Healthcare associated infections

Question 1

time cutoff for nosocomial infection classification?

Answer 1

symptoms develop 48 hours after hospitalisation?

Question 2

main infection associated with IV catheters?

prevention?

Answer 2

Coagulase negative staphylococci (epidermidis etc) form biofilms (abx resistant) and metastasise throughout body.
Prevention: Hand hygiene. optimal site selection for easy review. Chlorhexidine antisepsis. Daily review.

Question 3

Urinary catheter associated infections?

symptoms and diagnosis? treatment problems?

Answer 3

Still normally E.coli [or pseudomonas?] but more often drug resistant! (carbapenemases, ESBL [extended spectrum beta-lactamases]). Damn biofilms!
often few local symptoms. pyuria not reliable indicator of infection.

Question 4

Exemplify and define critical, semi-critical and non-critical items and their sanitisation?

Answer 4

Critical items enter sterile areas (e.g. scalpels, IV and urinary catheters) [autoclaved or prepacked]
Semi-critical items touch mucous membranes (e.g. bronchoscopes) [high-level disinfection, with glutaraldehyde]
Non-critical items touch intact skin: bedpans, floors, stethoscopes etc. [low level disinfection: phenol, lysol]