Infection Control CIC Exam Dumps

The selection of an appropriate antiseptic for the insertion of an intravascular device (e.g., peripheral or central venous catheters) is a critical infection prevention measure to reduce the risk of catheter-related bloodstream infections (CRBSIs). The Certification Board of Infection Control andEpidemiology (CBIC) emphasizes evidence-based practices in the "Prevention and Control of Infectious Diseases" domain, which includes adhering to guidelines for aseptic technique during invasive procedures. The Centers for Disease Control and Prevention (CDC) provides specific recommendations for skin antisepsis, as outlined in the "Guidelines for the Prevention of Intravascular Catheter-Related Infections" (2017).

Option A, chlorhexidine, is the preferred antiseptic for skin preparation prior to intravascular device insertion in adults with no contraindications. Chlorhexidine, particularly in a 2% chlorhexidine gluconate (CHG) with 70% isopropyl alcohol solution, is recommended by the CDC due to its broad-spectrum antimicrobial activity, residual effect (which continues to kill bacteria after application), and superior efficacy compared to other agents in reducing CRBSI rates. Studies cited in the CDC guidelines demonstrate that chlorhexidine-based preparations significantly lower infection rates compared to povidone-iodine or alcohol alone, making it the gold standard for this procedure when tolerated by the patient.

Option B, povidone-iodine, is an alternative antiseptic that can be used for skin preparation. It is effective against a wide range of microorganisms and is often used when chlorhexidine is contraindicated (e.g., in patients with chlorhexidine allergy). However, its efficacy is less persistent than chlorhexidine, and it requires longer drying time, which can be a limitation in busy clinical settings. The CDC considers povidone-iodine a second-line option unless chlorhexidine is unavailable or unsuitable. Option C, alcohol (e.g., 70% isopropyl or ethyl alcohol), has rapid bactericidal activity but lacks a residual effect, making it less effective for prolonged protection during catheter dwell time. It is often used as a component of chlorhexidine-alcohol combinations but is not recommended as a standalone antiseptic for intravascular device insertion. Option D, antibiotic ointment, is not appropriate for skin preparation during insertion. Antibiotic ointments (e.g., bacitracin or mupirocin) are sometimes applied to catheter sites post-insertion to prevent infection, but their use is discouraged by the CDC due to the risk of promoting antibiotic resistance and fungal infections, and they are not classified as antiseptics for initial skin antisepsis.

The CBIC Practice Analysis (2022) supports the adoption of CDC-recommended practices, and the 2017 CDC guidelines explicitly state that chlorhexidine-based preparations with alcohol should be used for skin antisepsis unless contraindicated. For a patient with no contraindications, the infection preventionist should suggest chlorhexidine to optimize patient safety and align with best practices.

Theoptimal specimen for identifying the etiologic agentin a prosthetic joint infection (PJI) is ajoint aspirate(synovial fluid). This is because:

It provides direct access to the infected sitewithout contamination from external sources.

It allows for accurate microbiologic culture, Gram stain, and leukocyte count analysis.

Why the Other Options Are Incorrect?

A. Blood– Blood cultures may help detecthematogenous spreadbut are not the best sample for identifyinglocalizedprosthetic joint infections.

B. Wound drainage– Wound cultures oftencontain contaminantsfrom surrounding skin flora and do not accurately reflect joint space infection.

D. Sinus tract tissue– Cultures from sinus tracts often representcolonization rather than the primary infecting organism.

CBIC Infection Control Reference

APIC guidelines confirm thatjoint aspirate is the most reliable specimen for diagnosing prosthetic joint infections​.

The human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) are both bloodborne pathogens that pose significant risks in healthcare settings, and understanding their similarities is crucial for infection prevention and control. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the importance of recognizing transmission modes and implementing appropriate precautions in the "Prevention and Control of Infectious Diseases" domain, aligning with guidelines from the Centers for Disease Control and Prevention (CDC). Comparing these viruses involves evaluating their epidemiology, transmission routes, and occupational risks.

Option C, "Transmission may occur from asymptomatic carriers," is the correct answer. Both HIV and HBV can be transmitted by individuals who are infected but show no symptoms, making asymptomatic carriage a significant similarity. For HBV, chronic carriers (estimated at 257 million globally per WHO, 2019) can transmit the virus through blood, semen, or other bodily fluids without overt signs of disease. Similarly, HIV-infected individuals can remain asymptomatic for years during the latent phase, yet still transmit the virus through sexual contact, blood exposure, or perinatal transmission. The CDC’s "Guidelines for Prevention of Transmission of HIV and HBV to Healthcare Workers" (1987, updated 2011) and "Epidemiology and Prevention of Viral Hepatitis" (2018) highlight this shared characteristic, underscoring the need for universal precautions regardless of symptom status.

Option A, "The primary mechanism of transmission for both is maternal-fetal," is incorrect. While maternal-fetal transmission (perinatal transmission) is a significant route for both HIV and HBV—occurring in 5-10% of cases without intervention for HBV and 15-45% for HIV without antiretroviral therapy—it is not the primary mechanism. For HBV, the primary mode is horizontal transmission through unprotected sexual contact or percutaneous exposure (e.g., needlesticks), accounting for the majority of cases. For HIV, sexual transmission and intravenous drug use are the leading modes globally, with maternal-fetal transmission being a smaller proportion despite its importance. Option B, "Needlestick exposure leads to a high frequency of healthcare workerinfection," is partially true but not a precise similarity. Needlestick exposures carry a high risk for HBV (transmission risk ~30% if the source is HBeAg-positive) and a lower risk for HIV (~0.3%), but the frequency of infection among healthcare workers is significantly higher for HBV due to its greater infectivity and stability outside the host. This makes the statement more characteristic of HBV than a shared trait. Option D, "The risk of infection from mucous membrane exposure is the same," is false. The risk of HIV transmission via mucous membrane exposure (e.g., splash to eyes or mouth) is approximately 0.09%, while for HBV it is higher (up to 1-2% depending on viral load and exposure type), reflecting HBV’s greater infectivity.

The CBIC Practice Analysis (2022) and CDC guidelines emphasize the role of asymptomatic transmission in shaping infection control strategies, such as routine testing and post-exposure prophylaxis. This shared feature of HIV and HBV justifies Option C as the most accurate similarity.

Standard Precautionsare sufficient forcongenital cytomegalovirus (CMV), which means thatgloves should be used when handling body fluids. CMV is primarily transmitted viadirect contact with saliva, urine, or blood.

Why the Other Options Are Incorrect?

A. Wear masks and gloves–Masks are not necessary unless performing high-risk aerosol-generating procedures.

C. No barrier precautions are needed–Gloves are required when handling bodily fluidsto prevent transmission.

D. Use gowns, masks, gloves, and a private room– CMV does not requireContact or Airborne Precautions.

CBIC Infection Control Reference

APIC guidelines state thatCMV transmission is prevented using Standard Precautions, primarily with glove use for body fluid contact​.