Healthcare associated infections

Question 1

What are healthcare associated infections?

Answer 1

Infections that were not present or were in pre-symptomatic phase at time of admission to hospital, which arise >48 hours after admission or within 48 hours of discharge

Question 2

What are the outcomes of healthcare associated infections?

Answer 2

Extended length of stay, pain, discomfort, permanent disability or death
Increased cost
Litigation
Loss of public confidence and decreased staff morale

Question 3

What are the common sites of infection?

Answer 3

UTI
Surgical site infection
Resp tract infection
Bloodstream infection
Skin and soft tissue

Question 4

What are the means of transmission of infection?

Answer 4

Direct contact
Respiratory/droplet
Faecal-oral
Penetrating injury

Question 5

What infections can spread through direct contact?

Answer 5

Staph aureus, coliforms

Question 6

What infections can spread through droplets?

Answer 6

Neisseria meningitides, mycobacterium TB

Question 7

What infections can spread via faecal oral route?

Answer 7

C diff, salmonella

Question 8

What infections can spread through penetrating injury?

Answer 8

Group A streps, bloodborne viruses

Question 9

What is cleaning?

Answer 9

Physical removal of organic material and decrease in bacterial load

Question 10

When is cleaning used?

Answer 10

Low risk instruments e.g. intact kin contact

Before disinfecting/sterilising

Question 11

What is disinfection?

Answer 11

Large reduction in microbe numbers but spores remain

Question 12

When is disinfecting used?

Answer 12

Some medium risk e.g. mucous membrane contact

Question 13

What are the methods of disinfecting?

Answer 13

Heat- pasteurisation e.g. linen, boiling e.g. vaginal specula
Chemical

Question 14

What is sterilisation?

Answer 14

Removal/destruction of all microbes and spores

Question 15

When is sterilisation used?

Answer 15

Some medium risk instruments

High risk instruments e.g. surgical

Question 16

What are the methods of sterilisation?

Answer 16

Autoclave (steam under pressure)
Hot air oven
Gas (ethylene dioxide)
Ionising radiation

Question 17

What are the surveillance methods?

Answer 17

Local- lab based, clinical area

National- mandatory surveillance reporting

Question 18

What infections are in mandatory surveillance reporting?

Answer 18

MRSA
MSSA
C diff
Surgical site infection
E coli

Question 19

What is an outbreak?

Answer 19

2 or more cases of infection linked in time and place

Question 20

What are the control measures in an outbreak?

Answer 20

Si gel room isolation
Clinical area/ward closure
Reinforcement of prevention measures
Staff exclusion and decolonisation

Question 21

What is C diff?

Answer 21

part of normal gut flora in 2% adults and 30% elderly

Produces 2 toxins- toxin negative strains do not cause disease

Question 22

What are the clinical characteristics of c diff infection?

Answer 22

Diarrhoea, characteristic odour of faeces, abdominal pain, pyrexia, increased WCC
Pseudomembranous colitis

Question 23

What is the treatment if C diff infection?

Answer 23

Only treat if symptomatic
Oral metronidazole
Oral vancomycin if severe or failure to improve on metronidazole
Oral fidaxomicin if 2nd episode