevent disease

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2
Q

Why do we need to prevent health care associated infections? (HCAI)

A
  • To reduce morbidity and mortality which may result from sepsis
  • To reduce the length of stay in hospital
  • To reduce the economic burden
  • To reduce the risk of surgcal procedures
  • Patients with HCAI are 7x more likely to die as inpatients
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3
Q

What is the difference between healthcare acquired vs community acquired infections

A

Health care acquired infections are contracted more than 72 hours of being in hospital.

If has not been 72 hours then it is considered community acquired

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4
Q

What are the principles of prevention?

A
  • Remove known sources
  • Block routes of transfer
  • Enhance natural resistance
  • Offeer chemical (antimicrobial) prophalyxis
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5
Q

How do you we prevent healthcare associated infections?

A
  • Operative theatre air quality
  • Vaccination
  • Post exposure prophylaxis
  • Surveillance - outbreak investigation
  • Standardisation
  • ANTT - aseptic no touch technique
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6
Q

How do we reduce the risk of infection in surgery?

A
  • Antibiotics and prophylaxis
  • Foot flow - minimising coming in and out
  • People in theatre
  • Airflow directed away from patient (laminar air flow system)
  • Scrubbing and hand washing
  • Reduce contamination
  • Sterile environment
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7
Q

List the infection transmission route of healthcare associated infections

A
  • Direct contact
  • Faeca - oral
  • Airbone/droplet
  • Blood to blood
  • Environent or person spread - indirect
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8
Q

How do you reduce transmission of HCAI from the environment?

A
  • Enforce good practice with built environment
  • Encourage safe activities in environment
  • Modify environment (e.g., water treatment)
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9
Q

Describe how to prevent airborne transmission

A
  • Place the infected patients in source isolation
  • Protect the vulnerable by use of filtered air and negative pressure
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10
Q

Describe how to prevent direct contact transmission of infections

A
  • Patients with microorganisms that pose a risk for others (e.g., MRSA, vancomyscin-resistant enterococci, clostridium difficile, Noravirus) are placed in source-isolation
  • Aseptic technique
  • Hand hygiene
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11
Q

Decssribe how prevent faecal (oral) transmission of infections

A
  • Hand washing
  • Gown and glove before
  • Use patient dedicated or disposable equipment
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12
Q

Describe the role of the infection control team within hospit

A

Advises on the prevention, surveillance, investigation, and control of infection within the board

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13
Q

Describe environmental infection protection measures

A
  • Decontamination (cleaning, disinfection, sterilisation) of contaminated equipment (e.g., ventilator tubing) or medical devices (e.g., surgical instruments)
  • Patients should be provided with food and drinks free from harmful microorganisms, clean linen, clean environment, and air of appropriate quality
  • Safe disposal of hospital waste
  • Screening for suspected carriage (patient) and immunisation (staff)
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14
Q

Describe the different types of wound

A
  • Clean
  • Clean/contaminated - has opportunity to become contaminated beacuse it is in close proximity to a contaminated area
  • Dirty - contaminated, purulent (filled with pus)
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15
Q

Explain the difference between colonisation vs infection

A

Colonisation is when microorganisms exist in the body but don’t invade tissue or cause detecectable (clinical) damage

Infection is when microorganisms begin to invade the body tissues and cause detectable (clinical) damage

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16
Q

Which two organisms are most responsible for HCAI?

A
  • Methicillin resistant staphylcococcus aureus (MRSA- gram-negative bacteria)
  • Clostridium difficile
17
Q

List the routes of delivery of antibiotics

A
  • Oral
  • Intravenous - injection or infusion
  • Intramuscular
  • Local
18
Q

What patient-related factors increase risk of infections

A
  • Host resistance (healing response, local wound characteristics, operative characterisitics)
  • Age
  • Malnutrition
  • Hypovolemia - poor tissue perfusion
  • Obesity
  • Diabetes
  • Steroids
  • Other immunosuppressants
19
Q

What procedure related factors increase the risk of infections?

A
  • Some procedure are riskier than others depending on entry of tract
  • Pre-existent sepsis (local or distant)
  • Poor skin preperation, including shaving
  • Nonviable tissue in wound
  • Hematoma
  • Foreign material including drains and sutures
  • Dead space
20
Q

Which part of the body is the most aseptic and susceptible to infection

A

Bone

21
Q

What is the golden standard to be sent to microbiology?

A

Bone sequestrate

22
Q

Which is better to send to microbiology? Pus or swabs?

A

Pus

23
Q

List the infections that are most commonly acquired in hospitals

A
  • Surgical wound infection
  • Respiratory tract infection (pneumonia)
  • Gastrointenstinal infections (e.g., Clostridium difficile)
  • Urinary tract infection (UTI)
  • Bacteraemia
24
Q

Describe wecan enhance the host’s abiltity to resist infections

A
  • Boosting specific immunity by active or passive immunization
  • The appropriate use of prophylactic antibiotics
  • Care of invasive devices that breach the natural defences (e.g. urinary catheters, intravenous lines)
  • Attention to the risks predisposing to postoperative infection.
  • Optimising nutrition (malnutirion, obesity, diabetic control)
25
Q

Describe how to reduce the risks of and prevent postoperative infections

A

The preoperative length of stay in hospital should be kept to a minimum.

Intercurrent infections should be treated appropriately before surgery whenever possible (e.g. treatment of UTI before resection of the prostate).

Operations should be kept to the minimum duration consistent with good operating technique.

Adequate debridement of dead and necrotic tissue is essential, together with adequate drainage and maintenance or re-establishment of a good blood supply to provide the body’s natural defences with optimum working conditions.

Prevention of pressure sores and stasis by good nursing techniques and active physiotherapy minimizes the risks of developing respiratory tract infection or UTI.

Medicine - Year 1 (61 decks)

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