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Phase 1 - S2 Infection (M) > Session 5 - Hospital Acquired Infections and Adaptive Immunity > Flashcards

Session 5 - Hospital Acquired Infections and Adaptive Immunity Flashcards

1
Q

What are hospital acquired infections?

A

An infection that has taken place and/or originated in a hospital setting.

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2
Q

What are the most prevalent types of hospital acquired infections?

A
  • Urinary Tract Infections
  • Pneumonia
  • Surgical wound infections
  • Skin and soft tissue infections
  • Primary bloodstream infections
  • Gastro-intestinal infections
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3
Q

Give examples of viruses that can cause a hospital acquired infection

A
  • Blood borne viruses (Hep B, C, HIV)
  • Norovirus
  • Influenza
  • Chickenpox
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4
Q

Give examples of bacteria that can cause a hospital acquired infection

A
  • Staph. aureus
    • inclusive of the MRSA strain
  • Clostridium difficile
  • E. coli
  • Klebsiella pneumoniae
  • Pseudomonas aeruginosa
  • Mycobacterium tuberculosis
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5
Q

Give examples of fungi that can cause a hospital acquired infection

A
  • Candida albicans
  • Aspergillus species
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6
Q

Give examples of parasites that can cause a hospital acquired infection

A
  • Malaria
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7
Q

What general patient measures can we take to prevent hospital acquired infections?

A
  • Optimise the patient’s conditions
  • Antimicrobial prophylaxis
  • Skin preparation
  • Hand hygiene
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8
Q

What specific patient measures can we take to prevent hospital acquired infections?

A
  • Conduct MRSA screens
  • Mupirocin nasal ointment
  • Disinfectant body wash
  • Halting patient to patient transmission by isolation of infected patients and protection of susceptible patients
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9
Q

What measures can be taken to prevent healthcare worker to patient spread of infection?

A

Healthcare workers:

  • Should be healthy
    • disease free
    • vaccinated
  • Should use good practice methods
    • good clinical techniques (sterile non-touch)
    • hand hygiene
    • PPE
    • anti-microbial perscribing
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10
Q

What environmental interventions can be taken in order to prevent hospital acquired infections?

A
  • Cleaning
    • disinfectants
    • steam cleaning
    • hydrogen peroxide vapour
  • Medical devices
    • single use equipment
    • sterilisation
    • decontamination
  • Good food hygiene practice
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11
Q

What is the adaptive immune response?

A

The second part of the immune response that follows the innate immune response.

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12
Q

When does adaptive immunity come into action?

A

Adaptive immunity begins if the innate immune and inflammatory response are unable to clear the infection. It is a more specific form of immunity.

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13
Q

How is the adaptive immune response activated?

A

Antigens are presented to the adaptive immune system by APC (antigen presenting cells) with digested antigens travel to the lymph nodes.

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14
Q

What are the different antigen presenting cells (APCs)?

A
  • Dendritic cells
  • Langerhans’ cells
  • Macrophages
  • B cells
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15
Q

What do APC cells do when they reach the lymph nodes?

A

They present the antigen to the naive T helper cells by the MHC molecules present on the T cell’s surface.

This activates the naive T helper cells and allows them to mature into active T helper cells.

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16
Q

What are the different MHC molecules and in which types of cells are they found?

A

MHC molecules come in two different classes:

  • MHC I
    • found on all nucleated cells
  • MHC II
    • found on dendritic cells, macrophages, and B cells
17
Q

What are the key features of MHC I and MHC II?

A
  • They have co-dominant expression
  • They are polymorphic genes (different alleles for everyone)
  • They have different main functions:
    • MHC I: present peptides from intracellular microbes
    • MHC II: present peptides from extracellular microbes
18
Q

Which T cells recognise MHC I molecules?

A

CD8+ T cells

19
Q

Which T cells recognise MHC II molecules?

A

CD4+ T cells

20
Q

What are some clincal problems with MHC molecules?

A

Is a major cause for organ transplant rejection due to conflicting MHC molecules from the donor and the patient.

21
Q

What do CD4 T cells do in the adaptive immune response?

A

Activate humoral immunity to act on extracellular microbes:

  • B cells
  • Complement system
22
Q

What do CD8 T cells do in the adaptive immune response?

A

Activate cell-dependent immunity for intracellular microbes:

  • B cell activation
  • Completment system
  • Macrophages
  • Cytotoxic T cells

CD4 T cells are needed to activate CD8 T cells, therefore MHC II is needed for activation.

23
Q

How are B cells activated?

A

B cells are activated by T cells, which encourage them to start producing antibodies.

24
Q

What do B cells produce to help fight infections?

A

B cells produce various different kinds of immunoglobulin antibodies that have different functions.

25
Q

What are the different kinds of immnoglobulin antibodies and what are their functions?

A
  • IgA
    • mucosal immunity
  • IgE
    • immunity against helminths
    • mast cell degranulation (allergies)
  • IgG
    • Fc-dependent phagocytosis
    • complement activation
    • neonatal immunity
    • toxin/virus neutralisation
  • IgM
    • complement activation
26
Q

What are the differences in antibody concentrations between first and second exposure to the same infection?

A

First exposure: IgM concentration will be higher than IgG concentration to fight the infection.

Second exposure: results in a faster response, therefore IgG will be higher than IgM because it is better at fighting infections.

27
Q

Why is IgG better than IgM at fighting infections?

A

Due to it’s structure, it can enter a cell and act on intracellular pathogens.

28
Q

What is the isotype switch?

A

This is when B cells change the kind of immunoglobulin they are secreting.

This happens when B cells switch from IgM to IgG molecules when an infection lasts for a long time.

29
Q

How can you test if a person has been exposed to a certain pathogen before using immunoglobulins?

A

Test for the presence of that pathogen’s IgG levels.

If IgG is present in the patient, they have been previously exposed to the pathogen.

Phase 1 - S2 Infection (M) (11 decks)

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