Infection Control Flashcards
infection that was neither present nor in the prodromal (incubation) stage when they entered the hospital.
health care-associated infections (HAIs).
earliest efforts to control infection followed the recognition in the 19th century that women were dying in childbirth from bloodstream infections caused by
group A streptococcus (Streptococcus pyogenes)
ushered in the modern age of infection control in the late 1950’s
Staphylococcus aureus
is an infection contracted outside a health care setting or an infection present on admission.
Community-acquired infections
is an infection contracted outside a health care setting or an infection present on admission.
Community-acquired infections
Community-acquired respiratory infections commonly involve strains of _____ or _____ and are usually more sensitive to antibiotic treatment
Haemophilus influenzae or Streptococcus pneumoniae
act that was designed to stimulate economic recovery in various ways, including strengthening the nation’s health care infrastructure and reducing health care costs
American Recovery and Reinvestment Act of 2009 (February 17 2009)
within the recovery act ____ was authorized to support states in the prevention and reduction of HAI
50 million
has established the National Healthcare Safety Network (NHSN) program to monitor the incidence of HAI in the United States.
Centers for Disease Control and Prevention (CDC)
- monitor the incidence of HAI in the united states
- data collected are used to improve patient safety at the local and national levels
National Healthcare Safety Network (NHSN)
most prevalent HAI (most to least relevant)
UTI (33%)
Pneumonia (15%)
Surgical site infections (15%)
Bloodstream infections (13%)
other miscellaneous infections (24%)
patients with indwelling urinary catheters have a threefold increased chance of dying from ____
urosepsis
-a bloodstream infection that is a complication of a UTI
urosepsis
most HAIs are ___ in origin
endogenous
three principal factors that determine the likelihood that a given patient will acquire an infection
• Susceptibility to infection and/or immune status of the patient
• The virulence of the infecting organism
• The nature of the patient’s exposure to the infecting organism
all contribute to the likelihood of HAI by suppressing the immune system or altering the host’s normal microbiota to that of resistant microves
Corticosteroids, cancer chemotherapeutic agents, and antimicrobial agents
is it possible to immunize patients against HAI?
no. it can never be completely eliminated, only controlled
are the most common type of health care associated infection reported to the NSHN
UTIs
approx ___ are associated with a urinary catheter
75%
produce most health care associated UTIs, and escherichia coli is the number one organism involved
gram negative rods
cause the remainder of the health care associated UTIs
Gram-positive organisms, Candida spp and other fungi
the most common HAI pathogens that cause pneumonia include
gram negative rods
causes most community acquired pneumonias, are not not important etiologic agents in health care-associated infections except very early during the hospital course (first 2 to 5 days)
S. aureus
H. influenzae
Moraxella catarrhalis
S. pneumoniae
approx ___ of surgical patients develop surgical site infections; ___ of these infections develop after the patient has left the hospital
4%
cause most of these surgical infections, followed by gram neg rods and candida spp
gram positive organisms
is a serious infection that occurs when microbes enter the bloodstream through a central line
central line-associated bloodstream infection
a tube that health care providers place in a large vein in the neck, chest, or arm to give fluids, blood, or medications or to do certain medical tests quickly.
central line
In the preantibiotic era, most HAls were caused by ____ and _____
S. pneumoniae and group A Streptococcus (S. pyogenes),
In the 1940s and 1950s, with the advent of treatment of patients with ____ and ____ resistant strains of S. aureus appeared
penicillin and sulfonamides,
in the 1970s, and aminoglycosides led to the emergence of resistant aerobic gram-negative rods, such as specific species of
Klebsiella
Enterobacter
Pseudomonas.
Serratia
in contaminated food or intravenous solutions
Direct contact
from patient to patient on the hands of HCWs (MRSA, rotavirus)
Indirect contact-
inhalation of droplets (>5 um in diameter) that cannot travel more than 3 feet (pertussis)
Droplet contact
inhalation of droplets (>5 um) that can travel large distances on air currents (tuberculosis)
Airborne contact-
disease spread by vectors, such as mosquitoes (malaria) or rats (rat-bite fever)
Vector-borne contact
role of the microbiology laboratory in HAIs
supplies the data on organism identification and antimicrobial susceptibility profiles that the infection control practitioner reviews daily for evi-
dence of HAI.
there are two major ways to type strains using
phenotypic or molecular typing methods
classic phenotype techniques include
biotyping
use of antibiograms
serotyping
bacteriocin typing
bacteriophage typing
analyzing unique biologic or biochemical characteristics
biotyping
analyzing unique biologic or biochemical characteristics
biotyping
analyzing antimicrobial susceptibility patterns
antibiograms
analyzing antimicrobial susceptibility patterns
antibiograms
serologic typing of bacterial or viral antigens, such as bacterial cell wall O antigens
serotyping
serologic typing of bacterial or viral antigens, such as bacterial cell wall (O) antigens
serotyping
examines an organisms susceptibility to bacterial peptides
bacteriocin typing
examines the ability of bacteriophages to attack certain bacterial strains
bacteriophage typing
bacteriophage typing have been useful for typing
pseudomonas p. aeruginosa and s. aureus
have largely replaced phenotypic methods as a means of confirming the relatedness of strains involved in an outbreak
Genotypic, or molecular, methods
