CIC Exam Dumps : CBIC Certified Infection Control Exam

The correct answer is D, "Peracetic acid," as this agent is appropriate for the disinfection of bronchoscopes. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, bronchoscopes are semi-critical devices that require high-level disinfection (HLD) to eliminate all microorganisms except high levels of bacterial spores, as they come into contact with mucous membranes but not sterile tissues. Peracetic acid is recognized by the Centers for Disease Control and Prevention (CDC) and the Association for the Advancement of Medical Instrumentation (AAMI) as an effective high-level disinfectant for endoscopes, including bronchoscopes, due to its broad-spectrum antimicrobial activity, rapid action, and compatibility with the delicate materials (e.g., optics and channels) of these devices (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). It is commonly used in automated endoscope reprocessors, ensuring thorough disinfection when combined with proper cleaning and rinsing protocols.

Option A (iodophor) is typically used for intermediate-level disinfection and skin antisepsis, but it is not sufficient for high-level disinfection of bronchoscopes unless specifically formulated and validated for this purpose, which is uncommon. Option B (alcohol) is effective against some pathogens but evaporates quickly, fails to penetrate organic material, and is not recommended for HLD of endoscopes due to potential damage to internal components and inadequate sporicidal activity. Option C (phenolic) is suitable for surface disinfection but lacks the efficacy required for high-level disinfection of semi-critical devices like bronchoscopes, as it does not reliably eliminate all microbial threats, including mycobacteria.

The selection of peracetic acid aligns with CBIC’s emphasis on evidence-based reprocessing practices to prevent healthcare-associated infections (HAIs) associated with endoscope use (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.4 - Implement environmental cleaning and disinfection protocols). This choice ensures patient safety by adhering to manufacturer and regulatory guidelines, such as those in AAMI ST91 (AAMI ST91:2015, Flexible and semi-rigid endoscope processing in health care facilities).

Empiric antibiotic therapy is theimmediate initiation of antibioticsbased on clinical judgment before laboratory confirmation of an infection. In this case, thepresence of fever, erythema, and tenderness at the central line sitesuggests a possible bloodstream infection, prompting empiric treatment with vancomycin.

Step-by-Step Justification:

Initiation Before Lab Confirmation:

Empiric therapystarts treatment based on symptomswhile awaiting culture results​.

Prevents Complications:

Delayed treatment in central line-associated bloodstream infections (CLABSI)can lead to sepsis.

Common in High-Risk Situations:

Empiric treatment is used in caseswhere waiting for lab results could worsen the patient’s condition.

Why Other Options Are Incorrect:

B. Prophylactic:

Prophylactic antibioticsare given to prevent infection, not to treat an existing one.

C. Experimental:

Experimental treatment refers toclinical trials or unproven therapies, which does not apply here.

D. Broad spectrum:

Broad-spectrum antibiotics covermultiple bacteria, but empiric therapy may benarrow-spectrum based on suspected pathogens​.

CBIC Infection Control References:

APIC Text, Chapter on Antimicrobial Stewardship and Empiric Therapy​.

The correct answer is B, "1 and 4 only," indicating that the information can best be used to heighten awareness among Emergency Department (ED) staff and review the TB exposure control plan. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, tuberculosis (TB) remains a significant public health concern, particularly with the increasing proportion of cases among foreign-born persons in the United States. The data showing a rise from four to 22 states with over 50% of TB cases among foreign-born individuals highlights an evolving epidemiological trend that warrants targeted infection prevention strategies (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.1 - Conduct surveillance for healthcare-associated infections and epidemiologically significant organisms).

Heightening awareness among ED staff (option 1) is critical because the ED is often the first point of contact for patients with undiagnosed or active TB, especially those from high-prevalence regions. Increased awareness can improve early identification, isolation, and reporting of potential cases. Reviewing the TB exposure control plan (option 4) is equally important, as it allows the infection preventionist to assess and update protocols—such as ventilation, personal protective equipment (PPE) use, and screening processes—to address the heightened risk posed by the growing number of cases among foreign-born individuals (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.2 - Implement measures to prevent transmission of infectious agents).

Option 2 (inform staff who are foreign-born) is not the best use of this data, as the information pertains to patient demographics rather than staff risk, and targeting staff based on their origin could be inappropriate without specific exposure evidence. Option 3 (educate patients and visitors) is a general education strategy but less directly actionable with this specific epidemiological data, which is more relevant to healthcare worker preparedness and facility protocols. Combining options 1 and 4 aligns with CBIC’s emphasis on using surveillance data to guide prevention and control measures, ensuring a proactive response to the increased TB burden (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.5 - Use data to guide infection prevention and control strategies).