Health care associated infections

Question 1

What is a health care ass infection

Answer 1

Direct result of health care interventions eg medical or surgical treatment or being in contact with healthcare setting
As a result of treatment
Healthcare in community, bought in by paitetns, staff or visitors and transmitted to others eg norovirus

Question 2

Most common health care ass infections

Answer 2

Meticillin resistant stph aureus - MRSA
Meticillin snesitive staph aurues - MSSSA
C.difficile
E.coli

Question 3

How reduce risk HCAI

Answer 3

Appropriate infection control practice and good hygeine - hand washing
Safe prescribing and antimicrobial stewardship

Question 4

Examples of HCAIs

Answer 4

C.difficile
MRSA
CAUTI
MSSA-bactaraemia
Indwelling catherter line related infections
HAP/VAP neumonia
Surigcal site infections
GI infections eg norovirus as part of outbreak
Candida auris
CPE - carbapenemase produucing enterobacteriaceae
Antimicrobial resistant pathogens eg ESBL, GRE/VRE
Other transmissable infections - MDR/XDR TB, VHFs eg ebola, SARS/COVID19,, vCID, BBVs

Question 5

IMpact of HCAIs

Answer 5

Increased morality, morbidity, length of stay, antimicrobial resistnace, staff sickness, poor patient experience, financial costs, direct and indirect

Question 6

Legislations and regulations around HCAIs

Answer 6

Health and safety act 1974
COSHH - law on control of substances hazardous to health
Workplace regulations
Building regulations
HTMs and HBNs - health building notes

Question 7

What is a HTM

Answer 7

Health technical memoranda
Com advice and guidance on design, installation and operation o specialised bilding and engineering used in healthcare

Question 8

What is a HBN

Answer 8

Health building notes
Plans from initial oncept to post project evaluation in relation ot infeciton cotrol

Question 9

Water infection control

Answer 9

Water safety group -> water safety plan

Question 10

Water born pathgens

Answer 10

Pseurdomonas, legionella
Ass w hospital outbreask
Primarily immunocomp people a trisk

Question 11

Who is most at risk of infection

Answer 11

Immunocomp, children, burns, ICU

Question 12

Areas at risk of colonisation water borne pathogens

Answer 12

Types of taps, sinks - water tmeperature
Areas w low use - not flushing pipes/taps
Redundant piping

Question 13

How water safety works

Answer 13

Water sampling -> lab identify and uatify -> report -> action

Question 14

Ventialtion principles

Answer 14

Dilute contaminants
Control airflow path - ngative isolate patients, positive protect vulnerable patients, ultra clean ventialtion in joint replacements
Control of hazards - remove excess moisture
Comfort

Question 15

What is airborne transmission

Answer 15

Spread of infectious agent by dissemination of droplet nuclei/aerosols <5u remain infectious in air over long distances and time vs contact or droplet transmission

Question 16

Ventilation critical areas in a hospital

Answer 16

Surgical departmnet
Aseptic phaemacy prodyction
UCV theatre
Burns units
Labs
Obs/maternity
Laser surgical units
Isolation
Imaging units
Pathology deparmtnets
Mortuaries
Steriliser/packaging units
Hydrotherapy units
Infectious diseases units
Itensive treatment/therapy units

Question 17

What is MRSA

Answer 17

Meticillin resistnat staph aureus - gram positiev

Question 18

Infections caused by S.aureus

Answer 18

Cellulitis, oneumonia, endocarditis and device related infections
May colonise skin and nasopharynx not causing infection
Resitant to flucloaxacillin - most beta lactams
Often multi resistant - flurorquinones eg ciprofloxacin, laclonides eg azithromycin - always need to check

Question 19

Why screen MRSA

Answer 19

Different anitbiotics
Spread person person prevent
More common in healthcare faiclities

Question 20

What is CPE

Answer 20

Carbapenamase producing enterboacterales
eg e.coli, klebsiella
Gram negative bacteria from gut
Resist beta lactam
CPE breaks down carbapenam and most anitbiotics

Question 21

What are carbapenams

Answer 21

B lactams
eg merapenam
V broad specturm antibitoics
Resist most of beta lactamases produced by bacteria

Question 22

MRSA screening

Answer 22

Charcoal swab - black top
Separate for nose, throat, groin, wounds, device sites, csu if catherterised
Agar plates
Indicator dye = stpah aureus go green colonies
Anibiotics fluclox - if grows then MRSA

Question 23

CPE screening

Answer 23

Rectal seab or stool sample
TIMELY
Red topped swab for PCR
cHARCOAL SWAB for coluture
Different hospitals differnet numbers of swabs - three in 48 hrs
Selevtive agar for CPE - antibiotics and
PCR
Lateral flow
Only 5 most common genes