Infection Session 4- Healthcare Infections And Adaptive Immunity Flashcards

(40 cards)

1
Q

What are healthcare infections?

A

Infections arising as a consequence of providing healthcare, so for hospital patients the infection was neither present nor incubating at time of admission

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2
Q

Why are healthcare infections important?

A

Frequent
Impact on health
Impact on healthcare organisations
Preventable

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3
Q

Give some examples of healthcare infection pathogens

A
Hep C
HIV
Norovirus
MRSA
E coli
Malaria
Candida Albicans
C diff
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4
Q

What can make a patient more at risk of a healthcare infection?

A
Extremes of age
Obesity/malnourished
Diabetes
Cancer
Immunosuppression
Smoker
Surgical patient
Emergency admission
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5
Q

What general patient interventions can prevent healthcare infections?

A

Optimise patient’s condition- smoking, nutrition, diabetes
Antimicrobial prophylaxis
Skin preparation
Hand hygiene

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6
Q

What specific patent interventions can prevent healthcare infections?

A

MRSA screens
Mupirocin nasal ointment
Disinfectant body wash

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7
Q

What can be done to prevent patient to patient transmission of healthcare infections?

A
Vaccination
Good clinical techniques
Hand hygiene
PPE
Antimicrobial prescribing
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8
Q

What environmental interventions can be done to prevent healthcare infections?

A

Wash hand basins
Cleaning- disinfectants, steam cleaning and H2O2 vapour
Medical devices- single use equipment, sterilisation and decontamination
Appropriate kitchen and ward food facilities
Good food hygiene practice
Positive/negative pressure rooms

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9
Q

What are the five I’s when it comes to healthcare infections?

A
Identify
Isolate
Investigate
Inform
Initiate treatment
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10
Q

Describe the main features of antigen presenting cells

A

Strategic location (B+T cell interaction)
Pathogen capture
Diversity in pathogen sensors (PRRs)

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11
Q

Where can antigen presenting cells be found?

A

Skin
Mucous membranes
Lymphoid organs
Blood circulation

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12
Q

What methods of pathogen capture can antigen presenting cells do?

A

Phagocytosis

Macropinocytosis

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13
Q

Name the different types of antigen presenting cells

A

Dendritic cells
Langerhans’ cells
Macrophages
B cells

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14
Q

Where are dendritic cells found and what do they present to?

A

Lymph nodes, mucous membranes, blood

Present to T+B cells

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15
Q

Where are Langerhans’ cells found and what do they present to?

A

Skin

Present to T cells

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16
Q

Where are macrophages found and what do they present to?

A

Various tissues

Present to T cells

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17
Q

Where are B cells found and what do they present to?

A

Lymphoid tissue

Present to T cells

18
Q

What substances are involved in humoral immunity?

A

Antibodies

Complement

19
Q

What substances are involved in cell-dependant immunity?

A

Cytotoxic T cells (CD8+ T cells)
Macrophages
Antibodies

20
Q

Where are class I + II major histocompatability complexes found?

A

Class I- found on all uncleared cells

Class II- found on dendritic cells, macrophages and B cells

21
Q

What are the key features of MHC class I and II?

A

Co-dominant expression- both parental genes are expressed to increase number of different MHC molecules
Polymorphic genes- different alleles among different individuals to increase presentation of different antigens/microbes

22
Q

What is the main difference between class I + class II MHC?

A

Class I present peptides from intracellular microbes

Class II present peptides form extracellular microbes

23
Q

What is the significance of the structure of the peptide binding cleft?

A

Variable region with highly polymorphic residues so have a broad specificity- many peptides presented by the same MHC molecule.

24
Q

Which T cells are activated by MHC class I?

25
Which T cells are activated by MHC class II?
CD4+
26
Describe the antigen presenting features
Both self and non self peptides are presented All peptides from the same microbe are presented by different MHC molecules Susceptibility to infections depends on the types on MHC molecules
27
What clinical problems are associated with MHC molecules?
Major causes for organ transplant rejection- HLA molecules mismatch between donor and recipient HLA association and autoimmune disease
28
Which microbes are extracellular or intracellular?
Extracellular- bacteria, parasites, worms and fungi | Intracellular- viruses, bacteria, protozoa
29
What do CD4+ and CD8+ differentiate into?
CD8+ becomes cytotoxic T cells | CD4+ become TH1,2 and 17 cells
30
Which T helper cells are activated by extracellular microbes?
TH2 and TH17
31
Which T helper cells are present in response to intracellular microbes?
TH1
32
What do TH1 do?
Activate B cells and macrophages | Assist antigen presenting cells to activate CD8+
33
What do TH2 do?
Activate eosinophils, B cells and mast cells
34
What do TH17 do?
Activate neutrophils
35
What are the different antibodies and what are their functions?
IgG- Fc dependant phagocytosis, complement activation, neonatal immunity, toxin/virus neutralisation IgE- immunity against helminths, mast cell degranulation IgA- mucosal immunity IgM- complement activation
36
Describe the characteristics of C. Diff
``` Watery diarrhoea Severe abdominal pain Loss of appetite Fever Blood in stools Weight loss ```
37
How is C. Diff caused?
C. Diff is a minor component in normal flora of large intestine so when other flora are cleared the c diff is no longer competing for resources so can grow and cause infection.
38
Which antibiotics can cause C. Diff?
Amoxicillin Ampicillin Cephalosporins Clindamycin
39
Describe the characteristics of MRSA
Causes bacteraemia and infective endocarditis
40
Describe the characteristics of norovirus
``` Acute gastroenteritis Nausea Vomiting Diarrhoea Abdominal cramps Abdominal pain Mucus in stool Headache and fever ```