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Flashcards in MISC - Healthcare associated infections Deck (12):
1

Contact transmission
- examples
- 2 types

Direct: person to person
e.g. Scabies, herpes simplex

Indirect: via contaminated intermediate object or person
E.g. MRSA, VRE, influenza, norovirus

2

Droplet transmission
- size
- how is it generated
- examples

–>5 μm
–Generated by coughing, sneezing
–Drop to ground by about 1m

Examples: influenza, pertussis, SARS, Neisseria meningitidis, rhinovirus

3

(4) Who are susceptible to infection?

•Old and young age
•Diabetes, immune compromise, other medical conditions
•Intensive care
•Breech in 1st line defences
–Devices, IV lines, urinary catheters, endotracheal tube, drain tube
–Procedures eg surgery
–Antimicrobial therapy

4

What is MRSA resistant to?

All penicillins & cephalosporins available in Australia

5

What ABx do you give to cover ventilator-associated pneumonia?

IV vancomycin plus several courses of other antibiotics (piperacillin/tazobactam, meropenem, ciprofloxacin)

6

Compare colonisation vs. infection

•Colonisation
–Growth of an organism somewhere in the body WITHOUT causing any clinical illness
–Predisposes person to developing infection
–Can be transmitted to other patients

•Infection
–Growth of an organism causing a clinical illness

I.e. Do not need to treat colonisation

7

What is VRE?
- primary mode of spread
- where is it affected
- Environmental Mx

= vancomycin resistant enterococcus
•Primary mode of spread
–Contaminated hands of healthcare workers
–Environment also important
•Primarily colonises gastrointestinal tract
•Use contact precautions and single rooms

8

What is Multiresistant Gram negative bacilli?
- examples
- resistance against which ABx
- where does it occur

E.g. Klebsiella, Acinetobacter, Enterobacter, Pseudomonas
•Some resistant to all available antibiotics
•Occurring in community, returned travellers
–Eg New Dehli metallo-beta-lactamase in water in India

9

Discuss clostridium difficile in terms of its association with antibiotic use

Due to prolonged use of ABx; fluoroquinolones, cephalosporins, carbapenems, and clindamycin

•Causes diarrhoea ↔ pseudomembanous colitis ↔ toxic megacolon
•Resurgence in recent years
–Major outbreaks in Canada, Europe, US
•Hypervirulent strains
–Increased morbidity and mortality
•More common than MRSA in some places

10

What are the (6) main types/sites of healthcare associated infections?

•Surgical site infection
•Intravascular line associated infection
–Peripheral IV line
–Central line
•Nosocomial pneumonia
–Ventilator associated pneumonia
•Catheter associated urinary tract infection
•Prosthetic joint infection
•Diarrhoea

11

Norovirus
- what system does it affect
- how does it spread

Causes gastroenteritis outbreaks
–Hospitals, nursing homes, rehab facilities, cruise ships, schools etc

•Very contagious
•Spread from person to person
–Through contaminated food or water
–By touching contaminated surfaces
–Via droplets from vomitus

12

How (6) can you prevent hospital associated infections?

–Hand hygiene
–Antibiotic stewardship (systematic approach to using antibiotics prudently)
–Transmission precautions
–Bundles
–Environmental cleaning
–Antibiotic prophylaxis

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