CHBT Infection Control and Disinfection Procedures 1 — Questions and Answers
Question 1: Which organism is the most common cause of access-related bloodstream infections in hemodialysis patients?
- Staphylococcus aureus (Correct answer)
- Escherichia coli
- Pseudomonas aeruginosa
- Candida albicans
Correct answer: Staphylococcus aureus
Staphylococcus aureus, including MRSA strains, is the leading cause of vascular access-related bacteremia in hemodialysis patients.
Question 2: What level of disinfection is required for hemodialysis machine external surfaces?
- Low-level disinfection with an EPA-registered hospital disinfectant (Correct answer)
- High-level disinfection
- Sterilization
- Simple soap and water cleaning only
Correct answer: Low-level disinfection with an EPA-registered hospital disinfectant
External machine surfaces are non-critical items that require low-level disinfection with an EPA-registered product to remove pathogens that could cause infection through indirect contact.
Question 3: According to CDC guidelines, gloves must be changed and hand hygiene performed between patients and:
- When moving between clean and contaminated tasks for the same patient (Correct answer)
- Only when visibly soiled
- At the end of the shift only
- Only when handling blood products
Correct answer: When moving between clean and contaminated tasks for the same patient
CDC guidelines require glove changes and hand hygiene between any transition from contaminated to clean tasks to prevent cross-contamination.
Question 4: What is the CDC-recommended strategy for preventing hepatitis B transmission in hemodialysis units?
- Dedicated machines, supplies, and staff for HBsAg-positive patients, plus vaccination of susceptible patients and staff (Correct answer)
- Universal use of N95 respirators
- Monthly hepatitis B testing only
- Antiviral prophylaxis for all staff
Correct answer: Dedicated machines, supplies, and staff for HBsAg-positive patients, plus vaccination of susceptible patients and staff
The CDC recommends cohort isolation of HBsAg-positive patients with dedicated equipment and staff, combined with hepatitis B vaccination of all susceptible patients and healthcare workers.
Question 5: What is the purpose of performing routine cultures of dialysis water and dialysate?
- To monitor bacterial counts and ensure they remain within safe limits to protect patients from gram-negative bacteremia and pyrogenic reactions (Correct answer)
- To detect chlorine residual
- To verify calcium and magnesium levels
- To test for endotoxins only
Correct answer: To monitor bacterial counts and ensure they remain within safe limits to protect patients from gram-negative bacteremia and pyrogenic reactions
Regular microbiological cultures monitor bacterial colony counts in water and dialysate so corrective action can be taken before counts exceed AAMI limits and harm patients.
Question 6: Which bloodborne pathogen is MOST efficiently transmitted by needlestick injury in the hemodialysis setting?
- Hepatitis B virus (HBV) (Correct answer)
- Hepatitis C virus (HCV)
- HIV
- Cytomegalovirus (CMV)
Correct answer: Hepatitis B virus (HBV)
HBV has the highest transmission risk per needlestick exposure (up to 30%), far exceeding HCV (~3%) and HIV (~0.3%).
CHBT Infection Control and Disinfection Procedures 1
Which organism is the most common cause of access-related bloodstream infections in hemodialysis patients?