Health care associated infections Flashcards
What is a health care ass infection
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
Most common health care ass infections
Meticillin resistant stph aureus - MRSA
Meticillin snesitive staph aurues - MSSSA
C.difficile
E.coli
How reduce risk HCAI
Appropriate infection control practice and good hygeine - hand washing
Safe prescribing and antimicrobial stewardship
Examples of HCAIs
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
IMpact of HCAIs
Increased morality, morbidity, length of stay, antimicrobial resistnace, staff sickness, poor patient experience, financial costs, direct and indirect
Legislations and regulations around HCAIs
Health and safety act 1974
COSHH - law on control of substances hazardous to health
Workplace regulations
Building regulations
HTMs and HBNs - health building notes
What is a HTM
Health technical memoranda
Com advice and guidance on design, installation and operation o specialised bilding and engineering used in healthcare
What is a HBN
Health building notes
Plans from initial oncept to post project evaluation in relation ot infeciton cotrol
Water infection control
Water safety group -> water safety plan
Water born pathgens
Pseurdomonas, legionella
Ass w hospital outbreask
Primarily immunocomp people a trisk
Who is most at risk of infection
Immunocomp, children, burns, ICU
Areas at risk of colonisation water borne pathogens
Types of taps, sinks - water tmeperature
Areas w low use - not flushing pipes/taps
Redundant piping
How water safety works
Water sampling -> lab identify and uatify -> report -> action
Ventialtion principles
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
What is airborne transmission
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
Ventilation critical areas in a hospital
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
What is MRSA
Meticillin resistnat staph aureus - gram positiev
Infections caused by S.aureus
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
Why screen MRSA
Different anitbiotics
Spread person person prevent
More common in healthcare faiclities
What is CPE
Carbapenamase producing enterboacterales
eg e.coli, klebsiella
Gram negative bacteria from gut
Resist beta lactam
CPE breaks down carbapenam and most anitbiotics
What are carbapenams
B lactams
eg merapenam
V broad specturm antibitoics
Resist most of beta lactamases produced by bacteria
MRSA screening
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
CPE screening
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
