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MICI Module 3 > Infection Control, Specimen Collection & Specimen Processing > Flashcards

Infection Control, Specimen Collection & Specimen Processing Flashcards

1
Q

What are laboratory functions

A

Diagnostic

Epidemiological

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2
Q

Describe diagnostic lab function

A

Detection of infectious agents, guidelines for treatment
Information for individual cases
Collated info for general use

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3
Q

Describe epidemiological lab function

A

Information provided can be used to complement clinical info
Track resistant isolates
Follow trends
Detect or confirm outbreaks
Support control efforts and public health

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4
Q

How can you make the best use of the lab

A

Appropriate specimens collected
Label properly to decrease frustration
Be cost effective
Eliminate delays

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5
Q

What are general principles of specimen collection

A

Send good quality specimens
Avoid contamination
Label with patient name, birthday and health number
Put relevant info on the requisition

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6
Q

How can you maximize sample quality

A

Use appropriate transport media
Get specimens to lab asap
Work WITH the lab

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7
Q

What are the types of urine collection

A

Mid stream (most common)
In out catheter
Indwelling catheter

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8
Q

Describe mid stream collection

A

Avoid touching skin

Pass a few millilitres then collect specimen in clean sterile container

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9
Q

How long should you wait to bring urine specimen to lab

A

No transport media needed if at lab within 2 hours or refrigerated at 4c and delivered within 24 hours

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10
Q

Describe in/out catheters

A

Insert catheter
Discard first few ml
Collect the specimens and submit

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11
Q

Describe indwelling catheter

A

Collect specimen using needle and syringe after cleaning collection site with alcohol

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12
Q

What are types of respiratory tract specimens

A 
Sputum (most common)
Induced swelling (If dry cough)
Tracheal aspirate (using tube)
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13
Q

Describe sputum collection

A

Cleanse mouth with boiled water
Avoid post nasal discharge
Deep cough from chest
DRY STERILE CONTAINER get to lab within 24 hours or refrigerate 4c

Contamination detected by squamous cells

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14
Q

Describe induced sputum

A

Induction of sputum using saline aerosols
Looks watery
Dry sterile container

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15
Q

Describe tracheal aspirate

A

Useful in intubated patients

Specimen collection traps more prone to leaking during transport

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16
Q

What are patient instructions for stool collection

A

Pass stool on clean dry surface (paper)

Place almond sized portion in the specimen container

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17
Q

How is stool transported for culture

A

Cary Blair transport medium; keeps things alive but does not let it grow

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18
Q

How is stool transported for parasite detection

A

SAF preservative

Formalin’s

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19
Q

How is stool transported for cytotoxicity and virology

A

Dry sterile container

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20
Q

When are swabs used

A

Throat
Wounds
Urethra

Not for abscesses, fluid or TB culture

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21
Q

What are other kinds of specimens

A 
Tissue 
Pleural fluid 
Pericardial fluid 
CSF 
Vitreous fluid

All collected in dry sterile container

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22
Q

Microbiology specimens should never be put in _____________

A

Formalin

It kills all bacteria

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23
Q

When are results usually available

A

Microscopy usually available within 1-2 hours for stat samples
Cultures can take a few weeks but usually 3-5 days

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24
Q

Describe rapid testing

A

Usually detect an antigen
Causes particles to agglutinate or create colour
Mistakes in technique can cause incorrect results
Sensitivity sacrificed for speed

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25
Q

Describe microscopy

A

Gram stain most commonly used
Used for diagnosis
Less sensitive than culture
Assesses quality of specimen (Q scoring)
Types of cells (squamous cells) used to infer contamination has occurred

26
Q

Describe media

A

May be liquid (broth) or solid (plates)

27
Q

What is broth used for

A

Detecting very low numbers of organisms
Increasing the number of a type of organisms in a specimen (enrichment)
Biochemical testing

28
Q

Describe solid media

A

Usually agar
Isolating colonies of bacteria can detect low numbers

Can be:
Differential: distinguish colonies

Selective: species inhibited from growing

Fairly sensitive

29
Q

Describe blood agar

A

Contains 5% sheeps blood

Allows detection of hemolysis

30
Q

Describe chocolate agar

A 
Cooked blood
More nutritious (H. Influenzae grows)
31
Q

Describe MacConkey medium

A

Contains bile salts and crystal violet to inhibit gram positive organisms
Lactose fermentation detected
Used for stool and urine specimens

32
Q

Describe blood cultures

A

Innoculated at bed side into bottles with some sterile fluid
2 sets taken aerobic and anaerobic
Most labs use automated systems for monitoring
Keep at room temp until placed on machine
Needs to be on machine within 18 hrs

33
Q

Describe incubation conditions

A

Atmosphere

Temperature

34
Q

Describe usual atmosphere conditions

A

Aerobic (ambient air)
Micro aerobic 2-5% oxygen (ex campylobacter)
Anaerobic <1% oxygen

35
Q

Describe usual incubation temperature

A

Most often 35°

36
Q

Describe colony

A

Growth of bacteria on a solid medium
Appearance useful
Presence of haemolysis
Pigment

37
Q

Describe biochemical identification

A

Based on the enzymes an organism is actively expressing
Profile typical of each species
Once most commonly used method

38
Q

What is MALDI

A

Spectrometry

Colony and matrix is vaporized and analyzed

39
Q

What are other identification methods

A

Identification of specific antigens on the organisms surface (agglutination/immuno fluorescent microscopy)

Molecular methods (genome sequencing/nucleic acid probes)

40
Q

What is susceptibility testing

A

Determines which antimicrobials are likely to be less effective against an individual strain
Doesn’t take into account the ability of a persons defences against attack
A prediction

41
Q

What are susceptibility testing methods

A

Expose organism to concentration of anti microbial (disc, broth, dissolved in agar)

Lack of growth indicated inhibition (minimal inhibitory concentration)

42
Q

What are other susceptibility testing methods

A

Detection of enzymes that break down antimicrobials (beta lactamase)
Molecular means

43
Q

What are further testing methods

A

Typing can be useful to determine relationship of organisms:
Serotyping
Molecular typing (whole genome sequencing, pulsed field)
Antibio gram and bio type

44
Q

What is the epidemiologic triad of disease

A

Host
Agent
Environment

45
Q

What are the links of the chain of transmission

A 
Agent 
Reservoir 
Portal of exit 
Mode of transmission 
Portal of entry 
Susceptible host
46
Q

Describe the agent (pathogen)

A

First component in the chain of infection
Important characteristics: ability to multiply, ability to withstand environmental stress
Human or non human reservoirs

47
Q

When are agents epidemiologically important

A

Transmitted
Causes infection
Produces clinical disease

48
Q

What are characteristics of agents

A

Infectivity: ability to enter survive and multiply within the host

Pathogenicity: extent to which disease is produced

Virulence: serious disease producing potential

49
Q

Describe a reservoir

A

Place where agent lives and replicates

Must be able to exit reservoir and enter susceptible host via portal of entry

50
Q

What are the 5 modes of transmission

A 
Contact (indirect or direct) 
Droplet (large propelled over short distance)
Common vehicle 
Airborne 
Vector borne
51
Q

Describe a susceptible host

A

Person or other living animal that affords lodging to an infectious agent

Definitive (primary): parasite reaches maturity
Intermediate (secondary): in which a parasite is in its larval stage

52
Q

Describe basic reproduction number

A 
R= CQD 
C = contact rate 
Q= probability of tranmission 
D = duration of infectivity

Incorporates social and biological determinants of transmission

53
Q

What is a nosocomial infection

A

Health care associated infection

54
Q

What are the most common nosocomial infections

A

Uti (MOST COMMON)
Surgical site
Pneumonia
Bacteremia

55
Q

What are examples of multi drug resistant organisms

A 
Nosocomial infections: 
MRSA
VRE
C DIFF
CPE
Candidia Auris (newest)
56
Q

What does good hand hygiene do

A

Reduces nosocomial infections by 40-50%

57
Q

What are the 4 moments of hand hygiene

A
  1. Before patient/environment contact
  2. Before aseptic procedure
  3. After body fluid exposure
  4. After patient/environment contact
58
Q

What are 3 principles of precautions

A

You can not easily tell who has what
Body substances of all patients considered infectious
Behaviour is determined by risk of encountering substance

59
Q

What are routine precaution practices

A

Based on point of care risk assessment

60
Q

What are additional precautions

A

Contact
Droplet
Airborne

61
Q

What are components of infection prevention and control

A

Elimination (isolation/quarantine)
Engineering/environmental controls (ventilation, barriers, cleaning, separation)
Administrative controls

62
Q

What are some interventions/preventions

A

Infection prevention and control (IPAC)
Surgical site infection
Ventilator associated pneumonia
Central line blood stream infection

MICI Module 3 (3 decks)

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