Microbiology
This was previously featured in an exam
This was previously featured in an exam
Principles
Question 40 of 77
A patient presents with severe diarrhoea following a course of antibiotics. C. difficile colitis is diagnosed. Which of the following is the best way to prevent spread of C. difficile to others:
Answer:
Clostridium difficile infection is a common cause of antibiotic-associated diarrhea. Clostridium difficile is a gram-positive anaerobic bacterium that is transmitted from person to person by the fecal-oral route. The transmission of C. difficile occurs through spores or bacteria in stools or through spores in the environment. Isopropyl alcohol (alcohol gel) is not effective against C. difficile spores, so the use of soap and water is essential.Control of Hospital Acquired Infection
Microbiology / Principles / Controlling Infection
Last Updated: 21st April 2019
Good Clinical Practice
- Infected patients should be isolated in a side room with dedicated hand washing and toilet facilities.
- Staff should be 'bare below the elbows' at all times.
- Staff should use disposable plastic aprons and gloves for touching the patient, which should be discarded after use.
- Hands should be washed with liquid soap and dried with disposable towels after seeing the patient.
- For diseases spread via the respiratory route, the use of facemasks should be considered.
Definitions
Important definitions:
- Cleaning is the removal of foreign material from areas or objects to a point at which they are visually free from debris.
- Disinfection is the reduction in the number of infectious particles.
- Disinfectants are substances which kill or inhibit microbes.
- Sterilisation is the inactivation of all infectious agents and is achieved mainly via autoclaving or irradiation.
Methods of disinfection:
- Iodine is a slow-acting skin anti-bacterial disinfectant.
- Chlorhexidine is an anti-staphylococcal agent.
- Isopropyl alcohol (alcohol gel) is not effective against C. difficile spores, so the use of soap and water is essential.
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- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
