Hospital acquired infections (I) Flashcards
Define hospital acquired infections.
Infections that are contracted 48 hours after hospitalisation, that were not present or incubating at the time of admission
What are hospital acquired infections also known as?
Nosocomial infections
What are hospital acquired infections a result of?
Direct result of healthcare intervention:
- medical or surgical treatment
- direct contact with a healthcare setting
What are some risk factors for hospital acquired infections? (6)
- age >70
- lengthy hospital stays
- foreign bodies - catheters, mechanical ventilation
- recent antibiotic use
- metabolic diseases (especially DM)
- immunosuppression
What is the difference between MRSA and MSSA?
- MRSA - methicillin-resistant S. aureus
- MSSA - methicillin-sensitive S. aureus
What are the most common hospital acquired infections? (3)
- surgical site infections
- respiratory infections - pneumonia, LRTI
- UTI
- (bloodstream infections)
- (GI infections)
What are the most common causative pathogens for surgical site infections? (2)
- E. coli
- S. aureus
What are the most common causative pathogens for nosocomial pneumonia? (2)
- S. aureus
- P. aeruginosa
- (can also get ventilator-associated pneumonia)
What are the most common causative pathogens for nosocomial UTIs?
E. coli
What are the most common causative pathogens for bloodstream infections?
S. aureus
What are the most common causative pathogens for GI infections?
C. difficile
What is the main multidrug-resistant organism in hospitals?
MRSA (Methicillin-Resistant Staphylococcus Aureus)
What are the symptoms of sepsis - hospital acquired infections? (5)
- fever
- rigors
- myalgia
- dizziness
- confusion
What are the symptoms of MRSA/MSSA/PVL-SA - hospital acquired infections? (5)
- cellulitis
- impetigo
- abscesses
- folliculitis
- SSSS - Staphylococcal scalded skin syndrome
What are the symptoms of C. difficile - hospital acquired infections? (4)
- persistent diarrhoea
- fever
- loss of appetite
- abdominal pain
What conditions does E. coli cause - hospital acquired infections? (3)
- UTI
- haemolytic uraemic syndrome (HUS)
- gastroenteritis
What condition does norovirus cause - hospital acquired infections?
Gastroenteritis
What are the specific risk factors for E. coli - hospital acquired infections? (3)
- age
- winter
- male gender
What are the specific risk factors for C. difficile - hospital acquired infections? (5)
- age
- underlying disease
- antibiotic therapy
- recent hospital stay
- NGTs
What are the specific risk factors for MRSA - hospital acquired infections? (4)
- age
- underlying illness
- open wounds
- invasive devices - urinary catheters
What are the specific risk factors for PVL-SA - hospital acquired infections? (5)
5 Cs (+ younger age)
- Contaminated items
- Close contact
- Crowding
- Cuts
- Chronic skin conditions
What are the first-line investigations for hospital acquired infections? (5)
- O2 sats
- CXR
- FBC
- blood gas
- blood culture
What infection precautions can we take for hospital acquired infections? (8)
- hand hygiene
- PPE
- safe use and disposal of sharps
- sterile venepuncture technique
- appropriate waste disposal
- appropriate dealing with blood and body fluid spillage
- appropriate laundry
- decontamination with cleaning, disinfection and sterilisation
When do we consider antibiotic prophylaxis for long-term catheters?
Only consider Abx prophylaxis for those who have symptoms of UTI
How do we take care of enteral feeding devices to prevent hospital acquired infections?
Wash stoma daily with water, flush feeding tube before and after feeding (boiled water for immunosuppressed)
How do we manage an MRSA hospital acquired infection?
- 1st line: vancomycin
- teicoplanin
- 2nd line: linezolid
