Lecture 29 - Nosocomial infections Flashcards
(31 cards)
what are nosocomial infections?
infections acquired in hospitals
how do we define nosocomial infections?
infections diagnosed more than 48hrs after admission and within 30 days after discharge of hospital
what are some common ways to get a nosocomial infection?
surgical wounds, catheters and gastroenteritis (feces)
what are healthcare associated infections?
infections in residents of rest homes, people attending dialysis centres or other community healthcare facilities
a patient had a surgery to insert a rod into his hip. what infection could have happened and how?
1-2% chance he develops a deep infection
would be from skin of the patient/surgeon
would most likely be staph aureus (does deep infections)
who are more susceptible to s. aureus wound infections?
people who have s. aureus nasal colonisation, because it can move from nose to other parts of the body
if a patient thoroughly washed themselves before a surgery and still got infected, what would be the cause?
skin from the surgeon and his team, or bacteria in hair follicles that can’t be washed out
can you give people antibiotics before surgery to prevent wound infections?
it doesnt work
a patient has acute appendicitis which ruptures a few hours before her appendicectomy. what is the cause?
- release bacteria into peritoneal cavity
- gut flora from the ruptured appendix
- e coli or other gram negative anaerobes
which bacteria commonly infect the skin in nosocomial infections?
staphylococcus aureus
streptococcus pyogenes
which bacteria commonly infects the throat?
streptococcus pyogenes
which bacteria come from the intestines, and what do they infect?
- e coli and other gram negative anaerobes
- infect the bladder, kidneys and intra-abdominal organs (peritoneal cavity)
which bacteria causes infections in skin wounds?
staphylococcus aureus
what can we do to lower the chance of a wound infection in the gut?
take an oral antibiotic prophylaxis a couple of day before surgery
or an injection intravenously hours before the operation
what are the problems with oral antibiotic prophylaxis of the gut?
not good for emergency surgeries
still a lot of bacteria in the gut so doesn’t reduce risk that much
can we give antibiotic prophylaxis to eliminate risk of wound infection?
no, it will reduce risk though
what are the methods to prevent wound infections and abcesses?
- avoid contamination of surgical site
- clean to remove contamination from site
- remove dead tissue
- drain fluid collections
- antibiotic prophylaxis
when should we administer antibiotic prophylaxis and how to be most effective?
intravenous infection of antibiotics 2 hours or less before surgery. the longer you leave it the less effective, and too early the ABs can be peed out so concentration is lower
do we need different types of ABs depending on the type of surgery?
yes.
hip joint surgery = staph AB
appendix surgery =
a patient is given a urinary catheter before surgery, and after surgery they cannot walk to the lavatory. how did this happen?
cumulative 5% chance of infection per day
source of organisms = the organisms colonising their mucosa of the urethral meatus
E. coli, Klebsiella pneumoniae
prevention of nosocomial infection revision before exam?
yes
describe hand hygiene in ward 1 and 2 back in the 1840s
doctors and med students from the necropsy dissecting rooms even after washing their hands, transmitted more infections to mothers than midwives, and ended up with higher maternal mortality
what was the solution for the maternal mortality rates in ward 1?
semmelweis insisted doctors and med students scrub their hands with chlorinated lime solution after touching cadavers
what is the second hygiene development?
in 1995, hand disinfectants became more common and nosocomial infections reduced a lot
bottles of 0.5% chlorhexidine gluconate
