Hospital Acquired Infections

Question 1

What is a hospital acquired infection

Answer 1

An infection caught whilst hospitalised.

Question 2

What is the medical term for a hospital acquired infection

Answer 2

Nosocomial

Question 3

Why is most nosocomial infections due to bacteria?

Answer 3

Because antibiotics are frequently used in hospitals and this can causes resistance so bacteria within the hospital is different to outside.

Question 4

Define nosocomial infection

Answer 4

Strictly an infection which is not present or incubating prior to 48 hours of admittance.

Question 5

What is the prevalence of healthcare associated infections

Answer 5

6.4%

Question 6

What are the percentages of health care associated infections

Answer 6

Respiratory infection - 22.8%
Urinary tract infections - 17.2%
Surgical Site infection - 15.7%

Question 7

What are risk factors that cause nosocomial infections

Answer 7

Increase duration of hospital stay 
Indwelling catheters 
Mechanical ventialtion 
Total parenteral nutrition 
Antibiotic usage 
Use of histamine beta blockers 
Age 
Immune deficiency

Question 8

What is HAP

Answer 8

Nosocomial pneumonia refers to any pneumonia contracted by a patient in a hospital at least 48-72 hurst’s after being admitted.

Question 9

What is HAP caused by

Answer 9

Caused by a bacterial infection

Question 10

What are the common bacteria involved in HAP

Answer 10

Pseudomonas aeruginosa
Staphylococcus aureus
Klebsiella Pneumoniae
E coli

Question 11

What is an UTI

Answer 11

An infection involving any part of the urinary system

Question 12

What is the most common type of health associated infection

Answer 12

UTI

Question 13

How are UTIs normally acquired

Answer 13

Through catheters

Question 14

Whats the most important risk factor for a catheter associated UTI

Answer 14

Prolong use of it

Question 15

Give some examples of uni BACTERIA

Answer 15

E coli
Pseudomonas species 
Enterococcus species 
staphylococcus aureus. 
Coagulase- negative staphlyococci

Question 16

Describe an E Coli bacteria

Answer 16

Gram negative
Faculatively anaerobic
Rod shaped
Warm blooded organisms.

Question 17

Define sepsis

Answer 17

a life threatening condition when the body response to infection causes injury to its own organs and tissues.

Question 18

What are the common signs of sepsis

Answer 18

Fever
Increased heart rate
Increased breathing rate
confusion

Question 19

How are you more likely to develop sepsis

Answer 19

Recently had Surgery
a catheter has been fitted
Stayed in hospital for a long time.

Question 20

What other conditions is sepsis usually associated with

Answer 20

Gi tract- liver disease, gall bladder disease 
Gu Tract- urinary tract obstruction 
pElvis 
Lower respiratory tract 
Vacualr 
Heart

Question 21

What are the symptoms of sepsis

Answer 21

Shivering 
Extreme pain
Pale or discoloured skin 
Sleepy
I feel like I might die 
Short breath

Question 22

in 2007 what were the underlying infections that caused 9000 hospital deaths

Answer 22

MRSA and C.DIFF

Question 23

What is MRSA

Answer 23

Gram + bacteria
Difficult to treat
Type of staph bacteria that is resistant to many antibiotic treatment.

Question 24

Which antibiotics is MRSA completely resistant to

Answer 24

penicillin

Cephalsporin

Question 25

How can MRSA be transmitted in a hospital

Answer 25

Wound infections | Pneumonia

Question 26

What is C.diff

Answer 26

Spore forming anaerobic gram positive bacillus bacteria Produces exotoxins A and B Usual human habitat large intestine

Question 27

How do you test for c.diff

Answer 27

Requires 2 test Clostridium difficile antigen - Glutamate dehydrogenase identifies the presence of the organism Or Toxin test - ELISA PCR

Question 28

what is CDAD

Answer 28

It is the clinical presentation of c.diff associated diarrhoea where the toxins cause inflammation of the intestinal wall

Question 29

What are the risk for infection for CDAD

Answer 29

Any antibiotics can induce CDAD as they alter the gut flora allowing c diff to flourish and produce toxins.

Question 30

What are other risk factors for CDI

Answer 30

``` Age above 65 Previously had CDI Recent hospitalisation Antibiotic exposure Immunocompromised ```

Question 31

What is the treatment for CDI

Answer 31

conservative treatment stop antibiotics supportive therapy dieticians referral

Question 32

What is GRE glycopeptide resistant enterococci

Answer 32

Found in the bowel | Can cause UTI and bacteria

Question 33

Which antibiotics are GRE resistant to

Answer 33

Vancomycin | teicoplanin

Question 34

What are the two common species of GRE

Answer 34

E. Faecalis | E. Faecium

Question 35

GRE occurs in which hospital patents

Answer 35

Immunocompromised | prolonged stay

Question 36

What are some vancomycin resistant treatment options

Answer 36

Enterococcus faecalis- amoxicillin | Enterococcus faecium resistant to amoxicillin so use linezolid or daptomycin

Question 37

What is daptomycin

Answer 37

A cyclic lipopeptide which acts against gram + | It destructs the membrane potential leading to inhibition of protein, Dna and rna synthesis

Question 38

How is antibiotics inactivated

Answer 38

Bacteria acquire genes encoding enzymes that inactivate antibiotic such a beta lactamases and carbapenemases

Question 39

What are extended spectrum BETA Lactamases ESBLS

Answer 39

Are enzymes which can produce bacteria making them resistant to cephlaspmrims.

Question 40

What antibiotics are ESBL e coli able to resist

Answer 40

Penicllin and cephalpsoirms.