Week 4 - Healthcare infections Flashcards
What % of patients get HCI?
-8%
How do HCI have economic impact on NHS?
-If the pt stay is extended over the trimpoint then NHS does not get paid
What are the mose commonly acquired HCI?
- C.diff
- Norovirus
What are the most common healthcare viruses?
- Norovirus causing gastroenteritis
- Influenza
How is norovirus spread?
-Faecal-oral, person-person, aerosolization
What virus causes winter vomiting infection?
-Norovirus
What is the treatment for norovirus?
- Usually self-limiting
- Fluid resuscitation in extreme cases
What is MRSA?
-Methicillin-Resistant staphylococcus Aureus
Why does MRSA have a high mortality?
-Develops in hard to treat places eg Heart valves
What are the common signs of C diff infection?
- Diarrhoea
- Fever
- Abdo cramp
Why is c.diff associated with hospitals?
-It is a spore-forming bacteria which can survive on objects and surfaces in harsh conditions which are then ingested and become vegetative
What is the gram status of E.coli and Klebsiella?
-Gram negative
When are fungi seen in healthcare infections?
-In the immunocomprimised patient
What people are at risk of getting HCI?
- Extremes of age
- Smoker
- Surgical patient
- Emergency admission
- Immunocomprimised
Why are premature babies at risk of HCI?
- Poorer immune system
- Decreased skin quality
What patient factors can you apply to prevention and control of HCI?
- Interactions with other patients, HCP, visitors
- MRSA screen and antimicrobial prophylaxis if appropriate
- Disinfectant bodywash
- Optimise patient conditions eg decrease smoking, increase nutrition
- Isolation of infected patients/protection of susceptible patients
- Barrier nursing
What pathogen factors can you apply to preventing and controlling HCI? Use C.diff as an example
- Virulence factors affect prevention and control eg c.diff is opportunistic and toxin production is in the stationary phase so the infection is not recognised until well established and already contagious
- High virulence -> single use equipment
What practice factors can you apply to prevention and control?
- HCP training on prevention and control
- Government policies and their implementation eg hand hygiene
What place factors can you apply to prevention and control?
- Space/layout of toilets and handwash basins
- Furniture and furnishings to be easy clean, disinfectant use
- Medical devices for single use only or to be sterilised
- Good food hygiene and kitchen facilities
What would you do if someone is highly infectious in hospital?
- Isolation room with toilet/commode
- PPE including apron and gloves
- Barrier nursing
Why is the use of some antibiotics liked to c.diff infections? Which abx?
- Reduce the number of normal flora giving C diff the opportuity to grow
- Ceftriaxone
What toxins are produced by c.diff? How do they infer virulence?
- Enterotoxin A -> alters the permeability of the intestinal wall (inflammation)
- Cytotoxin B -> cytotoxic to cells
What is the gram status of C.diff?
-Gram positive bacilli
Name some other clostridium species apart from C.diff
- C. tetani
- C.Pefringes
- C.botulinum
Why is india associated with high rates of antibiotic resistance?
-Abx are available over the counter and there is no prescription control resulting in over-use of abx and non-compliance
What are the complications associated with norovirus?
- Dehydration
- Malnutrition
- Death
What is a healthcare infection?
-Infections arising as a consequence of providing/receiving healthcare which is neither present nor incubating at time of admission (ie onset must be after 48 hours)
