05-07 Healthcare-Associated Infections Flashcards Preview

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Flashcards in 05-07 Healthcare-Associated Infections Deck (14):
1

1. Recog epidem and med behaviors that give rise to healthcare-assoc infxs

EPIDEMIOLOGY
—Affects 1.7 million pts/yr (1 in 20 hospitalized pts daily!)
—99,000 deaths/yr

MED BEHAVIORS THAT GIVE RISE
—central lines
—folley caths
—ventilators
—providers who are carriers of MRSA, others
—antibiotic usage
—long-hospitalizations

2

2. ID manifestations (i.e. common syndromes) seen in healthcare-assoc infxs

MANIFEST AS TYPICAL SYNDROMES
—Central Line Assoc Bloodstream (CLABSI)
—Cath-assoc UTI (CAUTI)
—Surg sit infx (SSI)
—Vent-assoc events (VAE)
—MRSA
—C diff infx (CDI)

See specific cards

3

3. Review public health impact of HCAI, and the std px measures taken to address them

STANDARD PX MEASURES
—#1 = HAND HYGIENE
—isolation precautions
—req'd immunizations
—anti-microbial stewardship

4

4. Recog the critical role of px in the containment of HCAI

Prevention is critical...duh

5

5. Recog their economic impact

~$30 BILLION dollars a year wasted on HCAI fall-out!

6

6. Describe the role of culture techniques in the dx of HCAIs

not addressed

7

7. ID the role of the MD in px and containment of HCAIs

not addressed

8

Drug of choice for most pre-op prophylaxis...when to give?

cefazolin
—give 1 hr pre-op
—d/c 24 hrs post-op

9

Healthcare work req'd vaccinations

Hep B
Influenza (yearly)
MMR
Varicella
TDaP

10

CLABSI
—Relative mortality
—Usual bugs

CENTRAL LINE-ASSOC BLOODSTREAM INFX
—12-25% mortality and mostly preventable

Usual bugs = cutaneous flora
—Coag-neg staph
—Staph aureus
—Enterococci
—Candida
—Gram negatives (nosocomial)

11

SSI
—Avg incubation
—Typical pathogens
—Risks

SURGICAL SITE INFXS
Average Incubation
—5-7 days
—1-2 days for Rapidly progressive GAS or Clostridial

Typical Pathogens (Endogenous, nosocomial skin flora and qqf airborne)
—S. aures
—Coag neg staph
—Enterics and anaerobes

Risk Factors
—Pt's susceptibility (DM, obese, HIV, age etc)
—Inapp abx proph / shaving
—Prolonged pre-op stay/long-surgery
—Surgeon's skill
—Infections elsewhere

12

VAE
—Mortality
—Bug categories
—Risks

VENTILATOR ASSOC EVENTS (VAP)
Mortality
—6-14%

Bugs
—aspiration of endogen or nosocomial oropharygenal or gastric flora

Risks
—Amt prev abx
—Contaminated vent
—Achlorhydria
—NG
—COPD, age
—Upper abd surg

13

MRSA
—% of pop w/ S. aureus nasal colonization

—MRSA is #2 cause of HAIs
—33% people S.aureus colonized (2% MRSA)

14

CDI
—Epidemiology
—% of abx-related diarrhea?
—Risk Factors
—Sequeale
—Transmission
—Px

C. DIFF
Epidem
—Becoming MORE common
—Only HAI not decr'ing
—Causes ~20% of all abx-related diarrhea

Risk Factors
—Age
—Abx
—Gi srug
—Immunosupp
—PPI usage

Sequelae
—toxic megacolon
—sepsis
—death

Transmission
—by healthcare workers

Preventions
—hand hygiene
—contact precautions
—clean w/ chlorine-containing agents
—use Abx responsibly