T24 Nosocomial Infections

nosocomial infections happen when

2 days after admit until 3 days after discharge or 30 days after surgery

common causes of nosocomial infections

• UTI (will show pyuria)

• surgical wound

surgical wound nosocomial infection - most common causative agent and risk

S. aureus, DM

surgical wound nosocomial infection - prevention

give antimicrobial prophylaxis and control glucose

pathogen present in dilute antiseptics

P. aeruginosa

risk factors of nosocomial infection

• large hospital

• ICU

• catheter

• mechanical ventilation

how to prevent catheter-related nosocomial infection

change every 4 weeks because E. coli grow when bladder always contains residual urine

how to prevent mechanical ventilation-associated nosocomial infection

elevate head 30-45 degrees

common pathogens in nosocomial infection

C. difficile
ESKAPE

• E: Enterococcus

• S: S. aureus (MRSA)

• K: Klebsiella and E. coli producing beta-lactamase

• A: A. baumannii

• P: P. aeruginosa

• E: Enterobacter

primary blood stream infection - caused by

intravascular device (central-line associated CLABSI)

central-line associated blood stream infection (CLABSI) - pathogen

• coagulase negative staphylococcus (S. epidermidis, S. saprophyticus)

• S. aureus

central-line associated blood stream infection (CLABSI) - risk

dialysis, chemotherapy

central-line associated blood stream infection (CLABSI) - prevention

chlorhexidine

secondary blood stream infection - cause

• post-op wound

• intraabdominal infection

• UTI

• pneumonia

blood stream infections - pathogens creating biofilms

S. epidermidis, S. aureus, P. aeruginosa

MRSA - treat with what

vancomycin

MRSA - pathogenesis

PBP-2 change to PBP-2A through mecA gene

MIC level for VRSA

16+

VISA

thicker cell wall, reqiure higher dose of vancomycin

VRSA - change

ala-ala to ala-lac or ala