Infection Control: Health Care Associated Infection (HAI)

Question 1

What is a health care-associated infection (HAI)?

Answer 1

• Infection acquired after admission to a health care facility
• Not present or incubating at time of admission
• Also known as nosocomial or iatrogenic infection

Question 2

Why are hospital patients at risk for HAIs?

Answer 2

• High acuity of illness
• Undergo aggressive treatments that compromise immunity
• Close proximity of susceptible patients receiving antibiotics

Question 3

What is Clostridioides difficile infection (CDI)? Clostridium difficile or C.diff

Answer 3

• One of the most common and costly HAIs
• Often occurs after antibiotic disruption of gut flora
• Symptoms: watery/infectious diarrhea, fever, abdominal pain
• Transmitted via hardy spores
• Requires strict infection control measures

Question 4

What is pseudomembranous colitis (PMC)?

Answer 4

• More severe form of CDI
• Severe inflammation of the colon
• Caused by overgrowth of Clostridioides difficile bacteria
• Characterized by raised yellow-white plaques (pseudomembranes) on colon lining during endoscopy
• Symptoms: severe diarrhea, abdominal cramps, fever, dehydration
• Often occurs after antibiotic disruption of normal gut flora
• Requires prompt antibiotic treatment and supportive care

Question 5

What infection control measures help prevent C. difficile transmission?

Answer 5

• Contact isolation for patients
• Good hand hygiene, preferably soap and water for diarrhea cases
• Gloves, gowns, thorough environmental cleaning
• Antibiotic stewardship

Question 6

How else can the incidence of HAIs be reduced?

Answer 6

• Nurses using critical thinking when practicing aseptic techniques
• Considering patient’s infection risks
• Anticipating how care approach may increase/decrease transmission risk

Question 7

What are the two types of healthcare-associated infections (HAIs)?

Answer 7

• Exogenous (from microorganisms external to the individual, not normal flora)
• Endogenous (from patient’s own flora that become altered/overgrown)

Question 8

Give examples of exogenous HAI

Answer 8

• Salmonella organisms
• Clostridium tetani
• Methicillin-resistant Staphylococcus aureus (MRSA)
• Vancomycin-resistant Enterococcus (VRE)
• Carbapenem-resistant Enterobacteriaceae (CRE) like Klebsiella
• Acinetobacter baumannii
• Pseudomonas aeruginosa
• Clostridium difficile
• Norovirus
• Influenza virus

Question 9

Give examples of endogenous HAI

Answer 9

• Enterococci (Enterococcus)
• Yeasts
• Streptococci (Streptococcus)
• Staphylococcus aureus
• Escherichia coli
• Pseidomonas aeruginosa
• Candida
• C. Diff
• Herpes simplex virus
• Varicella-zoster virus

Question 10

How do endogenous HAIs develop?

Answer 10

• When sufficient numbers of microbes from one body site transfer to another
• E.g. Enterococci from fecal matter to skin causing wound infections

Question 11

What factors determine the number of microbes needed to cause infection?

Answer 11

• Virulence of the organism
• Host susceptibility
• Site affected

Question 12

What influences a patient’s risk for HAI?

Answer 12

• Number of healthcare workers with direct contact
• Type and number of invasive procedures
• Therapy received
• Length of hospitalization

Question 13

What are major sites for HAIs?

Answer 13

• Surgical/traumatic wounds
• Urinary tract
• Respiratory tract
• Bloodstream

Question 14

Why do older persons have increased HAI susceptibility?

Answer 14

• More likely to have chronic diseases
• Effects of aging process itself

Question 15

What are potential outcomes of HAIs?

Answer 15

• Extended healthcare stays
• Increased disability
• Prolonged recovery times
• Decreased quality of life
• Increased healthcare costs