Healthcare associated infections Flashcards
What are healthcare associated infections?
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
What are the outcomes of healthcare associated infections?
Extended length of stay, pain, discomfort, permanent disability or death
Increased cost
Litigation
Loss of public confidence and decreased staff morale
What are the common sites of infection?
UTI Surgical site infection Resp tract infection Bloodstream infection Skin and soft tissue
What are the means of transmission of infection?
Direct contact
Respiratory/droplet
Faecal-oral
Penetrating injury
What infections can spread through direct contact?
Staph aureus, coliforms
What infections can spread through droplets?
Neisseria meningitides, mycobacterium TB
What infections can spread via faecal oral route?
C diff, salmonella
What infections can spread through penetrating injury?
Group A streps, bloodborne viruses
What is cleaning?
Physical removal of organic material and decrease in bacterial load
When is cleaning used?
Low risk instruments e.g. intact kin contact
Before disinfecting/sterilising
What is disinfection?
Large reduction in microbe numbers but spores remain
When is disinfecting used?
Some medium risk e.g. mucous membrane contact
What are the methods of disinfecting?
Heat- pasteurisation e.g. linen, boiling e.g. vaginal specula
Chemical
What is sterilisation?
Removal/destruction of all microbes and spores
When is sterilisation used?
Some medium risk instruments
High risk instruments e.g. surgical
What are the methods of sterilisation?
Autoclave (steam under pressure)
Hot air oven
Gas (ethylene dioxide)
Ionising radiation
What are the surveillance methods?
Local- lab based, clinical area
National- mandatory surveillance reporting
What infections are in mandatory surveillance reporting?
MRSA MSSA C diff Surgical site infection E coli
What is an outbreak?
2 or more cases of infection linked in time and place
What are the control measures in an outbreak?
Si gel room isolation
Clinical area/ward closure
Reinforcement of prevention measures
Staff exclusion and decolonisation
What is C diff?
part of normal gut flora in 2% adults and 30% elderly
Produces 2 toxins- toxin negative strains do not cause disease
What are the clinical characteristics of c diff infection?
Diarrhoea, characteristic odour of faeces, abdominal pain, pyrexia, increased WCC
Pseudomembranous colitis
What is the treatment if C diff infection?
Only treat if symptomatic
Oral metronidazole
Oral vancomycin if severe or failure to improve on metronidazole
Oral fidaxomicin if 2nd episode