Healthcare-Associated Infection

Question 1

Which organisms are associated with catheter associated BSI?

Answer 1

MRSA

R Gram negs

MSSA

Yeasts/Candida

Question 2

Which organisms are associated with urinary catheter associated UTI?

Answer 2

Yeasts/Candida

E. coli

R Gram negs

MRSA

Question 3

Which organisms are associated with surgical site infection?

Answer 3

MSSA

MRSA

R Gram negs

Question 4

Which organisms are associated with ventilator associated pneumonia?

Answer 4

E. Coli

R Gram negs

Question 5

Which organisms are associated with antibiotic associated diarrhoea?

Answer 5

C. Diff.

Question 6

Summarise the epidemiology of HAIs.

Answer 6

• 4 million people in Europe get a HAI every year
• ~ 37,000 die as a direct result of the infection
• Antimicrobial use - key driver of antimicrobial resistance (AMR)

7.8% of patients in Europe

Question 7

What is the most common HAI?

Answer 7

Hospital acquired pneumonia

Question 8

What are other common causes of HAI?

Answer 8

Surgical site infection - 19%

Urinary tract infection - 17%

Bloodstream infection - 14%

Gastrointestinal infection - 8%

Question 9

What is C. Difficile?

Answer 9

Gram positive spore forming anaerobe. Spores are transmissible, contaminate environment, persist for long periods. Ingested spores germinate in gut. Gut flora disturbed by abx exposure, to different extents.

C. difficile produces toxins A and B.

• Diarrhoea, colitis
• Toxinotype III / BI / NAP1 / 027
• Pro-inflammatory – causes inflammation
• Cytotoxic – cell damage
• Enterotoxic – damage to the gut

Question 10

What is a good antibiotic for C. Difficile?

Answer 10

Fidaxomicin - macrolide antibiotic

Question 11

What are non-drug approaches to treating C. Difficile?

Answer 11

Faecal transfer: Fresh faeces, healthy donor, in saline, filtered

Question 12

What percentage of catheters become colonised?

Answer 12

60% colonised within 96h