Flashcards in Healthcare Infections Deck (94):
What are healthcare infections?
Infections arising as a consequence of providing health care, including community care
Who can healthcare infections present in?
What is it called when a hospital patient gets a healthcare infection?
Hospital acquired infection
What must be true of a hospital acquired infection?
The patient must neither be present nor incubating an infection at the time of admission
How is it ensured that the patient has not got an infection present or incubating at the time of admission when diagnosing hospital acquired infections?
Onset must be at least 48 hours after admission
Give an example of a group of people considered to be a hospital visitors
Give an example of a group of people who are considered to be hospital staff
What % of in-patients acquire an infection as a result of being in hospital?
What is the problem with healthcare infections?
Can impact health, leading to increased deaths/poor outcome of treatment
Impacts the health care organisation
Why are healthcare infections particularly tragic?
The majority of these infections are preventable
What % of HCAI are UTIs?
What % of HCAI is pneumonia?
What % of HCAI are surgical wound infections?
What % of HCAIs are of the skin and soft tissue?
What % of HCAIs are of the primary bloodstream?
What % of HCAI are gastro-intestinal?
What contributes to the financial cost of HCAIs?
Patient's extended stay
Where are the areas for potential prevention of HCAIs?
Prevent pathogen from existing/meeting patient
Prevent colonisation leading to infection
Stop pathogen and infection from spreading
Give four examples of HCAI viruses
Blood borne viruses
Give 3 examples of blood borne viruses
Hepatitis B and C
How can blood borne viruses spread in a hospital environment?
Blood splashes or needle stick injuries in health workers
What does norovirus cause?
Projectile vomiting in patients and staff
When is chickenpox particularly bad?
Give 6 examples of HCAI bacterium
Give an example of a S. Aureus infection?
How is S. Aureus often passed on?
By healthcare workers and unclean equipment
What is the problem with clostridium difficile in the hospital environment?
Forms spores that can survive for months in clinical environment
What is the problem with E. Coli and Klebsiella pneumoniae?
Wide drug resistance in developing
What is the problem with pseudomonas aeruginosa?
Inheriting resistance, particularly in UTIs
What is the problem with mycobacterium tuberculosis?
Often not picked up and contacts have to be traced
Give two examples of HCAI fungi
How may an aspergillus infection be acquired in the hospital environment?
Spores can be released during building work
When is a aspergillus species HCAI important?
In immunodeficient patients
Give an example of a HCAI parasite
What patient factors may lead to a HAI?
Extremes of age
What are the 4 Ps of infection prevention and control?
What is considered when looking at the patient in infection prevention and control?
General and specific patient risk factors for infections
Who may a patient interact with in the hospital environment?
What is considered when looking at pathogen factors in infection prevention and control?
What ecological interactions should be considered when looking at infection prevention and control?
What practices should be considered when looking at infection prevention and control?
General specific activities of healthcare workers
Policies and their implementation
Organisational structure and engagement
Regional and national political initiatives
Leadership at all levels from government to ward
What are the general patient interventions aimed to prevent and control infections?
Optimise patient's health
What can be done to optimise the patients health in infection prevention and control?
What are some specific patient interventions aimed to control and prevent infection?
Mupirocin nasal ointment
How can patient to patient transmission be prevented in a healthcare setting?
Isolation of infected patients
Protection of susceptible patients
What healthcare worker interventions can be made to prevent and control infections?
Keep workers disease free
How can HCW be kept disease free?
What is good practice of HCW when considering infection control and prevention?
Good clinical techniques
Effective antimicrobial prescribing
What environmental interventions can be made when considering infection prevention and control?
Appropriate kitchen and ward food facilities
Good food hygiene practice
Positive/negative pressure rooms for immunocompromised patients
What must be considered with the built environment with infection prevention and control?
How can a hospital environment be cleaned?
Hydrogen peroxide vapour
How can it be ensured that infection isn't carried on medical devices?
Single use equipment
How should you I-five check patients?
What does the identify stage of the I-five check of patients consist of?
Blood borne infections
Funny looking rash
What are the global concerns relating to hospital acquired infection and drug resistance?
Where is clostridium difficile found as microbiota?
In the human GI tract
In what % of humans is C. Diff found in the GI tract as microbiota?
~3%, higher in hospitalised patients
Why can C. Diff in the microbiota become pathogenic?
Use of broad spectrum antibiotics
Why does use of broad spectrum antibiotics allow C. Diff to become pathogenic?
It massively alters the GI microbiota, which;
Allows for endogenous C. Diff to proliferate
Allows for an exogenous infection to occur
Why is an exogenous C. Diff infection more likely to occur in a hospital setting?
Due to the large number of patients releasing spores into the environment, which can colonise the GI tract
What does the C. Diff pathogen release?
Toxins A & B
What do C. Diff toxins A and B do?
Act on the gut to cause cytokine release
What does the cytokine release induced by C. Diff cause?
Tissue damage and death
How does C. Diff differ in neonates?
Neonates commonly carry large amounts of C. Diff in their gut, but lack the receptors for the toxins to take effect
What are the symptoms of a C. Diff infection?
What can inflammation caused by C. Diff lead to?
Bowel perforation and sepsis
Why can inflammation caused by C. Diff cause bowl perforation and sepsis?
Due to cessation of peristalsis
How is a diagnosis of C. Diff made?
From a stool sample, checking for antigen detection or toxin detection
What is the treatment for C. Diff?
Oral metronidazole or vancomycin
Discontinuing current antibiotic regime
What kind of pathogen is staphylococcus aureus?
A gram positive coccus
Where is staphylococcus aureus found as part of the normal microbiota?
Carried on skin and mucous membranes of normal individuals
What does S. Aureus require to cause infection?
Significant host compromisation
What has happened regarding S. Aureus in recent decades?
Around 50% of hospital S. Aureus isolates have been found to be resistant to methicillin
What is it called when S. Aureus is resistant to methicillin?
What is resistance due to in MRSA?
A chromosomal acquisition of the gene for a distinct penicillin binding protein that has a low affinity for ß-lactams
What is MRSA linked with?
Longer hospital and ICU stays
Longer durations of mechanical ventilation
Higher mortality rates
What is the problem with treating MRSA?
It is resistant to many microbials
How is MRSA best treated?
What is the problem with vancomycin treatment of MRSA?
Resistance has been increassing
What can S. Aureus infection cause?
Localised skin infections
What is the vaccination against S. Aureus?
There is none
What is the best prevention of S. Aureus?
What kind of pathogens are noroviruses?
Positive-stranded, non-enveloped RNA viruses
Where do noroviruses replicate?
In the GI tract
Where are noroviruses shed?
What is norovirus commonly known as?
The winter vomiting virus
How does norovirus infection occur?
Via the fecal-oral route, following the ingestion of contaminated food or water, person-to-person contact, or contact with contaminated surfaces
What is norovirus a major cause of?
Epidemic acute gastroenteritis at schools, prisons, and other closed environments
Who does norovirus affect?
Adults and school-age children, but not infants
How does norovirus clinically present?
How long do norovirus symptoms last?
How is norovirus diagnosed?
Antiviral antibodies can be detected by ELISA
What is the specific antiviral treatment for norovirus?
There is none