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30 Cards in this Set
- Front
- Back
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How do HAI's rank on leading causes of death in U.S.?
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6th
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What are the 4 primary types of HAI?
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UTI, pneumonia, bloodstream infection, surgical site infection
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What is the most common HAI?
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UTI
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What are risk factors for CA-UTI?
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prolonged cath, female, older, immunocompromised
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Symptoms of CA-UTI?
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Fever, rigors, altered mental status, CVA tenderness, hematuria, over 1000 bacteria/mL urine
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What are some common organisms that cause UTI in the hospital?
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E. coli, Staph, Serratia, Citrobacter, Pseudomonas, Candida
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How do you treat CA-UTI?
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Remove catheter and give antibiotics
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What is the mortality rate for nosocomial pneumonia?
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about 50%
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What is hospital acquired pneumonia?
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penumonia occurring over 2 days after admision
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What is ventilator associated pneumonia?
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pneumonia occurring 2-3 days after put on vent
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What is health care associated pneumonia?
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occurs in patients in long-term care facilities or received IV antibiotics, chemo, or wound care recently
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How do you suspect/diagnose nosocomial pneumonias?
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fever, altered mental status, more o2 requirement, respiratory distress, culture results
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Risk factors for nosocomial pneumonias?
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Being intubated, NG tube, feeding tubes, supine position, sedation, sinusitis, prolonged antibiotic therapy, central venous line
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What organisms commonly cause hospital pneumonias?
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Gram- bacilli, specifically Pseudomonas, Klebsiella, Acinetobacter, Enterobacter
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How can you prevent hospital pneumonia?
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Elevation of head, "sedation vacation"
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What is the biggest risk factor for bloodstream infection?
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Central venous catheters (extraluminal or intraluminal in origin)
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How do you diagnose hospital bloodstream infection?
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2 sets of 2 cultures from separate sites prior to antibiotic therapy. Positive if 3x fold greater growth from catheter or growth 2 hours before peripheral blood sample
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Risk factor for blood stream infections in hospital?
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Colonization of insertion sites or hub, jugular or femoral cath, neutropenia, premies, parenteral nutrition
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What factors lower risk of blood stream infections in the hospital?
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Subclavian or subcu cath
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What organisms usually cause hospitlal blood stream infections?
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Staph, Candida, Klebsiella, Pseudomonas, Acinetobacter, E. coli
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Which MRSA strain is usually hospital acquired?
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USA 100 is nosocomial and USA 300 is community
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What are risk factors for MRSA infection in the hospital?
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ICU care, dialysis, contact with contaminated people
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Treatment of MRSA?
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Vancomycin, Daptomycin (not pneumonia), linezolid (not bloodstream)
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Describe vancomycin resistant enterococci
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commonly E. faecium. acquires resistance through vanA gene via plasmid or transposon. also resistant to aminoglycoside, macrolide, penicillin, cephalosporin, lincosamide, TMP/sulfa, f-quinolone
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What do you treat these VRE beast organisms with???
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Obviously daptomycin or linezolid
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What causes antibiotic associated colitis?
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C. diff
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What is the most common HAI?
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C. diff
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What toxins does C. diff make?
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Toxin A (enterotoxin) and Toxin B (cytotoxin). They inactivate Rho pathways involved in cytoskeleton structure leading to loss of junctions and apoptosis
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Why must you wash your hands with soap to get rid of C. diff?
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the spores are alcohol, heat, acid, disinfectant resistant
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Treatment for C. diff?
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Metronidazole (Flagyl), vancomycin
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