Infections Prevention and Control

Question 1

Colonisation vs infection, explain the difference

Answer 1

colonisation - presence and multiplication but no invasion or damage
infection - entry and multiplication causing damage

Question 2

What is a reservoir

Answer 2

Place where micro-organism normally lives and reproduces

Question 3

Endogenous vs exogenous, explain the difference

Answer 3

exogenous - from another person or environment

endogenous - self-infection with own organisms

Question 4

Give three types of exogenous infection with an example of each

Answer 4

Airborne - TB
Contact - Staphylococcus aureus
Inoculated - HIV

Question 5

Give an example of endogenous infection

Answer 5

surgical wound infection, ventilated initiated pneumonia or UTI

Question 6

What are the susceptibilities in the natural barriers of the host

Answer 6

skin wounds
stomach acids (PPIs)
Mucus.cilia (CF)
Urinary flow (catheters)

Question 7

What are the susceptibilities in immuno-compromised host?

Answer 7

chemotherapy
haematological malignancy
comorbidities (diabetes), high sugar more for bacteria

Question 8

What are some exposure type host susceptibility?

Answer 8

multiple hospital admissions 
antibiotic courses (clear usual bacteria)
intensive care

Question 9

Give examples of infection more likely to appear in the community

Answer 9

TB
Chicken pox (VZV)
Infuenza A
food poisoning (salmonella, campylobacter)

Question 10

Give examples of infection more likely to appear in the hospitals

Answer 10

Catheter related UTI
Ventilator associated pneumonia
clostridium difficile
IV catheter associated bloodstream infection

Question 11

Why are hospitals a likely source of infection?

Answer 11

overcrowded
fragility 
close contact 
less staff
lots of antibiotic use
no side rooms for isolation

Question 12

What is the definition of HCAI (health care associated infection)

Answer 12

An infection that occurs more than 48 hours after admission to the hospital (longer if long incubation)

An infection that occurs within 10 days of discharge from hospital (30 days for surgical wound)

An infection that occurs with 72 hours of an outpatient procedure

Question 13

MSSA is sensitive to flucloxacilin and vancomycin. What is MRSA not sensitive to

Answer 13

Flucloxacilin

Question 14

Enterococcus is sensitive to vancomycin and daptomycin, what is VRE not sensitive to?

Answer 14

Vancomycin resistant enterococcus

Question 15

E.coli is sensitive to ceftriaxone and meropenem

What are ESBL E coli and CPE not sensitive to?

Answer 15

ESBL E coli - ceftriaxone

CPE - ceftriaxone and meropenem

Question 16

What is group A strep

Answer 16

streptococcus pyogenes (gram positive cocci)

Question 17

What can streptococcus pyogenes cause?

Answer 17

cellulitis
tonsillitis
wound infections
necrotising fascitis

Question 18

what is a common reason for unnecessary antibiotic prescription?

who is an exception?

Answer 18

sending urine for culture when there is no clinical suspicion of UTI (asymptomatic bacteria) - catheter urines are nearly always dipstick positive.

pregnant women - high risk of pyelonephritis

• threat to baby
• single course of antibiotics if confirmed high bacterial count in urine.

Question 19

How to break the chain of infection

Answer 19

remove the source
prevent transmission
reduce patient susceptibility
identify carriage

Question 20

next big problem after MRSA?

Answer 20

carbapenemase producing enterobacteriaceae