Bioscience 2 Infections & Clinical Practice PDF

Tutorial Module 3 Bioscience 2 Infections and their applications in clinical practice 1 Important note To prepare for this module please first watch the recorded lectures and other learning material for this module on Bioscience 2 vUWS site. T...

Tutorial Module 3 Bioscience 2 Infections and their applications in clinical practice 1 Important note To prepare for this module please first watch the recorded lectures and other learning material for this module on Bioscience 2 vUWS site. Then try to complete this tutorial by answering the following questions. It is essential that you participate in class discussions, and this is a requirement for active attendance. Tutors will often ask you to share your answer to a question as a way of engaging in class discussions. Text Reference: Lee, G., & Bishop, P. (2016). Microbiology and infection control for health professionals (6th ed.). Melbourne, Victoria: Pearson Australia. COMPLETION OF THIS TUTORIAL WILL ENABLE THE STUDENT TO: Understand some terminologies associated with infections. Understand chain of infection and discuss possible portals of entry and exit for some infectious organisms. Understand the differences between a reservoir and a source of infection. Explain how infections are transmitted in hospitals. Describe what standard and transmission-based precautions are. Understand the importance of hand hygiene in healthcare facility. Discuss factors that contribute to the incidence of infections in healthcare settings. Discuss why Healthcare-associated infections are important. Develop an awareness of what groups of patients are most susceptible to infection by hospital pathogens. Activity 1: Understanding terminology associated with infections through a case study 1. Please review the following case study and fill the gaps using the following terms: contamination, colonized, host, pathogen, carrier, sub-clinical infection, clinical infection, opportunistic infections, healthcare associated infection (HAI), sterilisation John is admitted to hospital with fever, chills, and cough. John has history of diabetes that compromises his immune system. John developed fever and chills three days after undergoing a procedure in a local dental clinic. He is diagnosed with a due to inadequate of dental equipment, resulting in of medical instruments with a. 2 Initially John had with no obvious signs and symptoms. This was quickly progressed to with prominent signs and symptoms of fever, chills, and cough. The pathogen causing the infection was found to be Staphylococcus aureus, which is known to cause in people with compromised immune system. The bacteria had in John’s respiratory tract without initially causing any signs and symptoms of infection, making John a , meaning that John could spread the bacteria to others even when he did not show any signs of disease. With weakened immune system, John was a susceptible , and this allowed the pathogen to proliferate and cause a severe respiratory infection. 2. What is the difference between disinfection and sterilisation? 3. How is a disinfectant and an antiseptic different? 3 Activity 2: Have a look at the chain of infection in the following diagram. Define each component of the chain of infection and provide some examples for each component. Examples of Reservoir: Examples: Examples of Source: Examples: Examples: Types: 4 Activity 3: Have a look at the chain of infection in the following diagram. Provide some precautions that can break the link at each component of the chain of infection. (See Fig. 3.16, p.318, Lee & Bishop, 2016). The Infection Control Policy describes the importance of standard and additional precautions in healthcare settings and the legal responsibilities of nurses in the areas of infection control. Please open the Infection Control Policy document by clicking on the link below and review pages 20-27, which will also help you to complete this activity. https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2023_025.pdf Infectious agent Susceptible host Reservoir Portal of exit Portal of entry Mode of transmission Standard precautions: Contact precautions: Droplet precautions: Airborne precautions: 5 HAIs are an ever-present factor in every health system, are varied and complex, many caused by multi-resistant organisms (MROs) that can be difficult to detect and treat. HAIs can cause significant mortality, morbidity and stress to the patients and could also result in prolonged hospital admissions, increased costs of care and increased drug use (particularly antibiotics). The Australian Commission on Safety and Quality in Health Care (ACSQHC, 2010) released the Australian Guidelines for the Prevention and Control of HAIs. The aim was also to lead and coordinate national improvements in safety and quality in health care across Australia. A Healthcare Associated Infection (HAI) occurs when a patient acquires an infection as a result of receiving healthcare. They occur more than 48 to 72 hours after admission and within 10 days after hospital discharge (Centre for Disease Control and Prevention, 2004). They include central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, and infections at surgery sites. Activity 4: Read through the following case study and then answer the questions below: On 30 July Emmie (26 yrs old) was admitted to hospital with acute appendicitis. An open appendectomy was performed. The appendix was found to be inflamed but had not perforated. She was given IV Cefuroxime 1.5g and Metronidazole 500 mg at the induction of anaesthesia. The wound was sutured, and a dressing was applied. The post-operative period was uneventful, and she was discharged on 02 August. On discharge, she was afebrile and tolerating a normal diet. An appointment was made for her to have the sutures removed on 5 August. HOWEVER: 04 August, Emmie is readmitted to the hospital. She has become increasingly unwell over the past two days. She complains that her wound is very painful, looks red and swollen, and has been oozing a whitish fluid. She says that she ‘feels terrible’. On examination: Looks unwell. Vital signs: Temperature 38.20 C, Pulse 92, Respirations 16, BP 110/70mmHg Wound: Red and swollen. Gaping between sutures. Purulent discharge present. A wound swab was taken for culture and sensitivity (you will cover this later). Results found the presence of E. coli (Escherichia coli) in the wound. IV Ampicillin (1g) 6 hourly was commenced to treat the infection. Questions: 1. How would you explain the reason for Emmie’s discomfort and feeling unwell? 2. What microorganism was responsible for the infection? That is the cause (aetiology) of Emmie’s illness. 3. What is the normal habitat of E. coli? 6 4. What was the purpose of the Culture and Sensitivity test? 5. What makes you believe Emmie’s infection was acquired in hospital? 6. List and briefly elaborate the main sources of Emmie’s hospital acquired infection, identifying possible exogenous and endogenous sources. Where do you think the pathogen (E. Coli) came from and how do you think it could have travelled from its source to the wound? 7. How might this infection have been prevented? Activity 5: Health Care Associated Infections (HAIs) see pp 299-309 Lee & Bishop, 2016. 1. Name the most common health care associated infections. 2 Identify factors that predispose patients to HAIs. See table 13.3 page 309 (Lee & Bishop, 2016). 7 Activity 6: Review chapter 21 of Lee & Bishop (2016), Microbiology and infection control for health professionals, p546-547, and answer the following questions: The urinary tract is one of the common sites of infection, especially in females. It is the most common site of hospital-acquired infection. 1. Have a look at the following figure and explain why urinary tract infections (UTI) are more common in females compared to males? 2. What is the most common microorganism that causes UTI? 3. Any factor that prevents the normal urine flow or complete bladder emptying makes an individual more susceptible to UTI. Name and explain two factors that affect urine flow in males and females that predispose them to UTI. Activity 7: Introduction to MRSA (methicillin-resistant Staphylococcus aureus) Penicillin was initially very effective in treating Staphylococcus infections in the 1940s. However by the 1950s strains of S.aureus had appeared that were resistant to it. Please read “Organisms That Cause Healthcare Associated Infections- Staphylococci” in Lee & Bishop, 2016, p 299- 300, and answer the following questions: 8 1. What factors do you think might have led to the development of MRSA? 2. Explain the main sources and modes of transmission of MRSA. 3. Discuss factors in the prevention of MRSA. 9