Deck 3: Laboratory Role in Infection Control

Question 1

An iatrogenic infection is one that is:

A) Caused by gram-negative bacteria
B) Occurs as a result of medical treatment
C) Is found in urinary tract infections
D) Is not subject to outbreak investigation

Answer 1

B
The definition of an iatrogenic infection is one that is acquired in a health care setting.Iatrogenic infections can be caused by gram-negative bacteria,but other types of bacteria may also cause these types of infections (i.e.,methicillin-resistant Staphylococcus aureus).Urinary tract infections can be a type of iatrogenic infection,but other types of infections are also iatrogenic.Because an iatrogenic infection is acquired in a health care setting,outbreak investigations are routinely conducted to determine the source of the infection so that the bacteria can be killed and the spread of infection stopped.

Question 2

A microbiology technologist is working at the bench and notices that a patient from the myocardial intensive care unit grows a Klebsiella pneumoniae bacterium that is an extended-spectrum b-lactamase-producing isolate.This technologist would advise the physician to:

A) Order any antimicrobial that is effective against gram-negative rods in general.
B) Limit the use of antimicrobial agents that tend to induce the formation of extended-spectrum b-lactamases.
C) Draw more blood cultures, as the ones that grew that organism are contaminated.
D) Be on the lookout for diarrhea.

Answer 2

B
Being able to recognize what pathogens are isolated from patients in a myocardial intensive care unit (MICU)may provide the opportunity for the infection control practitioner to inform health care providers of the effects of antibiotic pressure.As an example,if extended-spectrum b-lactamase-producing Klebsiella pneumoniae isolates were seen in that MICU,the physicians may be advised to limit the use of antimicrobial agents that tend to induce the formation of extended-spectrum b-lactamases.

Question 3

An outbreak occurs when:

A) Numbers of isolates or infection rates increase significantly above the baseline.
B) Numbers of isolates or infection rates decrease significantly below the baseline.
C) Many people in a community are infected with a particular organism.
D) The mortality rate from a particular organism increases above 2%.

Answer 3

A
When numbers of isolates or infection rates increase above the baseline or when an isolate of a rare or potential bioterrorism agent is recovered,an "outbreak" may have occurred.The microbiology lab may be the first to recognize that event and will likely participate in the investigation of that outbreak.

Question 4

Patients in both extended care facilities and home care settings are frequently immunosuppressed by disease or therapy and often need intravascular or other device-related care.The microbes identified in these patients are often opportunistic pathogens and include all the following EXCEPT:

A) Pseudomonas aeruginosa
B) Neisseria meningitis
C) Candida
D) Acinetobacter

Question 5

Information that the microbiology laboratory can provide to infection control practitioners includes:

A) The prevalence of a particular pathogen
B) Data on the effectiveness of handwashing techniques
C) Information about the outbreak of meningitis cases in the surrounding counties
D) The antibiotic ordering patterns of particular physicians

Question 6

Nosocomial infections are:

A) Acquired in the community
B) Acquired at prisons
C) Acquired at schools
D) Acquired at hospitals

Question 7

An index case is:

A) An epidemiologic curve for a particular pathogen
B) The last case described in an outbreak
C) The first case described in an outbreak
D) The case where the number of infections with a particular organism rises above the baseline

Question 8

In an outbreak investigation and in the collection of routine surveillance data,what sorts of activities are critical?

A) Microbiologists' awareness of the processes that occur in a routine investigation
B) Alerting the public health department about potential outbreaks
C) Analyzing data on antimicrobial susceptibility from pathogens in the hospital so the health care providers understand the type of antimicrobials that must be used
D) Collecting, processing, reporting, and reviewing pertinent cultures

Question 9

Organisms that are frequently encountered as causes of health care-associated infections in acute care settings include all the following organisms EXCEPT:

A) Methicillin-resistant Staphylococcus aureus
B) Enterococci
C) Clostridium difficile
D) Neisseria meningitis

Question 10

When an outbreak is suspected,all the following steps are taken in investigating that event EXCEPT:

A) Establish a case definition.
B) Confirm that an outbreak exists.
C) Immediately treat all persons involved with appropriate antibiotic.
D) Establish an epidemiologic curve

Question 11

If a large statewide or worldwide epidemic occurs,one of the major difficulties is:

A) Collecting and transporting specimens from people who live out of state or around the world
B) Determining what organism is causing the outbreak
C) Arranging to get all the people with the infections to come back to the main area of the outbreak for an extended period
D) Making sure enough media and technologists are available to process the large amount of cultures associated with the outbreak investigation

Question 12

To keep abreast of all infections that occur in the hospital,infection control practitioners set up surveillance programs.These surveillance programs look at this parameter to determine if there are more or fewer infections in a given period.

A) Antimicrobial susceptibility reports
B) Infection rates
C) Handwashing rates
D) Glove usage

Question 13

This ongoing process helps public health and health care officials recognize outbreaks,upward trends of infections,and positive effects of interventions.

A) Handwashing techniques
B) Intervention
C) Surveillance
D) Antimicrobial resistance

Question 14

Organisms that represent public health concerns can be recovered from patients in an acute care hospital.All of the following isolates are considered significant or major public health concerns that are reportable to public health jurisdictions to follow up as a potential outbreak EXCEPT:

A) Neisseria meningitis
B) West Nile virus
C) Methicillin-resistant Staphylococcus aureus
D) Encephalitis viruses

Question 15

When reviewing surgical site infections,the infection control practitioner must determine if the patient's infection is nosocomial by considering all the following EXCEPT:

A) Whether an endotracheal tube was present during surgery
B) The length of surgery
C) The degree of contamination of the surgical site (gunshot wound to the abdomen versus a hernia repair)
D) Whether any breaks in surgical technique occurred

Question 16

This program involves a close watch of only specific,high-risk,high-volume procedures for nosocomial infections.

A) Baseline data
B) Total surveillance program
C) Targeted surveillance program
D) Data mining

Question 17

In acute care hospitals,transmission of pathogens as a result of treatment occur as all the following "classifications" of infections EXCEPT:

A) Hand-hygiene-acquired infections
B) Surgical site infections
C) Catheter-related bloodstream infections
D) Ventilator-associated pneumonias

Question 18

Prisoners or people housed in behavioral health facilities are more likely to contract infections with pathogens from their intimate contact with blood and body fluids.A likely pathogen may be:

A) Pseudomonas aeruginosa
B) Hepatitis C
C) Methicillin-resistant Staphylococcus aureus (MRSA)
D) Clostridium difficile

Question 19

The counties surrounding yours are seeing an increase in the number of whooping cough cases.This is important for the microbiology laboratory because:

A) Physicians may start sending these cases to you.
B) You will need to advise physicians to suspect such cases and to send them to the hospitals in the surrounding counties.
C) You need to make sure that the infection control practitioners in those counties have baseline data.
D) You need to educate health care providers on specimen collection and transportation and have the specialized media ready so you can detect any cases in your county.

Question 20

What is pulsed-field gel electrophoresis?

A) The process of performing various environmental cultures to aid in infection control investigations
B) A strain-typing technique that can be an important adjunct to epidemiologic investigations
C) A culture technique that compares the two antibiograms of an isolate with the index case
D) A technique that checks for water quality

Question 21

In the United States,15 to 20 outbreaks annually owing to waterborne pathogens cause this illness and affect several thousand people.

A) Diarrhea
B) Hepatitis C
C) Naegleria
D) Legionnaire's disease

Question 22

Waterborne illnesses that may be associated with contaminated drinking water or recreation water include all the following EXCEPT:

A) Legionellosis
B) Hepatitis A
C) Pseudomonas skin infection
D) Hepatitis B

Question 23

An example of an emerging disease is:

A) Influenza
B) West Nile virus
C) Malaria
D) Chicken pox

Question 24

What types of activities have led to the emergence of the microbiology laboratory as the forefront in keeping Americans safe?

A) Terrorist
B) Research
C) Military
D) Educational

Question 25

The hospital infection control committee will expect reports from the laboratory that deal with all the following EXCEPT:

A) Antibiograms
B) Water contamination rates
C) Blood culture contamination rates
D) Pathogens recovered in certain hospital units

Question 26

This is practiced throughout the hospital and mandates safety for all personnel when handling blood and body fluids.

A) Biosafety Level 2
B) Handwashing
C) Wearing of respirators
D) Standard precautions

Question 27

Although environmental cultures are not usually performed because the environment is rarely implicated in disease transmission,they occasionally are useful.Samples will be taken from all of the following EXCEPT:

A) Air
B) Water
C) Hands
D) Surfaces

Question 28

Laboratory technologists must not only keep themselves educated in their contribution to the infection control team,they must keep:

A) Housekeeping alerted as to the nature of the microbiology laboratory's biohazardous waste
B) Laboratory management aware of equipment needs
C) The infection control personnel educated regarding the laboratory's contribution to the team
D) The Centers for Disease Control and Prevention (CDC) informed of the continuing education needs of the microbiology laboratory's staff

Question 29

The role of the microbiology laboratory is to perform cultures and provide culture results to health care providers.The microbiology laboratory also has the responsibility to:

A) Report the identification or suspicion of certain infectious diseases to local, state, and federal public health entities.
B) Report any bioterrorism findings to the news media.
C) Report odd infectious diseases to the Centers for Disease Control and Prevention (CDC).
D) Report any bioterrorism finding to the police.