Hospital Acquired Infections Flashcards
What are the most common types of hospital-acquired infections?
- staphylococcus aureus (MRSA)
- clostridium difficile (C. diff)
- escherichia coli (E. coli)
These pathogens pose significant challenges due to their increasing antibiotic resistance.
What type of bacteria is Clostridium difficile?
Gram-positive, rod-shaped, anaerobic bacteria
C. diff is often associated with antibiotic use and healthcare settings.
What can allow C. diff to proliferate in the intestines?
Interruption of the normal intestinal microbiome by antibiotics
C. diff may colonize without symptoms until antibiotics disrupt the balance.
What toxins does Clostridium difficile produce?
- Toxin A (enterotoxin)
- Toxin B (cytotoxin)
These toxins are responsible for the symptoms and complications associated with C. diff infection.
Which antibiotics are most associated with Clostridium difficile infections?
- Clindamycin
- Ciprofloxacin
- Cephalosporins
- Carbapenems
- Co-amoxiclav
All these antibiotics start with the letter āCā.
What are the clinical features of a C. diff infection?
- Colonisation - usually asymptomatic
- Infection - diarrhoea, nausea, abdominal pain
- Infection with colitis - diarrhoea, nausea, abdominal pain, dehydration, systemic symptoms (fever, tachycardia, hypotension)
Symptoms can vary based on the severity of the infection.
How is Clostridium difficile diagnosed?
Based on stool samples, testing for:
* C. diff antigen (especially glutamate dehydrogenase)
* A and B toxins
Stool tests are crucial for confirming the presence of C. diff.
What is the first-line treatment for a first episode of C. diff infection?
Oral vancomycin for 10 days
Other treatment options may be considered if the first line is not effective.
What is the management for recurrent C. diff episodes less than 12 weeks apart?
Oral fidaxomicin
Management strategies differ based on the timing of recurrent episodes.
What is a potential treatment for life-threatening C. diff infections?
Oral vancomycin + IV metronidazole
This combination is used in severe cases to combat the infection.
What is faecal microbiota transplantation?
Transfer of stool microbiome from a donor to a patient
This method is used for recurrent C. diff cases and can be administered via capsules, colonoscopy, or enema.
What complication of C. diff infection involves inflammation in the large intestine?
Pseudomembranous colitis
Characterized by yellow/white plaques forming pseudomembranes on the bowel wall.
What is toxic megacolon?
Severe inflammation in the large intestine leading to dilation of the colon
It poses a high risk of bowel rupture and requires supportive care and possibly surgical intervention.
What is MRSA?
Methicillin-resistant Staphylococcus aureus infection
one of first organisms that highlighted dangers of hospital acquired inf
How should a MRSA screen be performed?
- nasal swab or swab of skin lesion/wound
Who should be screened for MRSA?
- all patients awaiting elective admissions
Most common antibiotic used to treat MRSA
- vancomycin
