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Outline the requirements for successful infection control
Hand Hygiene. Hand hygiene is the most important measure to prevent the spread of infections among patients Respiratory Hygiene/Cough Etiquette Sharps Safety Safe Injection Practices Sterilization and Disinfection of Patient-Care Items and Devices. Environmental Infection Prevention and Control.
Describe the difference between sterilization and disinfection, and give anexample method to achieve each of these
Sterilisation—the killing or removal of all viable organisms, including spores * Method: Heat, Irradiation Disinfection—the killing of many but not all microorganisms * Method: pasteurisation, filtration, Chemical disinfectants
Describe the additional infectious disease risks associated with the health care environment
Potential routes of infection include: * Airborne transmission (suspended particles) * Respiratory droplets * Direct/indirect contact * Faecal-oral
Outline the infection control methods in place in health care settings
Standard precautions * Hand hygiene * Use of PPE where appropriate * Environmental controls—waste management; routine cleaning; spill management
Describe why in-patients are more vulnerable
Healthcare environment Promotes atypical/resistant organisms compared to community-acquired • Older & more vulnerable hosts • Multiple routes of infection—frequent contact between patients-carers • Use of antimicrobials • Constant environmental pressure is selective for resistant organisms • Promoted by ease of genetic transfer in bacteria
What to do if there is spill in healthcare setting:
Small spills (< 10 cm) 1. Wipe with paper towel; 2. wash with detergent and water; 3. disinfectant (e.g. sodium hypochlorite, alcohol wipe) Large spills in “wet” areas * Hose spill into sewerage system; * Flush area with water and detergent; * Disinfectant (e.g. sodium hypochlorite) Large spills in “dry” areas * Contain area of spill and decontaminate using chlorine * Remove spill * Clean area with water and detergent * Disinfectant (sodium hypochlorite)
A staff member of a pathology laboratory was given a bacterial sample to identify. Under the microscope, the Gram-stained sample looked like pink/reddish rods. How would you describe the morphology of the bacterial cells?
Gram-negative Bacillus This indicates that the bacterial cells are elongated and cylindrical in shape, resembling rods, as opposed to being spherical (cocci) or spiral-shaped (spirilla).
Are virus’ living organisms
Are not living organisms because they: * Consist only of DNA or RNA and protein * Are incapable of independent reproduction * Are smaller than any cell (~0.1 �m) * Have no cell membrane * Do not have ribosomes * Have few enzymes for metabolism
How are virus’s classified
Viruses are classified based on their genetic makeup (nucleic acid and arrangement of nucleic acid), structure, and symmetry.
Robert Koch theory
• The suspected pathogen must be present in all cases of the disease and absent from healthy animals. • The suspected pathogen must be grown in pure culture • Cells from a pure culture of the suspected pathogen must cause disease in a healthy animal • The suspected pathogen must be reisolated and shown to be the same as the original
What is the difference between moulds and yeasts?
Moulds are multicellular fungi, while yeasts are single cell fungi
What are the qualities of the perfect antimicrobial agent?
It needs to be pathogen-specific, with few/no side effects to the host.
Mechanisms of antibiotic resistance
Limiting uptake of antibiotic drug Production of enzymes such as B-lactamases that can inactivate the B-lactam ring Enzyme inhibitors that are used in combination with antibiotics to combat resistant bacteria
What is the appropriate personal protective equipment when dealing with infected patients that can transmit an airborne respiratory infection?
• Gloves • Hand hygiene • safety glasses • Aprons/gowns Surgical mask for: Carer, Patient during transfer Observe respiratory hygiene and cough etiquette
Potential sources of infection in the health-care setting
Surfaces * Door handles * Taps * Toilet seats etc. Instruments * Respirators * Ultrasound probes etc. Medical supplies * Bandages * Surgical instruments * Ultrasound gel etc.
The first cells recruited from the blood to a site of tissue infection are
neutrophils
A patient becomes infected with Staphylococcus aureus bacteria in a wound to the skin of the hand. Naïve T cells would initially be activated by bacterial antigens at which site?
The draining lymph nodes
A staff member of a pathology laboratory was given a bacterial sample to identify. Under the microscope, the Gram stained sample looked like pairs of purple circles. How would you describe the morphology of the bacterial cells?
Gram-positive diplococci
What is a dimorphic fungus?
It is a fungus with two distinct phases: mould at room temperature and yeast at body temperature
Describes why infections in the health care setting are more difficult to treat than community-acquired infections?
Secondary bacterial HCAIs are often antibiotic or multidrug resistant, AND a health care setting often has a higher population of vulnerable patients.
Mechanism of antibiotic resistance
Enzyme inactivation and modification. Modification of the antibiotics target site. Overproduction of the target. Replacement of the target site. Efflux and reduced permeability.
appropriate personal protective equipment (PPE) to wear when dealing with infected patients that can transmit a respiratory infection via droplets?
gloves, gown, surgical mask and safety glasses, and practise good hand hygiene and respiratory / cough etiquette
As a health care worker, describe your training in terms of infection control?
understanding who the susceptible patients are, appropriate PPE, good hygiene practices and careful technique in between patients, waste management, understanding the different diseases and modes of transmission
The activation of naive T cells occurs in
The spleen and lymph nodes