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Infection > Infection Prevention > Flashcards

Infection Prevention Flashcards

0
Q

What is an outbreak?

A

When there are two or more cases linked in time and place.

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1
Q

What is an endemic disease?

A

When it is at its usual background rate

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2
Q

What is an epidemic?

A

A rate of infection greater than the usual background rate

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3
Q

What is a pandemic disease?

A

Very high rates of infection spreading across many regions, countries or continents

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4
Q

What is the basic reproduction number?

A

Average number of cases one case generates over the course of its infectious period in an otherwise uninfected, non-immune population.

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5
Q

If the basic reproduction number is >1, 1 or <1, what is happening to the number of cases?

A

R0 >1 - increase in cases
R0 = 1 - number of cases is stable
R0 < 1 - decrease in cases

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6
Q

What are the reasons for outbreaks, epidemics and pandemics?

A

New pathogen, antigens, virulence factors or resistance

New host - not immune, healthcare effects

New practice - social (eg air con, STIs), healthcare eg surgery

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7
Q

What factors determine transmissibility?

A

Infectious dose

ID50

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8
Q

What is the infectious dose?

A

Number of micro-organism required to cause infection

Varies by microorganism, presentation of microorganism, immunity of potential host

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9
Q

What is ID50?

A

Snakes get dose required to infect 50% of the population.

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10
Q

What a interventions can be done in preventing infection?

A

Pathogen (and vector) - reduce/eradicate
Patient - improve health and immunity
Practice - behavioural change
Place - environment engineering

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11
Q

How can pathogens be eradicated or reduced?

A

Antibacterials
Decontamination
Sterilisation
Eliminate vector breeding sites

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12
Q

What can be done with patients to reduce chance of infection?

A 
Nutrition
Treatment
Immunity 
-passive
-active
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13
Q

Give an example of a way of giving passive immunity

A

Maternal antibodies

IV immunoglobulin

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14
Q

What is herd immunity

A

When vaccinated people can protect those who have not been vaccinated

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15
Q

What changes can be done to practice to prevent spread of infection?

A

Avoid pathogen or vector
PPE
Behaviour - eg safe sex, sharps disposal, food/drink preparation

16
Q

What changes can be made to a place to prevent spread of an infection?

A 
Safe water
Clean air
Good quality housing
Well-designed healthcare facilities
Prevent over-crowding
17
Q

What are some good consequences of control of infection?

A

Decreased incidence

Elimination of disease

18
Q

What are some bad consequences of controlling infection

A

Decreased exposure to pathogen -> decreased immune stimulus -> decreased antibodies -> increased susceptibility -> outbreak

Later age of exposure can in some cases increase severity of illness

19
Q

What are some consequences of antibiotic resistance?

A

Treatment failure
Prophylaxis failure eg for surgery, cancer
Economic costs

20
Q

What does it mean if a pathogen is multi-drug resistant?

A

Non-susceptibility to at least one agent in three or more antimicrobial categories

21
Q

What does extensively drug resistant mean? (XDR)

A

Non-susceptibility to at least one agent in all but two or fewer antimicrobial categories

22
Q

What is antimicrobial stewardship?

A

Appropriate use of antimicrobials to achieve optimal clinical outcomes
minimise toxicity and other adverse events
reduce cost of healthcare infections
limit selection for antimicrobial resistant strains

23
Q

What are the elements of the stewardship programme?

A

Multidisciplinary team
Surveillance (process measures and outcome measures)
Interventions

24
Q

How is the stewardship programme carried out?

A

Persuasive - education, reminders, audit, feedback

Restrictive - restricted susceptibility reporting, formulary restriction, prior authorisation

Structural - computerised records, rapid lab tests, expert systems, quality monitoring

25
Q

What are process measures?

A

Looking at quantities of drugs used, appropriateness, and benchmark institutions against others

26
Q

What are outcome measures?

A

Patient outcomes, emergence of resistance, C. diff infection rate

27
Q

What does successful stewardship require?

A

Long term confirmed and appropriate resources
Hospital leadership support, delegated authority to challenge inappropriate antimicrobial therapy
Integration into patient safety and quality of care structures and processes.

28
Q

What are some unintended consequences of the stewardship programme?

A

Readmission risk slightly increased

Infection (14 decks)

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