Nosocomial Infections

Question 1

What are important factors associated with nosocomial infections?

Answer 1

• clean working environments, good architectural design (including access to handwashing facilities and sharps disposal) , a good nursing staff to patient ratio and early discharge of patients

Question 2

How are nosocomial infections spread?

Answer 2

based on person to person contact

- most common vehicle is health care professional’s hands

Question 3

Incidence of nosocomial infections? (in order of frequency)

Answer 3

1) urinary tract (related to catheters)
2) pneumonia
3) surgical wound infection
4) skin

Question 4

Major Organisms Associated with Hospitals (1)

Answer 4

antibioic resistant bacteria, selected by antibiotic use and spread by the hands of doctors and nurses and occasionally in point source fashion

Question 5

Examples of Antibiotic resistant bacteria? (1)

Answer 5

MRSA, VISA, VRE, streptococcus pneumoniae, enterobacter, acinetobacter, pseudomonas aeruginosa, MDR-TB

Question 6

Major Organisms Associated with Hospital (2)

Answer 6

Diarrhea and Vomiting

Question 7

Examples of Diarrhea/Vomiting (2)?

Answer 7

Clostridium difficle

SRVG (small round viruses of gastroenteritis: norwalk and norwalk-like viruses)

Question 8

Major Organisms Associated with Hospital (3)

Answer 8

Respiratory

Question 9

Examples of Respiratory (3) ?

Answer 9

stapylococcus aureus
gram negative rods
streptococcus pneumoniae
TB
VZV

Question 10

Major Organisms Associated with Hospital (4)

Answer 10

Blood (the most infectious body fluid)

Question 11

Examples of blood? (4)

Answer 11

HBV
HCV
HIV

Question 12

Routes of Transmission: what can you get from

unwashed hands - MOST IMPORTANT ROUTE

Answer 12

MRSA, VISA, VRE, Clostridium difficile, SRVG?

Question 13

Routes of Transmission: what can you get from Respiratory secretions (private room, negative air pressure, HEPA filtration, masks)

Answer 13

TB , VZV (chicken pox)

Question 14

Routes of Transmission: what can you get from aerosolized vomit (cohorting, handwashing)

Answer 14

SRVG

Question 15

Routes of Transmission: what can you get from Faeces (barrier, handwashing)

Answer 15

C. difficle, SRVG

Question 16

Routes of Transmission: what can you get from fomites (surface cleaning disinfection

Answer 16

MRSA, VISA, VRE, C. diff

Question 17

Routes of Transmission: what can you get from contaminated needles and surgical equipment (sterile supply, sharps disposal)

Answer 17

HBC, HCV, HIV

Question 18

Universal Precautions for Nosocomial Infections?

Answer 18

1) HANDWASHING
2) personal protective equipment
3) disposal of sharps immediately after use
4) clean up spills of biological waste, bleach disinfection
5) proper disposal of biological waste

Question 19

Risk Assessment for MRSA?

Answer 19

1) known carrier = single room, barrier precautions
2) high risk patient = isolate until MRSA resukts
3) MRSA found - screen entire ward
4) close ward if more than one person with MRSA
5) screen all HCP’s until decontaminated

Question 20

Use of antibiotics?

Answer 20

High doses & short courses – only use antibiotics if you need them
- longer you use the antibiotics, the worse it gets