Nosocomial Infections Flashcards
(45 cards)
nosocomial infection
infection acquired inside the hospital environment
healthcare associated infection (HAI)
an infection acquired as a result of healthcare interventions
can be acquired within or outside of the hospital environment
ex. treating with immunosuppressants –> secondary infection
what are the most common HAIs
- UTIs
- aspiration pneumonia
- infectious diarrhea
- surgical site infections
- URT infections
- dermatophytes (ringworm)
what organisms are most common in HAI
viruses, bacteria (primary or opportunistic), fungi
commensal organisms most common
often causes biofilm formation
what are the main risk factors for HAIs
- weakened immune system
- implants and invasive devices
- anesthesia and sedation
- surgery
what are the two ways that an immune system can be weakened
- diseases that disrupt barrier function or target immune system components
- medications (immunosuppressants)
what species are implant associated infections most common in
dogs
what devices are most commonly associated with implant infections
- IV catheters
- urinary catheters
- bone plates
- surgical implants
IV catheter infection
causes LOCAL infection but can spread and cause septicemia
- local cellulitis
- abscess formation
- septic thrombophlebitis
organisms can form biofilm on catheter –> hematogenous dissemination
risk factors for IVC infection
- administration of blood products or parenteral nutrition through IVC
- duration of placement (>3 days)
- # of attempts to place
urinary catheter infections
ascending catheter colonization leading to bacteriuria and biofilm formation
can cause subclinical or clinical bacteriuria
- does NOT commonly cause bacteremia
risk factors for urinary catheter infection
- duration of catheterization
- immunosuppression
- antimicrobial usage (wipes out normal flora)
- non-sterile placement
- open vs closed catheters
do you culture/treat subclinical bacteriuria
no
do you culture/treat clinical bacteriuria
yes - remove catheter and culture urine collected by cystocentesis
do NOT collect from bag or catheter tip
diagnosing IV or urinary catheter infections
IVC: blood culture
UC: urine culture
monitor patients for new fever development and local inflammation
do NOT culture catheter tips or urine from UC bag - too many bacteria will grow
how to prevent IVC infections
- standard precaution: hand washing, gloves
- shave and prep
- monitor site and fever
- replace every 72 HOURS
how to prevent urinary catheter infections
- minimize use and duration
- use sterile technique while placing
- maintain closed system
- keep bag in dependent position (below patient)
- e-collar
- UC care q8-12
should you administer prophylactic antimicrobials when placing a U catheter
NO - can increase chance of developing UTI by wiping out normal flora
is anesthesia/sedation related infections more common in dogs or cats
dogs - at risk for aspiration pneumonia associated with anesthesia/sedation
nosocomial penumonia
hospital acquired or ventilator acquired pneumonia that occurs in a patient hospitalized for at least 48 hours +/- on a ventilator
often occurs after sedation, anesthesia, intubation, vomiting, or impaired swallowing
what are risk factors in dogs for HAP
laryngeal paralysis
brachycephalic breeds
clinical signs of HAP
new fever
cough
tachypnea
leukocytosis
leukopenia
how to diagnose HAP
3 view thoracic radiographs
- lung consolidation normally only visualized on one side
can do airway lavage
HAP prevention
- fasting before sedation/anesthesia
- careful ET tube placement
- avoid excessive sedation
- suction
- upright positioning
