The Certification Board of Infection Control and Epidemiology (CBIC) has developed the CBIC exam to ensure that all individuals practicing infection control and prevention meet a high professional standard.
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The infection control practices assessed by the CBIC exam include both the analysis and interpretation of collected infection control data, and the investigation and surveillance of suspected outbreaks of infection.
Other practices assessed by the CBIC exam may include infection education, the development of infection control policies, the management of infection prevention and control activities, the provision of infection risk consultation and assessment, and the planning and implementation of infection prevention and control measures.
The major CBIC examination content areas effective July 1, 2007:
I. Identification of Infection Disease Processes
II. Surveillance and Epidemiologic Investigation
III. Infection Prevention and Control
IV. Program Management and Communication
VI. Infection Control Aspects of Employee Health
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Certification Board of Infection Control and Epidemiology, Inc. (CBIC) Practice Questions
1. Identification of Bacillus anthracis:
- Shows gram-positive diplococci in short chains.
- Shows gram-negative diplococci in short chains.
- Shows gram-positive nonmotile rods.
- Requires immediate quarantine precautions of index case.
2. Agents and methods used to sterilize or disinfect are segregated into three tiers. Which of the following statement is NOT accurate regarding these categories?
- Low-level agents, such as iodophors, kill most bacteria and fungi, but not viruses.
- Alcohol is an intermediate disinfectant that does not kill or inactivate spores.
- Hydrogen peroxide is an example of a high-level disinfectant.
- High disinfectants may not eradicate high concentrations of bacterial spores.
3. Decubiti in spinal cord injury patients:
- Are not commonly associated with spread of infection to nearby bone
- Typically show single, dominant organisms on culture
- Occur in about two-thirds of patients with such neurologic injuries
- Are related to pressure and contamination
4. Nosocomial infections include all of the following EXCEPT:
- Postsurgical wound infection identified in outpatient suture clinic 1 week following hospital discharge.
- Neonatal herpes diagnosed in newborn infant vaginally delivered from HSV-infected mother.
- Congenital malformations in newborn with positive IgM titer for rubella.
- Diagnosis of nosocomial infection made by attending surgeon.
5. Which of the following actions is NOT considered an effective infection control strategy in surgical environments?
- Preferential use of flash sterilization
- 15 or more air exchanges hourly
- Hallways and nearby areas ventilated with positive pressure
- Wet-vacuum mechanical cleaning of surgical suites at end of day
1. Answer: C
Infection control personnel are often the first individuals notified of preliminary results, particularly when there is a high index of suspicion for a worrisome pathogen or one that involves a patient with an aggressive clinical course. IC staff must have working familiarity with the ways in which preliminary results are communicated, and understand differential diagnostic considerations and implications for action. Laboratories report results of preliminary gram-stain results, some of which help narrow diagnostic possibilities, as in the typical “tennis racket” appearance of Clostridium tetani, the infectious agent of tetanus. Here, Bacillus anthracis is a gram-positive rod associated with environmental flora in settings that involve livestock, such as sheep and cattle. Because it is transmitted via inhalation or breaks in intact skin or mucous membranes, quarantine precautions of the index are not indicated, while further investigations are certainly warranted.
2. Answer: A
Hospitals seeking to fulfill OSHA regulations for prevention of illnesses spread by bloodborne pathogenic microbes employ intermediate-level agents for disinfection, particularly in critical areas such as the emergency department, surgical suites (and related-use areas as in pre- and post-op recovery), and laboratories. Iodophors are examples of low-tier agents that kill most bacteria but may not kill certain strains of fungi or viruses. Their lack of activity against resistant microbial strains and spores makes use of more effective agents imperative, especially in higher risk areas. A greater range of microbial kill or inactivation is seen with intermediate agents such as alcohol and sodium hypochlorite (bleach). This broader kill or inactivation range extends to vegetative organisms such as M. tuberculosis, viruses such as HBV and HIV, and fungi. High-level disinfectants additionally kill most bacterial, viral, and fungal strains, but may not fully eradicate areas, equipment, or surfaces contaminated by high concentrations of bacterial spores.
3. Answer: D
Decubiti develop in about one-third of patients with spinal cord injury. Given this high occurrence rate, decubitus ulcers present management issues that call for appropriate actions to prevent their development or hasten resolution in a timely manner by a well-educated clinical staff. Pressure and contamination combine to create a setting in which decubiti may develop. These factors underscore the role of active infection surveillance and interaction with clinical staff to ensure that patients are kept clean and that all available methods are employed (e.g., turning, special mattresses) to prevent excessive pressure and breaching of healthy, intact skin. Colonizing organisms are typically mixed, comprising aerobic and anaerobic flora. What may appear to be a small decubitus on the skin surface may instead represent more profound damage to subjacent soft tissue. Underlying osteomyelitis, or spread of infection to nearby bone, is commonly traced to a preexisting decubitus ulcer in these and other at-risk patient groups.
4. Answer: C
Nosocomial infections encompass those hospital-acquired illness caused by pathogenic microbes that were not present in the index case when the patient entered the facility, whether the diagnosis is made during that stay or after discharge. Because infections categorized as nosocomial in nature may involve clinical as well as laboratory diagnoses, the diagnosis may also be made based on appropriate clinical data by an attending physician. The surgical site infection of Patient A occurred after discharge but is nosocomial in origin. The vaginal delivery in case B is the likely source of the neonate’s herpes infection and is likewise nosocomial. However, the malformations and positive rubella titer in case C results from placental transfer of the rubella virus, which is not considered nosocomial.
5. Answer: A
Surgical suite infection control practices must be known, assessed, and regularly revised to improve outcome measures. Routine sterilization procedures are preferable to flash sterilization, which may be incomplete because of inadequate precleaning, timing, or temperature considerations. Air exchange is also important, with at least 15 hourly air exchanges recommended, of which at least three should be using fresh air. Horizontal laminar air flow, air filtering, and positive pressure ventilation of hallways and areas adjacent to the surgical theatres should also be employed. Mechanical cleaning should be considered essential to proper postcleaning sterilization and should include daily wet vacuuming after the last procedure has been performed.
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by Enoch Morrison | Last Updated: January 8, 2019