Hospital-Acquired Infections Flashcards

1
Q

Examples of HAI organisms and clinical syndromes

A
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2
Q

Definition of HAI

A

• Onset within certain period from contact, not present on admission, possible acquired in hospital

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3
Q

Most common HAI syndromes

A

HAP → SSI → UTI → BSI → GII (25, 19, 17, 14,8)

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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
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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)
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6
Q

3 groups of doctors for the influence of an SSI

A

host defence

wound environment

pathogens

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7
Q

MRSA BSI → implications

A
  • Morbidity Prolonged infection
  • Affects bed capacity Repeat surgery
  • Prolonged antibiotics Use of isolation rooms
  • Complications
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8
Q

Infection control strategies

A

Reduced infection →measuring → analysing → improving infection control activities

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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.
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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
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