22 Questions
What are examples of endogenous sources of nosocomial infections?
The nasopharynx, GI, or genitourinary tracts
Which type of nosocomial infection is associated with ventilators?
Hospital-acquired pneumonia
What is a common method for diagnosing nosocomial infections?
Culture of certain pathogens
What is a key step in the management of nosocomial infections?
Removal of source (e.g., central line; urinary catheter)
What risk factors contribute to the invasion of a colonizing pathogen in nosocomial infections?
Length of hospital stay
Where are community-acquired infections acquired?
Outside of a hospital setting
Which type of infecting organism is commonly involved in community-acquired infections?
Streptococcus pneumoniae
What percentage of hospitalized patients had nosocomial infections?
8.7%
When do most nosocomial infections become evident?
After 48 hours of admission
Where do exogenous sources of infections come from?
Medical personnel, equipment, and healthcare environment
Which of the following is NOT an example of a common nosocomial pathogen?
Clostridium botulinum
What distinguishes a community-acquired infection from a hospital-acquired infection?
The type of infecting organism
What is the definition of nosocomial infections?
Infections with no evidence of incubation
Which of the following is NOT a common nosocomial pathogen?
Streptococcus pneumoniae
Where do most nosocomial infections originate from according to the text?
Exogenous sources
What percentage of hospitalized patients had nosocomial infections according to the text?
8.7%
What is a common type of infecting organism in community-acquired infections mentioned in the text?
Haemophilus influenzae
What is the most appropriate management step for nosocomial infections caused by catheters?
Removal of source (eg, urinary catheter)
Which factor is NOT a common risk factor for the invasion of colonizing pathogens in nosocomial infections?
Frequency of handwashing by healthcare personnel
In the context of nosocomial infections, what is the main purpose of adjunctive surgery?
To assist antimicrobial therapy when indicated
Which type of nosocomial infection poses a high risk due to the severity of illness of the patient?
Bloodstream infection (BSI incl. CLABSI)
What differentiates endogenous sources from exogenous sources in the context of nosocomial infections?
Endogenous sources originate outside the patient's body.
Study Notes
Transmission of Infection
- Community acquired infections are acquired outside of a hospital setting and can be distinguished by the type of infecting organism, often involving Haemophilus influenzae or Streptococcus pneumoniae, which are usually more antibiotic sensitive.
Hospital Acquired Infections (Nosocomial Infections)
- Defined as infections that are not present or incubating at the time of hospital admission, and become evident after 48 hours of admission.
- Caused by viruses, bacteria (e.g. Ha-MRSA, Acinetobacter spp., Pseudomonas aeruginosa), and fungi.
- Epidemiology: 5% of all hospitalizations in the US, affecting 8.7% of hospitalized patients in 55 hospitals across 14 countries.
Pathophysiology of Nosocomial Infections
- Infections can come from endogenous (within the patient) or exogenous (outside the patient) sources, including medical personnel, equipment, and the healthcare environment.
- Risk factors for invasion of colonizing pathogens include severity of illness, immunocompromised state, and length of hospital stay.
Types of Nosocomial Infections
- Bloodstream infection (BSI, incl. CLABSI)
- Hospital acquired pneumonia (VAP)
- Catheter-associated urinary tract infection (CAUTI)
- Surgical site infection (SSI)
Diagnosis and Management of Nosocomial Infections
- Diagnosis involves detailed history and examination, lab tests, and culture of certain pathogens.
- Management involves removal of the source of infection (e.g. central line, urinary catheter), antimicrobial therapy if indicated, and adjunctive surgery if necessary.
This quiz covers the concepts of the chain of infection, differences between community acquired and hospital acquired infections, and a detailed look at hospital acquired infections. Learn more about how infections are transmitted in different settings.
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