Session 5- MRSA, C.Difficile, Norovirus Flashcards
Explain the 4 P’s of healthcare infection prevention
- Patient/ worker interventions (reducing risk factors, specific prophylaxis and reducing transmission)
- Pathogen (virulence factors, ecological interactions with other bacteria/ antibiotics)
- Practice
(Activities of everyone in the establishment; patients, workers etc) - Place
fixed and variable features of the hospital environment. E.g appropriate toilet and kitchen facilities on the ward
How do you test for C. Difficile?
ELISA test of stool sample to look for exotoxins A and B
What type of bacteria is C. difficile?
Gram positive bacillus
Obligate anaerobe
How does C. Difficile spread?
Through endospores (shed in stool) which persist in the environment and can be ingested (faecal- oral transmission).
Name 4 species of clostridium and the diseases they can cause
- Clostridium Difficile (AAD and PMC)
- Clostridium Perfringens (Myonecrosis/ gas gangrene, food poisoning, anaerobic cellulitis)
Normal member of vaginal and GI flora - Clostridum Botulinum (Botulism/ paralysis/ muscle weakness)
- Clostridium Tetani (tetanus)
No honey under 12 months old. Why?
Can contain the spores of Clostridium Botulinum which release the toxin causing botulism.
After 1 we have defences against the spores. Must be treated with anti-toxin.
What is debridement?
Removal of dead/ infected tissue from a wound to promote healing
When is vancomycin given intravenously and when orally?
Vancomycin is poorly absorbed so oral dosing cannot be used for systemic infections. It can be given orally for severe C. Difficile infection.
MRSA- I.V. vancomycin
Treatment for C. Difficile infection?
Mild- metronidazole
Severe - oral vancomycin
Complications associated with norovirus infection?
- Dehydration in patients
- very infectious; can causes epidemics in crowded environments quickly
- no specific treatment so patients have to wait 48 hours for symptoms to cease- time out of work, life commitments and potentially longer hospital stays
Examples of patient interventions for infection prevention?
HCAI = healthcare associated infections
Reduce patient risk/ optimise their health:
- control diabetes
- smoking
- nutrition
- antimicrobial prophylaxis
- hand hygiene
- skin preparation before surgery
Specific HCAI interventions:
- MRSA screening followed by topical antibiotics (mupirocin nasal cream) for people with MRSA carriage/ disinfectant body wash
- Hand washing for C. Difficile
Reducing patient- patient transmission
- isolation (positive/ negative pressure rooms)
- protection for susceptible patients
Healthcare worker interventions for infection prevention?
Themselves:
- in good health
- vaccinated
Good practice:
- hand hygiene
- PPE
- prescribe antimicrobials when needed
- good clinical techniques (sterile, non-touch).
Environmental interventions for infection prevention?
- layout of toilets, wash hand basins
- cleanliness of furniture and furnishings
- use of disinfectants whilst cleaning
- potential for vapourised hydrogen peroxide (antimicrobial) release to sterilise air
Medical devices:
- one use
- sterilisation
- decontamination
- Good food hygiene practice
- Appropriate kitchen and toilet facilities
‘Have you i-fived your patient?’
What does this mean in terms of infection control?
- Identify the infection (symptoms and signs)
- Isolate the patient and susceptible individuals
- Investigate to confirm type of infection
- Inform staff and public health if necessary
- initiate treatment
MDR
XDR
PDR
Multidrug resistance
Extensive drug resistance
Pan drug resistance (all antimicrobials)
