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ID > WK 12- Infection Control > Flashcards

WK 12- Infection Control Flashcards

1
Q

What are core infection control components

A
  • Hand hygiene
  • Aseptic technique
  • Standard & Transmission based precautions
  • Environmental control
  • Staff immunisation –Hep B, Influenza
  • Monitoring of MDROs
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2
Q

What is a nosocomial infection

A

An infection for which there is no evidence that this was present or incubating at the time of hospital admission

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3
Q

What are the most common nosocomial infections

A
  • Urinary tract infections -33%
  • Pneumonia -15.5%
  • Surgical wound infections -15%
  • Primary bacteraemia -13% → mainly in those who are immune compromised (ie. Chemo patients)
  • Others -23.5%
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4
Q

What organism is the most common cause of nosocomial infections

A

Staph aureus

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5
Q

What are current contemporary issues that hinder infection control

A
  • Increase in highly complex and invasive medical and surgical procedures.
  • A trend to large “mega” hospitals→ due to having high risk patients
  • An overuse of broad spectrum antibiotics in hospital.
  • The emergence of multiresistant organisms in hospitals.
  • Immunosuppressive therapy
  • The use of antibiotics as growth promoters in animal feeds→ used to enhance growth
  • The increase in material and human costs of a patient acquiring a nosocomial infection (can also run out of options of how to treat patients due to reistance)
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6
Q

What are examples of multi-resistant organisms

A
  • Methicillin resistant Staphylococcus aureus (MRSA)
  • Vancomycin resistant Enterococci (VRE)
  • Extended spectrum βlactamase (ESBL) producing organisms (usually Klebsiella pneumonia)
  • Multiresistant gram negative bacilli (eg: Acinetobacter, Pseudomonas (pseudomonas is most common))
  • CPE→ carbapenem resistant enterobacteriaciae
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7
Q

How do MRSA bacteria develop resistance

A
  • Penicillin: Production of penicillinase (BlaZ)

- Methicillin: Production of PBP-2A (MecA)

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8
Q

What are the main major ICU infections

A 
VAP= ventilator associated pneumonia
Catheter associated blood strea infection
Catheter related blood stream infection
Catheter associated UTI
Fever without a focus
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9
Q

What factors have encouraged the emergence of multi-resistant organisms

A

Hospital size and service provided→Bed numbers (multiple beds in single room makes it easier to spread nosocomial infections), transplantation (due to prior immune suppression), cardiac surgery

  • Patient related factors→Underlying disease, immunosuppression, age, trauma, obesity
  • Extrinsic factors→Invasive devices, surgical procedures, antibiotic pressures (more organisms someone is exposed to, greater risk of developing resistance)
  • Environmental factors→contaminated air, water or food.
  • Community acquisition→ travel (Asian countries→china, india), prison, ATSI, homeless
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10
Q

What is passive detection of antibiotic resistance

A

-“Passive” detection→ Isolates from clinical samples taken to determine the aetiology of a clinical episode of sepsis.

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11
Q

What is active detection of antibiotic resistance

A

-“Active” detection or surveillance→ Screening of patients in high risk areas, Surgical wound surveillance, Laboratory based surveillance

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12
Q

How can spread of nosocomial infections be reduced

A
  • Education and ownership of infection control by ALL staff.
  • The adoption and implementation of Standard and Additional precautions.
  • The early identification and isolation of patients colonised or infected with multiresistant organisms
  • Rational antimicrobial prescribing.
  • Minimisation of the use of indwelling devices such as iv lines and urinary catheters (as bacteria form biofilms→ most likely pseudomonas and staph aureus)
  • Basic hygiene
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13
Q

What factors contribute to nosocomial surgical wound infections

A
  • Type of procedure→ orthopaedic is most common
  • Pre-existing contamination of the area
  • Duration of surgery and technical skill→ longer surgery=higher risk of infection
  • Tissue viability
  • Patient factors
  • Duration of stay in hospital prior to surgery
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14
Q

What factors contribute to nosocomial line related infections

A
  • Type of line (central vs peripheral)
  • Duration (longer its in there= higher risk of infection)
  • IV wound site care
  • Infusate
  • Use of coated lines (ie. Coated with antimicrobial)
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15
Q

What factors contribute to nosocomial resp infections

A
  • Bypassing of normal defence mechanisms by mechanical ventilation.
  • Patient factors
  • Antibiotic selective pressure
  • Cross infection in high risk units
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16
Q

What viruses are commonly involved in nosocomial infections

A
  • blood borne viruses can spread in low income areas due to reusing needles (low resources)
  • Influenza (A &B)
  • Respiratory syncytial virus
  • Varicella zoster (Chickenpox)
  • Rotavirus
  • Hepatitis A
  • Hepatitis B
17
Q

What is the risk of being exposed to; HIV, Hep C or Hep B if exposed to fluids in hospital

A

HIV= 0.3%

  • Hep C= 3%
  • Hep B= up to 30%
18
Q

How can exposure to blood borne diseases be prevented in hosp

A

-minimised through the adherence to occupational exposure follow up protocol and implementation of risk minimisation processes following an exposure

19
Q

What does sterilisation mean

A

Sterilisation is the process of killing or removing all viable organisms→ the use of physical or chemical procedures to destroy all microbial life, including large numbers of highly resistant bacterial endospores
-Done through→ Autoclaving, Dry heat, Gamma irradiation, Filtration, Low temp gas plasma H2O2 (Sterrad), Peracetic acid (Steris)

20
Q

What does disinfection mean

A

Disinfection is the process of removing most but not all viable organisms→ microbial inactivation that eliminates virtually all recognized pathogenic micro-organisms but no necessarily all microbial forms (ie spores).
-Done through:
→Low level disinfection: Antiseptics (Phenols, Alcohol, Chlorhexidine, Iodine)
→High level disinfection: Boiling, Pasteurisation, Glutaraldehyde

21
Q

What does infection mean

A

-Infection
-An invasion of pathogens or microorganisms into
the body that produces systemic illness or end
organ dysfunction

22
Q

What does colonisation mean

A

-Colonisation
-Presence of microorganisms within a non-sterile
site that at present are not producing a systemic
illness or end organ dysfunction

23
Q

What predisposes to candidiasis

A
  • Diabetes
  • Antibiotic Use
  • Immunosuppresive med–> like steroids
24
Q

What is the most common cause of septic arthritis

A

staph aureus

ID (13 decks)

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