CBIC CBIC Healthcare-Associated Infections 2 — Questions and Answers
Question 1: Which organism is most frequently implicated in hospital-acquired Clostridioides difficile infections?
- Clostridioides difficile ribotype 017
- Clostridioides difficile ribotype 027 (Correct answer)
- Clostridioides difficile ribotype 001
- Clostridioides difficile ribotype 078
Correct answer: Clostridioides difficile ribotype 027
Ribotype 027 (NAP1) has been associated with increased virulence, higher toxin production, and outbreak-level hospital-acquired C. difficile infections in the US.
Question 2: What is the recommended contact precaution addition specifically for patients with C. difficile infection?
- Alcohol-based hand rub before and after contact
- Soap and water handwashing instead of alcohol hand rub (Correct answer)
- N95 respirator use during patient contact
- Negative pressure room placement
Correct answer: Soap and water handwashing instead of alcohol hand rub
Alcohol-based hand rubs do not effectively kill C. difficile spores; soap and water handwashing is required to mechanically remove spores.
Question 3: Which HAI is tracked using the NHSN definition requiring 'no other recognized cause' and applies to ICU patients?
- CAUTI
- CLABSI
- VAE (ventilator-associated event) (Correct answer)
- SSI
Correct answer: VAE (ventilator-associated event)
The NHSN Ventilator-Associated Events (VAE) protocol tracks a tiered set of complications in mechanically ventilated patients with no other recognized cause.
Question 4: Which patient population has the highest risk of developing a healthcare-associated bloodstream infection?
- Ambulatory surgical patients
- Medical-surgical floor patients without devices
- ICU patients with central venous catheters (Correct answer)
- Emergency department observation patients
Correct answer: ICU patients with central venous catheters
ICU patients with central venous catheters have the highest CLABSI risk due to device presence, severity of illness, and frequent line manipulation.
Question 5: Under NHSN definitions, which criterion is required to classify a bloodstream infection as a secondary BSI rather than a primary CLABSI?
- The patient has no central line present
- A matching pathogen from another identified infection site within 14 days (Correct answer)
- The culture was drawn from a peripheral vein
- The organism is a common skin contaminant
Correct answer: A matching pathogen from another identified infection site within 14 days
A secondary BSI is attributed to another identified infection site (e.g., UTI, SSI) when the same organism is identified within the NHSN-defined window period.
Question 6: Which intervention is part of the CAUTI prevention bundle endorsed by APIC and IHI?
- Routine catheter irrigation with antibiotic solution
- Daily review and prompt removal of unnecessary urinary catheters (Correct answer)
- Prophylactic antibiotics for all catheterized patients
- Changing urinary catheters every 72 hours
Correct answer: Daily review and prompt removal of unnecessary urinary catheters
Daily review of catheter necessity and prompt removal when no longer indicated is the most impactful evidence-based CAUTI prevention measure.
CBIC CBIC Healthcare-Associated Infections 2
Which organism is most frequently implicated in hospital-acquired Clostridioides difficile infections?