Healthcare Acquired Infections

Question 1

What is the difference between colonisation and infection?

Answer 1

Colonisation - Bacteria are present in the noses of many individuals (staff, relatives of patient) Infection - A break in the bodies natural defences has allowed the organism which has colonised a part of the body to enter the body beneath the skin

Question 2

What are the microbial and host factors that can lead to an increased risk of infection?

Answer 2

Microbial: - Increased resistance - Increased virulence - Increased transmissability - Increased survival ability - Ability to evade host defences Host: - Foreign devices inserted (central line, catheter, ventilation) - Antibiotics - Breaks in skin surface - Immunosuppression - Extremes of ages

Question 3

What are the main modes of transmission of microbes?

Answer 3

1) Direct contact - Staph aureus 2) Respiratory/droplet - Neisseria meningitidis, Mycobacteria TB 3) Faecal-oral - C.diff, Salmonella 4) Penetrating injury - Group A Strep

Question 4

What is the chain of infection and how can it be broken?

Answer 4

Chain of infection: - Source of microbe - Transmission - Host Break the chain: - Awareness of risks - Infection prevention and control - Hand hygiene - PPE - Vaccination - Post-exposure prophylaxis

Question 5

What is meant by cleaning?

Answer 5

• Physical removal of organic material and decrease in microbial load - Using detergent - Drying is essential

Question 6

What is meant by disinfection?

Answer 6

• Large reduction in microbe numbers - spores may still remain - Use heat and chemicals

Question 7

What is meant by sterilisation?

Answer 7

• Removal/destruction of ALL microbes & spores - Use seam, heat, gas or radiation

Question 8

How are outbreaks identified?

Answer 8

An outbreak is when there are 2 or more cases of an infection linked in time and place

Question 9

How are outbreaks controlled?

Answer 9

• Single room isolation - Cohorting of cases - Closure of clinical or ward areas - Staff exclusion or decolonisation

Question 10

Reduction in which 4 drugs can reduce the chances of acquiring C.difficle?

Answer 10

Ceftriaxone

Co-amoxiclav

Clindamycin

Ciprofloxacin

Question 11

How should C.diff be treated?

Answer 11

Oral metronidazole

Question 12

What are the clinical features of C.diff?

Answer 12

Diarrhoea

Faeces with a characteristic odour

Pyrexia

Raised WCC