HCAI

Question 1

what are the two advantages of having sick individuals in one location?

Answer 1

1. available facilities
2. concentration of expertisew

Question 2

what is the disadvantage of having sick individuals in one location?

Answer 2

enhanced possibility of transmission of infection between in individuals

Question 3

in the community the rate of infection is (fill in blank) than in healthcare environments

Answer 3

much lower

Question 4

4 factors that contribute to healthcare associated infections?

Answer 4

1. patients with underlying illness eg. same risk factors same infection susceptibility
2. patients with similar predisposing risk factors eg. neonatal unit
3. healthcare workers mov between patients
4. high usage of immunosuppressive drugs and antimicrobials which drives selective pressures
5. new susceptible patients introduced to new environment

Question 5

3 conditions to meet to be a HCAI

Answer 5

1. got it while in hospital or because of a healthcare-associated intervention
2. developed at least 48h after admission or within 48h of discharge
3. got by healthcare staff as a consequence of their work. eg. direct contact with patients or indirect through contact with contaminated blood

Question 6

what disease is a needle stick injury associated with

Answer 6

Hepatitis B

Question 7

what are the 5 predominant HCAIs? (with %)

Answer 7

1. Bacteraemia 30-40%
2. LRTI 15-20%
3. UTI 16-18%
4. Surgical wounds 8%
5. Other 17-19%

Question 8

what the top 4 UTI pathogens?

Answer 8

• E.coli
• Enterococci
• Staphylococci
• Candida

Question 9

what are the top 2 LRTI pathogens?

Answer 9

• Pseudomonas aeruginosa
• S.aureus

Question 10

What are the top 4 Surgical wound infection pathogens?

Answer 10

• Staphylococci
• Enterococci
• E.coli
• Pseudomonas aeruginosa

Question 11

What are the top 4 bacteraemia pathogens?

Answer 11

• Staphylococci
• Enterococci
• Candida
• E. coli

Question 12

6 examples of viruses causing HCAIs

Answer 12

• Influenza
• Varicella-zoster
• Measles
• Rotavirus
• Norovirus
• Hepatitis A, B and C

Question 13

Define an endogenous source of HCAIs

Answer 13

When the organism originates from a site within the patient; self or auto-infection

Question 14

Define an exogenous source of HCAIs

Answer 14

When the organism is derived from another patient or member of staff through cross-infection or from the hospital environment

Question 15

What is commensalism?

Answer 15

When one organism benefits whilst the other neither benefits nor suffers as a result of the relationship

Question 16

What is a parasitic relationship?

Answer 16

When only the parasite benefits and the host is usually harmed

Question 17

What is a mutualistic relationship?

Answer 17

When both organisms benefit

Question 18

Two alternative names for commensal flora

Answer 18

• normal flora
• microbiota

Question 19

procedures involving mucosal surfaces that lead from commensal to parasitic relationship

Answer 19

• insertion of urinary catheter leading to transfer of patient’s own flora
• bowel surgery
• intubation

Question 20

procedures leading to circumvention of host defence mechanisms which lead from commensal to parasitic relationship

Answer 20

• intubation and respiratory commensals accessing the lungs
• surgical wounds and wound infection by skin flora