HAI

Question 1

2. What is the prevalence of HAI in the UK?

Answer 1

8%

Question 2

3. List 5 HAIs in order of prevalence.

Answer 2

Pneumonia
Surgical site infection 
UTI
Blood stream infection 
Gastrointestinal infection

Question 3

4. What did the hospital microbiome project find?

Answer 3

On the 1st day of admission the bugs go from the environment onto the patient
From the 2nd day onwards, bugs go outwards from the patient

Question 4

5. What type of bacterium is C. difficile?

Answer 4

Gram-positive spore-forming anaerobe

Question 5

6. Why might E. coli bacteraemia be increasing in prevalence?

Answer 5

Dehydration in elderly patients

The drive to limit antibiotic use may lead to more invasive infections

Question 6

7. List some approaches to reducing the incidence of E. coli bacteraemia.

Answer 6

Reduce number of bugs – hygiene and sanitation
Reduce the number of resistant bugs – screen patients for certain organisms (e.g. MRSA, VRE)
Prioritise side rooms
Reduce transmission (educating staff, cleaning the environment, reducing the use of broad-spectrum antibiotics)

Question 7

8. Why are carbapenemase-producing enterobacteriaceae (CPE) such a big problem?

Answer 7

Carbapenems are often the last resort antibiotic

Infection by these bacteria are associated with a high mortality

Question 8

9. Why are HAIs becoming more common?

Answer 8

More invasive procedures 
More prosthesis
Obesity 
Diabetes 
Extremes of age 
Immunosuppression
Emerging organisms and resistance

Question 9

10. List some ways in which the hospital environment is managed to reduce infection risk.

Answer 9

Environmental hygiene and cleaning
Control environmental sources (e.g. water)
Building works (aspergillus)
Negative pressure isolation (protects others from the patient)
Positive pressure isolation (protection of patients from the outside)