CBIC Infection Prevention 3 — Questions and Answers
Question 1: A hospital experiences a cluster of Legionnaires' disease cases. The FIRST priority investigation step is to:
- Administer prophylactic antibiotics to all exposed staff
- Conduct a water system risk assessment and collect environmental samples (Correct answer)
- Discharge all affected patients immediately
- Shut down all water sources in the facility
Correct answer: Conduct a water system risk assessment and collect environmental samples
The immediate priority is to identify and characterize the environmental source through a water system risk assessment and sampling to guide targeted remediation.
Question 2: Which sterilization method is MOST appropriate for heat-sensitive flexible endoscopes?
- Steam autoclave at 134°C
- Dry heat oven
- High-level disinfection with glutaraldehyde or OPA (Correct answer)
- Ethylene oxide gas sterilization only
Correct answer: High-level disinfection with glutaraldehyde or OPA
Flexible endoscopes that contact mucous membranes are semicritical items requiring high-level disinfection; steam and dry heat would damage them.
Question 3: In the chain of infection, which link does respiratory hygiene/cough etiquette primarily interrupt?
- Susceptible host
- Reservoir
- Mode of transmission (Correct answer)
- Portal of entry
Correct answer: Mode of transmission
Covering coughs and sneezes and disposing of tissues interrupts the mode of transmission by reducing respiratory droplet spread in the environment.
Question 4: Which metric is used by NHSN to adjust HAI rates for patient population risk and allow fair facility comparisons?
- Incidence density rate
- Prevalence proportion
- Standardized Infection Ratio (SIR) (Correct answer)
- Attack rate
Correct answer: Standardized Infection Ratio (SIR)
The SIR compares observed infections to a risk-adjusted predicted number based on national baseline data, enabling meaningful benchmarking across facilities.
Question 5: A construction project is beginning adjacent to an oncology unit. The MOST critical infection prevention measure is to:
- Move all immunocompromised patients to a different floor and establish an ICRA (Correct answer)
- Increase antifungal prophylaxis for all patients
- Post signage warning patients about dust
- Perform daily cultures of patients in adjacent rooms
Correct answer: Move all immunocompromised patients to a different floor and establish an ICRA
Implementing an Infection Control Risk Assessment (ICRA) and relocating highly susceptible patients protects immunocompromised individuals from fungal spores released during construction.
Question 6: The single most effective intervention proven to reduce surgical site infections (SSIs) is:
- Preoperative antiseptic showering
- Appropriate timing and selection of prophylactic antibiotics (Correct answer)
- Laminar airflow in the OR
- Prolonged postoperative antibiotic courses
Correct answer: Appropriate timing and selection of prophylactic antibiotics
Administering the correct prophylactic antibiotic within 60 minutes before incision (120 min for vancomycin/fluoroquinolones) and discontinuing within 24 hours postoperatively is the highest-impact SSI prevention measure.
Question 7: Which of the following organisms is classified as a Category A bioterrorism agent by the CDC?
- Salmonella typhi
- Yersinia pestis (plague) (Correct answer)
- Norovirus
- Methicillin-resistant Staphylococcus aureus
Correct answer: Yersinia pestis (plague)
Yersinia pestis, the causative agent of plague, is a CDC Category A agent due to its high mortality, potential for person-to-person spread, and capacity for public panic.
CBIC Infection Prevention 3
A hospital experiences a cluster of Legionnaires' disease cases.
The FIRST priority investigation step is to: