Infection Prevention and Control (NOT FINISHED) Flashcards
What does HCAI stand for? and what does this mean?
healthcare associated infections
- any infection acquired as a result of accessing healthcare
- healthcare could include an acute hospital, rehab facility, nursing or residential home
What is the difference between endogenous and exogenous infection?
Which one is more common?
endogenous = from the patients own flora
exogenous = from other patient’s, staff or the environment
Exogenous is more common and is predominately device associated
What are the typical infection prevention arrangements for NHS organisations?
- Director of infection prevention and control - reports to Trust Board
- medical microbiologists
- infection prevention nurses
- antimicrobial pharmacist
- decontamination specialist
What does MRSA stand for?
- methicillin resistant staph aureus
What is the typical antibiotic used to treat staph aureus?
- flucloxicillin
Which strains of MRSA are becoming problematic?
- those containing PVL toxin and more associated with community transmission
What is MRSA’s mechanism of resistance?
- additional penicillin binding proteins in cell wall
- implies resistance to all beta-lactams
- association with multiple resistance
Which antimicrobials can be used to treat MRSA?
- glycopeptides - vancomycin (poor tissue penetration monitoring of levels, slow infusion)
- teicoplanin (difficulty with dosing, role of monitoring, cost)
- fusidic acid, rifampicin, linezolid, daptomycin
What are the national strategies to reduce MRSA infection?
- search and destroy (identify patients and treat them)
- targets for reductions in infection and a zero tolerance approach to avoidable infection
What measures are used to reduce MRSA?
- screening - nasal swab
- decolonisation treatment - topical antibiotic
- appropriate treatment of colonised patients
- care with peripheral and central lines
- prevention of pressure sores and ulcers
What kind of bacteria is c. diff?
- anaerobic gram positive bacilli
- spore forming - results in ability to withstand disinfection, drying, adverse conditions
- relatively resistant to alcohol and other frequently used disinfections
What are the risk factors for CDI?
- age
- antibiotics - damage gut microbial
- proton pump inhibitors - reduce stomach acid
- cross infection via poor hand hygiene or contaminated environment
- previous CDI
How can C.diff be diagnosed?
send a sample to lab and looking for c.diff toxin
How should c.diff be managed?
- avoid loperamide or other anti-motility agents as they may allow toxin to pol and predispose to toxic megacolon
- try to stop systemic antibiotics
- specific C.Diff treatment - metronidazole, oral vancomycin, fidaxomycin, faecal donor infusion
How can c.diff be prevented?
- isolation of cases
- hand washing
- cleaning of the environment
- antibiotic stewardship
