Nosocomial Infection

Question 1

What are nosocomial infections?

Answer 1

Nosocomial infections are those infections acquired in hospital that first appear 48 h or more after hospital admission. They are unrelated to the original illness that brings patients to the hospital.
- Its a localised or systemic condition That results from an adverse reaction to the presence of an infectious agent(s) or its toxin(s) .

Question 2

Development of nosocomial infection is dependent on pathophysiological factors. There are 2, what are they?

Answer 2

Decreased host defences/compromised immune system

Colonisation by pathogenic, or potentially pathogenic microbe

Question 3

What are some factors related to underlying health status which can lead to nosocomial infection?

Answer 3

Advanced age - very young children or elderly
Malnutrition
Alcoholism
Diabetes
Chronic lung disease
Immunocompromised patients

Question 4

What are some factors related to acute disease process which can lead to nosocomial infection?

Answer 4

Surgery, burns, trauma

Question 5

What are some factors related to invasive procedures which can lead to nosocomial infection?

Answer 5

ET or nasal intubation
Central venous catheterisation
Surgical drains
Urinary catheters

Question 6

What are some factors related to treatments which can lead to nosocomial infection?

Answer 6

Recent antimicrobial therapy
Immunosuppressive treatments
Blood transfusions

Question 7

What is an invasive device?

Answer 7

Any medical device that is introduced into the body, either through a break in the skin or through an opening in the body.

Question 8

What is a mechanical ventilator?

Answer 8

A mechanical ventilator is a machine that helps people breathe when they are not able to breathe enough on their own. Most patients who need support from a ventilator because of a severe illness are cared for in a hospital’s intensive care unit (ICU).

Question 9

What are some of the reasons as to why ventilators are used?

Answer 9

• To get oxygen into the lungs and body
• To help the body get rid of carbon dioxide through the lungs
• To ease the work of breathing—Some people can breath on their own, but it is very hard. They feel short of breath and uncomfortable.
• To breathe for a person who is not breathing because of injury to the nervous system, like the brain or spinal cord, or who has very weak muscles.

Question 10

What is a urinary catheter?

Answer 10

A urinary catheteris a flexible tube used to empty the bladder and collect urine in a drainage bag.

Question 11

What is a central line?

Answer 11

A central line is a type of catheter that is placed in a large vein that allows multiple IV fluids to be given and blood to be drawn.
(Bloodstream infections)

Question 12

Why is MRSA difficult to treat?

Answer 12

Reduced antimicrobial options
Side-effects
Difficult to administer
Poor penetration to particular body compartments

Question 13

What is glycopeptide used for?

Answer 13

• severe skin and soft-tissue infections associated with MRSA.
• urinary-tract infections that are severe or resistant to other antibacterials.
• septicaemiaassociated with MRSA.
• forpneumoniaassociated with MRSA.

Question 14

Linezolid can be used in treatment of MRSA. What are two features of using this antibiotic?

Answer 14

No cross-resistance with other classes of antimicrobial agents.
Resistance can develop with prolonged treatment or if dose is less than recommended.

Question 15

C.difficile is not a particularly resistant bacteria and is susceptible to a number of antibiotics. What is the treatment for it?

Answer 15

Metronidazole: drug of choice - cheaper and reduce vancomycin resistance
Rehydration - electrolyte solution
Surgery - rare - if patient doesn’t respond to antibiotic