Which percentage of hospital administered patient acquire a nosocomial infection?
which are the 6 most common nosocomial infections?
Urinary tract, respiratory, wound, skin, soft tissue and septicaemia.
define preventable nosocomial infection and give examples
- stuff you can control. Medical or nursing or surgical mishaps.
- ex: bad handwashing, leaving stuff inside patient, caughing all over.
define non-preventable nosocomial infection and give examples
- stuff you can't control
- ex: immunodeficient patient, surgeries where organs are seriously damaged, gunshot / stabbing to GI tract.
What are the 7 sources of hospital-acquired infections?
Environment, person-2-person (endogenous vs exogenous), food supply, water supply, air supply, fomites, vector.
Which are the 3 medical activities that can cause problems?
Intravenous access, urinary catheters, surgeries.
What are the 3 factors that play a role in the transmission of a nosocomial infection?
- 1. Source: location where microorganisms replicate and disseminate.
- 2. Route of infection: way by which microorganisms leave source to get to host (us)
- 3. Host: how susceptible are you? age? immune status? etc...
What must be done to have control over nosocomials?
Chain of infection (source to host) must be prevented.
Hospital infection control plans are in place to ... (there are 4)
- 1. render souce non-infectious
- 2. prevent microorganisms from leaving source
- 3. interfere with dissemination routes
- 4. prevent microorganisms to enter host
Which is the most efficient step in control over nosocomials?
the identification and detection of the source of infection
Which activities prevent infection?
- good clinical practices (separation of infected/non-infected patients)
- wound and enteric isolation (toilet facilities, basins)
- respiratory isolation (facemasks, SARS)
- strict isolation (enclosed isolation units, air systems)
- protective isolation (patients highly susceptible to infection) typing (serology, phage, molecular)
Give examples of universal precautions
- Good hygiene habits, such as hand washing and the use of gloves and other barriers
- Correct sharps handling
- Aseptic techniques.
What other types of precautions are used in addition to universal precautions?
- Prion diseases (e.g., Creutzfeldt-Jakob disease)
- Diseases with air-borne transmission (e.g., tuberculosis)
- Diseases with droplet transmission (e.g., mumps, rubella, influenza, pertussis)
- Transmission by direct or indirect contact with dried skin (e.g., colonisation with MRSA) or contaminated surfaces
Who are universal precautions recommended for?
not only for doctors, nurses and patients, but for health care support workers such as laundry and housekeeping staff.
Who is going to ace this exam?
We are, of course :-)
Give some examples of ways infections can be controlled within communities.
- Social and environmental factors
- Health education
- Food safety
- Vector control
- Immunization (immunoglobulins, vaccination)
- Chemoprophylaxis (e.g., rifampicin/ciprofloxacin for meningococcal contacts)
- Outbreak investigations
- National and international agencies
What are the 3 physical approches that we use in cleaning, sterilization and desinfection? give examples.
- Heat: dry (150-200oC); moist (pasteurization, boiling, autoclaving, microwaves); incineration (1000oC!)
- Radiation: gamma, ultraviolet
in order for a disinfectant to be effective, the following must be thought about...
- concentration of germicide?
- what is the target?
- what is the contact time?
- what is the temperature that I should use product at?
- load? Organic? Inorganic?
- miscellaneous factors... (Ph)
In decreasing order of resistance to desinfectants, list 5 different classes of organisms. give two examples for each.
Spores/cysts --> Mycobacteria --> Fungi -->Vegetative bacteria --> enveloped virus
What are antiseptics used for?
- used to inactivate and remove flora (transient, resident) from hands prior to surgical procedures and from site of operation
- used for treatment and/or prevention of infection on skin surfaces or mucous membranes
What are hand rubs used for?
removes transient flora only. Usually contains 60-70% ethanol...plus emollient(s)