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Microbiology > Hospital acquired infections > Flashcards

Hospital acquired infections Flashcards

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1
Q

how many US patients die from HCAIs every day

A

350

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2
Q

according to the UK national audit office what percentage of patient acquire HAI

A

9%

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3
Q

what makes hospitals complex environments helpful for pathogenic growth

A

Water circuits, shower and cooling tower aerosols;

medical and dental water aerosols, patients, staff and visitors: aerosols, touch surfaces

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4
Q

what are Hospital-Acquired (nosocomial) infections

A

a subset of infectious diseases acquired in a health care facility
To be considered nosocomial, the infection cannot be present at admission; rather, it must develop at least 48 hours after admission.

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5
Q

what are the 3 categories of risk factors for the invasion of colonising pathogens in a hospital

A
  • Iatrogenic risk factors
  • Organizational risk factors
  • Patient risk factors
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6
Q

what are the iatrogenic risk factors for pathogen invasion in hospitals

A

– invasive procedures (eg, intubation, indwelling vascular lines, urine catheterization)
– antibiotic use and prophylaxis.

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7
Q

what are the organisation risk factors for pathogen invasion in hospitals

A

– contaminated air-conditioning systems, water systems

– staffing and physical layout of the facility (eg, nurse-to-patient ratio, open beds close together).

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8
Q

what are the patient risk factors for pathogen invasion in hospitals

A

– the severity of illness, underlying immunocompromised state, and length of stay.

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9
Q

what surface cleaning problems do hospitals have

A

– Most surfaces are not smooth - they have draw marks, scratches (etc where pathogens can hide)
– Stainless steel is not easy to clean, as claimed: risk of cross contamination
– Hand hygiene compliance is poor, even among professionals

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10
Q

what is terminal cleaning

A

environmental cleaning after discharge of a patient

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11
Q

which major antibiotic resistant bacteria is not eradicated by terminal cleaning

A

MRSA

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12
Q

what percentage of HCAIs are antibiotic resistant

A

70%

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13
Q

what are the ESKAPE Group of pathogens

A

six nosocomial pathogens that exhibit multidrug resistance and virulence: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp

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14
Q

what are ESBL bacteria? give examples

A

A group of bacteria that produce extended spectrum beta-lactamase. ESBL-producing bacteria can’t be killed by many of the antibiotics that doctors use to treat infections, like penicillins and some cephalosporins
( eg Acinetobacter baumannii, E. coli, P. aeruginosa)

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15
Q

give examples of thee superbugs commonly found in hospitals

A

MRSA (methicillin resistant Staphylococcus aureus)
VRE (vancomycin resistant enterococci)
Clostridium difficile spores

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16
Q

what are the causes of antibiotic resistance

A
  • Over prescribing of antibiotics
  • Patients not finishing their treatment
  • Over-use of antibiotics in livestock and fish farming
  • Poor infection control in hospitals and clinics
  • Lack of hygiene and poor sanitation
  • Lack of new antibiotics
17
Q

give examples of when copper has been used to protect human health in the past

A

 Egypt (2000 BC) - Sterilize drinking water and wounds
 Greece, Hippocrates (400 BC) – Treat leg ulcers related to varicose veins
 Aztecs – Copper oxide and malachite for skin conditions
 France (1850 AD) – Copper workers found to be immune during Cholera epidemic
 USA, Phildadelphia Hospital Study (1983 AD) – Low E. coli count on brass doorknobs
 Punjab, India (2005 AD) – E. coli eliminated in 24 hours in water-filled brass containers (TamraJal used for 5000 years)

18
Q

why is copper antimicrobial?

A

it is reactive due to the free electrons in the outer shell, electron transfer reactions can take place (+alterations between redox states). Release of copper ions occurs when microbes are transferred by touching, sneezing or vomiting, land on the copper surface. The ions prevent cell respiration, punch holes in the bacterial cell membrane or disrupt the viral coat, and destroy the DNA and RNA inside. the extremely reactive hydroxyl radical produced in reactions with hydrogen peroxide can also participate.

19
Q

antimicrobial copper can be used against what water and food borne pathogens

A

Legionella pneumophila, Helicobacter pylori, E. coli O157

Salmonella, Listeria monocytogenes

20
Q

what hospital acquired pathogens can antimicrobial copper fight

A
  • MRSA, VRE, C. difficile,
  • A. baumannii, K. pneumoniae NDM-1 etc
  • Viruses - influenza H1N1, norovirus, adenovirus
  • Fungi- Candida, Aspergillus (HVAC systems)
21
Q

what is MRSA

A

Methicillin Resistant Staphylococcus aureus “super bug”
A major human pathogen responsible for a range of infections.
Essentially resistant to all β–lactam antibiotics.

22
Q

why is MRSA resistant to all β–lactam antibiotics

A

due to the possession of the mecA gene encoding the low-affinity penicillin binding protein.

23
Q

what drugs are called the ‘antibiotics of last resort’

A

Carbapenems (eg meropenem)

24
Q

drugs developed in the evolution of β-lactamase to carbapenamases

A
  1. Penicillins
    • β-lactamases
  2. Cephalosporins
    • BS β-lactamases
  3. Cephalosporins e.g. cefoxatime
    • for ESBL:- CTX, OXA, TEM
  4. Carbapenems e.g. meropenem
    • for KPC, NDM-1
25
Q

what are transconjugants

A

a bacterial cell which has received genetic material by conjugation with another bacterium. (can transfer antibiotic resistance genes) (Cu can prevent transfer)

26
Q

how do you works out conjugation frequency

A

no. of transconjugants / no. of donor cells

27
Q

what relevant genes does the K.pneumoniae NDM-1 plasmid carry

A

Carries 12 resistance genes, including blaNDM-1, armA, and qnrB1, confers resistance to the three key antimicrobial classes (carbapenems, aminoglycosides, and fluoroquinolones).

28
Q

what equations represents why bacterial metabolic suicide on Copper occurs

A

Cu (I) + H2O2 → Cu (II) + O2 + OH- + OH.
Rapid 200,000x uptake of Cu(I) in seconds and attack
Generation and attack by Reactive Oxygen Species

29
Q

rapid destruction of genomic and plasmid nucleic acid could…

A

prevent mutational resistance developing
help reduce the spread of antibiotic resistance genes to receptive and potentially more virulent organisms
as well as genes responsible for virulence and toxin production.

30
Q

high-touch surfaces made of antimicrobial copper alloys harbour________ fewer bacteria than equivalent, non-copper surfaces in busy wards undergoing routine cleaning worldwide

A

80-90%

Microbiology (12 decks)

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