Hospital acquired infection Flashcards
what is a hcai
a hospital care acquired infection oocurs as a result of healthcare not incubating at the time of initial healthcare exposure,
what is the cut off time for hcai
Cut-off usually 48-72 hours. after initial healthcare exposure
what are the 5 most common forms of HCAI
HAP, surgical site infection, urinary tract infection, c difficile colitis, hospital acquired bacteraemia
why are hospital acquired infections such a problem
because they increase patient stay costing more money, they require isolation rooms , cause mortality which could have been prevented, they also drive antibiotic resistance requiring isolation rooms
list patients who are susceptible to hcai
young and old patients,
immunosupressed patients,
patients with prosthetic and implantable devices,
diabetic, obese, patients undergoing invasive procedures
name some super resistant organisms
mrsa, vre,cro,esbl
what has cause birth of super resistant micro organsims
Widespread prolonged use of (broad spectrum) antibiotics
what has made transmission of hcai so easy
poor handwashing, multiple bed moves, invasive devices, poor infection control, enviromental hygiene, isolation facilaties, poor staff ratios
what are endogenous sources of pathogens
live in or on patients, skin flora/ gut and urogenital flora
what are exogenous sources of pathogens
acquired from hospital or us and other patients
where are s aureus found in normal flora and what type of bacteria are they
skin flora gram positive
where are s epidermidis found on humans and what type of bacteria are they
skin flora gram positive,
describe properties of resident skin flora
protective function, not easily removed by hand washing cause infection only by skin breaks
describe properties of transient skin flora
loosely attached to skin, easily transferred, easily removed by handwashing, improtant source of cross infection, abundant around finger tips
what is transient flora is most common cause of vaginitis
Transient organisms (Candida spp.) frequent cause of vaginitis
what can affect vagina flora
age, ph and hormone level
why do we use mid stream urine samples
because on distal urethra there is sparse mixed flora,
Enterococci, S.epidermidis, diphtheroids most frequently
Also E.coli, Proteus, and non-pathogenic Neisseria,
MSU allows you to miss these microbes
SOURCES of pathogens
EXOGENOUS - those that patients get from:
The hospital environment
c diffcile, s aureus, legionella,aspergillus, psuedomonas
SOURCES of pathogens
EXOGENOUS - those that patients get from:
us and other patients
blood borne viruses, influenza, norovirus, s aureus and c difficile
how are endogenous flora transmitted to patient
they transmit it to themself
how are exogenous microbes transmitted
contact (direct or indirect), respiratory (air droplet or aerosol), vector borne in enviroment, vertical(in utero or peripartum)
what pathogens can be transmitted via direct contact
MRSA, MSSA, norovirus
what pathogens can be transmitted by indirect contact e.g contamination of enviromental object then contact by patient
c dfiicile, influenza, mrsa,mssa
how do you prevent contact transmission from lines
make sure it is needed, hcw must wash hands, clean site of line, after insertion check daily and remove in a timely fashion
when should you use handwashing not just alcohol gel
after toliet, visibly soiled hands, spore forming pathogens
what drugs can you treat c dificille or colitis with
think four cs Cephalosporins Co-Amoxiclav Clindamycin Ciprofloxacin
how can we prevent c diffficle
hand washing soap and water, not alcohol gel, ppe and isolation
do bacteria in respiratory and gut tend to be gram positive or negative
gram negative
