I: Healthcare Infections

Question 1

What are healthcare infections?

Answer 1

Infections arising as a consequence of providing healthcare.

Question 2

At which different stages on the infection model can infection be prevented?

Answer 2

• Intervene before the pathogen meets the patient

- Intervene with the mechanism of infection

Question 3

Name some HAI that are viruses.

Answer 3

• Hep B, C
• HIV
• Influenza
• Chickenpox

Question 4

Name some HAI that are bacteria.

Answer 4

• Staph aureus (including MRSA)
• C. Diff
• E.coli
• TB

Question 5

Name some HAI that are fungi.

Answer 5

• Candida albicans

- Asperillus species

Question 6

Name some HAI that are parasites.

Answer 6

Malaria

Question 7

What patient factors may impact on the number of HAI?

Answer 7

• Extremes of age
• Obesity/ malnourishment
• Diabetes
• Cancer
• Immunosuppression
• Smoker
• Surgical patient
• Emergency admisssion

Question 8

Name the 4 P’s of prevention.

Answer 8

1. Patient
2. Pathogen
3. Practice
4. Place

Question 9

Expand on patient infection prevention.

Answer 9

• Interactions with other patients
• Interactions with healthcare workers
• Interaction with visitors

Question 10

Expand on pathogen infection prevention.

Answer 10

• Virulence factors

- Ecological interactions

Question 11

Expand on practice related infection prevention.

Answer 11

• Activates of health workers e.g. Carrying sharps
• Policies and their implementation
• Political initiatives

Question 12

Expand on place related infection prevention.

Answer 12

• Fixed features (e.g. How close beds are)

- Variable features (e.g. Isolation rooms)

Question 13

Describe the principles of antibiotic resistance.

Answer 13

It is inevitable as antibiotics are selective and hence create a selective pressure. One an antibiotic is given, the susceptible strains are killed, whilst the rests at strains survive to multiple and be passed on.

Question 14

What is PPE?

Answer 14

Personal Protective Equipment such as gloves and masks which protect the health care worker from infection.

Question 15

Describe some global issues relating to drug resistance.

Answer 15

• India: Prescriptions aren’t required to purchase antibiotics over the counter
• China: Prescribe shit tons of antibiotics for their livestock

Question 16

Describe the characteristic of C.Diff.

Answer 16

• Diarrhoea as it presents in the large intestine

- Fever

Question 17

Describe the pathogenesis of C.diff.

Answer 17

• Bacteria (gram positive bacilli)
• when antibiotics are prescribed for a patient (in particular amoxicillin) it depletes normal gut flora meaning their is less competition so this bacteria thrives

Question 18

Describe the pathogenesis of staph aureus.

Answer 18

Staph aureus has virulence factor called coagulase. This promotes the conversion of fibrinogen to fibrin. This means it is able to form blood clots around itself within the blood, preventing phagocytosis

Question 19

Describe the clinical presentation of norovirus.

Answer 19

• Vomiting

- Diarrhoea

Question 20

How is the norovirus spread?

Answer 20

Faecal oral route

Question 21

How would a norovirus infection be managed? (Use 4 P’s)

Answer 21

Pathogen: Removal of contaminated feaces

Patient: Isolate, keep admissions to a minimum

Practice: Education about viral gastronitis, good communication

Place: Patients should be isolated in a side room. They will need their own designated toilet and commode. Special care required with laundry and cleaning of contaminated areas and rooms.