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MICI Module 3 > Infection Control, Specimen Collection & Specimen Processing > Flashcards

Infection Control, Specimen Collection & Specimen Processing Flashcards

(62 cards)

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1
Q

What are laboratory functions

A

Diagnostic

Epidemiological

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2
Q

Describe diagnostic lab function

A

Detection of infectious agents, guidelines for treatment
Information for individual cases
Collated info for general use

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3
Q

Describe epidemiological lab function

A

Information provided can be used to complement clinical info
Track resistant isolates
Follow trends
Detect or confirm outbreaks
Support control efforts and public health

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4
Q

How can you make the best use of the lab

A

Appropriate specimens collected
Label properly to decrease frustration
Be cost effective
Eliminate delays

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5
Q

What are general principles of specimen collection

A

Send good quality specimens
Avoid contamination
Label with patient name, birthday and health number
Put relevant info on the requisition

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6
Q

How can you maximize sample quality

A

Use appropriate transport media
Get specimens to lab asap
Work WITH the lab

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7
Q

What are the types of urine collection

A

Mid stream (most common)
In out catheter
Indwelling catheter

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8
Q

Describe mid stream collection

A

Avoid touching skin

Pass a few millilitres then collect specimen in clean sterile container

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9
Q

How long should you wait to bring urine specimen to lab

A

No transport media needed if at lab within 2 hours or refrigerated at 4c and delivered within 24 hours

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10
Q

Describe in/out catheters

A

Insert catheter
Discard first few ml
Collect the specimens and submit

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11
Q

Describe indwelling catheter

A

Collect specimen using needle and syringe after cleaning collection site with alcohol

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12
Q

What are types of respiratory tract specimens

A 
Sputum (most common)
Induced swelling (If dry cough)
Tracheal aspirate (using tube)
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13
Q

Describe sputum collection

A

Cleanse mouth with boiled water
Avoid post nasal discharge
Deep cough from chest
DRY STERILE CONTAINER get to lab within 24 hours or refrigerate 4c

Contamination detected by squamous cells

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14
Q

Describe induced sputum

A

Induction of sputum using saline aerosols
Looks watery
Dry sterile container

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15
Q

Describe tracheal aspirate

A

Useful in intubated patients

Specimen collection traps more prone to leaking during transport

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16
Q

What are patient instructions for stool collection

A

Pass stool on clean dry surface (paper)

Place almond sized portion in the specimen container

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17
Q

How is stool transported for culture

A

Cary Blair transport medium; keeps things alive but does not let it grow

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18
Q

How is stool transported for parasite detection

A

SAF preservative

Formalin’s

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19
Q

How is stool transported for cytotoxicity and virology

A

Dry sterile container

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20
Q

When are swabs used

A

Throat
Wounds
Urethra

Not for abscesses, fluid or TB culture

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21
Q

What are other kinds of specimens

A 
Tissue 
Pleural fluid 
Pericardial fluid 
CSF 
Vitreous fluid

All collected in dry sterile container

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22
Q

Microbiology specimens should never be put in _____________

A

Formalin

It kills all bacteria

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23
Q

When are results usually available

A

Microscopy usually available within 1-2 hours for stat samples
Cultures can take a few weeks but usually 3-5 days

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24
Q

Describe rapid testing

A

Usually detect an antigen
Causes particles to agglutinate or create colour
Mistakes in technique can cause incorrect results
Sensitivity sacrificed for speed

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25
Describe microscopy
Gram stain most commonly used Used for diagnosis Less sensitive than culture Assesses quality of specimen (Q scoring) Types of cells (squamous cells) used to infer contamination has occurred
26
Describe media
May be liquid (broth) or solid (plates)
27
What is broth used for
Detecting very low numbers of organisms Increasing the number of a type of organisms in a specimen (enrichment) Biochemical testing
28
Describe solid media
Usually agar Isolating colonies of bacteria can detect low numbers Can be: Differential: distinguish colonies Selective: species inhibited from growing Fairly sensitive
29
Describe blood agar
Contains 5% sheeps blood | Allows detection of hemolysis
30
Describe chocolate agar
``` Cooked blood More nutritious (H. Influenzae grows) ```
31
Describe MacConkey medium
Contains bile salts and crystal violet to inhibit gram positive organisms Lactose fermentation detected Used for stool and urine specimens
32
Describe blood cultures
Innoculated at bed side into bottles with some sterile fluid 2 sets taken aerobic and anaerobic Most labs use automated systems for monitoring Keep at room temp until placed on machine Needs to be on machine within 18 hrs
33
Describe incubation conditions
Atmosphere | Temperature
34
Describe usual atmosphere conditions
Aerobic (ambient air) Micro aerobic 2-5% oxygen (ex campylobacter) Anaerobic <1% oxygen
35
Describe usual incubation temperature
Most often 35°
36
Describe colony
Growth of bacteria on a solid medium Appearance useful Presence of haemolysis Pigment
37
Describe biochemical identification
Based on the enzymes an organism is actively expressing Profile typical of each species Once most commonly used method
38
What is MALDI
Spectrometry | Colony and matrix is vaporized and analyzed
39
What are other identification methods
Identification of specific antigens on the organisms surface (agglutination/immuno fluorescent microscopy) Molecular methods (genome sequencing/nucleic acid probes)
40
What is susceptibility testing
Determines which antimicrobials are likely to be less effective against an individual strain Doesn’t take into account the ability of a persons defences against attack A prediction
41
What are susceptibility testing methods
Expose organism to concentration of anti microbial (disc, broth, dissolved in agar) Lack of growth indicated inhibition (minimal inhibitory concentration)
42
What are other susceptibility testing methods
Detection of enzymes that break down antimicrobials (beta lactamase) Molecular means
43
What are further testing methods
Typing can be useful to determine relationship of organisms: Serotyping Molecular typing (whole genome sequencing, pulsed field) Antibio gram and bio type
44
What is the epidemiologic triad of disease
Host Agent Environment
45
What are the links of the chain of transmission
``` Agent Reservoir Portal of exit Mode of transmission Portal of entry Susceptible host ```
46
Describe the agent (pathogen)
First component in the chain of infection Important characteristics: ability to multiply, ability to withstand environmental stress Human or non human reservoirs
47
When are agents epidemiologically important
Transmitted Causes infection Produces clinical disease
48
What are characteristics of agents
Infectivity: ability to enter survive and multiply within the host Pathogenicity: extent to which disease is produced Virulence: serious disease producing potential
49
Describe a reservoir
Place where agent lives and replicates | Must be able to exit reservoir and enter susceptible host via portal of entry
50
What are the 5 modes of transmission
``` Contact (indirect or direct) Droplet (large propelled over short distance) Common vehicle Airborne Vector borne ```
51
Describe a susceptible host
Person or other living animal that affords lodging to an infectious agent Definitive (primary): parasite reaches maturity Intermediate (secondary): in which a parasite is in its larval stage
52
Describe basic reproduction number
``` R= CQD C = contact rate Q= probability of tranmission D = duration of infectivity ``` Incorporates social and biological determinants of transmission
53
What is a nosocomial infection
Health care associated infection
54
What are the most common nosocomial infections
Uti (MOST COMMON) Surgical site Pneumonia Bacteremia
55
What are examples of multi drug resistant organisms
``` Nosocomial infections: MRSA VRE C DIFF CPE Candidia Auris (newest) ```
56
What does good hand hygiene do
Reduces nosocomial infections by 40-50%
57
What are the 4 moments of hand hygiene
1. Before patient/environment contact 2. Before aseptic procedure 3. After body fluid exposure 4. After patient/environment contact
58
What are 3 principles of precautions
You can not easily tell who has what Body substances of all patients considered infectious Behaviour is determined by risk of encountering substance
59
What are routine precaution practices
Based on point of care risk assessment
60
What are additional precautions
Contact Droplet Airborne
61
What are components of infection prevention and control
Elimination (isolation/quarantine) Engineering/environmental controls (ventilation, barriers, cleaning, separation) Administrative controls
62
What are some interventions/preventions
Infection prevention and control (IPAC) Surgical site infection Ventilator associated pneumonia Central line blood stream infection

MICI Module 3 (3 decks)

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