Infection Control Flashcards

(40 cards)

1
Q

What is a hospital-acquired infection (HAI)?

A

An infection developed in hospital which was not present or incubating at the time of admission

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2
Q

What % of patients do admitted to hospital HAIs occur in?

A

~25%

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3
Q

What are the most common sites of HAIs?

A
  • Urinary tract
  • Surgical wounds
  • GI tract
  • Any septicaemia
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4
Q

How severe are HAIs?

A

Range, from mild to life-threatening

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5
Q

Why do HAIs develop?

A
  • Environment
  • The host susceptible to infections
  • Medical activites
  • Change in microbiota of environment from the selection pressures of the hospital
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6
Q

What aspects of the hospital environment can cause HAIs?

A
  • Food supply
  • Air supply
  • Fomites
  • Water supply
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7
Q

What medical activities can cause HAIs?

A
  • IV access
  • Catheters
  • Surgery
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8
Q

Why may patients be more susceptible to infection?

A
  • Increasing age
  • Co-morbidities
  • Chronic illness
  • Poor physical states
  • Neutropenia from chemotherapy
  • T cell deficiencies
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9
Q

Why may a patient have a T cell deficiency?

A
  • HIV
  • Transplant
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10
Q

Are HAIs exogenous or endogenous?

A

Can be either

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11
Q

What are endogenous microbiota?

A

The organisms that are part of the normal body microbiota, on the skin, GI tract etc.

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12
Q

What are exogenous microbiota with respect to HAIs?

A

Microbes transferred from the hospital to the patient, by direct contact of;

  • Contaminated hands
  • Clothing
  • Medical devices
  • Airborne spread
  • Contaminated food, water, or medicines
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13
Q

What can exogenous microbiota be considered to be part of, with respect to HAIs?

A

The ecosystem of the hospital

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14
Q

How can endogenously acquired HAIs be minimalised?

A
  • By effective disinfection of the skin prior to surgery, especially in the heavily bacterial contaminated parts of the body.
  • Appropriate use of perioperative antibiotics prophylaxis protocol.
  • Smoking cessation and good nutrition.
  • Any sutures or drains should be changed regularly
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15
Q

How can operations be classified?

A
  • Clean
  • Contaminated
  • Infected
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16
Q

What does the classification of an operation as clean, contaminated, or infected depend on?

A

The area involved

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17
Q

What does appropriate use of perioperative antibiotics prophylaxis protocal ensure?

A

That the antibiotic concentrations are highest at the surgical sites at maximal concentrations

18
Q

What can prolonged administration of antibiotics cause?

A

Increased risk of infection by resistant organisms

19
Q

How are exogenously acquired infections prevented?

A

Good clinical practice

20
Q

What methods are effective in preventing exogenously acquired infections?

A
  • Hand-washing
  • Alcohol gel hand rubs
  • Sterile gloves
21
Q

Amongst who should good clinical practice with respect to preventing infection be encouraged?

22
Q

How can the number of antibiotic resistant organisms be reduced?

A
  • Environmental cleaning
  • Judicious antibiotic prescribing
23
Q

How should the environment be cleaned to prevent antibiotic resistance?

A
  • Sterilisation
  • Disinfection
  • Waste disposal
24
Q

What should happen to any individuals harbouring resistant organisms?

A

They should be isolated in single rooms

25
What should happen to any individuals with air transmitted diseases?
They should be placed in a room with negative air pressure
26
How should instruments be used to prevent exogenous infection?
Should be single use where applicable, yet any recycled should be sterilised correctly
27
What should always be worn by healthcare workers to prevent exogenous infection?
Disposable gowns, gloves, and aprons
28
What do poor standards of care predispose to?
Higher rates of infection
29
What is meant by the endemic rate?
The normal rate of infection for a particular disease
30
What is an epidemic?
A significant increase in the rate of infection above the endemic level
31
What is an outbreak?
An epidemic due to a single cause
32
How can investigation of an infection source, especially in an outbreak, be aided?
Typing
33
What is the purpose of typing in infection investigation?
It determines if two organisms are identical or if there are differences between the two strains
34
What can typing be used to do?
Identify any difference, *cannot claim isolates are identical*
35
Give an example of where typing could be used in infection investigation
Could be used to identify that a surgical wound infection isolates are indistinguishable from an operating theatre washing basin, hence identify where the infection originated
36
What are the main typing techniques?
* Simple lab typing * Serological testing * Molecular typing
37
What is looked at in simple lab typing?
Appearance on agar
38
What does molecular typing use?
Restriction endonucleases
39
What happens in molecular typing?
Restriction endonucleases digest plasmid DNA or ribosomal RNA from the pathogen and check for the binding patterns produced
40
How is molecular typing interpreted?
Any identical bacteria will produce similar banding patterns