Nosocomial Infections and Staphylococcus aureus
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Questions and Answers

What is the primary difference between nosocomial and community-acquired infections?

  • Nosocomial infections originate in a hospital, while community-acquired infections are contracted outside of a healthcare setting. (correct)
  • Community-acquired infections are more contagious.
  • Community-acquired infections are bacterial, while nosocomial infections are viral.
  • Nosocomial infections are more severe.
  • According to the provided information, approximately how many patients annually acquire infections following NHS care in England?

  • 100,000
  • 200,000
  • 400,000
  • 300,000 (correct)
  • Which of the following is NOT mentioned as a typical source of healthcare-associated infections (HAIs)?

  • Ventilators
  • Surgical wounds
  • Contaminated food (correct)
  • Medical devices
  • What distinguishes Staphylococcus aureus from other pathogenic staphylococci?

    <p>Its production of coagulase (A)</p> Signup and view all the answers

    Where is Staphylococcus aureus commonly found in healthy individuals?

    <p>In the nares and on the skin (D)</p> Signup and view all the answers

    What condition often facilitates a Staphylococcus aureus infection?

    <p>A breach in the skin barrier (A)</p> Signup and view all the answers

    Which of these is NOT mentioned as a factor produced by S.aureus that contributes to its ability to colonize and invade tissues?

    <p>Endospores (A)</p> Signup and view all the answers

    What is the meaning of the 'aurum' to which Staphylococcus aureus is named after?

    <p>Golden pigment (C)</p> Signup and view all the answers

    Which of the following components assist S. aureus in adhering to host cells?

    <p>Fibrinogen binding proteins (C)</p> Signup and view all the answers

    What happens to S. aureus when the epithelial layer is compromised?

    <p>It penetrates deeper tissues, potentially leading to bloodstream infections. (B)</p> Signup and view all the answers

    How do neutrophils typically combat S. aureus infections?

    <p>By phagocytosing bacteria and utilizing ROS (C)</p> Signup and view all the answers

    What characterizes a S. aureus biofilm?

    <p>A community of bacteria encased in an extracellular matrix (B)</p> Signup and view all the answers

    What is S. aureus's intracellular survival strategy?

    <p>It replicates within host cells and can eventually lyse them. (D)</p> Signup and view all the answers

    Why are S. aureus biofilm infections challenging to treat?

    <p>Biofilms hinder effective antibiotic penetration. (B)</p> Signup and view all the answers

    What is a major concern regarding S. aureus infections?

    <p>Antibiotic resistance development (C)</p> Signup and view all the answers

    Besides skin infections, which of the following is another type of infection caused by S. aureus?

    <p>Osteomyelitis (bone infection) (C)</p> Signup and view all the answers

    What is the function of the mecA gene in MRSA?

    <p>It encodes a variant of PBP, specifically PBP2a, resistant to beta-lactam antibiotics. (D)</p> Signup and view all the answers

    Which antibiotic is notably ineffective against MRSA due to resistance mechanisms?

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

    How do Vancomycin resistant S.aureus (VRSA) strains evade the action of vancomycin?

    <p>By altering the target site to D-Ala-D-Lac. (A)</p> Signup and view all the answers

    What is the primary consequence of S.aureus developing vancomycin resistance?

    <p>A reduction in the variety of effective treatment options. (C)</p> Signup and view all the answers

    What is the main role of beta-lactam antibiotics in treating bacterial infections?

    <p>They inhibit peptidoglycan synthesis by targeting penicillin binding proteins (PBPs). (A)</p> Signup and view all the answers

    What is a major challenge in treating infections caused by S.aureus strains?

    <p>High rates of antibiotic resistance and recurrence of infection. (D)</p> Signup and view all the answers

    What differentiates HA-MRSA from CA-MRSA?

    <p>HA-MRSA is hospital-acquired while CA-MRSA is community-associated. (C)</p> Signup and view all the answers

    Which of the following mechanisms does S.aureus use to resist fluoroquinolones?

    <p>Active efflux through the NorA efflux pump. (B)</p> Signup and view all the answers

    Flashcards

    Beta-lactamases

    Enzymes produced by bacteria that inactivate beta-lactam antibiotics like penicillin.

    MRSA

    Methicillin-resistant Staphylococcus aureus, a strain of S.aureus resistant to methicillin and similar antibiotics.

    VISA

    Vancomycin intermediate resistant Staphylococcus aureus, showing partial resistance to vancomycin.

    VRSA

    Vancomycin resistant Staphylococcus aureus, completely resistant to vancomycin.

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    SCCmec

    A mobile genetic element in MRSA that contains the mecA gene, contributing to resistance.

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    PBP2a

    A variant of penicillin-binding protein in MRSA that is immune to beta-lactam antibiotics.

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    Peptidoglycan synthesis

    The process essential for bacterial cell wall formation inhibited by beta-lactams.

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    D-Ala-D-Lac

    A modified peptide in VRSA that reduces vancomycin's effectiveness by altering binding.

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    Adhesins

    Proteins that help bacteria attach to host cells.

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    Fibrinogen binding proteins (Fnbp)

    Adhesins that bind to integrin receptors on host cells.

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    Neutrophils

    Type of phagocyte that kills bacteria with reactive oxygen species.

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    Abscess

    Localized collection of pus at the site of infection.

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    Biofilm formation

    Bacterial communities bound by an extracellular matrix.

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    Facultatively intracellular pathogen

    Pathogen that can live inside or outside host cells.

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    Staphylococcus aureus infections

    Infections caused by S.aureus, ranging from mild to severe.

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    Antibiotic resistance

    Ability of bacteria to survive treatment with antibiotics.

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    Nosocomial Infections

    Infections originating in a hospital, also known as HAIs or HCAIs.

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    HAIs

    Hospital Acquired Infections that occur during a patient's admission.

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    Community Acquired Infections

    Infections contracted outside of a hospital in the community.

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    Impact of HAIs

    300,000 annual infections in England costing £1 billion to NHS.

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    Staphylococcus aureus

    A Gram-positive cocci that forms grape-like clusters, known for causing infections.

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    Facultative Anaerobe

    An organism able to survive with or without oxygen, like S.aureus.

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    Colonization

    The ability of a bacterium to inhabit a host without causing disease.

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    Infection Mechanisms

    Processes like adhesion, tissue invasion, and biofilm formation used by pathogens.

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    Study Notes

    Nosocomial Infections (HAIs)

    • Nosocomial infections, also known as Hospital Acquired Infections (HAIs) or Healthcare Associated Infections (HCAIs), are infections that develop during a hospital stay but were not present at admission.
    • Approximately 300,000 patients in England acquire infections after care within the NHS annually, costing roughly £1 billion.
    • In developing countries, 1 in 10 hospitalized patients acquire at least one HAI.
    • HAIs are often associated with medical devices or surgical wounds, ranging from infections associated with catheters to serious blood infections associated with ventilators or surgical site infections.
    • These infections are caused by various bacterial, viral, and bacterial pathogens, including antibiotic-resistant bacteria like Acinetobacter baumannii, ESBL-producing Enterobacteriaceae, Staphylococcus aureus, and Clostridium difficile.

    Staphylococcus aureus (S. aureus)

    • S. aureus is a Gram-positive coccus appearing in grape-like clusters. It produces a golden pigment.
    • S. aureus produces coagulase, an enzyme causing blood clotting, distinguishing it from other coagulase-negative staphylococci.
    • It's a facultative anaerobe, surviving with or without oxygen.
    • S. aureus is found in the nostrils and skin of approximately 30% of the population, acting as carriers without causing infection.

    S. aureus Infections

    • S. aureus can cause various infections, including skin and soft tissue infections (SSTIs), bone and joint infections, heart valve infections, pneumonia, and infections related to medical devices or implanted materials.
    • S. aureus has developed resistance to various antibiotics.
    • Historically, beta-lactamases inactivated penicillin but methicillin-resistant strains (MRSA) and other resistant strains have risen.
    • MRSA is a significant cause of bacteremia, with approximately 12,878 cases in the UK between 2018-2019. Mortality rates for these cases, were ~26%.
    • Vancomycin-intermediate resistant S. aureus (VISA) and vancomycin-resistant S. aureus (VRSA) strains exhibiting resistance to vancomycin are also on the rise. This complicates treatment.
    • Treating S. aureus infections has become significantly more complicated and challenging due to increasing resistance.

    Hospital Transmission

    • S. aureus transmission in hospitals can occur endogenously (from existing colonization within the body) or exogenously (through person-to-person contact with skin, equipment, or airborne particles).
    • Hospitals implement measures to prevent and control MRSA spread including hand hygiene, general cleanliness, covering wounds, and using appropriate protective equipment.

    Treatment and Recurrence

    • Treatment drug choices for S. aureus infections vary based on the type of infection, e.g. Daptomycin for MSSA/MRSA and Linezolid for MRSA infections.
    • Recurrence (relapse) of S. aureus infections, particularly in prosthetic joint infections and SSTIs, is common, often due to lingering bacteria in biofilm or cells.
    • Recurrence rates can range between 10-50% for S aureus infections.

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    Description

    This quiz explores the critical topic of nosocomial infections (HAIs) that patients may acquire during their hospital stays. It covers the impact of these infections, common pathogens involved such as Staphylococcus aureus, and their association with medical devices. Test your knowledge on this vital aspect of healthcare and infection control.

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