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CSI > Javier Ratchett - Hospital Acquired Infection > Flashcards

Javier Ratchett - Hospital Acquired Infection Flashcards

1
Q

Describe the chain of infection

A

1) Agent leaves reservoir/ host through portal of exit
2) This is conveyed via some mode of transmission
3) Enters through appropriate portal of entry to infect susceptible host

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2
Q

What is a resevoir?

A

Habitat that the infectious agent normally lives and multiplies in eg. humans, animals environment

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3
Q

What is the portal of the exit?

A

The path by which pathogen leaves the host and usually the site where the pathogen is localised

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4
Q

What are the different modes of transmission?

A

DIRECT
- Direct contact
- Droplet spread
INDIRECT
- Airborne
- Vehicleborne
- Vectorborne

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5
Q

What is the portal of entry?

A

The manner in which pathogens enter susceptible hosts

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6
Q

What is the impact of HAIs on healthcare systems

A
  • Increases bed pressure
  • 2 billion pound cost for the NHS
  • 60 000 days lost healthcare workers contracting HAIs
  • Increase in mortality and morbidity
  • More complaints and dissatisfaction
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7
Q

What is meant by zoonosis

A

Infectious disease that is transmissible under natural conditions from vertebrae animals to humans

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8
Q

What are the 4 main risk factors of HAIs?

A
  • Medical procedures and antibiotic uses
  • Organisational factors
  • Patient characteristics
  • Behaviour of healthcare staff
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9
Q

If someone has an infection, what are their WBC count, CRP level and respiratory rate?

A

WBC count - High
CRP level - High
Respiratory rate - High

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10
Q

What is D-alanyl-D-alanine carboxypeptidase transpeptidase also known as and what is its function?

A
  • Penicillin Binding Protein
  • Assists with peptidoglycan matrix assembling by creating crosslinks between chains
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11
Q

What are the mechanisms in which bacterial resistance occurs?

A
  • Decreased uptake of drug
  • Mutated channel so drug cannot enter
  • Enzyme digests/breaks down drug
  • Inactivating enzymes
  • Horizontal gene transfer
  • Alternative enzyme to bypass the reaction that the drug inhibits
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12
Q

How do antibiotics inhibit D-alanyl-D-alanine carboxypeptidase?Ho

A

Antibiotics binds to the enzyme and inhibits the action of it preventing it from forming the cross links in the peptidoglycan layer, killing the bacteria.

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13
Q

How do bacteria evade beta-lactam containing antibiotics

A

They can express a beta-lactamase enzyme which breaks beta-lactam of antibiotic, rendering the antibiotic useless

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14
Q

Why would a patient not respond to amoxicillin but respond to co-amoxiclav

A

Bacteria inhibits amoxicillin via beta lactamases but co amoxiclav contains clavulanic acid which inhibits those beta lactamases therefore the amoxicillin has can inhibit the bacteria

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15
Q

Why would a patient taking co-amoxiclav develop a C.difficile infection

A

The antibiotic reduces gut flora therefore decreases competition for c.diff and so creates an environment that c.difficile can survive in.

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16
Q

What is sepsis?

A

Body’s extreme response to an infection which can rapidly lead to tissue damage, organ failure and death

17
Q

What is the sequence of septic shock?

A

Hypotension(low BP)
tachycardia (high heart rate)
tachypnoea(high respiratory rate)

18
Q

What can sepsis lead to?

A
  • Tissue damage
  • Organ failure
  • Death
19
Q

What is hospital acquired infection?

A

An infection that patients get while receiving treatment for medical or surgical conditions

20
Q

When are HAIs usually acquired?

A
  • During procedures such as surgery
  • From devices used in medical procedures such as catheters and ventilators
21
Q

Can be HAIs be caused by microorganisms already present in the patient’s body? How?

A

YES - Medical procedures can weakend the body’s defences causing them to be more susceptible to infection.

22
Q

Where is the most common place for a patient to contract an HAI?

A

Outpatient settings

23
Q

What is CLABSI?

A

Central line associated bloodstream infections

24
Q

What is MRSA?

A

Methicillin resistant staphylococcus aureus

25
Q

What are the 5 common types of HAI?

A
  • Catheter associated HAI
  • Surgical site infections
  • Bloodstream infections
  • Pneumonia
  • Clostridium difficile
26
Q

What are the 4 risk factors of HAI?

A
  • Medical procedures and antibiotic use
  • Organisational factors
  • Patient characteristics
  • Behaviour of healthcare providers and their interactions with the health care system
27
Q

What is indirect transmission?

A

Transfer of an infectius agent from reservoir to host by:
- Suspended air particles
- Inanimate objects (vehicles)
- Animate intermediates (vectors)

28
Q

What is specific immunity?

A

Protective antibodies are directed against a specific agent. These are acquired by:
- Response to infection, vaccine, toxoid
- Transplacental transfer
- Infection of antitoxin or immune globulin

29
Q

What processes in the chain of infection do the interventions target?

A
  • Controlling or eliminating the agent at the source of transmission
  • Intervening with the mode of transmission
  • Protecting portals of entry
  • Increasing host’s defences
30
Q

What are the 5 moments of hand hygiene?

A

1) Before touching a patient
2) Before a clean/aspetic procedure
3) After body fluid exposure risk
4) After touching a patient
5) After touching patient surroundings

31
Q

What is the difference between gram positive and negative cell walls

A

Gram positive - Peptidoglycan (same as murein)
Gram negative - thin layer of peptidoglycan and an outer membrane with lipopolysacharride

32
Q

What is the difference between gram positive and negative stains?

A

Gram positive - Purple
Gram negative - Red/pink

33
Q

What is shock?

A

An imbalance in supply and demand

34
Q

What are the test results that indicate infection

A
  • High C reactive protein level
  • High WBC count
  • Dip in normal oxygen saturation levels (lower than 95% is abnormal)
  • High respiratory rate (12-20 normal for adults)
35
Q

What are the signs of infection from catheter specimen urine?

A
  • Positive for epithelial cells
  • High number of organisms and WBCs
36
Q

What are the 4 mechanisms antibiotic resistance occurs via

A

1) Altered target site
2) Inactivation of the antibiotic
3) Altered metabolism profile
4) Decreased drug accumulation

37
Q

What are sources of antibiotic resistance genes?

A

Plasmids - contain resistant genes and can be swapped between bacteria
Transposons - allows transfer of resistant genes from plasmid to chromosome
Naked DNA - DNA from dead bacteria containing resistant genes is taken up by bacteria to incorporate into their DNA
Bacteriophages - viruses that attack bacteria and carry DNA from bacteria to bacteria

38
Q

How are antibiotic resistance genes spread?

A

Transduction - via bacteriophages
Conjugations - resistance genes can be transferred between bacteria and they connect via a pilus
Transformation - naked dna

39
Q

What are the 3 categories of antibiotic resistant bacteria?

A

Urgent
Serious
Concerning

CSI (11 decks)

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