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4.2 Medical Microbiology > IPC > Flashcards

IPC Flashcards

1
Q

Why is senior management involvement essential for IPC?

A

Senior management ensures funding and resources for the IPC team.

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2
Q

What is selective digestive decontamination?

A

A method to remove harmful microbes from the gut and skin.

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3
Q

What are hospital procedures that predispose to HCAI?

A

Poor cleaning/disinfection/sterilization of equipment.

Lack of proper hand hygiene.

High bed occupancy and inadequate patient isolation.

Insufficient staff and absence of infection control policies.

Antibiotic misuse.

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4
Q

What are the components necessary for preventing HCAI?

A

Governance and management structures.

Systems and processes for IPC implementation.

Resources like staffing, infrastructure, and equipment.

Inclusion of IPC in senior management committee discussions.

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5
Q

What are the HIQA 12 Standards?

A

These are evidence-based guidelines to ensure effective IPC practices in healthcare facilities, including policies, audits, training, and expert advice.

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6
Q

What are the three types of transmission-based precautions?

A

Contact Precautions: For infections spread by direct/indirect contact (e.g., MRSA, C. difficile).

Droplet Precautions: For respiratory droplets (e.g., COVID-19, influenza).

Airborne Precautions: For aerosols (e.g., TB, measles).

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7
Q

What are the ‘Five Moments of Hand Hygiene’?

A

Before touching a patient.

Before a clean/aseptic procedure.

After body fluid exposure risk.

After touching a patient.

After touching patient surroundings.

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8
Q

How did improved hand hygiene practices impact HCAI rates?

A

Overall compliance significantly increased (p<0.001).

MRSA infections fell from 1.88 to 0.91 cases per 10,000 bed days.

C. difficile infections reduced from 16.75 to 9.49 cases per 10,000 bed days.

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9
Q

What are the key PPE guidelines for IPC?

A

Use gloves for contact with blood, fluids, or mucous membranes.

Use aprons/gowns to prevent clothing soiling.

Use masks/eye protection for splashes or sprays.

Perform hand hygiene after PPE removal.

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10
Q

What role does environmental cleaning play in IPC?

A

Regular cleaning of high-touch surfaces and clinical spills.

Use of disinfectants like sodium hypochlorite for C. difficile and VRE.

Enhanced technologies like UV light and hydrogen peroxide vapour for persistent contamination.

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11
Q

What is antimicrobial stewardship, and what are its objectives?

A

Ensures appropriate antibiotic use to improve patient outcomes, reduce resistance, and decrease healthcare costs.

Objectives include prescribing the right drug, dose, and duration for the correct infection type.

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12
Q

What are the ‘6 D’s of Antimicrobial Stewardship’?

A

Diagnosis.

Debridement/Drainage.

Drug selection.

Dose.

De-escalation.

Discontinuation.

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13
Q

How do care bundles improve infection prevention?

A

They are evidence-based interventions applied consistently to all patients.

Examples: VAP care bundle reduced infection rates from 8.9 to 0 per 1,000 ventilator days.

CDI care bundles decreased incidence from 1.10 to 0.66 cases per 1,000 patient days.

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14
Q

What are examples of care bundles?

A

Ventilator-associated pneumonia (VAP) care bundle.

Clostridium difficile care bundle.

Urinary catheter care bundle.

Sepsis care bundle.

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15
Q

What are the main challenges in decolonization?

A

Resistance to mupirocin.

Limited efficacy of chlorhexidine bathing.

Challenges with gut decolonization.

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16
Q

What is faecal microbiota transplantation (FMT), and how is it used in IPC?

A

A method to restore healthy gut microbiota.

Used for decolonizing ESBL, VRE, and CRE carriers.

Clinical trials show significant reductions in hospital stay and infections post-FMT.

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17
Q

What is the difference between horizontal and vertical IPC programs?

A

Horizontal Programs: Reduce risk for a broad range of pathogens through general practices.

Vertical Programs: Target specific pathogens using measures like active surveillance and isolation.

18
Q

What are mandatory surveillance requirements for HCAI in Ireland?

A

Monitoring of pathogens like MRSA, VRE, C. difficile, and resistant Enterobacterales.

Surveillance includes both bloodstream infections and colonization.

19
Q

What are enhanced disinfection technologies?

A

UV light devices and hydrogen peroxide vapour (HPV) reduce multidrug-resistant organism (MDRO) rates.

UV light decreased CDI rates by 25%; HPV reduced VRE acquisition by up to 80%.

20
Q

What are guidelines for proper antibiotic prescribing?

A

Start antibiotics only for bacterial infections.

Obtain cultures before prescribing.

Document treatment details and review antibiotics within 48 hours to adjust therapy.

21
Q

How is surveillance conducted for resistant Enterobacterales and VRE?

A

Use rectal swabs or faecal samples with chromogenic media or molecular methods.

High-risk patients (e.g., ICU, oncology) require regular screening.

22
Q

What are the standards for hospital design to prevent HCAI?

A

Single rooms with en suite facilities.

Proper ventilation systems in operating rooms and isolation units.

Easily decontaminated fixtures and fittings.

23
Q

Why are audits important in IPC?

A

Assess compliance with hand hygiene, care bundles, and antimicrobial prescribing.

Feedback motivates staff to improve practices and ensures guideline adherence.

24
Q

What are the risks associated with poor hospital maintenance?

A

Compromised ventilation and water systems.

Damaged furniture and fittings increasing contamination risks.

25
Q

What is selective oropharyngeal decontamination (SOD)?

A

The application of nonabsorbable antibiotics to the oropharynx to reduce microbial carriage.

26
Q

How does chlorhexidine bathing impact MDRO acquisition?

A

Chlorhexidine bathing has shown mixed results but can reduce environmental contamination and MDRO carriage rates.

27
Q

What are common methods for VRE screening?

A

Rectal swabs or faecal samples tested using chromogenic media or molecular detection of vanA and vanB genes.

Active surveillance in high-risk patients.

28
Q

What measures reduce catheter-associated urinary tract infections (CAUTI)?

A

Using care bundles that include proper insertion techniques, maintenance protocols, and timely catheter removal.

29
Q

What is the role of sodium hypochlorite in environmental cleaning?

A

Effective against C. difficile spores and VRE but can cause surface damage and HCW sensitivity.

30
Q

How do audits contribute to antimicrobial stewardship?

A

Monitor prescribing patterns and adherence to guidelines, ensuring prudent use of antimicrobials.

31
Q

Why is isolation critical in IPC?

A

Prevents cross-contamination and transmission of pathogens, especially for patients with multidrug-resistant organisms (MDROs).

32
Q

What is the significance of the ‘Start Smart, Then Focus’ initiative?

A

Encourages appropriate initial antibiotic use followed by reassessment within 48 hours to refine therapy.

33
Q

How does bed spacing in hospitals impact IPC?

A

Adequate spacing reduces the risk of airborne and contact transmission between patients.

34
Q

What are droplet precautions, and when are they used?

A

Prevent infections like influenza and COVID-19 by using masks and isolating patients in single rooms.

35
Q

What are the challenges with environmental contamination in IPC?

A

High-touch surfaces and improper cleaning protocols can lead to persistent contamination and outbreaks.

36
Q

How do UV disinfection technologies complement traditional cleaning?

A

They provide additional decontamination, reducing the reliance on manual cleaning efforts and improving overall IPC outcomes.

37
Q

What is the role of hand hygiene audits?

A

Tracks compliance among healthcare workers and identifies areas needing improvement to reduce HCAI.

38
Q

What are the benefits of single-use medical devices in IPC?

A

Eliminates risks of cross-contamination associated with reusable devices, especially when sterilization processes are inadequate.

39
Q

How does antibiotic misuse contribute to HCAI?

A

Promotes the development of resistant pathogens, making infections harder to treat and control.

40
Q

What is the significance of healthcare worker (HCW) education in IPC?

A

Ensures HCWs are aware of best practices, guidelines, and the importance of compliance to minimize HCAI risks.

4.2 Medical Microbiology (20 decks)

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