Healthcare-associated Infections Overview

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Questions and Answers

Which of the following is an example of a disease transmitted through equipment/fomites?

  • Hepatitis B
  • Brucellosis
  • Tetanus (correct)
  • Rabies

A person who harbours an infectious agent but does not show signs of infection is best described as:

  • A carrier
  • An ill person
  • An infected person
  • A colonized person (correct)

Which of these is NOT a typical portal of exit for infectious agents?

  • Gastrointestinal tract
  • Skeletal system (correct)
  • Skin/mucous membrane
  • Respiratory tract

What is a significant difference between colonization and infection?

<p>Infection involves multiplying bacteria and an immune response, while colonization does not. (C)</p> Signup and view all the answers

Which of the following is the most effective way to prevent direct contact transmission?

<p>Hand hygiene (B)</p> Signup and view all the answers

What is the typical timeframe for an infection to be considered a Healthcare-Associated Infection (HAI) after admission to a healthcare facility?

<p>More than 48 hours after admission (D)</p> Signup and view all the answers

Which of the following is NOT a typical consequence of Healthcare-Associated Infections (HAIs)?

<p>Reduced patient discharge time (B)</p> Signup and view all the answers

How is indirect contact transmission best described?

<p>Spread through contaminated intermediate objects (A)</p> Signup and view all the answers

Which of the following best describes a 'carrier state'?

<p>The presence of a microorganism in the body without symptoms, but able to transmit (A)</p> Signup and view all the answers

Which of the following is NOT a type of infectious agent?

<p>Carbapenem (B)</p> Signup and view all the answers

Which of the following is NOT considered a major type of Healthcare-Associated Infection (HAI)?

<p>Community-acquired pneumonia (D)</p> Signup and view all the answers

What is one example given of how staff can transmit pathogens to patients?

<p>Transmitting their own nasal staph to patients. (C)</p> Signup and view all the answers

Which of the following is NOT categorized as a 'host factor' contributing to the development of Healthcare-Associated Infections (HAIs)?

<p>Environmental contamination (D)</p> Signup and view all the answers

What is the primary mechanism by which ESBLs contribute to antibiotic resistance?

<p>They produce enzymes that break down certain antibiotics. (C)</p> Signup and view all the answers

What does the acronym 'HAI' stand for in the context of healthcare?

<p>Healthcare-associated infection (B)</p> Signup and view all the answers

Which statement best describes MRSA?

<p>It is a type of staph bacteria resistant to certain antibiotics called beta-lactams. (B)</p> Signup and view all the answers

What is the estimation on how many patients are harmed while receiving healthcare in developed countries?

<p>1 in 10 (A)</p> Signup and view all the answers

What is a characteristic of carbapenem-resistant Pseudomonas aeruginosa?

<p>It is difficult to treat when carbapenem resistant. (D)</p> Signup and view all the answers

Which of the following is considered part of the 'inanimate environment' in the context of HAIs?

<p>Medical instruments and equipment (D)</p> Signup and view all the answers

Besides patients, who might be included in a HAI?

<p>All healthcare staff (A)</p> Signup and view all the answers

What is the potential consequence of HAIs, besides increased costs and bed blockages?

<p>Subject to litigation (D)</p> Signup and view all the answers

What is a common characteristic of gram-positive cocci, as it relates to HAIs?

<p>They include Staphylococci and Streptococci. (D)</p> Signup and view all the answers

Which of the following best describes CRE?

<p>It's a type of bacteria that produces enzymes causing resistance to carbapenems. (C)</p> Signup and view all the answers

Environmental risk factors for HAIs include all EXCEPT which of these?

<p>The age of the patient (A)</p> Signup and view all the answers

Which medical procedure is LEAST likely to increase the risk of acquiring a healthcare-associated infection (HAI)?

<p>Administering a routine blood test (C)</p> Signup and view all the answers

What is the primary way in which invasive devices, such as intubation tubes and catheters, increase the risk of infection?

<p>They bypass the patient's natural defense mechanisms. (C)</p> Signup and view all the answers

Which factor related to the duration of device use increases the risk of infection?

<p>The longer a device remains in place, the greater the risk of infection. (A)</p> Signup and view all the answers

Which of the following patient treatments is LEAST likely to increase the risk of infection?

<p>Standard saline intravenous drip (B)</p> Signup and view all the answers

What is the BEST approach to prevent healthcare-associated infections (HAIs) according to the text?

<p>Breaking the chain of infection by interrupting transmission. (C)</p> Signup and view all the answers

Which category of pathogens is identified as the MOST important cause of healthcare-associated infections (HAIs)?

<p>Gram-negative bacteria (A)</p> Signup and view all the answers

What is the term used to describe an infection caused by microorganisms that are part of the patient's own body flora?

<p>Endogenous infection (B)</p> Signup and view all the answers

Which of the following best describes a fomite in the context of infection transmission?

<p>An inanimate object that carries infection passively. (A)</p> Signup and view all the answers

According to the provided definitions, what is a reservoir in the context of infectious diseases?

<p>A place where an infectious agent can survive but may or may not multiply (C)</p> Signup and view all the answers

Which of the following is NOT typically a method of transmission for sexually transmitted infections?

<p>Contact with fomites such as clothing. (B)</p> Signup and view all the answers

Which of these is a primary method of transmission for Gram-negative bacteria like Klebsiella and Acinetobacter?

<p>Colonization on patient skin transmitted via staff hands. (A)</p> Signup and view all the answers

In addition to blood, which bodily fluid is most directly linked to the transmission of endemic hepatitis B virus (HBV) from mother to child?

<p>During delivery. (C)</p> Signup and view all the answers

Which of the following infections can be transmitted through both blood-to-blood contact and vertical transmission from mother to fetus?

<p>Cytomegalovirus. (C)</p> Signup and view all the answers

Which action is LEAST likely to cause blood-borne transmission?

<p>Using clean surgical instruments. (C)</p> Signup and view all the answers

How are infections typically spread through droplets as described?

<p>Via large particles propelled from an infected person (D)</p> Signup and view all the answers

Which of the following is an example of fecal-oral transmission of infection?

<p>The spread of shigella through contaminated hands. (A)</p> Signup and view all the answers

Flashcards

Colonization

The presence of bacteria on a body surface (like on the skin, mouth, intestines or airway) without causing disease in the person.

Carrier state

The continued presence of a microorganism (bacteria, virus, or parasite) in the body that does not cause symptoms, but is able to be transmitted and infect other persons.

Infection

Presence of multiplying bacteria that overwhelms the host's defenses, leading to clinical symptoms.

Portal of exit

The path by which an infectious agent leaves the reservoir.

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Direct contact transmission

The most common means of transmission. Involves direct person-to-person contact.

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Indirect contact transmission

Transmission through contact with a contaminated intermediate object.

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Droplet transmission

Transmission through droplets from an infected person's respiratory system.

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Airborne transmission

Transmission through airborne particles that remain suspended in the air for longer periods.

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Healthcare-associated infections (HAIs)

Infections acquired during healthcare delivery in any setting, including hospitals, long-term care facilities, and home care.

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HAI definition

An infection that develops more than 48 hours after admission to a healthcare facility, without evidence of infection at the time of admission.

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Patient safety in healthcare

A significant problem in healthcare, affecting 1 in 10 patients in developed countries. It is caused by errors and adverse events during healthcare delivery.

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Cost of HAIs

HAIs increase hospital costs by delaying patient discharge, blocking beds, increasing treatment costs, and requiring more investigations.

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Catheter-associated urinary tract infection (CAUTI)

A major type of HAI, commonly encountered in the hospital setting.

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Hospital-acquired pneumonia (HAP) / Ventilator-associated pneumonia (VAP)

A major type of HAI, occurring in hospitalized patients.

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Surgical Site Infection (SSI)

A major type of HAI, frequently occurring after surgeries.

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Catheter-related bloodstream infection (CR-BSI)

A major type of HAI, associated with central venous catheters.

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Infectious Agent

A microorganism capable of causing disease. Examples include bacteria, viruses, fungi, and parasites.

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Methicillin-Resistant Staphylococcus aureus (MRSA)

Bacteria that are resistant to certain antibiotics, specifically beta-lactams.

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ESBL (Extended-Spectrum Beta-Lactamase)

Bacteria that produce enzymes called extended-spectrum beta-lactamases (ESBLs). ESBLs break down certain antibiotics like penicillins and cephalosporins, making them ineffective for treatment.

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CRE (Carbapenem-Resistant Enterobacteriaceae)

Bacteria that produce additional enzymes causing resistance to carbapenems. This makes treatment very difficult due to limited options.

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Vancomycin-Resistant Enterococci

Bacteria that cause infections in patients with weakened immune systems and have limited treatment options.

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Carbapenem-Resistant Pseudomonas aeruginosa

An organism that can cause infections in the bloodstream, lungs, or other parts of the body after surgery, particularly challenging to treat when resistant to carbapenems.

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Environmental Factors for HAIs

Factors contributing to healthcare-associated infections (HAIs) involving both living and non-living elements in a healthcare setting.

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Animate Environment in Healthcare

The animate environment in a healthcare setting, which includes healthcare workers, patients, visitors, and families.

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Staph transmission

Staphylococcus bacteria can spread from patient to patient by contaminated hands.

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GNB transmission

Gram-negative bacteria (GNB) can colonize the patient's skin and be transmitted by staff hands.

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Enteric Infections transmission

Fecal-oral transmission of infections occurs via hands in both the community and hospital settings.

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Fomites

Inanimate objects that can passively carry infection from one site or host to another.

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Sexually Transmitted Diseases (STDs)

Diseases that can spread through sexual contact. Examples include syphilis, gonorrhea, chlamydia, HIV, and HBV.

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Bloodborne Transmission

Several agents are transmitted by direct or indirect contact with infected blood.

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Vertical transmission

Transmission of infections from mother to child, primarily during childbirth or pregnancy.

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What are some procedures that increase the risk of HAIs?

Procedures that increase the risk of acquiring HAIs. Examples include surgeries, insertion of foreign bodies, and indwelling catheters.

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What is an endogenous infection?

Microorganisms that are part of the patient's own body flora, causing infection within the patient.

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What is a reservoir in the context of infection?

A place where an infectious agent can survive and potentially multiply.

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How do we break the chain of infection to prevent HAIs?

Interruption of the transmission of an infectious agent, the most effective way to prevent healthcare-associated infections (HAIs).

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What are infectious agents in the context of HAIs?

Pathogens that cause HAIs. Gram-negative bacteria are a primary concern.

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How does the duration of an invasive device correlate with infection risk?

The longer an invasive device remains in place, the higher the risk of infection. This is because the device bypasses the body's natural defenses, providing a pathway for infectious agents.

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What are key factors that can increase a patient's vulnerability to infection?

Factors that make individuals more susceptible to infection. Examples include immunosuppression, antacid treatment, certain medications and frequent blood transfusions.

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How do human factors contribute to the spread of infections?

Poor hand hygiene, inadequate equipment decontamination, and lack of proper staff practices can contribute to the spread of infections.

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Study Notes

Healthcare-associated Infections (HAIs)

  • HAIs refer to infections acquired during healthcare delivery in any setting (hospitals, long-term care, community)
  • Approximately 8.9 million HAIs occur annually in European hospitals and long-term care facilities combined.
  • More than half of certain HAIs are preventable.
  • A localized or systemic infection originating from an adverse reaction to an infectious agent or toxin.
  • An infection is considered an HAI if it appears more than 48 hours after admission.

Patient Safety - Facts

  • In developed countries, 1 in 10 patients experience harm during healthcare.
  • Harm can result from errors or adverse events.
  • High-risk industries (aviation, nuclear plants) have a higher rate of HAIs.
  • HAIs increase hospital costs due to delays in patient discharge, blocked beds, increased treatment costs, and potential litigation.

Major Types of HAIs

  • Catheter-associated urinary tract infection (CAUTI)
  • Hospital acquired pneumonia (HAP) / Ventilator-associated pneumonia (VAP)
  • Surgical site infection (SSI)
  • Catheter-related bloodstream infection (CR-BSI)
  • Host factors (e.g., coma, HIV, malignancies, diabetes, malnutrition, circulatory impairment, advanced age)
  • Agent factors (e.g., bacteria, viruses, fungi, parasites)
  • Environmental factors (e.g., medical instruments, equipment, cleanliness, temperature, humidity, procedures)

Infectious Agents

  • Microorganisms (bacteria, viruses, fungi, parasites) capable of causing disease are infectious agents
  • Gram-positive cocci (Staphylococci, Streptococci) and Gram-negative bacilli (Acinetobacter, Pseudomonas, Klebsiella) are frequent causes of HAIs.
  • Multi-drug resistant organisms (MDROs) such as ESBLs and CRE pose significant treatment challenges.

Reservoirs

  • Reservoirs are places where infectious agents live, grow, and reproduce—including humans (e.g., chickenpox, hepatitis B), animals, and equipment.

Transmission

  • Modes of transmission include contact (direct, indirect, droplet), airborne, vehicle (e.g., contaminated food or water), and vector-borne.
  • Direct contact involves physical touch, indirect contact involves contact with contaminated surfaces.
  • Droplet transmission involves large droplets expelled during coughing or sneezing
  • Airborne transmission includes small droplets that remain airborne for longer durations.

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