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NEW QUESTION # 95
Following recent renovations on an oncology unit, three patients were identified with Aspergillus infections.
The infections were thought to be facility-acquired. Appropriate environmental microbiological monitoring would be to culture the:
Answer: D
Explanation:
The scenario describes an outbreak of Aspergillus infections among three patients on an oncology unit following recent renovations, with the infections suspected to be facility-acquired. Aspergillus is a mold commonly associated with environmental sources, particularly airborne spores, and its presence in immunocompromised patients (e.g., oncology patients) poses a significant risk. The infection preventionist must identify the appropriate environmental microbiological monitoring strategy, guided by the Certification Board of Infection Control and Epidemiology (CBIC) and CDC recommendations. Let's evaluate each option:
* A. Air: Aspergillus species are ubiquitous molds that thrive in soil, decaying vegetation, and construction dust, and they are primarily transmitted via airborne spores. Renovations can disturb these spores, leading to aerosolization and inhalation by vulnerable patients. Culturing the air using methods such as settle plates, air samplers, or high-efficiency particulate air (HEPA) filtration monitoring is a standard practice to detect Aspergillus during construction or post-renovation in healthcare settings, especially oncology units where patients are at high risk for invasive aspergillosis. This aligns with CBIC's emphasis on environmental monitoring for airborne pathogens, making it the most appropriate choice.
* B. Ice: Ice can be a source of contamination with bacteria (e.g., Pseudomonas, Legionella) or other pathogens if improperly handled or stored, but it is not a typical reservoir for Aspergillus, which is a mold requiring organic material and moisture for growth. While ice safety is important in infection control, culturing ice is irrelevant to an Aspergillus outbreak linked to renovations and is not a priority in this context.
* C. Carpet: Carpets can harbor dust, mold, and other microorganisms, especially in high-traffic or poorly maintained areas. Aspergillus spores could theoretically settle in carpet during renovations, but carpets are not a primary source of airborne transmission unless disturbed (e.g., vacuuming). Culturing carpet might be a secondary step if air sampling indicates widespread contamination, but it is less direct and less commonly recommended as the initial monitoring site compared to air sampling.
* D. Aerators: Aerators (e.g., faucet aerators) can harbor waterborne pathogens like Pseudomonas or Legionella due to biofilm formation, but Aspergillus is not typically associated with water systems unless there is significant organic contamination or aerosolization from water sources (e.g., cooling towers). Culturing aerators is relevant for waterborne outbreaks, not for an Aspergillus outbreak linked to renovations, making this option inappropriate.
The best answer is A, culturing the air, as Aspergillus is an airborne pathogen, and renovations are a known risk factor for spore dispersal in healthcare settings. This monitoring strategy allows the infection preventionist to confirm the source, assess the extent of contamination, and implement control measures (e.g., enhanced filtration, construction barriers) to protect patients. This is consistent with CBIC and CDC guidelines for managing fungal outbreaks in high-risk units.
References:
* CBIC Infection Prevention and Control (IPC) Core Competency Model (updated 2023), Domain IV:
Environment of Care, which recommends air sampling for Aspergillus during construction-related outbreaks.
* CBIC Examination Content Outline, Domain III: Prevention and Control of Infectious Diseases, which includes environmental monitoring for facility-acquired infections.
* CDC Guidelines for Environmental Infection Control in Healthcare Facilities (2022), which advocate air culturing to detect Aspergillus post-renovation in immunocompromised patient areas.
NEW QUESTION # 96
Which of the following microorganisms does NOT cause gastroenteritis in humans?
Answer: A
Explanation:
Gastroenteritis, characterized by inflammation of the stomach and intestines, typically presents with symptoms such as diarrhea, vomiting, and abdominal pain. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the identification of infectious agents in the "Identification of Infectious Disease Processes" domain, aligning with the Centers for Disease Control and Prevention (CDC) guidelines on foodborne and enteric diseases. The question requires identifying the microorganism among the options that does not cause gastroenteritis, necessitating an evaluation of each pathogen's clinical associations.
Option B, "Rhinovirus," is the correct answer as it does not cause gastroenteritis. Rhinoviruses are the primary cause of the common cold, affecting the upper respiratory tract and leading to symptoms like runny nose, sore throat, and cough. The CDC and WHO classify rhinoviruses as picornaviruses that replicate in the nasopharynx, with no significant evidence linking them to gastrointestinal illness in humans. Their transmission is primarily through respiratory droplets, not the fecal-oral route associated with gastroenteritis.
Option A, "Norovirus," is a well-known cause of gastroenteritis, often responsible for outbreaks of acute vomiting and diarrhea, particularly in closed settings like cruise ships or nursing homes. The CDC identifies norovirus as the leading cause of foodborne illness in the U.S., transmitted via the fecal-oral route. Option C,
"Rotavirus," is a major cause of severe diarrheal disease in infants and young children worldwide, also transmitted fecal-orally, with the CDC noting its significance before widespread vaccination reduced its impact. Option D, "Coxsackievirus," a member of the enterovirus genus, can cause gastroenteritis, particularly in children, alongside other syndromes like hand-foot-mouth disease. The CDC and clinical literature (e.g., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases) document its gastrointestinal involvement, though it is less common than norovirus or rotavirus.
The CBIC Practice Analysis (2022) and CDC guidelines on enteric pathogens underscore the importance of distinguishing between respiratory and gastrointestinal pathogens for effective infection control. Rhinovirus's exclusive association with respiratory illness makes Option B the microorganism that does not cause gastroenteritis.
References:
* CBIC Practice Analysis, 2022.
* CDC Norovirus Fact Sheet, 2021.
* CDC Rotavirus Vaccination Information, 2020.
* Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 9th Edition, 2019.
NEW QUESTION # 97
A patient with pertussis can be removed from Droplet Precautions after
Answer: B
Explanation:
A patient with pertussis (whooping cough) should remain on Droplet Precautions to prevent transmission.
According to APIC guidelines, patients with pertussis can be removed from Droplet Precautions after completing at least five days of appropriate antimicrobial therapy and showing clinical improvement.
Why the Other Options Are Incorrect?
* A. Direct fluorescent antibody and/or culture are negative - Laboratory results may not always detect pertussis early, and false negatives can occur.
* C. The patient has been given pertussis vaccine - The vaccine prevents but does not treat pertussis, and it does not shorten the period of contagiousness.
* D. The paroxysmal stage has ended - The paroxysmal stage (severe coughing fits) can last weeks, but infectiousness decreases with antibiotics.
CBIC Infection Control Reference
According to APIC guidelines, Droplet Precautions should continue until the patient has received at least five days of antimicrobial therapy.
NEW QUESTION # 98
An outbreak of Candida auris is suspected in the infection preventionist's (IP) facility. The IP's investigation must be conducted in a standard method and communication is critical. Which first step is MOST important?
Answer: D
Explanation:
In an outbreak investigation, the first critical step is to notify facility administration and other key stakeholders. This ensures the rapid mobilization of resources, coordination with infection control teams, and compliance with regulatory reporting requirements.
Why the Other Options Are Incorrect?
* A. Conduct environmental cultures - While environmental sampling may be necessary, it is not the first step. The outbreak must first be confirmed and administration alerted.
* B. Plan to prevent future outbreaks - Prevention planning happens later after the outbreak has been investigated and controlled.
* D. Perform analytical studies - Data analysis occurs after case definition and initial response measures are in place.
CBIC Infection Control Reference
APIC guidelines state that the first step in an outbreak investigation is confirming the outbreak and notifying key stakeholders.
NEW QUESTION # 99
Which of the following activities will BEST prepare a newly hired infection preventionist to present information at the facility's orientation program?
Answer: D
Explanation:
The correct answer is C, "Reviewing principles of adult learning," as this activity will best prepare a newly hired infection preventionist to present information at the facility's orientation program. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, effective education delivery, especially for healthcare professionals during orientation, relies on understanding adult learning principles (e.
g., andragogy), which emphasize learner-centered approaches, relevance to practice, and active participation.
Reviewing these principles equips the infection preventionist (IP) to design and deliver content that addresses the specific needs, experiences, and motivations of the audience-such as new staff learning infection control protocols-enhancing engagement and retention (CBIC Practice Analysis, 2022, Domain IV: Education and Research, Competency 4.1 - Develop and implement educational programs). This preparation ensures the presentation is tailored, impactful, and aligned with the goal of promoting infection prevention behaviors.
Option A (observing other departments' orientation presentations) can provide insights into presentation styles or facility norms, but it is less focused on the IP's specific educational role and may not address the unique content of infection prevention. Option B (meeting with the facility's leadership) is valuable for understanding organizational priorities and gaining support, but it is more about collaboration and context- setting rather than direct preparation for presenting educational material. Option D (administering tuberculin skin tests to orientees) is a clinical task related to TB screening, not a preparatory activity for designing or delivering an educational presentation.
The focus on reviewing adult learning principles aligns with CBIC's emphasis on evidence-based education strategies to improve infection control practices among healthcare personnel (CBIC Practice Analysis, 2022, Domain IV: Education and Research, Competency 4.2 - Evaluate the effectiveness of educational programs).
This approach enables the IP to effectively communicate critical information, such as hand hygiene or isolation protocols, during the orientation program.
References: CBIC Practice Analysis, 2022, Domain IV: Education and Research, Competencies 4.1 - Develop and implement educational programs, 4.2 - Evaluate the effectiveness of educational programs.
NEW QUESTION # 100
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