Outbreak of Infection

Question 1

What is a healthcare associated infection?

Answer 1

An infection you might catch when getting healthcare in hospitals, care homes, doctor’s surgeries etc.

Most common in hospital are urine infections, post-surgical, skin infections, sickness and diarrhoea.

Question 2

What is a hospital acquired infection?

Answer 2

Generally an infection acquired after being in hospital for >48hrs

For some organisms this will vary depending on incubation period of organism

Question 3

Define an outbreak

Answer 3

Defined as 2 or more cases of an infection linked in time and place

Question 4

Describe the chain fo infection

Answer 4

Infectious agent - reservoir - portal of exit - mode of transmission - portal or entry - susceptible host

Question 5

What are some infectious agents?

Answer 5

bacteria
fungi
viruses
prion

Question 6

What are some reservoirs?

Answer 6

Humans
Equipment
Environment
Food
Animals

Question 7

Describe possible portals of exit

Answer 7

Blood and body fluids
Skin scales/wound
Coughing and sneezing

Question 8

Describe possible modes of transmission

Answer 8

Direct or indirect
Inhalation
Ingestion of contaminated food

Question 9

Describe possible portal of entry

Answer 9

Skin/surgical wounds
Eyes or mouth
Resp tract
Intestinal tract
Tubes

Question 10

Describe susceptible hosts

Answer 10

Underdeveloped immune system
Decreasing immune system
Drugs or diseases
Tubes

Question 11

Describe breaking the chain of infection

Answer 11

• Hand hygiene
• PPE
• Food safety
• Cleaning, disinfection, sterilization
• Isolation
• Infection prevention policies
• Pest control
• Personal hygiene
• Removal of catheters/tubes
• First aid
• immunization
• health insurance
• patient education
• waste disposal
• control aerosis and splatter

Question 12

What are the 5 moments for hand hygiene?

Answer 12

1. Before touching a patient
2. Before clean/aseptic procedure
3. After body/fluid exposure risk
4. After touching a patient
5. After touching patient surroundings

Question 13

Describe transmission based precautions

Answer 13

Contact
Gloves
Apron
Masks
Eye protection

Question 14

What is a droplet?

Answer 14

> 5um
Spread assumed to be ~1m
Drop to ground

Question 15

What is an aerosol?

Answer 15

<5um
Much more widespread
Remain suspended in air

Question 16

Describe cleaning

Answer 16

Physical removal of organic material and decrease in microbial load

Manufacturer’s instructions, detergent and water, drying is IMPORTANT

Cleaning essential prior to disinfection and sterilisation if these required

Question 17

Describe disinfection

Answer 17

Large reduction in microbe numbers - spores may remain

Heat; pasturisation or boiling

Chemical; need to be equipment compatible e.g. alcohol, hydrogen peroxide

Question 18

Describe sterilisation

Answer 18

Removal/destruction of ALL microbes and spores

Steam under pressure (autoclave), hot air oven, gas (ethylene dioxide), ionising radiation

Question 19

What dow we clean, disinfect and sterilise?

Answer 19

Clean; low risk i.e. stethoscopes, cots etc

Disinfect/sterilise as appropriate; medium risk i.e. bedpans, vaginal specula

Sterilise; high risk i.e. surgical instruments

Question 20

Describe surveillance in terms of infection

Answer 20

Local surveillance; lab based, ward/clinical based

National surveillance

All healthcare workers

Question 21

Describe mandatory surveillance reporting in Scotland

Answer 21

• MRSA bacteraemia (2006)
• MSSA bacteraemia (2006)
• C. diff (2006)
• Surgical site infections (2007)
• E.Coli bacteraemia (2016)