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| Section | Objectives |
|---|---|
| Topic 1: Infection Prevention and Control Program Management | - Regulatory compliance - Policy and guideline implementation - Program development and leadership |
| Topic 2: Identification of Infectious Disease Processes | - Chain of infection and transmission routes - Host susceptibility factors - Pathogenesis of infectious diseases |
| Topic 3: Surveillance and Epidemiologic Investigation | - Outbreak investigation and response - Healthcare-associated infection surveillance methods - Data collection and analysis |
| Topic 4: Occupational Health | - Healthcare worker exposure prevention - Immunization and post-exposure protocols |
| Topic 5: Cleaning, Disinfection, and Sterilization | - Environmental cleaning standards - High-level disinfection practices - Sterilization methods and validation |
| Topic 6: Environment of Care | - Air and water quality management - Healthcare facility design and risk reduction |
| Topic 7: Education, Consultation, and Research | - Staff education strategies - Evidence-based practice and guideline interpretation |
長い間CIC認定を希望しているかもしれませんが、CBIC勉強する時間や良い方法がありません。勉強はつまらないと思っていたのかもしれません。 CICの学習教材があなたの心を変えます。当社の製品を使用すると、すぐに勉強の幸せを感じるでしょう。熱心なJpshiken専門家のおかげで、CIC試験に合格するためのすばらしい学習ツールが考案されました。最初にデモを試してみると、勉強をやめられないことがわかります。 CIC学習教材を使用すると、自分自身に挑戦して、もっと知りたいと思うでしょう。
質問 # 59
During an outbreak investigation of Pseudomonas aeruginosa in a medical intensive care unit (ICU), what is a critical INITIAL step the infection preventionist (IP) should take to better understand an investigation process and this organism?
正解：D
解説：
The CBIC Certified Infection Control Exam Study Guide (6th edition) emphasizes that a critical initial step in any outbreak investigation is for the infection preventionist to develop a strong understanding of the organism involved, its epidemiology, reservoirs, modes of transmission, and previously reported outbreak sources.
Conducting a literature search of similar outbreak investigations provides this foundational knowledge and helps guide a structured, evidence-based investigation.
Pseudomonas aeruginosa is an opportunistic, water-associated pathogen frequently implicated in healthcare- associated outbreaks, particularly in ICUs. Prior outbreak investigations described in the literature commonly identify sources such as sink drains, faucets, respiratory equipment, humidifiers, contaminated medications, and inadequate reprocessing of medical devices. Reviewing published investigations allows the IP to anticipate likely sources, identify high-yield environmental sampling locations, and avoid unnecessary or unfocused interventions.
Options A and D may become appropriate later, depending on outbreak magnitude and reporting requirements, but they are not the initial step. Option B can be helpful but relies on anecdotal experience rather than systematic evidence. The Study Guide stresses that outbreak investigations should begin with background research and hypothesis generation, followed by targeted data collection and analysis.
For the CIC exam, this question reinforces that effective outbreak management starts with understanding what is already known, making a literature review the most appropriate initial action.
質問 # 60
Properly written instructional objectives should:
正解：D
解説：
Properly written instructional objectives are a fundamental component of effective education programs and are emphasized in the Education and Research domain of the CBIC Certified Infection Control Exam Study Guide (6th edition). Instructional objectives are designed to clearly state what the learner will be able to do after completing an educational activity. The Study Guide highlights that objectives must be learner-centered, measurable, and observable, which is best achieved by using clear action-oriented verbs.
Describing learner outcomes using action words-such as identify, analyze, demonstrate, apply, or evaluate- allows educators to define expected performance and assess whether learning has occurred. These action words are typically aligned with Bloom's taxonomy and support evaluation of cognitive, psychomotor, or affective learning domains. This approach ensures that education is outcome-driven rather than content-driven.
Option A is incorrect because communicating the intent of the program is the purpose of a program goal, not an instructional objective. Option C is unrelated to instructional design; continuing education unit eligibility is determined by accrediting bodies, not by objectives themselves. Option D is incorrect because instructional objectives are not limited to knowledge and application levels; they may address higher-order thinking skills such as analysis, synthesis, and evaluation.
For CIC exam preparation, recognizing that instructional objectives must be written in measurable, action- oriented terms is essential, as this principle directly supports effective education, competency validation, and performance improvement in infection prevention programs.
a
質問 # 61
An infection preventionist is reviewing a wound culture result on a surgery patient. The abdominal wound culture of purulent drainage grew Staphylococcus aureus with the following sensitivity pattern: resistant to penicillin, oxacillin, cephalothin, and erythromycin; susceptible to clindamycin, and vancomycin. The patient is currently being treated with cefazolin. Which of the following is true?
正解：B
解説：
The scenario involves a surgical patient with a purulent abdominal wound culture growing Staphylococcus aureus, a common pathogen in surgical site infections (SSIs). The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes accurate interpretation of culture results and antibiotic therapy in the
"Identification of Infectious Disease Processes" and "Prevention and Control of Infectious Diseases" domains, aligning with the Centers for Disease Control and Prevention (CDC) guidelines for managing SSIs. The question requires assessing the sensitivity pattern and current treatment to determine the correct statement.
Option B, "The current therapy is not effective," is true. The wound culture shows Staphylococcus aureus resistant to oxacillin, indicating methicillin-resistant S. aureus (MRSA). The sensitivity pattern lists resistance to penicillin, oxacillin, cephalothin, and erythromycin, with susceptibility to clindamycin and vancomycin.
Cefazolin, a first-generation cephalosporin, is ineffective against MRSA because resistance to oxacillin (a penicillinase-resistant penicillin) implies cross-resistance to cephalosporins like cefazolin due to altered penicillin-binding proteins (PBPs). The CDC's "Guidelines for the Prevention of Surgical Site Infections" (2017) and the Clinical and Laboratory Standards Institute (CLSI) standards confirm that MRSA strains are not susceptible to cefazolin, meaning the current therapy is inappropriate and unlikely to resolve the infection, supporting Option B.
Option A, "The wound is not infected," is incorrect. The presence of purulent drainage, a clinical sign of infection, combined with a positive culture for S. aureus, confirms an active wound infection. The CBIC and CDC define purulent discharge as a key indicator of SSI, ruling out this statement. Option C, "Droplet Precautions should be initiated," is not applicable. Droplet Precautions are recommended for pathogens transmitted via respiratory droplets (e.g., influenza, pertussis), not for S. aureus, which is primarily spread by contact. The CDC's "Guideline for Isolation Precautions" (2007) specifies Contact Precautions for MRSA, not Droplet Precautions, making this false. Option D, "This is a methicillin-sensitive S. aureus (MSSA) strain," is incorrect. Methicillin sensitivity is determined by susceptibility to oxacillin, and the resistance to oxacillin in the culture result classifies this as MRSA, not MSSA. The CDC and CLSI use oxacillin resistance as the defining criterion for MRSA.
The CBIC Practice Analysis (2022) and CDC guidelines stress the importance of aligning antimicrobial therapy with sensitivity patterns to optimize treatment outcomes. The mismatch between cefazolin and the MRSA sensitivity profile confirms that Option B is the correct statement, indicating ineffective current therapy.
References:
* CBIC Practice Analysis, 2022.
* CDC Guidelines for the Prevention of Surgical Site Infections, 2017.
* CDC Guideline for Isolation Precautions, 2007.
* CLSI Performance Standards for Antimicrobial Susceptibility Testing, 2022.
質問 # 62
A microbiology laboratory plays a pivotal role in both endemic and epidemic epidemiology. Which of the following should be investigated FIRST?
正解：B
解説：
Multi-drug resistant (MDR) Klebsiella pneumoniae in a high-risk area like the ICU requires urgent investigation because:
* It spreads rapidly via contaminated hands or equipment.
* It poses a serious risk to immunocompromised patients.
* An outbreak could lead to severe hospital-acquired infections (HAIs).
Why the Other Options Are Incorrect?
* A. One blood isolate of Streptococcus agalactiae in the nursery - Single cases are not indicative of an outbreak.
* B. Two isolates of Staphylococcus aureus in postoperative surgical sites - Common post-surgical pathogen; requires monitoring but not immediate outbreak investigation.
* D. Two blood isolates of coagulase-negative staphylococci in the oncology unit - Common contaminants in blood cultures and not immediately alarming.
CBIC Infection Control Reference
APIC guidelines prioritize investigating MDR pathogens in high-risk units, such as ICU, to prevent transmission.
質問 # 63
An infection preventionist (IP) believes that there is an increase in transmission of healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) infections in the surgical intensive care unit. Which of the following would allow the IP to assess whether there is an increase in the rate of healthcare-associated MRSA infections?
正解：C
解説：
The CBIC Certified Infection Control Exam Study Guide (6th edition) emphasizes that incidence rate is the most appropriate epidemiologic measure to assess whether there is an increase in transmission of healthcare- associated infections, including methicillin-resistant Staphylococcus aureus (MRSA). Incidence measures the number of new cases occurring in a defined population over a specific period of time, making it the key indicator for evaluating changes in infection risk and ongoing transmission.
When an infection preventionist suspects an increase in healthcare-associated MRSA infections, the primary concern is whether new cases are occurring more frequently than expected. Incidence rate allows comparison over time (e.g., month-to-month or quarter-to-quarter) and can be standardized using appropriate denominators such as patient days or device days. This enables detection of trends, clusters, or outbreaks and supports timely intervention.
Prevalence rate (Option C) reflects the total number of existing cases at a given point in time, including both old and new infections. While useful for understanding disease burden, prevalence cannot distinguish between ongoing transmission and prolonged duration of existing cases. Mortality rate (Option A) and case fatality rate (Option D) measure outcomes of infection severity, not transmission or acquisition.
For the CIC exam, it is critical to recognize that incidence rate is the correct measure for assessing increases in healthcare-associated infection transmission, making it the best choice for this scenario.
質問 # 64
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