Healthcare Associated Infections

Question 1

What is a HCAI

Answer 1

Any infection caused by any infectious agent acquired acquired either as a direct result of healthcare interventions such as medical or surgical, or from being in contact with the healthcare setting

Question 2

What kind of patients are at higher risk to HCAIs

Answer 2

Patients on antibiotics, cytotoxic drugs, steroids, patients with HIV, immunosuppressants, trauma (burns, post surgery)

Question 3

What are the two reservoirs for potential HCAIs

Answer 3

Endogenous (patients own flora)

Exogenous: another person, airborne, environment, catheter etc.

Question 4

Characteristics Clostridium difficile

Answer 4

Gram Positive, non-motile spore forming obligate anaerobic bacillus

• spread via faecal-oral route
• difficile to grow in culture
• spores can persist in the environment and resist heat and cold and not killed with alcohol rubs
• present in 2-15% of the gen pop

Question 5

Describe the pathogenesis of Clostridium Difficile

Answer 5

Disruption in the normal flora (e.g. by antibiotics).

• killing good bacteria leaves space for bad bacteria
• produce toxins

Question 6

Symptoms of Clostridium difficile infection

Answer 6

• Foul watery diarrhoea
• abdominal pain
• Ever and elevated WCC

Question 7

Characteristics of Staphylococcus aureus

Answer 7

• gram positive, non-motile, spherical, grows in chains
• haemolytic pattern on blood sugar
• 10-30% carry in gen pop

Question 8

Name some virulence factors of staphylococcus aureus

Answer 8

Produce enzymes (toxins) - collagenase, coagulase
- resistant to methicillin (MRSA)

Question 9

Characteristics of Candida albicans

Answer 9

Normal flora of mouth, DT and Vagina (commensal)

• invasive candidiasis, oral and vaginal infections (thrush)
• pathogenesis not fully understood
• candida auris is an emerging fungus that poses a global threat

Question 10

Symptoms of Candida albicans infection

Answer 10

• Thrush: pain during sex, urinating or abnormal discharge

- invasive candidiasis: candidaemia, most common fungal HCAI, mortality 40%

Question 11

Describe the pathogenicity of Candida albicans

Answer 11

• Can change cell morphology

- produces a range of difference enzymes that cause tissue damage

Question 12

What is an endemic

Answer 12

A disease that is constantly present in a population is an endemic disease, e.g. common cold

Question 13

What is an epidemic

Answer 13

A disease that spreads among many people in an era in a relatively short period of time e.g. influnza

Question 14

Define nosocomial

Answer 14

Originated in hospital