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Microbiology and Immunology > Week 13 > Flashcards

Week 13 Flashcards

1
Q

Nosocomial infections (4)

A
  • infection occuring in a patient during the process of care that was NOT present or incubating at time of admission
  • any type of setting (hospital, health care facility etc.)
  • can also appear after discharge
  • affects patients and staff
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2
Q

Nosocomial infections - when is an illness considered nosocomial

A
  • when symptoms present 48 to 72 hours after admission (depends on incubation period)
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3
Q

Factors causing development of Nosocomial Infections (2)

A
  • decreased host defenses (critically ill, antibiotics, etc)
  • colonization by pathogenic bacteria (antibiotic resistant, etc)
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4
Q

How common are nosocomial infections

A
  • 1/10 patients get an infection while recieving care
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5
Q

How many surgical site infections are nosocoimal

A

more than 50% of surgical site infections are antibiotic-resistant
- EX MRSA

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6
Q

Impacts of nosocomial infection (6)

A
  • prolonged hospital stay
  • long-term disability
  • increased resistance of microorganisms to antimicrobials
  • additional cost for healthcare system
  • additional cost for patients and their family
  • death
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7
Q

Factors that predispose to nosocomial infection (4)

A
  • underlying health status-
  • acute disease process
  • Invasive procedures
  • related to treatment
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8
Q

Nosocomial Infection: underlying health status (7)

A
  • impairment of host-defence mechanisms
  • advanced age
  • malnutrition
  • alcoholism
  • smoking
  • chronic lung disease
  • diabetes
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9
Q

Nosocomial Infection: acute disease process (4)

A
  • surgery
  • trauma (altered immune response)
  • burns (open wounds, no skin as barrier)
  • use of ventilators –> pneumonia
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10
Q

Nosocomial Infection: invasive procedures (6)

A
  • endotracheal/nasal intubation
  • central venous catheterization
  • extracorporeal renal support
  • surgical drains
  • NG tube
  • urinary catheter
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11
Q

Nosocomial Infection: related to treatment (5)`

A
  • blood transfusions
  • recent antimicrobial therapy
  • immunosupporessive treatment (corticosteroids, chemo)
  • recumberent position
  • parenteral nutrition
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12
Q

Causes of nosocomial infections (7)

A
  • Healthcare providers: transmit person-to-person
  • infected personal equipment (stethoscopes, bladder scan)
  • medical equipment inappropriately reprocessed
  • environmental contamination
  • airborne transmission
  • carriers on the hospital staff
  • antimicrobial misuse/resistance
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13
Q

Incidence of Hospital aquired infectiosn

A

1) UTI – catheterization
2) pneumonia
3) surgical wound infection
4) skin infections

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14
Q

Hospital organisms - UTI (4)

A
  • E. Coli
  • P. Aeruginosa
  • Klebesiella
  • Enterobacter
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15
Q

Hospital organisms - Resp (5)

A
  • staph aureus-
  • gram negative rods (pseudonomas aeruginosa)
  • streptococcus pneumoniae
  • TB
  • VZV
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16
Q

Hospital Organisms - Diarrhea/vomiting (2)

A
  • C. Difficile
  • Norovirus
17
Q

Hospital Organisms - Blood (3)

A
  • Hep B
  • Hep C
  • HIV
18
Q

Most infectious Hospital Organisms (4)

A
  • VISA = vancomycin resistant staph aureus
  • VRE = vancomycin resistant enterococcus
  • MDR_TB = multi drug resistant TB
  • Fungal pathogens = esp Candida Spp
19
Q

Clostridium Difficile - shape

A

rod

20
Q

Clostridium Difficile - gram status

A
  • gram positive
21
Q

Clostridium Difficile - where

A

normal microbiome of healthy people

22
Q

Clostridium Difficile - pathogenesis

A
  • Longterm antibiotic use –> antibiotic associated diarreha caused by C. Difficile
23
Q

Clostridium Difficile - at risk populations (6)

A
  • immunocompromised
  • health care settings for extended periods
  • older adults
  • recently taken antibiotics
  • had gastrointestinal procedures done
  • use proton pump inhibitors (reduce stomach acidity)
24
Q

Clostridium Difficile - how it causes harm in the body

A
  • produces two toxins (c. diff toxin A = TcdA, and c. diff toxin B = TcdB)
  • these toxins inactivate GTP binding protein = actin condensation and cell rounding = cell death
  • casues focal necrosis, then ulceration, then pseudomembranous collitis (inflammation of colon)
25
Q

Clostridium Difficile - symptoms (5)

A
  • watery diarrhea
  • dehydration
  • fever
  • loss of appetite
  • abdominal pain
26
Q

Clostridium Difficile - complications (6)

A
  • perforation of colon
  • septicemia
  • shock
  • death
  • necrotizing enterocolitis (premature babies)
  • neutropenic enterocolitis (cancer therapies)
27
Q

Clostridium Difficile - diagnosis (6)

A
  • patient history
  • clinical presentation
  • imaging
  • endoscopy
  • lab tests
  • detecting toxin in stool samples (culture rarely used)
28
Q

Clostridium Difficile - treatment (4)

A
  • stop antibiotic use
  • provide supportive therapy (electrolytes and fluids)
  • Metronidazole is prefered if C diff is confirmed
  • Vancomycin can be used if Met was ineffective or other criteria are met (under 10, allergy, etc.)
29
Q

Antimicrobial resistance

A
  • when microbes develop the ability to resist the effects of drugs
  • they are then not killed and their growth does not stop
  • common in hospitals (esp. intensive care)
  • caused by overprescription of antibiotics in office-based physicians = antibiotics lose impact
30
Q

Prevention of antimicrobial resistance

A
  • identify presence of definite infectious process
  • use narrow-spectrum antibiotics where possible
31
Q

Antibiotic resistant bacteria examples (9)

A

MRSA
VISA
VRE
Streptococcus pneumoniae
Enterobacter (ie ESBL)
Acinetobacter
Pseudomonas aeruginosa
MDR-TB
extended spectrum beta lactamase

32
Q

Risk factors for infection with drug-resistant bacteria (4)

A
  • Antimicrobial therapy in preceding 90 days
  • Current Hospitalization for > 5 days
  • High frequency of antibiotic resistance in the community or in the specific hospital unit
  • Immunosuppression
33
Q

Routes of transmission of nosocomial infections (6)

A
  • Unwashed hands: MRSA, VISA, VRE, C Difficile, norovirus
  • Respiratory secretions: TB, VZV
  • Aerosolized vomit: Norovirus
  • Faeces: C difficile, Norovirus
  • Fomites: MRSA VISA, VRE, C. Difficile
  • Contaminated Needles and Surgical Equipment: HCB, HCV, HIV

Microbiology and Immunology (10 decks)

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