Healthcare Infections Flashcards

0
Q

Risk factors for a patient to acquire a hospital acquired infection?

A
Extremes of age
Malnourishment
Diabetes
Cancer
Immunosuppressed
Smoker
Surgical admission
Emergency
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1
Q

What are healthcare infections?

A

Infections arising as a consequence of providing healthcare

  • in hospital patients 48 hours after admission
  • in healthcare workers and hospital visitors
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2
Q

What practises need to be done to reduce hospital-acquired infections?

A

Hand washing

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3
Q

What can be done about the place to reduce hospital acquired infection?

A

Presence of washbasins
Layout of ward - Nightingale ward is bad
Single rooms
No carpets

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4
Q

Lost some viruses that can be hospital-acquired

A

Blood Bourne such as hep A, B and C
Norovirus
Influenza
Chicken pox

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5
Q

List some bacteria that can be hospital acquired

A
Staph aureus including MRSA
C. diff
E. coli
Klebsiella pneumoniae
Pseudomonas aeruginosa
Mycobacterium tuberculosis
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6
Q

What fungi infections can be hospital acquired?

A

Candida albicans

Aspergillus

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7
Q

What parasites can be hospital acquired?

A

Malaria (very rare)

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8
Q

What patient interventions can there be to reduce risk of hospital acquired infection?

A
Optimise the patient's condition eg smoking, nutrition, diabetes
Antimicrobial prophylaxis
Skin preparation
Hand hygiene
MRSA screening
Mupirocin nasal ointment
Disinfectant body wash
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9
Q

How can patient to patient transmission be halted?

A

Physical barriers such as isolation, protection of susceptible patients

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10
Q

How can healthcare workers prevent spread of infection?

A

Ensure they are disease-free and vaccinated
Good practise such as hand hygiene and PPE
Be careful about antimicrobial prescribing

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11
Q

What environmental interventions can be done to prevent spread of infection?

A

Space and layout eg toilets and wash hand basins
Furniture and furnishings
Cleaning - disinfectants, steam cleaning, hydrogen peroxide vapour
Medical devices - single use, sterilisation, decontamination
Appropriate kitchen and ward food facilities
Food should be sterile
Theatres and isolation rooms should be positive/negative pressure

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12
Q

Shape and gram stain of Clostridium difficile?

A

Gram positive

Bacillus

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13
Q

How is Clostridium difficile spread?

A

Produces spores which pass into the faeces of people with it in their gut
Can live harmlessly in the gut, becomes a problem when numbers increase greatly

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14
Q

What can cause an increase in number of C. diff in the gut?

A

Antibiotics

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15
Q

What is the pathogenesis of C. diff?

A

Produces enterotoxins A and B which cause fluid secretion and Rosie damage

16
Q

What are the symptoms of C diff in patients?

A

Patients pass 3 or more loose/unformed stools a day
History of previous antibiotic exposure
Abdominal pain

17
Q

Management of C diff?

A

Oral metronidazole for 10 days
Or oral vancomycin
Oral rehydration therapy because of diarrhoea

18
Q

What diseases can Staph aureus cause?

A
Skin infections (impetigo)
Respiratory disease eg flu and pneumonia
Food poisoning 
MRSA
Osteomyelitis
Sceptic arthritis
Endocarditis
19
Q

What antibiotics have been used to treat Staphylococcus aureus?

A

Penicillin

Methicillin

20
Q

How is Staphylococcus aureus spread?

A

Airborne transmission

Hands of healthcare workers

21
Q

What should happen to patients colonised with MRSA?

A

Isolated in a side room

22
Q

How is carriage of MRSA eradicated?

A

Hand washing
Disinfectant body wash
Mupirocin nasal ointment

23
Q

What Gram stain and shape is Staph aureus?

A

Positive

Coccus

24
Q

What type of virus is norovirus?

A

Single-stranded RNA

Non-enveloped

25
Q

How is norovirus transmitted?

A

Fecal-oral route

26
Q

What can norovirus cause?

A

Acute diarrhoea and vomiting
Projectile vomiting
Explosive diarrhoea

27
Q

What should happen to patients with norovirus?

A

Diagnosed/suspected patients should be placed in a side room or share with patients who already have it

28
Q

How can norovirus be prevented from spreading?

A

Hand-hygiene
Gowns and gloves
Routine cleaning and disinfection

29
Q

What can food poisoning be caused by?

A

Salmonella enteritidis

Clostridium perfringens

30
Q

What are the three ways of horizontal antibiotic resistance transmission?

A

Transformation - uptake and expression of foreign genetic material

Transduction - bacterial DNA moved from one bacterium to another via a virus

Conjugation - transfer of DNA via a plasmid through a pillus