nosocomial infection

Question 1

Nosocomial infections

Answer 1

Hosp-acquired infections: Resistance to many AB

Question 2

nos infection caused by

Answer 2

Selective pressure in hosp/ community with high AB usage
□ Resistance to extended spectrum penicillin/ cephalosporins/ AG/ quinolones

□ Colonisation at multiple body sites: GI, Skin, pharynx

Question 3

nos infection transmission

Answer 3

□ Airborne: TB, varicella, aspergillus
□ Contact: s.aureu, enterococci, gram -ve bacilli
□ Common vehicle
□ Food contamination: salmonella, hep A

Question 4

common nos infection

Answer 4

1) Vascular device-associated bacteremia
2) ventilator assoc pneumoni bacteremia
3) surgical site infection
4) MRSA

Question 5

Vascular device-associated bacteremia

Answer 5

◊ Colonisation of insertion/ access hub
- IV, catheter
◊ Biofilm formation allow bact attachment
- Reusable bags, saline bags
◊ Develop bacteremia (blood stream)
1) Autoclave
2) Apply AB after surgery
Coat instrument with AB

Question 6

Surgical site infection

Answer 6

◊ During surgery introduction of skin organisms into wound
1) Coat instrument with disinfectant on medical instrument
- Silver, sulfadiazine

Question 7

MRSA

Answer 7

-Chromosomal mecA gene

-Altered PBP 2 / 2a in cell wall
Low affinity for all b-lactam AB

Question 8

Prevention of nos infection

Answer 8

§ Limit transmission of org between pt in direct pt care
□ adequate cleaning, PPE, training, prophylactic antimicrobial, isolation

§ Control environmental risks for infection

§ Limit risk of endogenous infections
□ minimise invasive procedures
□ promote optimal antimicrobial use

§ Surveillance of infections, identify and control outbreaks
□ Survey trend maybe biofilms/ not proper sterilisation of equip/ procedure

§ Prevent infection in staff members

Question 9

Risk assessment for nos infection

Answer 9

§ Level of pt care diff between pt grp: diff risk of acquisition of infection

§Risk assessment will be helpful to categorise pts and plan infection control interventions

1) minimal (no sig disease)

2) medium (infected pt, risk factors age)
- bio fluids exposure/ invasive non-surgical procedure (peripheral venous catheter, urinary catheter)

3) high (severe immunocom, trauma, burn, organ transplant)
-surgery
- high risk invasive (catheter central venuos)

Question 10

low / med level aseptic measures

Answer 10

alcohol
sodium hypochlorite
phenol
idophors

Question 11

high aseptic measures

Answer 11

clutaraldehyde
ortho-phthaladehyde
hydrogen peroxide gas (7.5% corrosive)

hydrogen peroxide/ peracetic acid