Microbiology Cheat Sheet
Healthcare-associated Infection & Control
Healthcare-associated infection control for NEET-PG: CAUTI, CLABSI, VAP, ESKAPE pathogens, hand hygiene 5 Moments, PPE doffing, and transmission precautions.
MedNext Academy | 3 min read
Healthcare-associated Infection & Control
Healthcare-associated infection control for NEET-PG: CAUTI, CLABSI, VAP, ESKAPE pathogens, hand hygiene 5 Moments, PPE doffing, and transmission precautions.
This topic covers the definition and types of healthcare-associated infections, the ESKAPE multidrug-resistant pathogens, and the basics of infection control and personal protective equipment.
High-yield lines
- A healthcare-associated infection develops during or as a consequence of healthcare and was not present or incubating at admission, with onset at least 48 hours after admission.
- Duration of device use is the single most important modifiable risk factor for device-associated infections, so daily necessity review and prompt removal are key.
- Catheter-associated UTI is the most common healthcare-associated infection, and drainage bag specimens are never acceptable for culture.
- Central line-associated bloodstream infection is prevented by maximal barrier precautions, chlorhexidine skin prep, and daily line necessity review.
- Ventilator-associated pneumonia is prevented by head-of-bed elevation to 30 to 45 degrees, sedation vacations, oral care, and subglottic suctioning.
- The ESKAPE pathogens are Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species.
- MRSA carries the mecA gene encoding PBP2a and is detected by cefoxitin disc, oxacillin MIC, or mecA PCR.
- Clostridioides difficile spores resist alcohol-based hand rubs, so soap and water handwashing is mandatory, and antimicrobial stewardship is the most effective prevention.
- Hand hygiene is the single most effective infection prevention measure, following the WHO 5 Moments framework.
- Standard precautions apply to all patients regardless of infection status, while transmission-based precautions add contact, droplet, or airborne measures.
- Airborne precautions for tuberculosis, measles, and varicella require a negative-pressure room and a fit-tested N95 respirator.
- Droplet precautions for influenza, meningococcal disease, and pertussis require a surgical mask within 1 to 2 metres of the patient.
- During PPE doffing, gloves are removed first because they carry the highest microbial load, with hand hygiene between each step.
- The autoclave at 121 degrees Celsius, 15 psi, for 15 to 20 minutes is the gold standard of sterilisation, while prions require 1N NaOH plus 134 degrees for 18 minutes.
Mapped competency codes
- MI8.5
- MI8.6
- MI8.7
Continue into the full chapter
This summary maps to MI8-zoonotic-diseases-and-miscellaneous.
Frequently Asked Questions
What defines a healthcare-associated infection?
An infection developing during healthcare that was not present or incubating at admission, with symptom onset at least 48 hours after admission.
What do the ESKAPE pathogens represent?
The six most clinically significant multidrug-resistant HAI pathogens: Enterococcus faecium, S. aureus, Klebsiella, Acinetobacter, Pseudomonas, and Enterobacter.
Why is soap and water required for Clostridioides difficile?
C. difficile spores are resistant to alcohol-based hand rubs, so mechanical handwashing with soap and water is needed to remove them.
Which PPE item is removed first during doffing and why?
Gloves, because they carry the highest microbial load, with hand hygiene performed between each removal step to prevent self-contamination.
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