Infection Prevention And Antimicrobial Stewardship Flashcards

1
Q

How does legionella pneumophila spread?

A

Aerosol and droplets

Not transmissible form person to person

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2
Q

How do ‘food poisoning’ organisms generally spread?

A

Lots of person to person transmission

Faecal-oral transmission

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3
Q

Name some infections with very good person to person spread

A

Influenza
Norovirus
Neisseria gonorrhoea

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4
Q

How does the guinea worm spread?

A

In water
Into people
Back into water

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5
Q

What is the vector of schistosomiasis?

A

Snails

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6
Q

Define endemic

A

The usual background rate of a disease (expected amount)

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7
Q

Define outbreak

A

2 or more cases linked in time and place

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8
Q

Define epidemic

A

Rate of infection greater than usual background rate

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9
Q

Define pandemic

A

Very high rate of infection spreading across many regions, countries and continents

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10
Q

What is R0?

A

The average number of secondary cases that one case generate over its infectious period

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11
Q

What is the approximate R0 for influenza?

A

2 - 3

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12
Q

What are the general reasons for outbreaks/epidemics/pandemics?

A

New pathogen
New hosts
New practice (social/healthcare)

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13
Q

Define antigenic drift

A

Subtle change by mutation

Some antibodies may still be effective

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14
Q

Define antigenic shift

A

Reassortment of DNA of virus

No one is immune (everyone susceptible)

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15
Q

How long are maternal antibodies present in a newborn?

A

~ 3 months

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16
Q

Define infectious dose

A

The number of microorganisms required to cause infection

Varies by microorganism, presentation and immunity of host

17
Q

PPIs suppress acid secretion, therefore which food poisoning agents are you at more risk of being infected with?

A

Clostridium difficile

Salmonella

18
Q

Epidemic curves are usually what shape?

A
Bell curve 
(Time = x, no of people infected = y)
19
Q

When will abnormal population curves of infection occur?

A

In small scale outbreaks
Eg. In a family, ward, prison
Due to random nature of events

20
Q

When do maternal antibodies move across the placenta?

A

Last 4 weeks of pregnancy

21
Q

Describe herd immunity

A

Vaccinating a significant portion of the population will prevent widespread disease
Fewer infected even though not vaccinated

22
Q

Why can decreased exposure to pathogens become a problem?

A

Decreased exposure -decreased immune stimulus
Decreased antibodies
Increased susceptibility
Can lead to outbreaks

23
Q

Is resistance reversible?

A

No

24
Q

What are the consequences of Abx resistance?

A

Treatment failure
Prophylaxis failure - eg. Operations
Economic costs - longer hospital stay, extra investigations needed

25
Q

Define MDR

A

Multi drug resistant

Non-susceptibility to at least 1 agent in 3 or more antimicrobial categories

26
Q

Define XDR

A

Extensively drug resistant

Non-susceptibility to at least 1 agent in all but 2 or fewer Abx categories

27
Q

Define PDR

A

Pan drug resistant

Non-susceptibility to all agents to all categories

28
Q

What evidence shows antimicrobials cause resistant?

A

Lab evidence
Ecological evidence
Individual level data

29
Q

What are the objectives of antimicrobial stewardship?

A

Appropriate use of antimicrobials
Optimal clinical outcomes
Minimise toxicity and other adverse effects
Reduce cost of health care for infections
Limit selection for resistant strains

30
Q

What restrictive techniques help with Abx stewardship?

A

Limit access to Abx

Need microbiologists to authorise some Abx

31
Q

What structural techniques can help with Abx stewardship?

A

Computerised records
Expert systems
Best treatment is listed on patient result sheets

32
Q

What is the defined daily dose?

A

Amount of drug given to an adult patient in 1 day