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Reducing HAIs AND ARIs and real-time PCR testing for CDI.

MLO and Northern Illinois University (NIU), Dekalb, IL, are co-sponsors in offering continuing education units (CEUs) for this issue's article on "REDUCING HAIs AND ARIs" and "REAL-TIME PCR TESTING FOR CDI." CEUs or contact hours are granted by the College of Health and Human Sciences at NIU, which has been approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.[R] program (Provider No. 0001) and by the American Medical Technologists Institute for Education (Provider No. 121019; Registry No. 0061). Approval as a provider of continuing education programs has been granted by the state of Florida (Provider No. JP0000496), and for licensed clinical laboratory scientists and personnel in the state of California (Provider No. 351). Continuing education credits awarded for successful completion of this test are acceptable for the ASCP Board of Registry Continuing Competence Recognition Program. After reading the articles, answer the following test questions and send your completed test form to NIU along with the nominal fee of $20. Readers who pass the test successfully (scoring 70% or higher) will receive a certificate for 1 contact hour of P.A.C.E.[R] credit. Participants should allow four to six weeks for receipt of certificates.

The fee for this continuing education test is $20.

The Cover Story, Clinical Issues, and Lab Management published in this month's MLO are peer-reviewed.

Note: This CE test includes questions from two articles featured in the cover story section: "Reducing HAIs and ARIs" and "Real-time PCR testing for CDI."

Objectives and Continuing education questions prepared by Gail S. Williams, PhD, MT (ASCP) SBB, CLS (NCA), Clinical Laboratory Sciences Program, College of Health and Human Sciences, Northern Illinois University, DeKalb, IL.


1. Currently, the primary cause of HAIs and ARIs is

a. MRSA.

b. VRE.

c. Both a and b (tied for No. 1).

d. Neither a nor b.

2. CDI causes

a. mild diarrhea.

b. toxic megacolon.

c. sepsis.

d. death.

e. all of the above.

3. What enzyme is produced by Klebsiella pneumonia, Escherichia coli, and Salmonella, leaving the infected patient with no antibiotic treatment options?

a. Methicillinase.

b. Beta-lactamase.

c. Carbapenemase.

d. None of the above.

4. MRSA has become an increasing problem in hospitals and communities because of

a. inadequate hand-washing.

b. inappropriate use of antibiotics.

c. patients with underlying health problems.

d. all of the above.

5. Influenza H1N1 infections become deadly 50% of the time when the patient is co-infected with

a. Klebsiella pneumoniae.

b. E coli.

c. Salmonella.

d. MRSA.

6. What estimated percent of HAIs are resistant to commonly used antibiotics?

a. 30%

b. 50%

c. 70%

d. 90%

7. How should Carbapenems be used?

a. They should be saved for the most severe infections where other antibiotics would be ineffective.

b. They should be used for all serious infections.

c. They should be used for Carbapenem-resistant organisms.

d. They should be widely used for all organisms.

8. What estimated percent of patients with respiratory infections who are treated with antibiotics actually need them for recovery?

a. 45%

b. 55%

c. 80%

d. 20%

9. A new method to reduce the use of antibiotics is

a. testing for Calcitonin levels.

b. testing for Procalcitonin levels.

c. sputum culture.

d. real-time PCR.

10. 0.05 nG/mL of PCT indicates

a. nothing; PCT is not related to infections.

b. normal levels; no antibiotic need.

c. bacterial infection likely.

d. start antibiotic therapy immediately.

11. Declining levels of PCT helps to determine that the appropriate antibiotic therapy is being used.



12. Ventilator-associated pneumonia, or VAP, is best diagnosed by culturing fluid collected by a standard bronchial-washing technique.



13. Quantitative cultures of lung specimens help to determine if the patient has a significant infection rather than a specimen contaminated with normal respiratory flora.



14. Which of the following tests for CDI has a rapid turnaround time?

a. Stool culture

b. Cytotoxicity assay for Toxin B

c. Real-time PCR

d. All of the above

15. Which test for CDI has the best combination of sensitivity and specificity?

a. EIA for Toxin A and B

b. Real-time PCR for Toxin B gene

c. Glutamate dehydrogenase

d. Stool culture

16. CDI with only Toxin A produced causes the most severe infection.



17. According to the APIC, approximately how many patients in hospitals die each year from CDI?

a. 13,000

b. 28,000

c. 109,000

d. 386,000

18. C difficile is a spore-forming

a. Gram-positive aerobic coccus.

b. Gram-positive aerobic bacillus.

c. Gram-positive anaerobic bacillus.

d. Gram-negative anaerobic bacillus.

19. Handwashing with alcohol based cleansers is sufficient to prevent the spread of CDI.



20. CDI usually occurs after antibiotic treatment for something else.



21. One practical way to reduce incidence of CDI is to

a. give normal intestinal flora to patients.

b. discontinue antibiotic use.

c. bleach the patient's colon.

d. use repeated ElAs to detect CDI.


MLO's Continuing Education Test is also online.

Both the CE test and a convenient payment feature are available through the auspices of Northern Illinois University.

Go to to print or to send electronically with payment.
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Article Details
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Publication:Medical Laboratory Observer
Article Type:Cover story
Geographic Code:1USA
Date:Oct 1, 2009
Previous Article:Real-time PCR testing for CDI improves outcomes and reduces costs.
Next Article:False-positive DOA testing results due to prescription medications.

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