Infection Prevention and Control Flashcards

A 28-week gestational age neonate develops candidemia. Which antifungal agent is the drug of choice, particularly given the risk of concurrent CNS involvement?

Answer: Amphotericin B (deoxycholate or liposomal formulation)

Amphotericin B is the preferred first-line treatment for invasive candidiasis in neonates because of its superior CNS penetration, which is critical since neonatal candidemia frequently involves meningitis.

Which intervention is most effective in preventing catheter-associated urinary tract infections (CAUTI) in neonates?

Answer: Removing urinary catheters as soon as they are no longer clinically necessary

Duration of catheterization is the strongest independent risk factor for CAUTI; timely removal when the catheter is no longer clinically indicated is the most effective prevention strategy.

Which of the following is NOT a component of the standard CLABSI prevention bundle?

Answer: Routine scheduled catheter replacement every 7 days

Routine scheduled catheter replacement is not recommended and may increase infection risk by creating additional opportunities for contamination; removal should be based on clinical indication only.

A mother with active, untreated pulmonary tuberculosis delivers a term neonate. What is the recommended approach regarding breastfeeding?

Answer: Breastfeeding should be deferred until the mother has received at least 2 weeks of effective anti-TB therapy and is non-infectious

Breastfeeding should be temporarily postponed until the mother has completed at least 2 weeks of effective anti-TB therapy and is considered non-infectious to prevent respiratory transmission to the neonate.

Which bundle component is most evidence-based for preventing ventilator-associated events (VAE) in mechanically ventilated neonates?

Answer: Closed suctioning systems combined with appropriate head-of-bed elevation when feasible

Closed suctioning systems reduce contamination risk during suctioning, and head-of-bed elevation reduces aspiration risk; both are evidence-based VAP prevention bundle components.

Which vaccination is specifically recommended for all healthcare workers in the NICU as part of a 'cocooning' strategy to protect neonates from pertussis?

Answer: Tdap (tetanus, diphtheria, acellular pertussis) booster

Tdap vaccination for all NICU healthcare workers creates a protective immune 'cocoon' around neonates who are too young to have completed their pertussis vaccination series.

A mother is found to have Group B Streptococcus (GBS) bacteriuria during the current pregnancy. What is the appropriate intrapartum management to protect the neonate?

Answer: Intrapartum antibiotic prophylaxis (IAP) with penicillin G administered to the mother

GBS bacteriuria at any colony count is an indication for intrapartum antibiotic prophylaxis with penicillin G because it signifies heavy GBS colonization and significant risk of neonatal early-onset GBS disease.