Microbiology 🦠 Flashcards

1
Q

what is the definition of HAIs?

A

HAIs are infections acquired in a hospital (or healthcare facility) 48 hours or more after admission.

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2
Q

what were HAIs previously refered as?

A

were previously referred to as β€œnosocomial” or β€œhospital infections”.

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3
Q

where could HAIs occur?

A

may occur in patients, visitors, or healthcare members (staff & workers)

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4
Q

what causes HAIs?

A

can be caused by any microbial agent: bacteria, virus, fungus, or parasite

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5
Q

what are the types of HAIs?

A
  1. Central line-associated blood stream infections (CLABSI)
  2. Catheter-associated urinary tract infections (CAUTI)
  3. Ventilator-associated pneumonia (VAP)
  4. Surgical site infections (SSI)
  5. Others e.g., C. difficile infections
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6
Q

what are the sources of HAIs?

A

Endogenous source:
- from patient’s own flora of the skin, gastrointestinal, respiratory, or genitourinary tract.

Exogenous source:
- Animate source:
a) Medical personnel.
b) Patients.

  • Inanimate source:
    a) Hospital environment : air, dust, water.
    b) Patient care equipment and medical devices : such as intravenous (IV) fluids and catheters, ventilators & respiratory equipment, endoscopes, disinfectants, and bedpans.
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7
Q

what is the mode of transmission of HAIs?

A

1. Contact transmission: e.g., MRSA & Clostridium difficile.

  • Direct contact with an infected person .
  • Indirect contact with contaminated surfaces (touched by the infected person, or where droplets or body fluid settled).
  • Hands are the most important vehicle for transmission of healthcare- associated infections

2. Respiratory (Airborne) transmission: e.g., T.B, Measles & Varicella.

  • Aerosols (i.e., particles < 5ΞΌm in size) remain suspended in air for long time and widely spread organisms by air currents.

3. Droplet transmission: e.g, Influenza & Mumps.

  • Droplets (i.e., particles > 5ΞΌm in size) travel for short distance through air, and organisms are deposited on mucosa of mouth, conjunctiva, or nose.

4. Common vehicle transmission:
- Contaminated items such as food, water, devices, and medication transmit organisms to host.

5. Vector borne transmission:
- Vectors such as mosquitoes, flies, rats, and other pests transmit organisms to host.

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8
Q

what are the factors affecting HAIs?

A

1. Microbial factors:
- Microbial virulence.
- Microbial dose.
- Microbial resistance.

  • Higher microbial virulence, dose and resistance increase the risk of HAI.

2. Patient susceptibility:
- Age : infants & old age patients are more susceptible to infection.

  • Immune status : immune-compromised patients are more susceptible to infection.
  • Prolonged hospital stay.

3. Environmental factors:
- Hospitals house large number of sick & immune-compromised people.

  • Medical procedures bypass body’s natural protective barriers.
  • Wide use of antibiotics in hospitals leads to emergence of resistant strains.
  • Medical staff move from patient to patient, so may help spread of pathogens.
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9
Q

what is the definition of HAIs Prevention & control precautions?

A

These are measures practiced by healthcare workers (HCWs) to prevent transmission of infection among patients and healthcare workers.

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10
Q

what do HAIs Prevention & control precautions include?

A

They include :
1- Standard precautions
2- Transmission-basedprecautions
3- HCWs vaccination

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11
Q

what are the standard HAIs Prevention & control precautions?

A
  • As defined by CDC : standard precautions are set of practices designed to prevent the transmission of HIV, Hepatitis B virus & other blood borne pathogens (bacteria & viruses).
  • Blood and other body fluids of all patients should be considered potentially infectious.
  • These practices should be done for care of all patients all times.
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12
Q

what are the elements of standard precautions?

A
  • Hand Hygiene
  • Personal protective equipment (PPE)
  • Safe injection practices
  • Sharps injury prevention
  • Respiratory hygiene/cough etiquette
  • Cleaning of care equipment between patients
  • Textiles and laundry
  • Care of environment
  • Safe waste disposal
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13
Q

what is the single most effective precaution for prevention of infection among patients & healthcare staff?

A
  • Hand hygiene is the single most effective precaution for prevention of infection among patients & healthcare staff.

– Types of hand hygiene.
– Hand washing technique.
– When to wash your hands?

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14
Q

what is PPE?

A
  • PPE are specialized clothing or equipment worn by an employee for protection against infectious materials.

They include:
a) Gloves
b) Masks & protective eye wear
c) Gowns/Aprons

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15
Q

Safe injection practices

A
  • Use aseptic technique .
  • Use syringe, needle, and fluid infusion set only once.
  • Use single-dose vials when possible.
  • Use and store multi-dose vials according to manufacturer recommendations.
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16
Q

Sharps injury prevention

A
17
Q

what is Respiratory hygiene/cough etiquette used for?

A
18
Q

Respiratory hygiene/cough etiquette

A
19
Q

Cleaning of care equipment between patients

A
20
Q

Textiles and laundry

A
21
Q

Care of environment

A
22
Q

Safe waste disposal

A
23
Q

what are Transmission-Based Precautions?

A

are used for patients with known or suspected infections, or for patients at risk of acquiring
infection from others.

24
Q

what do Transmission-Based Precautions include?

A

They include :
a) Air borne precautions
b) Droplet precautions
c) Contact precautions
d) Environment (Protective) precautions

25
Q

HCW vaccination for hepatitis B

A

Criteria:
- No past completion of vaccine series
- No serologic evidence of immunity

Regimen:

  • Three doses: second dose 1 month after first dose, third dose 5 months after second dose
  • serologic testing after completion
26
Q

HCW vaccination for Influenza

A

criteria:
- Recommended annually

Regimen:
- single dose annually

27
Q

HCW vaccination for MMR

A

criteria:

  • Born in 1957 or later and no past immunization, No serologic evidence of immunity
  • Born before 1957 is considered evidence of immunity

Regimen:

  • If not immune to measles/mumps, give two doses 28 days apart
  • If not immune to rubella, Give single dose
28
Q

HCW vaccination for Varicella

A

criteria:
- No past completion of vaccine series
- No serologic evidence of immunity
- No past infection

Regimen:
- Two doses 4 weeks apart

29
Q

HCW vaccination for Tetanus, Diptheria & pertussus (Tdap)

A
30
Q

HCW vaccination for Meningococcal

A

Criteria:
- Routine exposure to neiseria meningtidis

Regimen:
- Single dose

31
Q

Post HBV vaccination serologic testing

A
  • serologic testing for HCW is done after completion of vaccination to test HCW’s response to vaccine.
32
Q

what are types of exposure to Blood-Borne pathogens (BBPS)?

A

1- Percutaneous exposure through sharps injury.

2- Muco-cutaneous exposure through splash or blood or body fluids into mucous membranes.

33
Q

what is the risk of exposure to Blood-Borne pathogens (BBPS)?

A

the transmission of blood-borne pathogens (BBPs) including Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human immunodeficiency virus (HIV) are:
- HBV: risk is up to 30%
- HCV: risk is up to 3%
- HIV: risk is up to 0.3%

34
Q

Management ofexposure of HCW to blood-borne pathogens (BBPs)

A

First aid measures:

1- Encourage gentle bleeding, do not suck.

2- Wash the skin with soap and water, do not scrub.

3- Irrigate contaminated mucous membranes with large amount of water.

4- Cover the injury with dressing and seek medical advice without delay.

5- Report to the supervisor and the infection control team.

Post-exposure prophylaxis (PEP) of HCW:
1- Against HBV exposure.
2- Against HCV exposure
3- Against HIV exposure

35
Q

Recommendations for post-exposure prophylaxis of HCW against HBV infection

A
36
Q

Recommendations for post-exposure prophylaxis of HCW against HCV infection

A
37
Q

Recommendations for PEP of HCW against HIV infection

A