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Microbiology Midterm 2 > Infection Prevention and Control > Flashcards

Infection Prevention and Control 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
What is the R value of SARS-coV-2
2.3 someone who gets covid will infect 2.3 people
26
What is the R value for measles
12-18 someone who gets measles will infect 12-18 people (very virulent)
27
What is a health care association infection called
nonsocomial infection usually happens in acute case settings
28
What is the epidemiology of nonsocomial infections
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
What are the multidrug resistant organisms (MDRO)
MRSA VRE C. diff CPE (cabarpenemase producing Enterobacteriaceae) Candida auris (yeast not bacteria)
30
What are the MRSA rates in Canada
plateau now
31
What are the VRE rates in Canada
decreasing now
32
What are the C. diff rates in Canada
consistent overtime
33
What is the % attributable mortality in patients with CDAD in Canada from 1997 - 2005
also C. diff 4 fold increase from 1997-2005
34
Where was the most CDAD in Canada in 2007
most in Quebec, they had a hyper virulent strain a NAP1 stain (CNISP 2007 - 39 hospitals)
35
What are the CPE rates in Canada
Used to be most in Quebec now most in BC, AB, SK, MB barely anything in Atlantic
36
What are Candida auris rates in Canada
not much in Canada is associated with ICU patients with antibiotics In india, South Africa, Colombia the most
37
What is the evidence for infection control
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
What is the evidence for infection control in MRSA
Canada has $42-59 million annually Colonized: 20-30% become infected Mortality: RR = 3 vs MSSA
39
What contributes to 40-50% of reduction of infection
Hand Hygiene and Reduction in Healthcare Associated Infections (HAI)
40
What are the 4 hand hygiene moments
1. Before patient/enviroment contact 2. before aseptic procedure 3. After body fluid exposure 4. After patient/enviroment contact
41
When do you wear gloves
when likely to touch body substances, mucous membrane, non-intact skin
42
When do you wear a gown
when clothing is likely to be soiled
43
When do you wear smask/eye protection
wjhen it is likely to be splashed, droplet
44
What are the 3 principals of review precaution
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
What are the review of precautions types
Routine practices based on PCRA: happen 100% of the time Additional Precautions: only after specific diagnosis
46
What additional precautions do you take for C. diff
where gloves and gown because its contact
47
What additional precautions do you take for influnza
where mask and eye protection because droplet
48
What additional precautions do you take for TB, measles, chickenpox
Airborne so fitted N95 masks
49
What are the 6 questions for routine practices and PCRA
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
What does the yellow sign mean for additional precautions
Contact Precaution wear gown and gloves
51
What does the blue sign mean for additional precautions
Droplet precautions wear mask and eye protection
52
What does the pink sign mean for additional precautions
Airborne precautions airborne isolation room: negative air N95 respirator
53
Is putting on PPE or taking it off the specific order more important
off the order is very important because it can lead to self contamination if done wrong
54
When does removing PPE happen
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
How is is elimination obtained in infection prevention (IPAC)
with isolation and quarantine by public health measures
56
How is engineering/enviromental controls obtained through infection prevention (IPAC)
ventilation, Barries, cleaning, spatial separation
57
How is administrative controls obtained through infection prevention (IPAC)
education, training policies screening/surveillance
58
What are the Safer Healthcare Now inventions/prevenctions
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
What are the 4 interventions in SSI in the safer healthcare now
appropriate hair removal; when shaving appropriate antibiotic prophylaxis Normoglycermia Mormothermia
60
What are the 4 interventions in VAP in the safer healthcare now
head up 30-45 degrees sedation vacation/extubation readiness: take off ventilator as soon as possible Subglotic sution (EVAC tubes) Oral gastric tube
61
What are other IPAC activities
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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