Hospital Acquired infections Flashcards
What are healthcare infections?
Infections arising as a consequence of providing healthcare where the patient (or healthcare workers and visitors) neither had or was incubating the pathogen at the time of admission (48hours after admission).
How do hospital acquired infections differ from the normal infection?
Infection acquired in hospital are often much more resistant to antibiotics and are different to the usual infection that that microorganism gives.
Why are people in hospital much more susceptible to infections?
They are likely to be: • Obese or malnourished • Have Diabetes • Be of an extreme of age • Have Cancer • Be Immunosuppressed • Smoke • Be a Surgical patient • Emergency admission
Where can we intervene to prevent infections?
This can occur at different stages of the infection being contracted. We could prevent the pathogen from existing in the same place. Prevent the infection from becoming an infection even if colonisation takes place and finally stope spread of the infection to other people.
What are the 4 P’s of infection prevention and control?
Patients – interactions with other patients, healthcare workers and visitors
Pathogen – virulence factors, ecological? Interactions suhc as other bacteria ad antibiotics/disinfectants
Practice – policies and implementation, organisational structure and engagement regional and national political initiatives and leadership at all levels from government to the ward
Place – healthcare environment designs features – isolation units cleaning facilities etc.
What are the sources of hospital acquired infections?
- Patients/visitors
- Healthcare workers
- Food
- Air
- Water
- Surfaces and equipment
- Animals
How can we intervene with a patients to prevent healthcare acquired infections?
- Optimise patient’s condition such as prevention of smoking or optimising blood sugar in diabetes
- Antimicrobial prophylaxis
- Skin preparation
- Hand hygiene
- MRSA screen before surgery
- Disinfectants body wash
- Physical doors such as double doors and pressure differentials between private rooms and corridors
How can we intervene with the healthcare worker to prevent healthcare acquired infections?
- Disease free and vaccinated
* Good practice – sterile non touch technique, hand hygeine and good antimicrobial prescription
How can we influence environmental factors preventing healthcare acquired interventions?
- Enough space and good layout
- Toilets and wash hand basins cleaned
- Cleaning disinfectants, steam cleaning and hydrogen peroxide vapour
- Medical devices are sterile, single use and decontaminated of devices that aren’t
- Appropriate kitchen and ward food facilities
- Positive/negative pressure rooms for theatres and immunosuppressed
What are the 5 I’s that assist us to prevent infections?
- Identify – (A-F): abroad, blood borne infections, colonised with MDR, Diarrhoea/vomiting, expectorating (coughing up) and Funny look rash
- Isolate the patient
- Investigate
- Inform everyone this patient will come into contact with
- Initiate appropriate treatment
Discuss Clostridium Difficile
Obligate anaerobe, gram positive, spore forming, rods that produces toxins as part of the pathological process. All antibiotic use predisposes to C.Diff infection. C.diff exerts pathological basis via taxins: Toxin A is an enterotoxin (toxin effecting the intestines) causing excessive fluid secretion and inflammation on the lining of the bowel wall. Toxin B disrupts protein synthesis within cells and is therefore cytotoxic
What other clostridia are there?
Clostridium perfringens- gas gangrene, food poisoning
Clostridium botulinum- botulism
Clostridium tetani –tetanus
Discuss Staph aureus
Staphylococcus Aureus (drug resistence) MRSA Gram-positive coccal bacteria, faccultive anaerobe, grape like structures. Produces enzymes such as coagulase which clots plasma and coats itself in it to prevent phagocytosis. Also releases extoxins.
Discuss Norovirus (winter vomiting bug)
Norovirus is a small, non-enveloped single stranded RNA virus that is a major cause of acute gastroenteritis outbreaks. There is no specific treatment available so treatment consists of supportive measures. Transmission is through faecal oral and also respiratory.
