Hospital-Acquired Infections Flashcards
1
Q
Examples of HAI organisms and clinical syndromes
A
2
Q
Definition of HAI
A
• Onset within certain period from contact, not present on admission, possible acquired in hospital
3
Q
Most common HAI syndromes
A
HAP → SSI → UTI → BSI → GII (25, 19, 17, 14,8)
4
Q
Impacts of HAI
A
- high cost (£1bn/year), increase length of stay
- 3.5-10.5% of all hospitalised patients in industrialised countries get HAIs
- 8% of all UK infections are HAI
- 4m/year HAIs in Europe → 37,000 die as a result
5
Q
Role of surveillance
A
- … baseline rate, detect clustering, resource allocation, assess impact
- E.G. C difficile spore surveillance – gram positive spore-forming anaerobe
-
E.G. E. coli bacteraemia surveillance – incidence increasing due to ABx resistance, methods to reduce increase:
- Reduce number of bugs (i.e. sterilise, washing, etc.)
- Reduce number of resistance bugs (i.e. screen patients)
- Prioritise side rooms (i.e. for fever + rash in ED; for homeless man with cough and abnormal CXR)
- Medical education (i.e. hand cleaning technique)
6
Q
3 groups of doctors for the influence of an SSI
A
host defence
wound environment
pathogens
7
Q
MRSA BSI → implications
A
- Morbidity Prolonged infection
- Affects bed capacity Repeat surgery
- Prolonged antibiotics Use of isolation rooms
- Complications
8
Q
Infection control strategies
A
Reduced infection →measuring → analysing → improving infection control activities
9
Q
Carbapenemase-producing Enterobacteriaceae (CPE)
A
- Triple threat = Resistance, Rapid spread, Mortality
- Management = right drug, PKPD (right dose, polypharmacy, penetration/tissue conc., therapeutic drug monitoring), duration of therapy
- The landscape for HCAIs is changing… invasive procedures, prosthetics, obesity, diabetes, extremes of age, etc.
10
Q
Influences on HAI
A
- Ward layout/design (i.e. 1 basin per 6 beds)
- Cleaning responsibility
- Staffing ratio
- Clarity of roles
- Organisational structures