Hospital acquired infections/ Nosocomial infection

Question 1

What’s nosocomial infection

Answer 1

infection acquired while in healthcare institution

not present/incubating at time of admission

Question 2

What are the major types of nosocomial infections?

Answer 2

1. UTI
2. Surgical site infection
3. pneumonia/lower resp tract infection
4. bloodstream infection
   = 70-80% of HAI
5. other infections eg skin

Question 3

Important HAI pathogens need to know!

Answer 3

1. S aureus
2. Coagulase negative staphylococci (skin infections)
3. Other gram +ve cocci eg enterococcus
4. Enterobacteria (GNR) eg E coli, klebsiella, enterobacter
5. Nonfermentative GNR eg pseudomonas, acinetobacter baumannii
6. Clostridium difficile (anaerobic GPR, spores)
7. candida
8. aspergillus– immunocompromised pt
9. various viruses

Question 4

Pathogenesis of HAI

Answer 4

1. Host defenses depressed
2. Anatomical barriers breached
3. Exposure to virulent organisms

Question 5

What’s the most common source of pathogen in HAI?

Answer 5

Endogenous flora of pt

Question 6

What are the multiresistant pathogens in HCAI?

Answer 6

1. MRSA
2. VRE
3. ESBL (Enterobacteriaceae)
4. Carbapenem-R Enterobacteriaceae
5. MultiResisPA (psuedom aeru)
6. MRAB (acinetobacter baumannii)
7. Clostridioides difficile

Question 7

Hand hygiene

Answer 7

1. alcohol more efficacious– alcohol rub 20-30 sec

2. vs water soap = 40-60 sec

Question 8

Precautions for infection control

Answer 8

1. standard precautions – all pt
2. transmission-based precautions
   - contact MRSA
   - droplet influenza
   - airborne (tb): -ve pressure air flows into room so pathogen not escape