Hospital Acquired Infections Flashcards
What is a health-care associated infection?
Infections that occur after exposure to healthcare
>48 hours after admission to hospital
List 5 medical interventions that can increase the risk of infection.
Catheterisation Intubation Lines (e.g. central venous lines) Chemotherapy Prosthetic material
State 2 other factors that increase the risk of infection in the hospital setting.
Dissemination by healthcare staff
High conc. of ill patients
What are the ESCAPE pathogens?
Enterococcus faecium Staphylococcus aureus Clostridium difficile Acinetobacter baumanii Pseudomonas aeruginosa Enterobacteriaceae
ESC = Gram-positive APE = Gram-negative
What is the main problem with the escape pathogens?
Abx resistant
What is the most frequent cause of bacteraemia by a Gram-negative bacterium?
E. coli
Which antibiotics is E. coli resistant to in many countries?
Which antibiotics is E. coli still sensitive to?
Resistant to Cephalosporins
Sensitive to Carbapenems
What is ESBL encoded on?
Plasmid
What are carbapenemases encoded on?
Transposon (mobile genetic element)
What types of infections does Klebsiella pneumoniae tend to cause?
UTI
Respiratory tract
Which classes of antibiotics are Klebsiella widely resistant to?
Cephalosporins, fluoroquinolones + aminoglycosides
Carbapenem resistance in USA
Which group of patients are at risk of Klebsiella and P. aeruginosa infection?
Immunocompromised
Which class of antibiotics is P. aeruginosa widely resistant to?
Carbapenems
What is Enterococcus faecium widely resistant to? What does it cause?
Vancomycin
Causes blood stream infections
State the target protein and method of resistance to Cephalosporins
Target: Penicillin binding proteins (PBP)- inhibits peptidoglycan synthesis
Resistance: Extended-Spectrum Beta-Lactamase (ESBL) enzyme cleaves cephalosporin, inactivating it
