e等公務園+學習平臺
CRE診斷、治療與醫院感染管制《解答》
01關於多重抗藥性菌種院內感染之影響 ，下列何者正確?
- A1.延長住院日數，造成殘疾、失去生命
- B2.關閉病房、院譽受損、負法律責任
- C3.增加工作量，增加感染之危險性
- D4.以上皆是 ||正解
02關於CRE(carbapenem-Resistant enterobacteriaceae)的Identification，下列何者有誤?
- A1.Clinical Laboratory and Standards Institute (CLSI) 為了偵測carbapenemase 的存在,已將MIC Breakpoints for Carbapenems提高正解
- B2.Identification of E. coli or K. pneumoniae with overt resistance to any of the carbapenems should raise suspicion that it may be harboring a carbapenemase enzyme.
- C3.臺灣的CDC有做CRE的抗藥性檢測
- D4.NDM-1腸道菌感染症是法定傳染病 ||
03Infection Control for CRE (carbapenem-resistant enterobacteriaceae) ，下列何者有誤?
- A1.Hospitalized patients infected or colonized with carbapenemase-producing bacteria should be placed on airborn precautions正解
- B2.Hand hygiene
- C3.Antimicrobial stewardship
- D4.Screening high-risk patients to detect rectal colonization. ||
04關於 Antimicrobial Therapy for CRE (carbapenem-resistant enterobacteriaceae)
- A1.The optimal treatment of infection due to carbapenemase-producing organisms is uncertain
- B2.CRE 會 confers resistance to all penicillins, cephalosporins, and carbapenems
- C3.For severe infections, monotherapy 較combination antimicrobial therapy with two or more agents 效果 為佳正解
- D4.Emergence of resistance during monotherapy ||
05CRE(carbapenem-Resistantenterobacteriaceae)的transmission，下列何者有誤?
- A1.Enterobacteriaceae，which harbor carbopenem-encoding genes，can spread from person to person
- B2.Cross-infection within &outside of health system
- C3.Health workers 的手也是主要傳播媒介
- D4.CRE因帶有mobile genetic elements，不會wide spread transmission to other isolates & genera of bacteria ||正解
06關于NDM(New Delhi metallo-β-lactamase)何者不正確?
- A1.Genetic element為chromosome正解
- B2.Medical tourism 造成全球的擴散
- C3.Widespread nonprescription use of antibiotics in India造成huge selection pressure
- D4.Most common in E coli ||
07細菌對carbapenem有抗藥性的機制，下列何者不是？
- A1.Loss of porins
- B2.β-lactamase
- C3.Overexpression of efflux pump
- D4.Target mutations ||正解
08下列何者carbapenemase在USA最常見
- A1.KPC (Klebsiella pneumoniae carbapenemase)正解
- B2.NDM (New Delhi metallo-β-lactamase)
- C3.Oxacillinase
- D4.Amp C-like ||
09關於CRE(carbapenem-resistant enterobacteriaceae)的臨床表現，下列何者有誤?
- A1.Asymptomatic colonization
- B2.Outbreaks due to hospital-based clonal spread
- C3.Central venous catheter infections.
- D4.以上皆非 ||正解
10下列何種情況 應考慮對病人應進行CRE (carbapenem-resistant enterobacteriaceae)主動篩檢?
- A1.經調查後確定院內高風險區域
- B2.於48小時內來自高風險區域（如：長照機構或已證實有CRE院內群突發醫院）之入院病人。
- C3.病人須移轉至院內高風險區域（如：ICU）時。
- D4.以上皆是正解
11關於預防多重抗藥性菌種在病房傳播，下列何者有誤?
- A1.病人在單位間互轉，不用先告知是否為多重抗藥性菌種正解
- B2.優先考慮將多重抗藥性菌種病人安置在單人病房
- C3.將帶有相同多重抗藥性微生物的病人，集中照護
- D4.不建議將帶有多重抗藥性菌種病人安置於高傳染風險病人旁 ||
12關於多重抗藥性菌種發生的經過 ，下列何者正確?
- A1.在自然界中,原本就有抗藥性菌種存在
- B2.使用抗生素 ,除了殺死病菌, 也會破壞體內正常的菌種, 而使抗藥性菌種有機會增長.
- C3.抗藥性菌種會將抗藥性基因傳播給其他非抗藥性菌種
- D4.以上皆是 ||正解
13關於多重抗藥性菌種的院內感染管制措施 ，下列何者不正確?
- A1.Hand hygiene
- B2.Standard and contact precautions (e.g., gowns, gloves)
- C3.Cohorting of patients and staff,
- D4.以上皆不正確 ||正解
14關于KPC(Klebsiella pneumoniae carbapenemase)，何者有誤?
- A1.Higher incidence in long-term care facilities than in acute care hospitals in U.S.A
- B2.會造成hospital outbreak
- C3.Transmissible plasmids
- D4.Can not transmitted from klebsiella to other genera ||正解
15Factors of antibiotic resistance，包括
- A1.Aging population
- B2.Chronic disease
- C3.Invasive medical treatment
- D4.以上皆是 ||正解