Healthcare-Associated Infections
Hospital-Acquired Pneumonia (HAP)
Risk factors - Admission, Intubation
The causative organisms here:
Gram +ve - Strep pneumoniae, MRSA
Gram -ve - E.coli, Pseudomonas, Klebsiella
Investigations - Bloods, CXR, Sputum MC&S
Line Infection The causative organisms here - MRSA, Strep pyogenes
Investigations - Swab of infection site and send for culture
Before giving any Abx, the source of infection should be removed.
C. Difficile
Risk factors:
Recent treatment with broad-spectrum abx
Abx - 3 C's (Cephalosporins, Ciprofloxacin, Clindamycin), Penicillins
Long hospital stay
Elderly
Immunosuppression
Presentation:
Watery diarrhoea +/- blood
Painful abdominal cramps
Nausea
Signs of dehydration e.g. dry mucous membranes, tachycardia, oliguria
Fever
Management:
Fluid replacement
PO Vancomycin/Fidaxomicin, with addition of IV Metronidazole if severe
Oral vancomycin is very poorly absorbed in the gut (bioavailability of less than 10%), therefore stays within the lumen and acts there.
