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Year 3 Infection (JK) > Healthcare associated infections > Flashcards

Healthcare associated infections Flashcards

1
Q

Define HAI

A

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

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2
Q

4 possible outcomes of HAI

A

litigation
increased hospital stay, pain, discomfort, permanent disability and death
increased cost
loss of public confidence and decreased staff morale

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3
Q

6 most common sites of HAI

A 
UTI 
respiratory tract infections 
skin and soft tissue infections 
GI infections 
bloodstream infections
surgical site infection
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4
Q

How many different species of bacteria have been isolated from the human stool?

A

over 500

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5
Q

What percentage of the population is colonised with staph aureus and where is it found in humans?

A

30%

in their nose

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6
Q

Most people colonised with staph aureus is MRSA or MSSA?

A

MSSA

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7
Q

List 4 ways the same strain colonising can cause infection - examples

A

break in the skin eg surgical site infection
vascular device eg CVC
catheter associated UTI
ventilator associated pneumonia

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8
Q

5 microbial factors tipping the balance towards infection- increased…

A 
virulence 
transmissibility 
ability to evade hosts immune defences 
resistance 
survival ability
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9
Q

List some host factors tipping the balance towards infection

A 
break in the skin 
immunosuppression 
other drugs eg PPI 
devices eg catheter 
overcrowding 
age
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10
Q

3 parts of the chain of infection

A

source of microbe (endogenous or exogenous)
transmission
host

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11
Q

4 means of transmission and an example of a microbe transmitted this way

A

faecal oral - c diff
direct contact - staph aureus
respiratory/droplet - Neisseria meningitidis, TB
penetrating injury - blood borne viruses

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12
Q

List some ways to break the chain of infection

A 
appropriate PPE 
SIPCs
risk awareness 
closure of wards 
vaccination
hand hygiene
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13
Q

Define cleaning

A

physical removal of organic material and decrease in microbial load

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14
Q

Define disinfection

A

Large reduction in microbe numbers - spores may remain

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15
Q

Define sterilisation

A

Removal or destruction of ALL microbes and spores

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16
Q

Give an example of a low risk piece of equipment and how to decontaminate it

A

stethoscope - intact skin contact

cleaning compatible with manufacturers instructions

17
Q

Give an example of a medium risk piece of equipment and how to decontaminate it

A

mucous membrane - endoscope

disinfect or sterilise as appropriate

18
Q

Give an example of a high risk piece of equipment and how to decontaminate it

A

surgical instruments

sterilisation

19
Q

Explain the concept of cleaning

A

manufacturers instructions
detergent and water
drying
essential prior to disinfection and sterilisation

20
Q

2 methods of disinfection

A

heat

chemicals

21
Q

Heat - disinfection

A

pasteurisation or boiling

22
Q

Heat - chemical

A

vary in organism range and must be equipment compatible

eg alcohol, Hydrogen peroxide

23
Q

4 ways to sterilise

A

steam under pressure - autoclave
hot air oven
gas
ionising radiation

24
Q

Define outbreak

A

2or more cases of an infection linked in time and place

25
Q

What is the first purpose of IPC?

A

prevent individual infections and outbreaks

26
Q

What is the purpose of surveillance?

A

detect and identify a possible outbreak at the earliest opportunity

27
Q

What must be done to confirm an outbreak?

A

typing

28
Q

5 typing methods

A 
antiobiogram - antibiotic sensitivity pattern 
phage typing 
serotyping 
pyocin typing 
molecular typing
29
Q

6 outbreak control measures

A 
single room isolation 
ward closure 
staff exclusion 
cohort cases 
reinforce PIC measures 
staff decolonisation
30
Q

Clinical characteristics of C diff

A

diarrhoea
faeces have characteristic odour
abdominal pain, pyrexia, increased WCC
pseudomembranous colitis

31
Q

Epidemiology of c. diff colonisation

A

2% population
increases with age
30% elderly

32
Q

Do toxin negative strains of c.diff cause disease?

A

no

33
Q

What makes you more susceptible to c.diff infection?

A

imbalance in gut flora
elderly
antibiotics

34
Q

What needs to be present for a c.diff diagnosis?

A

diarrhoea

35
Q

First thing to do in c.diff infection

A

stop antibiotics predisposing if possible

36
Q

Symptomatic treatment of c.diff

A

oral metronidazole
oral Vancomycin if severe
oral fidaxomicin if 2nd episode

37
Q

4 C antibiotics

A

cephalosporins
co-amoxiclav
clindamycin
ciprofloxacin

Year 3 Infection (JK) (12 decks)

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