Healthcare Infections Flashcards Preview

[ ESA 3- Infection and Immunity > Healthcare Infections > Flashcards

Flashcards in Healthcare Infections Deck (94):
1

What are healthcare infections?

Infections arising as a consequence of providing health care, including community care

2

Who can healthcare infections present in?

Hospital patients
Hospital visitors
Hospital staff

3

What is it called when a hospital patient gets a healthcare infection?

Hospital acquired infection

4

What must be true of a hospital acquired infection?

The patient must neither be present nor incubating an infection at the time of admission

5

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

6

Give an example of a group of people considered to be a hospital visitors

Contractors/builders

7

Give an example of a group of people who are considered to be hospital staff

Lab workers

8

What % of in-patients acquire an infection as a result of being in hospital?

8%

9

What is the problem with healthcare infections?

Can impact health, leading to increased deaths/poor outcome of treatment
Impacts the health care organisation

10

Why are healthcare infections particularly tragic?

The majority of these infections are preventable

11

What % of HCAI are UTIs?

20%

12

What % of HCAI is pneumonia?

14%

13

What % of HCAI are surgical wound infections?

14%

14

What % of HCAIs are of the skin and soft tissue?

10%

15

What % of HCAIs are of the primary bloodstream?

7%

16

What % of HCAI are gastro-intestinal?

21%

17

What contributes to the financial cost of HCAIs?

Investigations
Treatment
Reputation loss
Funding loss
Patient's extended stay

18

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

19

Give four examples of HCAI viruses

Blood borne viruses
Norovirus
Influenza
Chickenpox

20

Give 3 examples of blood borne viruses

Hepatitis B and C
HIV

21

How can blood borne viruses spread in a hospital environment?

Blood splashes or needle stick injuries in health workers

22

What does norovirus cause?

Projectile vomiting in patients and staff

23

When is chickenpox particularly bad?

Adults

24

Give 6 examples of HCAI bacterium

Staph. Aureus
Clostridium diffile
E. coli
Klebsiella pneumoniae
Pseudomonas aeruginosa
Mycobacterium tuberculosis

25

Give an example of a S. Aureus infection?

MRSA

26

How is S. Aureus often passed on?

By healthcare workers and unclean equipment

27

What is the problem with clostridium difficile in the hospital environment?

Forms spores that can survive for months in clinical environment

28

What is the problem with E. Coli and Klebsiella pneumoniae?

Wide drug resistance in developing

29

What is the problem with pseudomonas aeruginosa?

Inheriting resistance, particularly in UTIs

30

What is the problem with mycobacterium tuberculosis?

Often not picked up and contacts have to be traced

31

Give two examples of HCAI fungi

Candida albicans
Aspergillus species

32

How may an aspergillus infection be acquired in the hospital environment?

Spores can be released during building work

33

When is a aspergillus species HCAI important?

In immunodeficient patients

34

Give an example of a HCAI parasite

Malaria

35

What patient factors may lead to a HAI?

Extremes of age
Obesity/malnutrition
Diabetes
Cancer
Immunosuppression
Smoker
Surgical patient
Emergency admissions

36

What are the 4 Ps of infection prevention and control?

Patient
Pathogen
Practice
Place

37

What is considered when looking at the patient in infection prevention and control?

General and specific patient risk factors for infections
Interactions

38

Who may a patient interact with in the hospital environment?

Other patients
Healthcare workers
Visitors

39

What is considered when looking at pathogen factors in infection prevention and control?

Virulence factors
Ecological interactions

40

What ecological interactions should be considered when looking at infection prevention and control?

Other bacteria
Antibiotics/disinfectants

41

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

42

What are the general patient interventions aimed to prevent and control infections?

Optimise patient's health
Antimicrobial prophylaxis
Skin preparation
Hand hygiene

43

What can be done to optimise the patients health in infection prevention and control?

Reduce/stop smoking
Improve nutrition
Control diabetes

44

What are some specific patient interventions aimed to control and prevent infection?

MRSA screening
Mupirocin nasal ointment
Hand hygiene

45

How can patient to patient transmission be prevented in a healthcare setting?

Isolation of infected patients
Protection of susceptible patients

46

What healthcare worker interventions can be made to prevent and control infections?

Keep workers disease free
Good practice

47

How can HCW be kept disease free?

Vaccinations

48

What is good practice of HCW when considering infection control and prevention?

Good clinical techniques
Hand hygiene
PPE
Effective antimicrobial prescribing

49

What environmental interventions can be made when considering infection prevention and control?

Built environment
Furniture/furnishings
Cleaning
Medical devices
Appropriate kitchen and ward food facilities
Good food hygiene practice
Theatres
Positive/negative pressure rooms for immunocompromised patients

50

What must be considered with the built environment with infection prevention and control?

Space/layout
Toilets
Wash basins

51

How can a hospital environment be cleaned?

Disinfectants
Steam cleaning
Hydrogen peroxide vapour

52

How can it be ensured that infection isn't carried on medical devices?

Single use equipment
Sterilisation
Decontamination

53

How should you I-five check patients?

Identify
Isolate
Investigate
Inform
Initiate

54

What does the identify stage of the I-five check of patients consist of?

Abroad
Blood borne infections
Colonised
Diarrhoea/vomiting
Expectorating
Funny looking rash

55

What are the global concerns relating to hospital acquired infection and drug resistance?

Costly
Preventable
Frequent
Deadly

56

Where is clostridium difficile found as microbiota?

In the human GI tract

57

In what % of humans is C. Diff found in the GI tract as microbiota?

~3%, higher in hospitalised patients

58

Why can C. Diff in the microbiota become pathogenic?

Use of broad spectrum antibiotics

59

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

60

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

61

What does the C. Diff pathogen release?

Toxins A & B

62

What do C. Diff toxins A and B do?

Act on the gut to cause cytokine release

63

What does the cytokine release induced by C. Diff cause?

Tissue damage and death

64

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

65

What are the symptoms of a C. Diff infection?

Diarrhoea
Abdominal pin
Malaise
Fever
Nausea

66

What can inflammation caused by C. Diff lead to?

Bowel perforation and sepsis

67

Why can inflammation caused by C. Diff cause bowl perforation and sepsis?

Due to cessation of peristalsis

68

How is a diagnosis of C. Diff made?

From a stool sample, checking for antigen detection or toxin detection

69

What is the treatment for C. Diff?

Oral metronidazole or vancomycin
Discontinuing current antibiotic regime

70

What kind of pathogen is staphylococcus aureus?

A gram positive coccus

71

Where is staphylococcus aureus found as part of the normal microbiota?

Carried on skin and mucous membranes of normal individuals

72

What does S. Aureus require to cause infection?

Significant host compromisation

73

What has happened regarding S. Aureus in recent decades?

Around 50% of hospital S. Aureus isolates have been found to be resistant to methicillin

74

What is it called when S. Aureus is resistant to methicillin?

MRSA

75

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

76

What is MRSA linked with?

Longer hospital and ICU stays
Longer durations of mechanical ventilation
Higher mortality rates

77

What is the problem with treating MRSA?

It is resistant to many microbials

78

How is MRSA best treated?

Vancomycin

79

What is the problem with vancomycin treatment of MRSA?

Resistance has been increassing

80

What can S. Aureus infection cause?

Localised skin infections
Deep infections
Acute endocarditis
Septicaemia
Pneumonia

81

What is the vaccination against S. Aureus?

There is none

82

What is the best prevention of S. Aureus?

Barrier protection
Hand disinfection

83

What kind of pathogens are noroviruses?

Positive-stranded, non-enveloped RNA viruses

84

Where do noroviruses replicate?

In the GI tract

85

Where are noroviruses shed?

In stool

86

What is norovirus commonly known as?

The winter vomiting virus

87

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

88

What is norovirus a major cause of?

Epidemic acute gastroenteritis at schools, prisons, and other closed environments

89

Who does norovirus affect?

Adults and school-age children, but not infants

90

How does norovirus clinically present?

Nausea
Vomiting
Diarrhoea

91

How long do norovirus symptoms last?

24-48 hours

92

How is norovirus diagnosed?

Antiviral antibodies can be detected by ELISA

93

What is the specific antiviral treatment for norovirus?

There is none

94

How can the incidence of norovirus infections be reduced?

Careful attention to handwashing and measures to prevent contamination of food and water supplies