In a medical college ICU, 35% of ventilated patients develop pneumonia despite adherence to hand hygiene protocols. Which additional intervention offers the strongest evidence-based reduction in ventilator-associated pneumonia?

A hospital reports a sudden rise in Clostridioides difficile colitis cases among postoperative patients. Which antibiotic policy change will most likely curb this outbreak?

In a 1200-bed tertiary care hospital, the infection control committee decides to implement bundled care for central line-associated bloodstream infection (CLABSI) prevention. Which of the following is NOT a core component of the bundle?

In the paediatric ward, two infants develop late-onset sepsis with Serratia marcescens. Cultures from which hospital source are most likely to be positive?

A 55-year-old diabetic man admitted for cellulitis develops sudden-onset breathlessness on day 5. ABG shows hypoxia, CXR is normal. Which hospital-acquired condition should be suspected first?

During an NABH audit, the infection control nurse is asked to demonstrate compliance with biomedical waste segregation in the pathology lab. Histopathology tissue waste is correctly disposed in:

A postnatal ward nurse is found to be a chronic nasal carrier of MRSA. What is the recommended first-line decolonisation regimen?

A patient in the oncology ward develops febrile neutropenia. Blood cultures grow Pseudomonas aeruginosa. The hospital antibiogram shows 80% sensitivity to piperacillin-tazobactam. The most appropriate empirical therapy is:

In a burns unit, a spike in Acinetobacter baumannii sepsis cases is noted. Which is the single most effective environmental measure to control the outbreak?

In a tertiary care hospital, ESBL-producing E. coli prevalence in surgical wards is 65%. Which antibiotic is preferred for empirical treatment of complicated UTI in this setting?

A patient admitted in the psychiatry ward attempts suicide by ingesting hospital cleaning fluid. Which policy document should the hospital's root cause analysis committee review first?

During peak dengue season, the medicine ward reports a cluster of nosocomial dengue cases. Which of the following hospital-level measures is MOST effective in preventing further spread?

A 30-year-old male patient is admitted in nephrology ward for peritoneal dialysis. Cloudy effluent with >100 WBC/mm³ is noted. The infection control committee suspects contamination during exchanges. The best corrective action is:

An ICU patient develops bloodstream infection due to Candida auris. Which infection control action is unique to this pathogen compared to Candida albicans?

In a tertiary care NICU, an increase in necrotizing enterocolitis (NEC) cases is noted. Which change in feeding policy is most strongly supported by evidence to reduce NEC rates?

A surgical ward experiences an outbreak of carbapenem-resistant Klebsiella pneumoniae. Which hospital measure has shown the most consistent outbreak control effect?

During hospital water quality testing, Legionella pneumophila is detected in the cooling tower water. The most effective immediate intervention is:

A 65-year-old post-cardiac surgery patient develops confusion, hyponatremia, and low serum osmolality. Which hospital-associated complication is most likely?

A tertiary care hospital's annual antibiotic audit shows 42% of post-op prescriptions exceed 5 days without indication. The most effective stewardship measure is:

In a dialysis unit, 20% of patients on haemodialysis develop Hepatitis C within a year. Which is the strongest independent risk factor in this setting?

A cluster of postsurgical Burkholderia cepacia infections is traced to contaminated antiseptic solution. Which property of this organism explains its survival?

In a hospital TB ward, an HIV-positive patient with pulmonary TB continues to produce positive sputum smears after 4 months of treatment. Which is the most likely cause?

In a tertiary care OT, the colony count in the sterile zone is 15 CFU/m³ with laminar airflow. This is:

During an NABH reaccreditation, surveyors ask to see 'process indicators' in the infection control program. Which is an example?

A patient in neurology ward develops aspiration pneumonia post-stroke. Which is the most cost-effective preventive strategy?

A surgical ICU adopts chlorhexidine oral rinse to prevent VAP. Six months later, no change in VAP rates is observed. The most likely reason is:

A 30-year-old obstetric patient develops septic shock postpartum. Blood cultures reveal Group A Streptococcus. The first infection control step is:

In a trauma ICU, a patient with multiple fractures develops DVT despite prophylactic LMWH. Which additional measure provides proven benefit?

A 40-year-old renal transplant patient in the transplant ward develops fever and diffuse pulmonary infiltrates 2 months post-op. Bronchoalveolar lavage grows Pneumocystis jirovecii. Which preventive measure was likely missed?