Hospital Acquired Infections Flashcards
What is a hospital acquired infection
An infection caught whilst hospitalised.
What is the medical term for a hospital acquired infection
Nosocomial
Why is most nosocomial infections due to bacteria?
Because antibiotics are frequently used in hospitals and this can causes resistance so bacteria within the hospital is different to outside.
Define nosocomial infection
Strictly an infection which is not present or incubating prior to 48 hours of admittance.
What is the prevalence of healthcare associated infections
6.4%
What are the percentages of health care associated infections
Respiratory infection - 22.8%
Urinary tract infections - 17.2%
Surgical Site infection - 15.7%
What are risk factors that cause nosocomial infections
Increase duration of hospital stay Indwelling catheters Mechanical ventialtion Total parenteral nutrition Antibiotic usage Use of histamine beta blockers Age Immune deficiency
What is HAP
Nosocomial pneumonia refers to any pneumonia contracted by a patient in a hospital at least 48-72 hurst’s after being admitted.
What is HAP caused by
Caused by a bacterial infection
What are the common bacteria involved in HAP
Pseudomonas aeruginosa
Staphylococcus aureus
Klebsiella Pneumoniae
E coli
What is an UTI
An infection involving any part of the urinary system
What is the most common type of health associated infection
UTI
How are UTIs normally acquired
Through catheters
Whats the most important risk factor for a catheter associated UTI
Prolong use of it
Give some examples of uni BACTERIA
E coli Pseudomonas species Enterococcus species staphylococcus aureus. Coagulase- negative staphlyococci
Describe an E Coli bacteria
Gram negative
Faculatively anaerobic
Rod shaped
Warm blooded organisms.
Define sepsis
a life threatening condition when the body response to infection causes injury to its own organs and tissues.
What are the common signs of sepsis
Fever
Increased heart rate
Increased breathing rate
confusion
How are you more likely to develop sepsis
Recently had Surgery
a catheter has been fitted
Stayed in hospital for a long time.
What other conditions is sepsis usually associated with
Gi tract- liver disease, gall bladder disease Gu Tract- urinary tract obstruction pElvis Lower respiratory tract Vacualr Heart
What are the symptoms of sepsis
Shivering Extreme pain Pale or discoloured skin Sleepy I feel like I might die Short breath
in 2007 what were the underlying infections that caused 9000 hospital deaths
MRSA and C.DIFF
What is MRSA
Gram + bacteria
Difficult to treat
Type of staph bacteria that is resistant to many antibiotic treatment.
Which antibiotics is MRSA completely resistant to
penicillin
Cephalsporin
How can MRSA be transmitted in a hospital
Wound infections
Pneumonia
What is C.diff
Spore forming anaerobic gram positive bacillus bacteria
Produces exotoxins A and B
Usual human habitat large intestine
How do you test for c.diff
Requires 2 test
Clostridium difficile antigen - Glutamate dehydrogenase identifies the presence of the organism
Or Toxin test
- ELISA
PCR
what is CDAD
It is the clinical presentation of c.diff associated diarrhoea where the toxins cause inflammation of the intestinal wall
What are the risk for infection for CDAD
Any antibiotics can induce CDAD as they alter the gut flora allowing c diff to flourish and produce toxins.
What are other risk factors for CDI
Age above 65 Previously had CDI Recent hospitalisation Antibiotic exposure Immunocompromised
What is the treatment for CDI
conservative treatment
stop antibiotics
supportive therapy
dieticians referral
What is GRE glycopeptide resistant enterococci
Found in the bowel
Can cause UTI and bacteria
Which antibiotics are GRE resistant to
Vancomycin
teicoplanin
What are the two common species of GRE
E. Faecalis
E. Faecium
GRE occurs in which hospital patents
Immunocompromised
prolonged stay
What are some vancomycin resistant treatment options
Enterococcus faecalis- amoxicillin
Enterococcus faecium resistant to amoxicillin so use linezolid or daptomycin
What is daptomycin
A cyclic lipopeptide which acts against gram +
It destructs the membrane potential leading to inhibition of protein, Dna and rna synthesis
How is antibiotics inactivated
Bacteria acquire genes encoding enzymes that inactivate antibiotic such a beta lactamases and carbapenemases
What are extended spectrum BETA Lactamases ESBLS
Are enzymes which can produce bacteria making them resistant to cephlaspmrims.
What antibiotics are ESBL e coli able to resist
Penicllin and cephalpsoirms.
