Hospital Epidemiology and the Laboratory

Question 1

Healthcare Associated Infections (HAIs)

Answer 1

infections acquired while receiving healthcare treatment

Question 2

Colonization

Answer 2

presence of organisms on a body surface without disease

Question 3

Infection

Answer 3

organisms invade body tissues causing disease

Question 4

How do the US monitor HAIs?

Answer 4

Through the CDC’s National Healthcare Safety Network (NHSN)

Question 5

What are NHSN reports used for?

Answer 5

to comply with state and federal reporting mandates, benchmark data

Question 6

Common HAIs in Acute Care Settings

Answer 6

pneumonia, surgical site infection, gastrointestinal illness, UTIs, primary bloodstream infection

Question 7

Leading HAI causing organisms in the US

Answer 7

C. difficle, S. aureus, Klebsiella spp., E. coli, Enterococcus spp. coagulase-negative Staphylococcus spp. and many more

Question 8

What is THE most commonly identified pathogen causing HAIs?

Answer 8

Clostridium difficile (CDI)

Question 9

Infection process

Answer 9

1) organism
2) reservoir
3) portal of exit
4) transmission
5) portal of entry
6) vulnerable hosts
* each link must be present for infection to occur

Question 10

Why are hospitalized patients at high risk?

Answer 10

they have increased exposure to exogenous organisms form healthcare worker behavior like poor hand hygiene and contaminated shared equipment

Question 11

When should you wash your hands as a healthcare worker?

Answer 11

1) before touching a patient
2) before clean/aseptic procedure
3) after body fluid exposure risk
4) after touching a patient
5) after touching patient surrondings

Question 12

Standard Body Substance Precautions

Answer 12

with all patient contact, hand hygiene. Involves gloves, gown, mask, eye protection/face shield as needed

Question 13

What are some diseases that can be transmitted by direct or indirect contact?

Answer 13

MRSA, VRE, CRE, C. difficile, norovirus, RSV

Question 14

What are some diseases that can be transmitted by droplets and splashes?

Answer 14

Neisseria meningitidis, pertussis, group A strep, H. influenza, influenza, RSV, other respiratory viruses

Question 15

What are some diseases that can be transmitted airborne?

Answer 15

tuberculosis, chicken pox, measles, influenza, SARS

Question 16

What immunizations should health-care workers get?

Answer 16

Influenza, MMR, Varicella, Hepatitis B, and Pertussis

Question 17

How can we prevent HAIs (vertically)?

Answer 17

active surveillance testing to identify carriers; contact precautions for patients with specific organism; decolonization of patients with specific organism

Question 18

How can we prevent HAIs (horizontally)?

Answer 18

Standard precautions, environmental cleaning, antimicrobial stewardship, gloves and gowns, universal decolonization

Question 19

Outbreak

Answer 19

more cases of disease than expected in a given area or amoung a specific group of people over a period of time

Question 20

Endemic

Answer 20

predicted number of cases

Question 21

Epidemic (outbreak)

Answer 21

significant increase from the endemic rate or an unusual infection

Question 22

What are the goals of an outbreak investigation?

Answer 22

1) identify the agent, reservoir, and mode of transmission
2) eliminate the reservoir
3) prevent transmission
4) prevent future outbreaks

Question 23

What are the steps to an outbreak investigation?

Answer 23

1) verify diagnosis
2) confirm outbreak
3) research the disease
4) case definition
5) descriptive epidemiology
6) develop a hypothesis
7) implement control and prevention measures
8) communicate findings

Question 24

Pseudoepidemics

Answer 24

either false clusters of real infections or real clusters of false infections (typically due to error in diagnosis or testing)