Micr 2220 Lect 14: Health Care Setting Infections

Front 1

What are iatrogenic infections

Back 1

result from treatments, not from in-patient care

Front 2

Sources of material contaminated with CJD prions

Back 2

-Human growth hormone extracted from cadaveric pituitary glands (recombinant used now)
-blood transfusion
-nanosurgery
-implantation with infected material e.g. corneal grafts

Front 3

Pathogens passed on by unscreened blood transfusions

Back 3

CJD, HIV, hep B&C, syphilis

Front 4

Mid 19th cent, Vienna Gen Hospital, what were women dying of & causative agent

Back 4

puerperal fever (blood poisoning) caused by s. pyogenes due to infection with cadaveric material (lack of hand washing)

Front 5

Commonist infections in healthcare setting

Back 5

Gastro (22%), Resp (20%), UTI (20%), Surgical site (14%), skin/soft tissue (10.5%), primary bloodstream infec (6.8%), Misc (3%)

Front 6

What is implicated often in infections of implanted plastic materials, how do they do it, treatment

Back 6

coagulase neg staphylococci (normally skin commensals), infect via biofilms (use extracellular slime to stick to plastics). Replace device

Front 7

Why are biofilms difficult to treat

Back 7

Metabolism of bacterial cells is down-regulated

Front 8

Why are people lying down at risk for infections

Back 8

Mucocililary escalator that keeps lungs clear works best and bladder empties fully when upright.

Front 9

Flowers and water are reservoirs for

Back 9

Pseudomonas and acinetobacter

Front 10

2 major causes of gastro infection in healthcare setting

Back 10

clostridium difficile and "winter vomiting disease" caused by norovirus

Front 11

Who is affected by norovirus and symptoms and timeframe

Back 11

all age groups. vorceful vomiting with nausea and watery diarrhoea, symptoms develop suddenly 24-48 hrs post infection

Front 12

treatment of norovirus infection

Back 12

typically self-limiting and recover in 1-2 days.

Front 13

Characteristics of norovirus and family

Back 13

pos strand RNA of family caliciviridae, resistant to disinfectants, low infectious dose

Front 14

Spread of norovirus

Back 14

usually faecal-oral route, but virus particles can be aerosolised in vomit and diarrhoea

Front 15

Characteristics of c. diff

Back 15

anaerobic, sporing, gram pos bacillus

Front 16

what predisposes someone to c. diff infection

Back 16

treatment with antibiotics that reduces commensal microbiota of lower gut

Front 17

How does c. diff cause diarrhoea

Back 17

produces two toxins

Front 18

what can c. diff cause in extreme cases and what predisposes people to this

Back 18

pseudomembranous colitis, any antibiotic can predispose but particularly those excreted via gut rather than kidneys (esp 3rd gen cephalosporins, quinolones, clindamycin)

Front 19

diarrhoea from people with c. diff is characteristic because

Back 19

characteristic smell due to production of para cresol by bacteria

Front 20

First line treatment of c. diff infection and what's used in severe cases

Back 20

first line metronidazole, severe vancomycin

Front 21

common cause of diarrhoea in hospital patients because of mass catering

Back 21

clostridium perfringes

Front 22

What event saved clinical microbiology

Back 22

food poisoning at stanley royd hospital 1984. 450 people ill, 19 died. public outcry...

Front 23

common causes of ventilator-associated pneumonia

Back 23

most gram neg bacilli (inc pseudomonas aeruginosa), and enterobacteriaceae (esp klebsiella pneumoniae, enterobacter aerogenes, citrobacter freundii, serratia marcescens), and recently acinetobacter and MRSA

Front 24

Aspiration pneumonia often caused by

Back 24

strep pneumoniae, s. aureus, haemophilus influenza, pseudomonas aeruginosa, enterobacteriaceae (esp klebsiella, enterobacter, citrobacter)

Front 25

What sort of pneumonia is a resk of general anaesthesia and what procedure is in place to prevent it

Back 25

Aspiration pneumoniae, patients required to take nothing by mouth 4 hrs b/f gen anaesthetic surgery

Front 26

Therapy for pneumoniae

Back 26

Emperical, broad spectrum at diagnosis based on local resistance, therapy narrowed once pathogen identified

Front 27

what pathogen can cause invasive kidney infection in immunocompromised patients

Back 27

candida albicans

Front 28

what pathogen often is isolated from infected diabetic urine

Back 28

candida albicans

Front 29

Treatment of UTI

Back 29

often resistant to common antimicrobials and multiple classes. Emperical then adjusted...

Front 30

most common UTI pathogens in hospital patients

Back 30

E.coli, proteus mirabilis, klebsiella, citerobacter, enterobacter

Front 31

pathogens burns commonly infected with

Back 31

s. aureus (meticillin susceptible and resistant), strep pyogenes, pseudomonas aeruginosa

Front 32

1983, babies colonised and died in bristol maternity hospital from what

Back 32

serratia marcescens

Front 33

serratia marscens originally treated with what and what makes them resistant to it and how does it do that

Back 33

netilmicin, have gene encoding AAC(6')-I enzyme which acetylates netilmicin and is easily picked up and unique to the species

Front 34

What do bacteria produce to be resistant to ceftazidime

Back 34

produce extended spectrum B-lactamase

Front 35

what pathogens in particular are not inactivated by alcohol rubs

Back 35

many viruses, c. diff (already desiccated)