Infectious Diseases in the 21st Century

Question 1

What was the main cause of death in 2014 in England and Wales

Answer 1

LRTI

Question 2

Which infectious disease is still in the top 10 causes of death in the Uk

Answer 2

Pneumonia

Question 3

What methods reduced bacterial infection

Answer 3

Sanitation –> want to try and break the cycle of infection
Vaccination
Pasteurisation –> was responsible for the biggest decrease in TB

Question 4

How many people die of TB each year

Answer 4

15,000,000 worldwide

5000 in the UK

Question 5

Why is TB increasing

Answer 5

Drug resistance is increasing
Long and difficult treatment
BCG Vaccine doesnt work effectively in areas where M. Tuberculosis is rare
Living conditions are decreasing –> particularly for migrant populations

Question 6

Who is the frequenct of MDR TB

Answer 6

15% worldwide

7.5% in the UK - relatively constant

Question 7

What is the main driver of resistance in TB

Answer 7

Underdosing

Question 8

Name the two main sources of bacteria causing infection

Answer 8

1) Commensal bacteria
2) Enbironmental/food sources –> used to be less frequent but changes in patient demographics makes more people susceptibel to these less virulent organisms

Question 9

What is the frequency of acute LRTI in children in the Uk

Answer 9

30 per 1000

Mainly Strep. Pneumoniae (v. sensitive to anitbiotics and generally resistance is low) and H. Influenzae

Question 10

What is the incidence of CAP in the over 12s

Answer 10

6 per 1000 –> 6th leading cause of death in the UK
Typically in elderly, predisposed followin a viral URTI
Generally H. Influenzae or Strep. pneumoniae
But if debilitated/immunocompromised may get more atypical forms of pneumonia i.e. Staph Aureus, Klebsiella, Pseudomonas

Question 11

What is the most common cause of HCAI in the Uk

Answer 11

E.Coli

Question 12

How many people does C. Diff normally colonise

Answer 12

3% but up to 7-% in children

Question 13

How many cases of C. Diff occur in the UK each year

Answer 13

55000 cases in 2006 in UK, 85% in the over 65s

Question 14

What are the anatibiotics that predispose to C. Diff

Answer 14

Co-amoxiclav
Cephalosporins
Clindamycin
Ciprofloxacin

Question 15

What caused the massive increase in C. Diff in the UK

Answer 15

Changes in prescribing policies and a move away from using bleach (which meant that C. Diff spores survived) lead to a massive increase in the number of cases

Question 16

What is ithe definition of MDR

Answer 16

must be resistant to three or more classes of antibiotics

Question 17

Discuss the treatment of P. aeurgiona, Acinobacter, E.Coli, K. Pneumoniae and ESBLs

Answer 17

Shows resistance to Beta-lactams, fluoroquinolones, aminoglycosides –> which are typically used to treat them

Colistin is generally last line –> but resistance to colistin has been observed