Nosocomial infections

Question 1

what are the 2 most common causes of nosocomial infections?

Answer 1

• E. coli (UTI)
• S. aureus (wound infections)

Question 2

pathogen and unique signs/symptoms associated with antibiotic use

Answer 2

• Clostridium difficile
  
  • ​watery diarrhea
  • leukocytosis

Question 3

pathogen and unique signs/symptoms associated with aspiration (secondary to altered mental status, old age)

Answer 3

• polymicrobial, gram - bacteria–often anaerobes
  
  • right lower lobe infiltrate
  • right upper/middle lobe–patient recumbent
  • prurulent malodorous sputum

Question 4

pathogen and unique signs/symptoms associated with decubitus ulcers, surgical wounds, or drains

Answer 4

• S. aureus (including MRSA)
• gram - anaerobes–Bacteroides, Prevotella, Fusobacterium
  
  • erythema
  • tenderness
  • induration
  • drainage from surgical wound sites

Question 5

pathogen and unique signs/symptoms associated with intravascular catheters

Answer 5

• S. aureus (including MRSA)
• S. epidermidis–long term
• Enterobacter
  
  • erythema
  • induration
  • tenderness
  • drainage from access sites

Question 6

pathogen and unique signs/symptoms associated with mechanical ventilation, endotracheal intubation

Answer 6

• late onset: P. aeruginosa, Klebsiella, Actinetobacter, S. aureus
  
  • new infiltrate on CXR
  • increased sputum production
  • sweet odor–Pseudomonas

Question 7

pathogen associated with renal dialysis unit, needlestick

Answer 7

• HBV

Question 8

pathogen and unique signs/symptoms associated with urinary catheterization

Answer 8

• E. coli
• Klebsiella
• Proteus spp.
  
  • dysuria
  • leukocytosis
  • flank pain or costovertebral angle tenderness

Question 9

pathogen and unique signs/symptoms associated with water aerosis

Answer 9

• Legionella
  
  • signs of pneumonia
  • GI symptoms–nausea, vomiting
  • neurologic abnormalities