Hospital-acquired infections Flashcards

1
Q

What is an antimicrobial

A

agent which interferes with growth and reproduction of a microbe

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2
Q

What is an antibacterial

A

agent used to reduce or eliminate harmful bacteria

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3
Q

What is an antibiotic

A

type of antimicrobial agent; originally referred to one of organic origin

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4
Q

What are healthcare-associated infections (HAIs)

A

Infections that occur after exposure to healthcare. Infection starts over 48 hours after admission
1/18 patients in hospital acquires an HAI

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5
Q

What are the most frequent types of HAIs

A
Surgical site infections
Urinary tract infections
Pneumonia
Bloodstream infections
Gastrointestinal infections.
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6
Q

What factors contribute to high rates of HAIs

A

Spread is very easy in hospitals, both via staff and when patients are moved between different wards or departments.
Higher concentration of sick people
Use of interventions
Prophylactic antibiotics can lead to drug-resistant infection

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7
Q

What interventions used in hospitals do HAIs often occur through

A
Catheters
Lines (IV, central, artery)
Intubation
Prophylactic antibiotics
Other prosthetic material
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8
Q

What us the most important feature of the most important HAIs

A

Drug resistance

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9
Q

What are the most important HAIs

A
ESCAPE
Enterococcus faecium
Staphylococcus aureus
Clostridium difficile
Acinetobacter baumanii
Pseudomonas aeruginosa
Enterobacteriaceae family
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10
Q

Give examples of bacteria in the Enterobacteriaceae family

A

E. coli
Klebsiella pneumoniae
Enterobacter sp.

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11
Q

Which of the HAIs are gram positive

A

Enterococcus faecium
Staphylococcus aureus
Clostridium difficile

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12
Q

Which of the HAIs are gram negative

A

Acinetobacter baumanii
Pseudomonas aeruginosa
Enterobacteriaceae family

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13
Q

What are the problems that arise when treating the ESCAPE pathogens

A

Clinicians are forced to use older, previously discarded drugs, such as colistin, that are associated with significant toxicity and for which there is a lack of robust data to guide selection of dosage regimen or duration of therapy

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14
Q

Which antibiotics are Enterococcus faecium resistant to

A

Vancomycin

60% vancomycin-resistant, as the bacterium synthesises a different PG precursor.

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15
Q

Describe S. aureus as a drug-resistant infection

A

Resistance to Methicillin (MRSA)
most common drug-resistant infection worldwide.
Methicillin is another β-lactam antibiotic, but resistance to it comes via expression of an additional PBP, one with a lower affinity for methicillin.

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16
Q

What can K. pneumoniae cause in immunocompromised and what is it resistant to

A

UTIs and RTIs

often cephalosporin and/or carbapenem resistant

17
Q

What can P. aeruginosa cause in immunocompromised and what is it resistant to

A

Infects the immunocompromised, most notably battlefield trauma cases

18
Q

What pathogen is the most frequent hospital-acquired cause of gram -ve bacteraemia

A

E. coli

19
Q

What pathogen is the most frequent case of call urinary tract infections

A

E. coli

20
Q

Which drugs is E. coli resistant to

A

Cephalosporins

Carbapanems

21
Q

Describe Cephalosporins

A

a class of β-lactam antibiotics that block peptidoglycan (PG) synthesis by inhibiting penicillin binding proteins (PBPs)

22
Q

Describe the resistance of bacteria to Cephalosporins (epidemiology and mechanism)

A

Resistance is up to 20% in some countries, and the - method is an extended spectrum β-lactamase (ESβL) enzyme which cleaves the cephalosporin

23
Q

Describe Carbapanems

A

class of β-lactam antibiotics which inhibit the same pathway. Most cephalosporin-resistant strains are still sensitive to carbapenems.

24
Q

Describe how resistance to Carbapanems develops

A

Resistance can develop through a carbapenemase enzyme (encoded on a transposon as opposed to ESβL’s plasmid)