Hospital acquired infection

Question 1

what is a hcai

Answer 1

a hospital care acquired infection oocurs as a result of healthcare not incubating at the time of initial healthcare exposure,

Question 2

what is the cut off time for hcai

Answer 2

Cut-off usually 48-72 hours. after initial healthcare exposure

Question 3

what are the 5 most common forms of HCAI

Answer 3

HAP, surgical site infection, urinary tract infection, c difficile colitis, hospital acquired bacteraemia

Question 4

why are hospital acquired infections such a problem

Answer 4

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

Question 5

list patients who are susceptible to hcai

Answer 5

young and old patients,
immunosupressed patients,
patients with prosthetic and implantable devices,
diabetic, obese, patients undergoing invasive procedures

Question 6

name some super resistant organisms

Answer 6

mrsa, vre,cro,esbl

Question 7

what has cause birth of super resistant micro organsims

Answer 7

Widespread prolonged use of (broad spectrum) antibiotics

Question 8

what has made transmission of hcai so easy

Answer 8

poor handwashing, multiple bed moves, invasive devices, poor infection control, enviromental hygiene, isolation facilaties, poor staff ratios

Question 9

what are endogenous sources of pathogens

Answer 9

live in or on patients, skin flora/ gut and urogenital flora

Question 10

what are exogenous sources of pathogens

Answer 10

acquired from hospital or us and other patients

Question 11

where are s aureus found in normal flora and what type of bacteria are they

Answer 11

skin flora gram positive

Question 12

where are s epidermidis found on humans and what type of bacteria are they

Answer 12

skin flora gram positive,

Question 13

describe properties of resident skin flora

Answer 13

protective function, not easily removed by hand washing cause infection only by skin breaks

Question 14

describe properties of transient skin flora

Answer 14

loosely attached to skin, easily transferred, easily removed by handwashing, improtant source of cross infection, abundant around finger tips

Question 15

what is transient flora is most common cause of vaginitis

Answer 15

Transient organisms (Candida spp.) frequent cause of vaginitis

Question 16

what can affect vagina flora

Answer 16

age, ph and hormone level

Question 17

why do we use mid stream urine samples

Answer 17

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

Question 18

SOURCES of pathogens
EXOGENOUS - those that patients get from:
 The hospital environment

Answer 18

c diffcile, s aureus, legionella,aspergillus, psuedomonas

Question 19

SOURCES of pathogens
EXOGENOUS - those that patients get from:
us and other patients

Answer 19

blood borne viruses, influenza, norovirus, s aureus and c difficile

Question 20

how are endogenous flora transmitted to patient

Answer 20

they transmit it to themself

Question 21

how are exogenous microbes transmitted

Answer 21

contact (direct or indirect), respiratory (air droplet or aerosol), vector borne in enviroment, vertical(in utero or peripartum)

Question 22

what pathogens can be transmitted via direct contact

Answer 22

MRSA, MSSA, norovirus

Question 23

what pathogens can be transmitted by indirect contact e.g contamination of enviromental object then contact by patient

Answer 23

c dfiicile, influenza, mrsa,mssa

Question 24

how do you prevent contact transmission from lines

Answer 24

make sure it is needed, hcw must wash hands, clean site of line, after insertion check daily and remove in a timely fashion

Question 25

when should you use handwashing not just alcohol gel

Answer 25

after toliet, visibly soiled hands, spore forming pathogens

Question 26

what drugs can you treat c dificille or colitis with

Answer 26

think four cs 
Cephalosporins
Co-Amoxiclav
Clindamycin
Ciprofloxacin

Question 27

how can we prevent c diffficle

Answer 27

hand washing soap and water, not alcohol gel, ppe and isolation

Question 28

do bacteria in respiratory and gut tend to be gram positive or negative

Answer 28

gram negative