ID-Hospital Acquired Infections

Question 1

What is one of the most important reasons for hospital acquired UTIs?

Answer 1

Urinary catheters placed for inappropriate reasons or for a prolonged period of time

Question 2

Should you obtain routine urinalyses and cultures on pts with foleys?

Answer 2

No–because without symptoms or signs of infection you’ll likely get a dirty urine and treat a uti that is not real, causing a CAUTI and increasing risk for antibiotic resistance

Question 3

What are components of CAUTI prevention?

Answer 3

• avoiding urinary catheter use and considering alternatives: condom cath, purewick, intermittent cath
• not checking urine culture unless symptoms

Question 4

What organism is most commonly associated with surgical site infection?

Answer 4

S. aureus

Question 5

Does post-operative antibiotic treatment prevent surgical site infections?

Answer 5

NO!!!

Question 6

Management of CLABSI based on pathogen: CoNS

Answer 6

Remove catheter and do antimicrobial therapy for 5-7 days

if catheter not removed, then systemic antimicrobials with lock therapy for 10-14d

Question 7

Management of CLABSI based on pathogen: Staphylococcus aureus–no immunosuppression or active malignancy

Answer 7

Remove catheter, antimicrobials for >14 d

Question 8

Management of CLABSI based on pathogen: Enterococcus

Answer 8

Remove catheter, antimicrobials: 7-14 days

Question 9

Managemetn of CLABSI based on pathogen: Gram negative bacilli

Answer 9

Remove catheter, antimicrobials 7=14 days

Question 10

Management of CLABSI based on pathogen: candida

Answer 10

remove catheter, antifungal for 14 days after first negative blood culture

Question 11

Complicated CLABSI with suppurative thrombophlebitis, endocarditis, osteomyelitis, or other site of metatstatic or deep seated infection

Answer 11

Remove catheter, antimicrobials for 4-6 weeks, 6-8 weeks for osteomyelitis

Question 12

Does hospital acquired pneumonia or VAP caused by pseudomonas need two agents for synergy?

Answer 12

There is no evidence that indicates that HAP or VAP caused by Pseudomonas requires combination or synergistic combo (typically talking about aminoglycosides)

Question 13

Best way to avoid HAP?

Answer 13

Avoid ventilation!

Question 14

How can the transmission of drug resistant bugs be reduced in the hospital?

Answer 14

Hand washing
Precautions (contact, airborne, droplet)
cleaning and disinfecting
judicious use of antimicrobials