Healthcare Acquired Infection

Question 1

Nosocomial infection is acquired during acute care in the _________. Whereas a healthcare associated infection can be acquired during any healthcare treatment

Answer 1

Hospital

*usually identified 48-72 hours to rule out incubating infection at admission

Question 2

When did Incentivizing HAI prevention through regulatory pressure begin?

Answer 2

Oct 2008

*Non-payment rules for “never events”

Question 3

What is the estimated U.S. acute care hospital infections in 2011?

Answer 3

722,000 infections in 648,000 patients (roughly 4% of admissions)

Question 4

What are the top 5 sites of infection?

Answer 4

1-Pneumonia
1-surgical site infections
3-gastrointestinal illness
4-UTI
5-Primary bloodstream infections

Question 5

How are HAIs typically identified?

Answer 5

By applying standardized surveillance criteria

Question 6

What are the top 5 leading organisms causing HAIs in U.S. acute care hospitals?

Answer 6

1-C difficile
2-S aureus
3-Klebsiella spp.
4-E. Coli
5-Enterococccus species

Question 7

Which group includes carbapenem resistant enterobacteriaceae?

Answer 7

E. Coli and enterobacter spp.

Question 8

Which group includes vancomycin resistant enterobacteriaceae?

Answer 8

Enteroccocus spp.

Question 9

Which group is commensal usually and resistant to methicillin?

Answer 9

Coagulase neg staphylococcus

Question 10

Which group includes carbapenem resistant A baumannii (CRAB)?

Answer 10

Acinetobacter baumannii

Question 11

What is the most commonly identified pathogen causing HAIs?

Answer 11

Clostridium difficile

Question 12

What are the two kinds of approaches in preventing HAIs?

Answer 12

1-Vertical (target specific pathogen)

2-Horizontal (broad and not pathogen specific)

Question 13

What are two ways for a patient to be exposed to exogenous organisms?

Answer 13

1-Healthcare worker behavior (poor hand hygiene)

2-Contaminated shared equipment

Question 14

What 5 pathogens are typical of direct and indirect contact?

Answer 14

1-MRSA
2-VRE
3-CRE
4-C difficile
5-Norovirus,RSV

*prevent by using gloves

Question 15

Which 6 pathogens are spread by droplets or splashing?

Answer 15

1-Neisseria memingitidis
2-Pertussis
3-Group A strep
4-H influenza
5-Influenza
6-RSV

*protect using mask and eyeware

Question 16

Which 5 pathogens are spread airborne?

Answer 16

1-Tuberculosis
2-Chicken pox
3-Measles
4-Influenza?
5-SARS (novel coronavirus)?

*protect with fitted N95 mask or Powered air purifying respirator

Question 17

What are the two main ways endogenous organisms are given opportunity to invade?

Answer 17

1-Surgery

2-Invasive devices (urinary catheter, vascular catheter, ventilators)

Question 18

What two organisms are most common for surgical site infections?

Answer 18

1-S aureus

2-coag neg staph

Question 19

What 4 organism commonly cause central line associated bloodstream infection (CLABSI)?

Answer 19

1-Coag neg staph
2-S aureus
3-Enterococcus
4-Candida

Question 20

Which three enteric gram negatives are likely causes of Ventilator associated pneumonia (VAP)?

Answer 20

E. Coli
Klebsiella
Enterobacter

Question 21

Which four non-fermenting gram negatives are likely causes of Ventilator associated pneumonia (VAP)?

Answer 21

1-P. aeruginosa
2-Acinetobacter
3-S. Aureus
4-Legionella