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Infection > Healthcare acquired infections > Flashcards

Healthcare acquired infections Flashcards

1
Q

What is HAI?

A
  • infections that were not present or in the pre-symptomatic phase at the time of admission to hospital - which arise > 48 hrs after admission or within 48 hrs of discharge
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2
Q

How many patients have HAI?

A

4.9% patients in Scotland in 2011

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3
Q

What are possible outcomes of HAI?

A

Extended length of stay, pain, discomfort, permanent disability, death

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4
Q

What are the most common sites of HAI?

A
  • UTI (22.6% of all HAI) – mainly related to catheterisation - Surgical Site Infection (18.6%) - Respiratory Tract Infection (17.5%) – intubation accounted for about a quarter of these - Bloodstream infections (10.8%) – many Central Venous (CVC) Catheter related
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5
Q

What risk do microbes pose to humans?

A

EVERYONE and EVERYTHING harbours microbes that may pose a risk! - Patients in hospital are more vulnerable to microbial colonisation AND infection

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6
Q

What is the fundamental question in clinical microbiology?

A

Colonisation versus infection

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7
Q

Who discovered staph aureus?

A

Alexander Ogston

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8
Q

What is MSSA?

A

Meticillin sensitive staphylococcus aureus

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9
Q

How much of the population has staph aureus in their nose?

A

30%

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10
Q

How can a colonised strain of staph aureus cause infection?

A
  • Break in skin e.g. surgical site infection - Vascular device e.g. PVC, CVC - Catheter associated urinary tract infection (CAUTI) - Ventilator associated pneumonia (VAP)
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11
Q

Which microbial factors tip the balance towards infection?

A

Increased: resistance, virulence, transmissibility, increased survival, ability to evade host defences

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12
Q

Which host factors tip the balance towards infeciton?

A

Devices: PVC, CVC, Urinary catheter Antibiotics Break in skin surface Foreign body Immunosuppression

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13
Q

What are some means of transmission for infection?

A
  • Direct contact - Resp. droplet - Faecal oral - Penetrating injury
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14
Q

How can we break the chain of infection?

A

Risk awareness Standard Infection Prevention and Control Precautions (SICPs) Hand Hygiene Appropriate PPE Vaccination Post Exposure Prophylaxis Environment

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15
Q

How can cleaning break the chain of infection?

A

Physical removal of organic material and decrease in microbial load

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16
Q

How can disinfection break the chain of infection?

A

Large reduction in microbe numbers - spores may remain

17
Q

How can sterilisation break the chain of infection?

A

Removal/Destruction of ALL microbes and spores

18
Q

What is low, medium and high risk factors for infection transmission and how do we counter these?

A

Low: intact skin contact - cleaning will fix Medium: mucous membrane contact - disinfection will fix High: surgical instruments - sterilisation will fix

19
Q

What is an important part of the cleaning process?

A

DRYING IS AN IMORTANT PART OF THE PROCESS

20
Q

What are two methods of disinfection?

A

Heat: Pasteurisation + Boiling Chemical: Chemicals vary in their organism activity range Needs to be equipment compatible - alcohol

21
Q

What are 4 methods of sterilisation?

A

Steam under pressure (autoclave) Hot Air Oven Gas (ethylene dioxide) Ionising Radiation

22
Q

What is the definition of an outbreak?

A

infection is defined as 2 or more cases of a infection linked in time and place

23
Q

How do we act when there is an outbreak?

A

Act on suspicion: Typing necessary to determine if the same strain present

24
Q

What are some control measures during an outbreak?

A
  • Single room isolation
  • Cohorting of cases
  • Clinical Area/Ward Closure
  • Re-inforcement of IPC measures
  • Staff exclusion (e.g. colonised staff in case of MRSA; non-immune staff in case of VZV, measles etc.)
  • Staff decolonisation or other measures
25
Q

What are the clinical features of C.diff.?

A
  • Diarrhoea - Faeces may have odour - Abdomen pain, pyrexia, raised white cell count - pseudomembranous colitis
26
Q

What percentage of peeps have c.diff as part of normal gut flora?

A

2% but carriage rate increases with age so by elderly 30% will have it!

27
Q

How can c.diff have effect?

A

Need 2 toxins to be produced - occurs when there is an imbalance in gut flora - Variable in severity - Elderly more susceptible

28
Q

Lab tests for C.diff?

A

Positive Toxin Test DOES NOT ALWAYS MEAN DISEASE!

29
Q

Why is c.diff infection still occuring?

A

Not possible to prevent all cases All antibiotics can predispose to CDI although some are more predisposing than others New strains? Less handwashing because more handgelling? Environmental contamination may still be an issue? Increased no. of vulnerable patients close together? Increased throughput of patients? Other drugs having an effect e.g. PPIs?

30
Q

What is the treatment of c.diff?

A

STOP THE ANTIBIOTICS PREDISPOSING TO C difficile IF POSSIBLE If symptomatic, treatment: - oral metronidazole - oral vancomycin - Oral fidaxomicin

Infection (12 decks)

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