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Microbiology Midterm 2 > Infection Prevention and Control > Flashcards

Infection Prevention and Control Flashcards

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Biology 101 flashcards
1
Q

Who is John Snow

A

Discovered the broad Street pump during the cholera outbreak

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2
Q

Who is Semmelweis

A

The father of epidemiology, introduced anti-septives and reduced maternal mortality rates

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3
Q

What are the variety of clinical manifestations in infectious diseases

A

symptomatic vs asymptomatic and cancer-related

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4
Q

What are the variety of time courses of infectious diseases

A

acute, subacute, chronic

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5
Q

What are the components of the epidemiological Triad of disease

A

host, agent, and environment

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6
Q

What are the components of the chain of infection transmission

A

agent

reservoir

portal of exit

mode of transmission

portal of entry

susceptible host

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7
Q

Who is the agent

A

the pathogen

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8
Q

What are important characteristics of the agent

A

ability to multiply

ability to withstand environmental stress (ex. temperature, humidity, pH)

+/- nonhuman host reservoirs (ex. water or ticks)

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9
Q

What is epidemiologically important in agents

A

mode of transmission (direct/indirect)

Causes of infection

Produces clinical diseases

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10
Q

What is infectivity

A

infected/#exposed

ability to enter, survive, and multiply within the host

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11
Q

What is pathogenicity

A

with clinical disease/#infected persons

extent to which overt disease is produced in an infected population

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12
Q

What is virulence

A

serious cases/#with clinical disease

serious disease-producing potential

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13
Q

What is reservoir

A

place where agent lives +/- replicates
ex. animal, environment/water, food

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14
Q

What is required to be a reservoir

A

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

ex. mosquito transmitting malaria
contaminated ICU sink (pseudomonas)

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15
Q

what are the 5 modes of transmission

A
  1. Contact (direct or indirect)
  2. Droplet
  3. Common vehicle
  4. Airborne
  5. Vector-borne
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16
Q

What are the characteristics of contact transmission

A

can be either direct or indirect
Most healthcare associated transmission
Ex. MRSA, C. difficile

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17
Q

What are characteristics of droplet transmission

A

large respiratory droplets propelled over a short distance (< 2 m)
Ex. Influence and Covid-19

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18
Q

What are characteristics of common vehicle transmission

A

from contaminated instrument/products (needle reused on someone)
Ex. HIV/HCV contaminated blood products

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19
Q

What are characteristics of airborne transmission

A

small droplets (<50 um) propelled long distances
Ex. TB, measles, chicken pox (VZV)

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20
Q

What are characteristics of vector-borne transmission

A

happens in tropical climates

Transmitted by insects
Ex. malaria

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21
Q

What is a susceptible host, and the two types

A

person or living animal that afford lodging to an infectious to an infectious agent

Definitive (primary): a parasite reaches maturity (passes its sexual stage)
Intermediate (secondary): a parasite is in its larval (asexual) state

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22
Q

What are the two risks of susceptible hosts

A

exposure risks: enviroments

Infectious risks: getting sick

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23
Q

What is the basic reproduction number

A

R = cqd

c= contact rate
q= probability of transmission
d= duration of infectivity

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24
Q

What are characteristics of the basic reproduction number

A

incorporates social and biological determinant of transmission

Varies with different microorganisms, different environments, and over time

R <1 will generally not propagate (ex. SARS) usually just close contact in healthcare not really in community

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25
Q

What is the R value of SARS-coV-2

A

2.3

someone who gets covid will infect 2.3 people

26
Q

What is the R value for measles

A

12-18

someone who gets measles will infect 12-18 people (very virulent)

27
Q

What is a health care association infection called

A

nonsocomial infection

usually happens in acute case settings

28
Q

What is the epidemiology of nonsocomial infections

A

UTI (35%): 80% with catheter

Surgical Site (20%)

Pneumonia (15%)
mortality 15-50% (OR 2.03)

Bacteremia (15%)
mortality 27%, from IVs or central lines

29
Q

What are the multidrug resistant organisms (MDRO)

A

MRSA
VRE
C. diff
CPE (cabarpenemase producing Enterobacteriaceae)
Candida auris (yeast not bacteria)

30
Q

What are the MRSA rates in Canada

A

plateau now

31
Q

What are the VRE rates in Canada

A

decreasing now

32
Q

What are the C. diff rates in Canada

A

consistent overtime

33
Q

What is the % attributable mortality in patients with CDAD in Canada from 1997 - 2005

A

also C. diff

4 fold increase from 1997-2005

34
Q

Where was the most CDAD in Canada in 2007

A

most in Quebec, they had a hyper virulent strain a NAP1 stain (CNISP 2007 - 39 hospitals)

35
Q

What are the CPE rates in Canada

A

Used to be most in Quebec now most in BC, AB, SK, MB

barely anything in Atlantic

36
Q

What are Candida auris rates in Canada

A

not much in Canada

is associated with ICU patients with antibiotics

In india, South Africa, Colombia the most

37
Q

What is the evidence for infection control

A

SENIC (Am J Epi 1985) - Study of Efficacy of Nonsocomial Infection Control

Survey between 1976-1983
Evaluated overall effectiveness of IC program in US hospitals
32% reduction in nonsocomial infections

38
Q

What is the evidence for infection control in MRSA

A

Canada has $42-59 million annually

Colonized: 20-30% become infected

Mortality: RR = 3 vs MSSA

39
Q

What contributes to 40-50% of reduction of infection

A

Hand Hygiene and Reduction in Healthcare Associated Infections (HAI)

40
Q

What are the 4 hand hygiene moments

A
  1. Before patient/enviroment contact
  2. before aseptic procedure
  3. After body fluid exposure
  4. After patient/enviroment contact
41
Q

When do you wear gloves

A

when likely to touch body substances, mucous membrane, non-intact skin

42
Q

When do you wear a gown

A

when clothing is likely to be soiled

43
Q

When do you wear smask/eye protection

A

wjhen it is likely to be splashed, droplet

44
Q

What are the 3 principals of review precaution

A
  1. you cannot easily tell who has what
  2. Body substances of all patients are considered potentially infectious
  3. Behaviour is determined by risk of encountering body substance, not only by diagnosis, i.e. Point of Care Risk Assessment (PCRA)
45
Q

What are the review of precautions types

A

Routine practices based on PCRA: happen 100% of the time

Additional Precautions: only after specific diagnosis

46
Q

What additional precautions do you take for C. diff

A

where gloves and gown because its contact

47
Q

What additional precautions do you take for influnza

A

where mask and eye protection because droplet

48
Q

What additional precautions do you take for TB, measles, chickenpox

A

Airborne so fitted N95 masks

49
Q

What are the 6 questions for routine practices and PCRA

A
  1. What are the patient’s symptoms?
  2. What is the degree of contact?
  3. What is the degree of contamination?
  4. What is the patient’s level of understanding and cooperation?
  5. What is the degree of difficulty of the procedure being performed and the experience level of the care provider?
  6. What is my risk of exposure to blood, body fluids, excretions, secretions, non-intact skin and mucous membranes?
50
Q

What does the yellow sign mean for additional precautions

A

Contact Precaution

wear gown and gloves

51
Q

What does the blue sign mean for additional precautions

A

Droplet precautions

wear mask and eye protection

52
Q

What does the pink sign mean for additional precautions

A

Airborne precautions

airborne isolation room: negative air
N95 respirator

53
Q

Is putting on PPE or taking it off the specific order more important

A

off the order is very important because it can lead to self contamination if done wrong

54
Q

When does removing PPE happen

A

at the exit of patient space (at exit of curtain space or by door of private room)
Exception: N95 , which is removed outside the room after the door is closed

Remove gloves –> then hand hygiene
gown –> hand hygiene
eye protection –> remove mask –> hand hygiene

55
Q

How is is elimination obtained in infection prevention (IPAC)

A

with isolation and quarantine by public health measures

56
Q

How is engineering/enviromental controls obtained through infection prevention (IPAC)

A

ventilation, Barries, cleaning, spatial separation

57
Q

How is administrative controls obtained through infection prevention (IPAC)

A

education, training

policies

screening/surveillance

58
Q

What are the Safer Healthcare Now inventions/prevenctions

A
  1. infection prevention and control (IPAC)
  2. SSI (surgical site infection)
  3. VAP (ventilator assoc. pneumonia)
  4. CLABSI (central line assoc blood stream infection)
59
Q

What are the 4 interventions in SSI in the safer healthcare now

A

appropriate hair removal; when shaving

appropriate antibiotic prophylaxis

Normoglycermia

Mormothermia

60
Q

What are the 4 interventions in VAP in the safer healthcare now

A

head up 30-45 degrees

sedation vacation/extubation readiness: take off ventilator as soon as possible

Subglotic sution (EVAC tubes)

Oral gastric tube

61
Q

What are other IPAC activities

A

Appropriate disinfection & sterilization for device/equipment reprocessing

Outbreak management

Advice Occ Health on ID matters related to
HCW

Education / Communication

Involved in Construction / Renovation - Research

Microbiology Midterm 2 (15 decks)

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