Flashcards in L9 - Infection control Deck (22):
Infetions that develop associated with the healthcare system is estimated to cost __ million per year
How can infections be transferred?
Contact direct/indirect and airbourne
patient --> patient
Patient --> healthcare worker
Visitor --> patient
May be acquired from:
- contaminated equipment or therapies
Occasional foodborne source
List some examples of healthcare associated infections:
UTI - Especially in people with urinary catheter
Wound infectiom after surgery
Pneumonia - Especially in ICU patients on ventilator
IV related blood stream infection
What are the risk factors for healthcare associated infections?
Severity of underlying illness - the sicker you are the worse
invasive medical devices that breach normal defence mechanisms
Frequent contact with healthcare personnel
Prolonged length of stay
Prolonged exposure to antimicrobial agents
Decreased immunity e.g diabetes, chemotherapy
which organisms are resistant to all available antibiotics and how are they combated?
need to use antibiotics previously abandoned because of toxicity e.g colistin
What is MRSA and what does it cause?
methicillin resistant S. Aureus
causes many different infections
resistant to many antibiotics
carried in nose, throat, groin, intestine - mainly transmitted on contaminated hands
What is VRE and what does it cause and how is it transmitted?
causes UTIs, heart valve infection
Found in GIT, skin
Which virus is responsible for causing explosive outbreaks of diarrhoea and vomiting on hospitals, cruise ships? How is it transmited?
transmitted via contaminated food or water
Environmental contamination important
What is the most common cause of antibiotic associated diarrhoea and is more common MRSA in some places
spread from patient to patient on contaminated hands
Carbanapenemase-producing enterobacteriaceae (CPE) is resistant to ____ and may be _____
Carbanapenemase-producing enterobacteriaceae (CPE) is resistant to carbapenems and may be untreatable
What are examples of droplet transmission?
whooping cough, flu, SARS other resp. viruses
Whats the difference between droplet and airborne transmission?
airborne remains airborne - can get into air conditioning
What are the two types of control measures for healthcare associated infections - and examples of each?
Non-specific - apply to all patients regardless of disease status
- hand hygiene (esp alcohol)
- standard and additional precautions with blood, body fluids etc
- anitbiotic stewardship
- sterilisation of equipment
- cleaning environment
Patient specific measures - identify individual patients affected by disease by screening
Infectious diseases are ________. Must be conducted in context of clinical care. There are many ________ factors
Infectious diseases are transmissible. Must be conducted in context of clinical care. There are many uncontrollable factors
What are the problems with randomisation in infectiosu disease sudy?
Feasibility - wards are different
ethics - can't deny preventionq
True or false
there is always an independence of outcomines in infectioous disease research
There is a lack of independence of outcomes - and stats usually assumes this
What is the problems with infection control literature?
Control of epidemic vs. endemic situation
retrospective studes (they suck)
Bad stats analysis
Assumption that intervention is responsible for fall in numbers
What is the Hawthorne effect?
When poeple are being watched they change their behaviour
when the auditors there you're going to work differently
Describe an interupted time series analysis
provides results as change in level of outcome and trend
controls for secular trend and previous interventions
can control for other confounding factors
What are the explicit protocols necessary in study design of infectious control?
Nature and timing of intervention
description of participants, setting, confounding factors, other infection control practices, lab procedures
Appropriate stats analysis
true or false
Healthcare associated infections cause morbidity/mortaility but many are preventable