4] Infection Control Flashcards by Keren Poulose

Micro-organisms that survive on the skin

Normal flora

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How do normal flora serve a protective function?

By stopping the growth of more virulent micro-organisms

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2 ways infections occur

Breach of intact skin or systemic infection

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6 ways intact skin gets breached

Microscopic
Surgery
Trauma
Lacerations
Burns
Pressure ulcers

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2 ways for systemic infections

Blood borne

Sepsis

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10 factors that influence liklihood of an infection

Necrosis/slough
Perfusion
Size of wound 
Duration of wound
Smoking
Drug and alcohol use
Poor nutrition 
Lack of sleep and exercise
Comorbidities 
Immunosuppression

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Presence of bacteria on wound surfaces with no multiplication of bacteria

Contamination

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All wounds are ???

Contaminated

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Multiplication of micro-organisms on the

wound surface without invasion of wound tissue and no host immune response

Colonization

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Presence of proliferating bacteria on the
wound surface where healing is delayed or stopped and subtle clinical signs of host
injury are noted

Critical colonization

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Invasion and multiplication of micro-
organisms in wound tissue resulting in
pathophysiologic effects or tissue injury

Infection

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7 signs of critical colonization

Discoloration of granulation tissue
Friable granulation tissue
Pocketing in wound base 
Wound breakdown 
Bad odor
High serous exudate levels
Delayed healing

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Acute indicators of infected wounds

Pain
Redness
Edema
Heat
Pus

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serous drainage with concurrent inflammation,
discoloration of granulation tissue, friable granulation tissue, foul odor, wound
breakdown is what type of wound?

Chronic wound

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Diabetic indicator of infected wound

Pus or 2+ signs of inflammation

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Surgical site infection indicator

Pus or signs of inflammation and a + culture

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What’s an indicator of an infected wound in an immunosuppressed pt?

Pain

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Population of community of bacterial living in organized structures at a liquid interface

Biofilm

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Biofilm provides ?

Physical protection to bacteria

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Biofilm is present in 70-80% of ?

Chronic wounds

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Biofilm bacteria is attached to?

Tissue surfaces

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Biofilm looks?

Cloudy, slimy

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Biofilm interferes with?

Epithelialization

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Treatment for biofilm

Debridement or apply nontoxic antiseptic solution daily

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What are 4 issues with biofilm?

No validated clinical characteristics No routine test Depth for debridement unknown Inadequate prevention

What’s the acronym for a superficial infection

NERDS

What does NERDS stand for

``` Non healing wounds Exudate Red and bleeding wound surface granulation tissue Debris (yellow/black) on wound surface Smell (bad odor) ```

What’s the acronym for deep infection?

STONES

What does STONES stand for?

``` Size bigger Temperature increased Os (exposed bone) New wound breakdown Exudate, erythema, edema Smell/odor ```

Superficial wound infection Dx occurs

Within 30 days post op

Superficial wound infection involves skin or subcutaneous tissue of the incision and atleast one of?

Pus Isolated organisms from culture Signs/Sx of infection Dx of SSI by surgeon or attending MD

Wound cultures only need to be obtained when

There are overt or subtle clinical signs of infection OR If wound is deteriorating or getting bigger

What’s recommended for all diabetic foot infections

Wound culture

Treatment for infections

Antibiotic for 24 hours or longer

3 major systemic antibiotics

Penicillin Cephalosporins Vancomycin

What kind of substances are cytotoxic and should be limited with wound cleansing?

Bleach Acetic acid (vinegar) Betadine Hydrogen peroxide

2 non tox is cleaning solutions

``` Isotonic saline Wound cleanser (NOT a skin cleanser) ```

agent that inhibits orkills microorganisms

Antimicrobial

3 classes of antimicrobials

Antiseptic Antibacterial Antifungal

agent that destroys or stopsbacterial growth (i.e. Bacitracin)

Antibacterial

substance that prevents or arrests the growth or action of microorganisms

Antiseptic

agent that inhibits or kills fungi

Antifungal

Betadine

Antiseptic

Bacitracin

Antibacterial

Nystatin

Antifungal

Examples: povidine iodine, acetic acid,hydrogen peroxide, dakin’s solution

Examples of antiseptics

H2O2 impairs ?

Microcirculation

Adkins (bleach) delays

Clotting, angiogenesis and epithelialization

Antibacterials should not be used regularly. T or F

True

Examples of antibacterials (6)

``` Bacitracin Neosporin Gentamicin Metrogel Mupirocin Silvadene ```

Acticoat, Aquacel Ag, Silvasorb, Silverlon  All of these products are comparable in ability to fight topical infection. Dressing?

Ionic silver

Ex] Iodosorb, Iodoflex | Topical dressing?

Molecular iodine

Patients infected or colonized with organisms that can be transmitted by direct or indirect contact  Gowns and gloves must be worn

Contact precautions

Patients known or suspected to be infected with organisms transmitted by large particle droplets generated by coughing, sneezing, talking – closeproximity

Droplet precautions

Patients known or suspected to be infected by | small particle residue of evaporated droplets that remain suspended in air and can be dispersed by air currents

Airborne precautions

Infection of dermis and subcutaneous layers

Cellulitis

Forms red, hot painful large areas | Ex] lower legs

Cellulitis

Patients with ? Are prone to anaerobic cellulitis of thr feet

Cellulitis is frequently accompanied by

Infection

Diagnosed by culture, symptoms, ESR, and WBC

Cellulitis

Managing cellulitis includes ?

Antibiotics, elevation of the body part, cool and wet dressing

Healthcare associated MRSA usually

Blood stream infection

Community associated MRSA usually

Skin and soft tissue infection

Manifest as skin infections suchas pimples and boils  Treatment is with vancomycin, clindamycin, or linezolid

MRSA

What does MRSA stand for

Methicillin-Resistant Staphylococcus Aureus

Another form of highly resistant bacteria normally found in intestines and female genital tract

VRE

What does VRE stand for

(Vancomycin-Resistant Enterococci)

Choice for treating VRE

Vancomycin

Commonly found in soil and water but also found on skin of healthy people  Outbreaks rare outside of healthcare settings

Acinetobacter Infections

Acinetobacter Infections causes

Variety of diseases from pneumonia to serious blood and wound infections

Acinetobacter Infections can colonize, especially in

Trach sites and open wounds

Infection that attacks the deeplayers of fascia  Very aggressive, fast moving  Releases a toxin that quickly and irreparably destroys flesh and muscle

Necrotizing fasciitis

Surgeons often must remove skin, large groups of muscle, orentire limbs to save a person's life

Necrotizing fasciitis

Yeast, heat rash, candida, whatever – it’s destructive to the skin!  Satellite lesions typically present

Fungus

Best way to treat fungus

With powder + zinc oxide ointment

4] Infection Control Flashcards

(75 cards)