Healthcare Infections

Question 1

What kind of infections are associated with providing healthcare?

Answer 1

UTIs
GI infections
Surgical wound infections
Pneumonia
Skin and soft tissue infections
Primary bloodstream infections

Question 2

What is the I-5?

Answer 2

Identify- (abroad, bb infections, colonised, diarrhoea/vomiting, expectorating, funny looking rash)
Isolate
Investigate
Inform
Initiate

Question 3

What kind of factors increase risk of contracting a healthcare related infection?

Answer 3

Various factors increase a patient’s risk of getting a HCAI:

• Extremes of age
• Obesity or malnutrition
• Diabetes
• Cancer
• Immunosuppression
• Smoker
• Surgery
• Emergency Admission (any procedures carry more risk as reduced preparation

Question 4

What are the 4P’s of infection prevention?

Answer 4

Patient: reduce interaction with other patients and healthcare workers, good hygiene, antimicrobial prophylaxis

Pathogen: reduce virulence factors, use disinfectants and antimicrobials

Practice: leadership, good policies and implementation, not over prescribing antibiotics

Place: reducing variable factors e.g hospital side room, sterile equipment

Question 5

Clostridium Difficile infection is common in healthcare. Give an overview of its features

Answer 5

Gram positive bacillus

Spore forming- spores survive unfavourable conditions and are therefore a means of reproduction; they can tolerate dryness, cold and give off poisonous
chemicals

Minor component of normal flora of large intestine

Use of antibiotics (amoxicillin, clindamycin, cephalosporin, quinolones (ciproflaxin, levoflaxin) kills normal gut flora
C. Difficile can thrive as there is fewer microbiota to compete, easier to proliferate.

Toxin A:

Enterotoxin ‣ Causes excessive fluid secretion ‣ Stimulates inflammatory response ‣ Cytopathic effects on tissue

Toxin B

Cytotoxin ‣ Disorganisation of cytoskeleton ‣ Disrupts protein synthesis, disorganisation of cell cytoskeleton

Rx- metronidazole, vancomycin, fidoxamicin