MSE-2019 infection prevention

9 alert organisms (CMSEPKCNR)

• C. difficile

• MRSA

• Staph. aureus

• E. coli

• Psuedomonas aeruginosa

• Klebsiella

• CPE

• Norovirus

• Respiratory viruses

C. difficile trends

• higher cumulative cases vs predicted trajectory

• Due to different clinical presentation in surgical patient these days

• Hydrogen peroxide vapour used to clean wards

MRSA

• beta lactam resistant - flucloxaccilin, caphalosporins

• Nosocomial infections

Period of communicability

• cross infection can occur at any time

• Risk is highest when patients have skin disease

PVL staph. aureus

• Panton-valentine leukocidin toxin production

• Defence mechanism used by bacteria against host immune system

• Breaks down WBCs

• Of 30% of flora makeup is staph. aureus, 2% produces PVL

PVL transmission

patient-to-patient transmissions, susceptible in closed communities (nursing homes, barracks)

E. coli

• government reduction target

• Harmless in healthy individuals

• Found in soil

3 groups of multi-antibiotic resistant, gram negative bacteria

• enterobacteria with ESBL, AmpC or carbapenemase enzymes

• Acinetobacter spp

• Psuedomonas

6 e.g.s of ESBL, AmpC or carbapenemase enzyme enterobacteria (EKECMS)

E.coli, Klebsiella spp, Enterobacter cloacae, citrobacter, morganella serratia

acinetobacter spp multi-antibiotic resistance

resistant to aminoglycoside antibiotics

Psuedomonas multi-antibiotic resistance

resistant to Ceftazidine, Carbapenems, aminoglycoside

E. coli multi-antibiotic resistance

resistant to tazocin, cipro, gentamycin

Seasons' influence on norovirus numbers

typical increase through autumn and into winter

Seasons’ influence on influenza numbers

Typical increase from october to march

5 audit topics

• hand hygiene

• Medical devices (peripheral cannuela, central venous line, urinary catheter)

• Environmental infection prevention (cleaning checklist, water outlet)

• disease isolation

• MRSA screening compliance

• Random audits - PPE, fans, Bristol stool charts

3 pathogens with contact contaminaton precautions

• MRSA

• Salmonella

• C. difficile

pathogen with droplet contamination precautions

Group A strep. (strep. pyogenes)

2 pathogens with airborne contamination precautions

norovirus, chickenpox

8 cross-contamnation precautions (PHPDSLRB)

• patient allocation

• hand hygiene

• personal protective equipment (PPE)

• decontamination of environment/equipment

• Safe waste disposal

• Linen handling

• Respiratory and cough hygiene

• body fluid management

MRSA wound patient allocation code

code A and B

Acinetobacter patient allocation

code A

C. difficile patient allocation

code B and C

Chicken pox patient allocation

code F and G

COVID patient allocation

Code I and J

CPE patient allocation

Code K and L

Psuedomonas aeruginosa patient allocation

code K and L

Pertussis patient allocation

Code H

Norovirus patient allocation

Code D and E