HAIs Flashcards
Define HAIs
Traditionally occurring >48 hrs after hospital admission, but can also refer to infections with multiresistant organisms acquired in the community
How many HAIs are there in Australia annually?
200,000
On average how much does a HAI increase length of hospital stay?
2.5x
Give examples of infections commonly spread directly from person-to-person
Scabies
Herpes simplex
Give examples of infections commonly spread via a contaminated intermediate object or person
MRSA
VRE
Influenza
Norovirus
Give 5 examples of infections spread by droplet transmission
Influenza Pertussis SARS Neisseria meningitidis Rhinovirus
Characteristics of droplet infection
> 5um particles
Drop to ground by ~1m
Characteristics of airborne transmission
<5um particles
Stay suspended in the air and can be inhaled by susceptible hosts over long distances
Give 3 examples of infections spread by airborne transmission
TB
Measles
Varicella
Primary mode of spread of MRSA
Contaminated hands of healthcare workers
Give 4 examples of multi-resistant GNRs
Klebsiella
Acinetobacter
Enterobacter
Pseudomonas
What are the most common demographics infected with multi-resistant GNRs?
Community
Returned travellers
What are the 6 main sites and types of infection in HAIs?
Surgical site IV line associated Nosocomial pneumonia (often ventilator associated) Catheter associated UTI Prosthetic joint infection Diarrhoea
5 major hospital associated bacterial pathogens
MRSA VRE Multiresistant GNRs C. difficile TB
4 major hospital associated viral pathogens
Respiratory viruses e.g. influenza
Norovirus
Varicella
Measles
2 major hospital associated fungal pathogens
Aspergillus
Candida
What type of infection does norovirus cause?
Gastroenteritis
How is norovirus spread?
Contaminated food or water
Touching contaminated surfaces
Via droplets from vomitus
How do you establish whether an outbreak has occurred?
Subtype pathogen
Try to identify source
When is it not appropriate to use alcohol based handwash products?
If hands visibly soiled
If pt has norovirus or C. diff
5 moments of hand hygiene
Before touching a pt Before procedure After procedure or body fluid exposure risk After touching pt After touching pt's surroundings
When are standard precautions used?
For all pts at all times when risk of exposure to blood, all body fluids (except sweat), non-intact skin and mucous membranes
What equipment is used in standard precautions?
Gloves, gowns, goggles
What are contact precautions?
Use of gowns and gloves for all pt contact
When are contact precautions used? Give 4 examples
Diarrhoea
Excessive wound drainage
Multidrug resistant organisms
Respiratory viruses
What additional piece of equipment is required for droplet precautions?
Surgical masks
When are droplet precautions used? Give 3 examples
Pertussis
Meningococcus
Respiratory viruses
When is a single room appropriate?
For anything above standard precautions (contact, droplet, airborne)
Airborne precautions room should have door closed
What piece of equipment is specific to airborne precautions?
Negative pressure ventilation using N95 mask
When are airborne precautions used? Give 5 examples
TB Varicella Measles Pandemic influenza SARS
What are 2 ways decolonisation can be achieved?
Nasal mupirocin for Staph aureus (incl MRSA)
Chlorhexidine
What are “bundles” of care?
3-5 evidence based processes tied together as a bundle (e.g. central line bundle, ventilator bundle, MRSA bundle), where compliance is “all or nothing”
Designed to reduce HAIs
What is the goal of surgical antibiotic prophylaxis and how is this achieved?
Prevention of surgical site infection
Ensure maximal concentration at time of incision (usually via single dose)
When is surgical antibiotic prophylaxis used? Give examples
If significant risk of infection (e.g. colonic resection)
If infection has devastating consequences (e.g. prosthetic joint infection)
What 6 vaccinations should healthcare workers have to prevent risk of infection?
Influenza Hep B MMR Varicella Hep A and pertussis in certain groups
List 6 important preventative measures for HAIs
Hand hygiene Abx stewardship Transmission precautions Bundles Environmental cleaning Abx prophylaxis