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28 Cards in this Set

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Standard incubation period for nosocomial infections
48 hours
Gram - rod
Nitrite +
Leukoesterase +
E. coli
Approximate percent of hospital patients that acquire a significant nosocomial infection
10%
6 most common nosocomial infected body sites
1. UTI = 34%
2. Surgical site = 17%
3. Bloodstream = 14%
4. Ventilator-associated pneumonia = 13%
5. Lower RT = 12%
6. GI = 10%
Most nosocomial pathogens come from where?
indigenous microflora from the patient themself
About 70% of nosocomial infections are due to _________
multi-antibiotic resistant bacteria
8 risk factors associated with Nosocomial infections
1. advanced age, malnutrition (EtOH, Tobacco)
2. Nursing home residents
3. Chronic diseases (DM, COPD, CF)
4. Trauma, surgery, burns
5. Invasive procedures and devices
6. Immunosuppression
7. recent antibiotic therapy
8. Recumbent position
What is needed in the treatment of catheter-associated UTI?
early removal of catheter
Gram + cocci in clumps that causes Abscesses
S. aureus or epidermidis
infection most commonly associated with catheters, shunts, or prosthetic devices
Staphylococcus epidermidis
Indwelling device infections are caused by strains that produce what?
Extracellular slime
What serves as the major habitat for S. epidermidis?
What other places may it inhabit?
skin

mucus membranes
-oropharynx
-nares
-vagina
-urethra
Nosocomial pneumonias develop most frequently from what?
inapparent aspiration of upper airway secretions
Hospital-acquired pneumonia rates:
-moderately to severely ill patients at __1__
-patients undergoing __2__
-patients requiring __3__
-severe underlying __4__
-infection with __5__
-patients requiring mechanical __6__
1. the extremes of age
2. ab or thoracic surgery
3. intensive care
4. disease or respiratory compromise
5. P. aeruginosa
6. ventilation*** (6-20 X's higher)
Colonization of the Upper RT with these bacteria occurs within days of ICU admission
Gram - bacilli (rods)
Most common bacteria that account for Nosocomial Pneumonia
S. aureus = 17.4%
P. aeruginosa = 17.4%
Klebsiella / Enterobacter = 18%
Haemophilus = 5%
Who is usually the most important reservoir for multi-drug resistant nosocomial organisms?
infected or colonized patients
Cross-infection and cross-colonization arise from what?
contaminated hands of health care workers
Morphology of P. aeruginosa
gram - rod
How is P. aeruginosa usually treated?
multiple antibiotics
What organism most commonly causes infection after broad-spectrum antibiotics?
Clostridium difficile
With C. difficile, a stool gram stain should be performed to detect what?

What other test is useful in the workup for C. difficile?
White blood cells

C. difficile toxins
What pathology does C. difficile cause?
Pseudomembranous colitis
Characteristics of C. difficile
Gram +
Spore-forming
Obligate Anaerobic Rod
2 toxins produced by C. difficile
Enterotoxin (toxin A)

Cytotoxin (toxin B)
When does C. difficile only produce its toxins?
during the growth phase when normal flora are killed off and C. difficle has a chance to grow
What do you do with a patient who is positive for MRSA?
place the patient in contact isolation
In immunocompromised patients with Nosocomial bloodstream infections, special cultures are done for these agents
Nocardia
Atypical Mycobacteria
CMV