Hospital Epidemiology

Question 1

define HAI -Healthcare (Hospital) associated/acquired Infection (HAI)

Answer 1

An infection associated in time with being in a health care facility. Generally, an infection that manifests itself 48-72 hours after admission or up to 48 hours after discharge.

Question 2

Reason that hospitalized patients are at high risk of infection?

Answer 2

• Underlying illnesses
• Cross-transmission of hospital flora
• surgery
• Antibiotic use
• Nurse to patient ratio
• Shared equipment

Question 3

Why is healthcare associated infection are a particular public health problem?

Answer 3

Antimicrobial resistance implications
Associated with serious clinical disease
Newly discovered or re-emerging pathogen

Question 4

where do Endogenous pathogens come from?

Answer 4

the patient

Question 5

where do Exogenous come from?

Answer 5

a source apart from patient

Question 6

example of Exogenous

Answer 6

healthcare personal- PPE
water and other solutions
instruments sterilization

Question 7

example of endogenous

Answer 7

skin flora
skin infection/uti
GI tract

Question 8

risk factors for Exogenous

Answer 8

prolonged hospital stay
shaving/hair removal
length of operation
prophylactic use

Question 9

risk factors for endogenous

Answer 9

Diabetes mellitus
Advanced age
Obesity
Malnutrition, recent weight loss
Cancer
Immunosuppressed (e.g., steroid use)
Other remote site of infection/colonization

Question 10

o How would you approach the investigation of a cluster of post-operative bacterial or other healthcare acquired infections?

Answer 10

Case-control study
Cases - patients who underwent a procedure during a specific time interval who developed surgical site infections
Controls – patients who underwent surgery during the same time period who did not develop infections

Question 11

Types of infections that are of most concern and how they occur?

Answer 11

UTI-most common

Pneumonia-2nd most common, most fatal

Question 12

How would you establish a surveillance mechanism for a healthcare acquired infection ?

Answer 12

urinary catheter associated UTI’s/# urinary catheter days x1000

Question 13

Goals of Surveillance for HAIs?

Answer 13

Establish baseline endemic rates
Identify outbreaks/clusters
Identify specific infection/colonization risk factors
Evaluate and improve control measures
Decrease endemic HAIs

Question 14

define Hospital-wide survelliance

Answer 14

Captures “everything”
Generates more data than there is time and resources to analyze and act on
Requires many resources
Inefficient

Question 15

define targeting surveillance

Answer 15

Unit specific
Infection type specific
periodic