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Flashcards in Infection Control Deck (40):
1

What is a hospital-acquired infection (HAI)?

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

2

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

~25%

3

What are the most common sites of HAIs?

  • Urinary tract
  • Surgical wounds 
  • GI tract
  • Any septicaemia

4

How severe are HAIs?

Range, from mild to life-threatening

5

Why do HAIs develop?

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

6

What aspects of the hospital environment can cause HAIs?

  • Food supply
  • Air supply
  • Fomites
  • Water supply

7

What medical activities can cause HAIs?

  • IV access
  • Catheters
  • Surgery

8

Why may patients be more susceptible to infection?

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

9

Why may a patient have a T cell deficiency?

  • HIV
  • Transplant

10

Are HAIs exogenous or endogenous?

Can be either

11

What are endogenous microbiota?

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

12

What are exogenous microbiota with respect to HAIs?

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

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

The ecosystem of the hospital

14

How can endogenously acquired HAIs be minimalised?

  • 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

How can operations be classified?

  • Clean
  • Contaminated
  • Infected

16

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

The area involved

17

What does appropriate use of perioperative antibiotics prophylaxis protocal ensure?

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

18

What can prolonged administration of antibiotics cause?

Increased risk of infection by resistant organisms

19

How are exogenously acquired infections prevented?

Good clinical practice

20

What methods are effective in preventing exogenously acquired infections?

  • Hand-washing
  • Alcohol gel hand rubs
  • Sterile gloves

21

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

Visitors

22

How can the number of antibiotic resistant organisms be reduced?

  • Environmental cleaning
  • Judicious antibiotic prescribing

23

How should the environment be cleaned to prevent antibiotic resistance?

  • Sterilisation
  • Disinfection
  • Waste disposal

24

What should happen to any individuals harbouring resistant organisms?

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