Hospital Acquired Infections

Question 1

Give the definition of hospital acquired pneumonia:

Answer 1

pneumonia that develops after more than 48 hours in a hospital

Question 2

What is ventilator-associated pneumonia?

Answer 2

pneumonia that develops in intubated patients in the intensive care unit

Question 3

What severity scale is used to assess pneumonia?

Answer 3

CURB-65

Question 4

What CURB-65 score should encourage you to consider intensive care?

Answer 4

3 or more

Question 5

Give 6 causative organisms of hospital acquired pneumonia:

Answer 5

1) Streptococcus pneumoniae
2) Haemophilus influenzae
3) MRSA
4) Moraxella catarrhalis
5) Pseudomonas aeruginosa
6) Staphylococcus aureus

Question 6

Name 3 IV antibiotics commonly used to treat HAP:

Answer 6

1) amoxicillin
2) doxycycline
3) clarithromycin

Question 7

What is a central-line associated blood stream infection?

Answer 7

a lab-confirmed bloodstream infection not related to an infection at another site that develops within 48 hours of central line placement

Question 8

Give 2 causative organisms of central-line associated blood stream infections:

Answer 8

1) coagulase-negative staphylococci (Staph. epidermidis)
2) Staphylococcus aureus

Question 9

Give 2 veins where central lines are commonly inserted:

Answer 9

1) jugular vein
2) femoral vein

Question 10

Give 4 presentations associated with central line associated blood stream infections:

Answer 10

1) fever
2) chills
3) sepsis-like symptoms (altered mental state, lethargy)
4) pain, swelling or discharge at the site of the central line

Question 11

What investigation is used for diagnosing central line associated blood stream infections?

Answer 11

blood cultures - one from the central line and one from a peripheral vein

Question 12

What is considered a positive result when using blood cultures to test for central line associated blood stream infections?

Answer 12

isolation of the same pathogen from a blood culture from the central line and peripheral vein with the single bacteria colony count being at least three times higher in the central line as compared to that obtained from a peripheral vein

Question 13

Give two treatments used for central line associated blood stream infections:

Answer 13

1) remove all non-tunnelled central lines
2) empiric antibiotics

Question 14

What antibiotic typically is used to treat MRSA?

Answer 14

vancomycin

Question 15

What is a catheter-associated UTI?

Answer 15

a UTI in which the positive urine culture was taken when an indwelling urinary catheter has been in place for more than two days

Question 16

Give 4 presentations associated with catheter-associated UTI:

Answer 16

1) suprapubic pain
2) feeling the need to urinate
3) flank pain
4) signs of urosepsis

Question 17

Give three ways used to help diagnose catheter-associated UTIs:

Answer 17

1) urinalysis
2) urine culture
3) blood cultures (if bacteraemia is suspected)

Question 18

Give two treatments of catheter-associated UTIs:

Answer 18

1) empiric antibiotics
2) remove/ replace catheter

Question 19

Give 3 bacteria genera that commonly cause surgical site infections:

Answer 19

1) Staphylococcus
2) Streptococcus
3) Pseudomonas

Question 20

Give 6 presentations associated with surgical site infections:

Answer 20

1) redness
2) delayed healing
3) fever
4) pain
5) swelling
6) pus discharge

Question 21

Give 6 risk patient factors for surgical site infections:

Answer 21

1) having long surgeries
2) being elderly
3) smoking
4) compromised immune system
5) being overweight
6) diabetes