MI: Hospital Acquired Infections

Question 1

How can HAIs be categorised?

Answer 1

By organism (e.g. MRSA)

By clinical syndrome (e.g. surgical site infection)

Question 2

What is the prevalence of HAI in the UK?

Answer 2

8%

Question 3

List 5 HAIs in order of prevalence.

Answer 3

• Pneumonia
• Surgical site infection
• UTI
• Blood stream infection
• Gastrointestinal infection

Question 4

What did the hospital microbiome project find?

Answer 4

On the 1st day of admission the bugs go from the envirnoment onto the patient

From the 2nd day onwards, bugs go outwards from the patient

Question 5

What type of bacterium is C. difficile?

Answer 5

Gram-positive spore-forming anaerobe

Question 6

Why might E. coli bacteraemia be increasing in prevalence?

Answer 6

Dehydration in elderly patients

The drive to limit antibiotic use may lead to more invasive infections

Question 7

List some approaches to reducing the incidence of E. coli bacteraemia.

Answer 7

• Reduce the number of bugs - hygiene and sanitation
• Reduce the number of resistant bugs - screen patients for certain organisms (e.g. MRSA, VRE)
• Prioritise side rooms
• Reduce transmission (educating staff, cleaning the environment, reducing the use of broad-spectrum antibiotics)

Question 8

Why are carbapenemase-producing enterobacteriaceae (CPE) such a big problem?

Answer 8

Carbapenems are often the last resort antibiotic

Infection by these bacteria are associated with a high mortality

Question 9

Why are HAIs becoing more common?

Answer 9

• More invasive procudures
• More prosthesis
• Obesity
• Diabetes
• Extremes of age
• Immunosuppression
• Emerging organisms and resistance

Question 10

List some ways in which the hospital environment is managed to reduce infection risk.

Answer 10

• Environmental hygiene and cleaning
• Control environmental sources (e.g. water)
• Building works (aspergillus)
• Negative pressure isolation (protects others from the patient)
• Positive pressure isolation (portection of patients from the outside)