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Flashcards in Infection Control Deck (40)
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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

2
Q

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

A

~25%

3
Q

What are the most common sites of HAIs?

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

How severe are HAIs?

A

Range, from mild to life-threatening

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
6
Q

What aspects of the hospital environment can cause HAIs?

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

What medical activities can cause HAIs?

A
  • IV access
  • Catheters
  • Surgery
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
9
Q

Why may a patient have a T cell deficiency?

A
  • HIV
  • Transplant
10
Q

Are HAIs exogenous or endogenous?

A

Can be either

11
Q

What are endogenous microbiota?

A

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

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
13
Q

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

A

The ecosystem of the hospital

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
15
Q

How can operations be classified?

A
  • Clean
  • Contaminated
  • Infected
16
Q

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

A

The area involved

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?

A

Visitors

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
Q

What should happen to any individuals with air transmitted diseases?

A

They should be placed in a room with negative air pressure

26
Q

How should instruments be used to prevent exogenous infection?

A

Should be single use where applicable, yet any recycled should be sterilised correctly

27
Q

What should always be worn by healthcare workers to prevent exogenous infection?

A

Disposable gowns, gloves, and aprons

28
Q

What do poor standards of care predispose to?

A

Higher rates of infection

29
Q

What is meant by the endemic rate?

A

The normal rate of infection for a particular disease

30
Q

What is an epidemic?

A

A significant increase in the rate of infection above the endemic level

31
Q

What is an outbreak?

A

An epidemic due to a single cause

32
Q

How can investigation of an infection source, especially in an outbreak, be aided?

A

Typing

33
Q

What is the purpose of typing in infection investigation?

A

It determines if two organisms are identical or if there are differences between the two strains

34
Q

What can typing be used to do?

A

Identify any difference, cannot claim isolates are identical

35
Q

Give an example of where typing could be used in infection investigation

A

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
Q

What are the main typing techniques?

A
  • Simple lab typing
  • Serological testing
  • Molecular typing
37
Q

What is looked at in simple lab typing?

A

Appearance on agar

38
Q

What does molecular typing use?

A

Restriction endonucleases

39
Q

What happens in molecular typing?

A

Restriction endonucleases digest plasmid DNA or ribosomal RNA from the pathogen and check for the binding patterns produced

40
Q

How is molecular typing interpreted?

A

Any identical bacteria will produce similar banding patterns