BIOL243 L14 Hospital Acquired infection

  • Created by: Katherine
  • Created on: 28-04-17 13:34
What are other names for HAI?
Healthcare Acquired infection (HCAI) or Nosocomial infection
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What are the contributers to nosocomial infection?
Environment, patient's own flora, vulnerabiliy, interventions and clinical staff and infected patients
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How many hospitalised patients acquire infection?
5 - 10%
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When can hospital acquired infection be acquired?
They are acquired in the hospital, but bot being present in incubuation at admission (no time limit) e.g. you could leave and then devlop symptoms
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Where are the most common hospital acquired infections?
Surgical site infections (30-35%), UTIs (20%), Pneumonia (up to 20%), Sepsis (3-5%), other (up to 20%)
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What is an exogenous infection?
It results from direct inoculation of organism into patients without colonization. Today this is relatively rare, in ICU, directly related to hygienic measures, easy to prevent.
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Give examples of how exogenous infection can be acquired?
Contaminated surgical tools, medical devices (cafeters, ventilaters)
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What is an endogenous infection?
Infectinos that are caused by already colonizing microorganisms. e.g. opportunistic
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What are early endogenous infections caused by?
Colonizing flora which was already present on the patient before hospitalization (e.g. E.coli, S.pneumoniae) Under normal circumstances, these microbes would not cause disease, but chaning conditions lead to disease
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What are late endogenous infections?
They are infections which arise from hospital flora which firstly colonizes the patients body, and then can cause infection flora (MRSA, P.aeruginosa).
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What are the factors related to HAI?
Microorganism, host (patient) treatment (e.g medical devices introduced to the patient), environment
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What is an opportunistic infection?
Where the occurence of severity of an infection is determined by patient, not by microbial factors
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What are the cuases of opportunistic infection?
Immunosuppression, breaching defences, foreign body, debility
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Antibiotic use links to...
Higher rates of opportunistic infection and antibiotic infection.
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In the 1990's, how resistant was Staphylococcus areus to Methiillin?
All sensitive to it - not resistant.
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When did MRSA develop?
1993 - and it keeps growing
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What is the predominant flora in the community?
Gram positive - antibiotic sensitive
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What is the predominant flora in the community?
Gram negative - antibiotic resistant . It is also heamolytic bacteria
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What is the suceptible population for a nosocomial colonisation?
Surgical patients (breach in skin integrity), patients in intensive care units (severe main disease, different invasive diagnostic and theraperutic procedures, variety of antibiotics), Patients with burns (huge skin defects), immunocompromised, old
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Are older people more prone to get MRSA and MSSA than younger?
Yes - resistance becomes mre prevalent due to ongoing antibiotic use
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What are device related infections?
Urinary catheter, intravascular devices, respiratory therapy.
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How do treatment related infections arise?
Antibirotics are generally overused = antibiotic resistant bacteria. Immunospuppressive drugs leads to deficient immunityy and higher susceptibility to infections
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What is in the hospital environent itself that makes it a breeding ground for nosocomial infections?
Dust, water (fluids, antiseptics), Air (airborne microbes, air conditioning), Food, medication (Iv, drugs), devices
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Are there different risks in different areas of the hospital? Expand on this:
YES - High risk = operation theatre, sterile units, incubators), Moderate risk = patient rooms, examination rooms, waiting rooms), Low risk (corridors, cafes).
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How do hospitals account for, and protect against nosocomial infections in the environment?
Air - strict regulation for theatres, staphylococci can be transmitted (also on ward), acinetobacter,aspergillus
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What is parenterals?
When something is introduced IV - e.g. nutrition
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What is the source of the HAI?
From patients, infected and/or colonized patient. Also contaminated environment (MRSA), healthcare personnel (BHS-A,MRSA, acute viral infections). Visitors (extremely rare)
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Where are lots of resistant bacteria found?
In ITU nurses and Junior doctors - the patients bring them in
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How are HAI trasmitted?
Hands of health care staff, not properly sterilized or disinfected instruments. Air, indirect contact with environment or food.
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How was the effectivness of hand washing measured?
In widwives clinics - when the midwives began to wash their hands, the rate of mothers surviving giving birth increased drastically
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What are the resident skin flora?
S. epidermidis, corynebacterium spp, propionibacterium.
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What are common transient bacteria?
S.aureus (MRSA), Pseudomonas spp, coliforms (Klebsiella, Enterobacter, Serratia, enterococci)
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Card 2

Front

What are the contributers to nosocomial infection?

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Environment, patient's own flora, vulnerabiliy, interventions and clinical staff and infected patients

Card 3

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How many hospitalised patients acquire infection?

Back

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Card 4

Front

When can hospital acquired infection be acquired?

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Card 5

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Where are the most common hospital acquired infections?

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