Infection Control Flashcards
What is infection?
Deposition and multiplication of bacteria and other micro-organisms in tissue or on surfaces of the body with an associated tissue reaction
How can C diff infection develop and spread?
Patient on antibiotics leads to diruption of gut flora which then leads to c dif bacteria proliferating and leading to symptomatic infection i.e. gut becomes the reservoir for infection
Diarrhoea contaminated with c diff leads to spread within hospitals via faecal-oral spread
what are the types of healthcare associated infections?
Pneumonia
Urinary infection
Surgical site infection
Gastroenteritis
Bloodstream infections
What is MRSA? What are the consequences?
Meticilin resistant Staphylococccus aureus
Ie.. resistant to flucloxacilin
Can cause a range of infections (deep seeded infections) but often colonises without causing infection
- skin infections
- chest infection
- endocarditis
- bone infection
- bacteraemia
- death
How can MRSA be detected?
Screening programmes via nasal/groin swabs and wound/urine/line sites and sputum tests
Why is surgical prophylaxis important in patients with MRSA?
Used to prevent surgical site infection complications associated with MRSA
Vancomycin is used as prophylaxis when patient has staphylococcus aureus colonisation
What is C dif?
Anaerobic gram positive bacilli which lives in gut and produces spores and toxins= toxins result in diarrhoea
What are the consequences of c dif infection?
Watery diarrhoea
Abdominal pain
Pseudomembranous colitis
Dehydration
Bowel perforation
Death
Recurrence of c dif infections
Why does c dif infection occur?
Colonisation of gut due to cross-infection after antimicrobials taken for an infection
Leads to over-growth of bacteria in the gut leading to toxins causing bowel damage
What should be done if patient identified with c dif infection?
Stop antibiotics
Start treatment
Monitor fluids
Specialists review
Terminal clean
Place patient in side room
Which drugs can be used to treat C dif?
Metronidazole
Oral vancomycin
Fidaxomicin
FMT i.e. donor faecal treatment
What are enterobacteriaceae?
Family of bacteria which live in bowels of healthy individuals
E.coli Klebsiellla Enterobacter Proteus Salmonella
What are the consequences of enterobacteriaceae?
UTI Intra-abdominal infections Pneumonia Bacterial meningitis Septic arthritis Osteomyelitis Endocarditis Bacteraemia
What is E. coli bacteraemia and what are the most common causes?
Spread of infection into blood from primary source
Causes:
- UTI
- unknown source
- hepatobiliary
- GI
Elderly at greatest risk
What is an example of a last resort antibiotics?
Carbapenems
-broad spectrum antibiotics used to treat antibiotic resistant enterobacteriaceae
How does carbapenem resistance develops?
Carbapenemase enzymes produced by bacteria which destroy carbapenem antibiotics making the bacteria resistant
What are examples of carbapenem-resistant organisms?
CPOs (carbapenem-producing organisms) Eg: -acinetobacter baumannii -pseudomonas aeruginosa -stenotrophomonas maltophilia
CPEs (carabapenem-producing enterobacteriaceae)
- klebsiella
- pneumonia
- Escherichia coli
- enterobacter cloacae
How can MDR gram negatives (CPEs) be controlled?
Screening
Isolation
Hand hygiene
Decontamination of the environment
Antibiotic restriction
What are the interventions for CPE prevention?
Antibiotic stewardship Hand hygiene Cleaning + disinfection Active screening Contact precautions Education
What type of bacteria is acinetobacter baumanii? Why is this bacteria so difficult to treat? What problems is it associated with?
Gram negative CPO
-hard to treat due to being resistant to multiple antibiotics and can remain on surfaces for 1 year
-adapts to hospital environment and forms biofilm on wards and wounds
-
Associated with wound colonisation and ventilator-associated pneumonia
What are the cleaning control measures for a MDR organisms?
Environment screening
Enhanced cleaning
Decant and deep clean
Use of hydrogen peroxide
Implement rapid cleaning team
Commence inter-theatre trip terminal cleaning
Embed an assurance framework for cleaning in theatres
Where is pseudomonas aeruginosa commonly found?
Soil, water and moist environments
I.e. can colonise hospital and domestic sinks and colonise patients at moist sites
Water transmission is very serious concern
How can pseudomonas aeruginosa spread and prevalence by reduced?
Filters on taps
Replacement of taps
Policies about not disposing of dirty water down sinks
What is the appropriate PPE for TB?
Aprons and gloves
Eye protection i.e. full face visor or goggles
FFP3 respirators
What are the different mechanisms of antibiotic resistance?
Efflux pump: bacterial pumps antibiotic out of cell
Decreased uptake
Inactivating enzymes
Alterations to drug targets
