Infection Prevention And Antimicrobial Stewardship Flashcards

1
Q

How does legionella pneumophila spread?

A

Aerosol and droplets

Not transmissible form person to person

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2
Q

How do ‘food poisoning’ organisms generally spread?

A

Lots of person to person transmission

Faecal-oral transmission

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3
Q

Name some infections with very good person to person spread

A

Influenza
Norovirus
Neisseria gonorrhoea

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4
Q

How does the guinea worm spread?

A

In water
Into people
Back into water

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5
Q

What is the vector of schistosomiasis?

A

Snails

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6
Q

Define endemic

A

The usual background rate of a disease (expected amount)

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7
Q

Define outbreak

A

2 or more cases linked in time and place

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8
Q

Define epidemic

A

Rate of infection greater than usual background rate

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9
Q

Define pandemic

A

Very high rate of infection spreading across many regions, countries and continents

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10
Q

What is R0?

A

The average number of secondary cases that one case generate over its infectious period

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11
Q

What is the approximate R0 for influenza?

A

2 - 3

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12
Q

What are the general reasons for outbreaks/epidemics/pandemics?

A

New pathogen
New hosts
New practice (social/healthcare)

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13
Q

Define antigenic drift

A

Subtle change by mutation

Some antibodies may still be effective

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14
Q

Define antigenic shift

A

Reassortment of DNA of virus

No one is immune (everyone susceptible)

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15
Q

How long are maternal antibodies present in a newborn?

A

~ 3 months

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16
Q

Define infectious dose

A

The number of microorganisms required to cause infection

Varies by microorganism, presentation and immunity of host

17
Q

PPIs suppress acid secretion, therefore which food poisoning agents are you at more risk of being infected with?

A

Clostridium difficile

Salmonella

18
Q

Epidemic curves are usually what shape?

A
Bell curve 
(Time = x, no of people infected = y)
19
Q

When will abnormal population curves of infection occur?

A

In small scale outbreaks
Eg. In a family, ward, prison
Due to random nature of events

20
Q

When do maternal antibodies move across the placenta?

A

Last 4 weeks of pregnancy

21
Q

Describe herd immunity

A

Vaccinating a significant portion of the population will prevent widespread disease
Fewer infected even though not vaccinated

22
Q

Why can decreased exposure to pathogens become a problem?

A

Decreased exposure -decreased immune stimulus
Decreased antibodies
Increased susceptibility
Can lead to outbreaks

23
Q

Is resistance reversible?

24
Q

What are the consequences of Abx resistance?

A

Treatment failure
Prophylaxis failure - eg. Operations
Economic costs - longer hospital stay, extra investigations needed

25
Define MDR
Multi drug resistant | Non-susceptibility to at least 1 agent in 3 or more antimicrobial categories
26
Define XDR
Extensively drug resistant | Non-susceptibility to at least 1 agent in all but 2 or fewer Abx categories
27
Define PDR
Pan drug resistant | Non-susceptibility to all agents to all categories
28
What evidence shows antimicrobials cause resistant?
Lab evidence Ecological evidence Individual level data
29
What are the objectives of antimicrobial stewardship?
Appropriate use of antimicrobials Optimal clinical outcomes Minimise toxicity and other adverse effects Reduce cost of health care for infections Limit selection for resistant strains
30
What restrictive techniques help with Abx stewardship?
Limit access to Abx | Need microbiologists to authorise some Abx
31
What structural techniques can help with Abx stewardship?
Computerised records Expert systems Best treatment is listed on patient result sheets
32
What is the defined daily dose?
Amount of drug given to an adult patient in 1 day