B Lecture 3: Hospital-acquired Infections

Question 1

What is the most common disease caused by an HAI?

Answer 1

Hospital acquired pneumonia

Question 2

What type of bacteria is c. difficile?

Answer 2

Gram pos spore-forming anaerobe

Question 3

Name the toxins produced by c. difficile

Answer 3

Toxins A and B

Question 4

What are the symptoms of C. difficile infection?

Answer 4

Diarrhoea

Colitis

Question 5

Name 2 Antibiotics that are used to treat C. difficile?

Answer 5

Metronidazole
Vancomycin
Fidaxomicin- Non-inferior to vancomycin for response to treatment and lower recurrence; now FDA and EMEA approved for C. difficile and available in UK

Question 6

What type of bacteria is vancomycin effective against?

Answer 6

Gram pos

Question 7

What is the pathognemonic endoscope finding for C diff infection?

Answer 7

Columns of inflammatory exudate in colon lining

Question 8

How should C diff infection be managed?

Answer 8

1. Stop antibiotics
2. Fluid + electrolyte resuscitation for patients with diarrhoea
3. ORAL vancomycin/ metronidazole to combat C. diff

Other options (but are VERY ££££££) are fidaxomicin or bezlotoxumab OR faecal transfer

Question 9

What are the most common causative pathogens in HAP?

Answer 9

S aureus
Klebsiella
Pseudomonas
Haemophilus

Question 10

Which 3 antibiotics can predispose you to C diff infection?

Answer 10

Cephalosporin
Clindamycin
Ciprofloxacin

Question 11

What 3 factors can influence a surgical site infection (SSI)?

Answer 11

Host defence
Wound environment
Pathogens

Question 12

How can the chance of acquiring an SSI be reduced?

Answer 12

• Do not routinely do hair removal. If hair needs to be removed, use electric clippers with a singe-use head, on the day of the surgery. Do not use razors.
• Consider giving antibiotic prophylaxis IV on starting anaesthesia
• Prepare skin at site of incision using an antiseptic
• Use an appropriate dressing for the wound