msali: infections. infection control in health-care agencies community-acquired infection nosocomial...
TRANSCRIPT
MSALI: IN
FECTI
ONS
INFECTION CONTROL IN HEALTH-CARE AGENCIES
Community-acquired Infection
Nosocomial Infection Hand Hygiene
NOSOCOMIAL INFECTIONS
Infection from Stay in Health-care Agency
Risk FactorsHost’s ConditionMultiple Antibiotic Therapy High-risk Units
NOSOCOMIAL INFECTIONS (CONT’D)
Common PathogensEscherichia coli (E. coli) Staphylococcus aureus Pseudomonas aeruginosa
HAND HYGIENE
Before and After
Patient ContactGlove Use
Antibiotic Resistant Infections
MRSA
Methicillin Resistant staphylococcus areus
- a bacteria
Common sites :NaresSkin
Colonized
TREATMENT
I & D
Contact ISO Precautions
Clindamycin
Tetracyclines
Rifampin
Linezolid
Mupirocin ointment for topical tx
PREVENTION
Hand Hygiene
Decolonization
DECOLINIZATION
Use of daily chlorhexidine baths in ICU
populations may decrease overall rates of
bloodstream infections and MRSA
acquisition, but effect on MRSA infections
less clear
VRE
Vancomycin-resistant Enterococci
- a bacteria
normally present in the human intestines and in the female genital tract and are often found in the environment.
WHAT TYPES OF INFECTIONS DOES VRE CAUSE?
It can cause infections of the urinary tract, the bloodstream, or of wounds associated with catheters or surgical procedures.
WHO IS AT RISK?
People who have been previously treated with the antibiotic vancomycin or other antibiotics for long periods of time.
People who are hospitalized, particularly when they receive antibiotic treatment for long periods of time.
People with weakened immune systems.
People who have undergone surgical procedures.
People with medical devices that stay in for some time such as urinary catheters or central intravenous (IV) catheters.
People who are colonized with VRE.
TREATMENT
People who are colonized do not usually need treatment.
Most VRE infections can be treated successfully with antibiotics other than vancomycin.
Laboratory testing of the VRE sample can determine which antibiotics will successfully treat the infection.
CLOSTRIDIUM DIFFICILE INFECTION
A spore-forming, Gram-positive anaerobic bacillus
The bacteria are found in the feces.
Associated with ABX use.
S/S OF CLOSTRIDIUM DIFFICILE INFECTION?
watery diarrhea (at least three bowel movements per day for two or more days)
fever
loss of appetite
nausea
abdominal pain/tenderness
THE RISK FOR DISEASE INCREASES IN PATIENTS WITH:
antibiotic exposure
proton pump inhibitors
gastrointestinal surgery/manipulation
long length of stay in healthcare settings
a serious underlying illness
immunocompromising conditions
advanced age
TREATMENT
The infection can usually be treated with an appropriate course of antibiotics,
including metronidazole, vancomycin , or recently approved fidaxomicin.
Fecal Transplant
Contact Isolation - Healthcare workers and visitors must use gloves and gowns on entry to a room of a patient with CDI.
Emphasize compliance with the practice of hand hygiene.
COMMUNITY ACQUIRED INFECTIONS
An infection acquired outside health care settings, such as in the home.
FIFTH DISEASE
Erythema Infectiosum
Caused by Parovirus B19.
Usually affects children
Incubation Period: 4-14 days
Communicable period: before rash appears
Transmission: contact and droplet
FIFTH DISEASE CONT…
Signs/Symptoms: cheeks appear “slapped”,
Lace or network pattern rash on limbs, then trunk. Malaise, cough, slight fever, headache.
Sunlight aggravates rash.
Rash lasts ~10 days
Treatment: none, treat symptoms
Complications: pregnant women -> hydrops fetalis
SARSSevere Acute Respiratory Syndrome
Caused by coronavirus (SARS-CoV)
Incubation Period- 2-7 days, very virulent
Transmission: Contact and Droplets
S/S: fever, chills, malaise, headache, cough, diarrhea (20%),
Associated with travelers to China, Hong Kong or Taiwan
Complications: respiratory failure
MERS
Middle East Respiratory Syndrome
First reported in Saudi Arabia in 2012.
On May 2, 2014, the first U.S. imported case of MERS was confirmed in a traveler from Saudi Arabia to the U.S. On May 11, 2014, a second U.S. imported case of MERS was confirmed in a traveler who also came from Saudi Arabia.
MERS CONT…
It is caused by a coronavirus called MERS-CoV.
Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness. They had fever, cough, and shortness of breath.
About 30% of people confirmed to have MERS-CoV infection have died.
AVIAN FLU
Contagious disease of birds and pigs
Causative agent: H5N1 influenza A virus
Affects susceptible human populations
Transmission: Direct contact with infected poultry or feces.
S/S: Fever, URI, sore throat
AVIAN FLU CONT…
Treatment: Tamiflu, Relenza
MUST be administered within 48 hrs of s/s.
Antibiotics for secondary pneumonia
Complications: respiratory failure
MAJOR concern is that it will mutate and cause pandemic human – human cases
LYME DISEASECaused by spirochete bacteria – Borrelia
burgdorferi
Can affect anyone.
Peak season May-August
Transmission: by tick bite
S/S: 3 stages
Early – erythema migrans – bull’s eye rash
Progresses to diffuse rash, fever, joint pain, headaches, cardiac arrythmias, muscle aches.
Late stage – arthritis, neuro deficits
LYME DISEASE CONT…
Diagnosis: Elisa Blood Test, Western Blot
Treatment: Doxycycline, Rocephin
Complications: Arthritis, Bell’s Palsy, Cardiac Arrhythmias
PREVENTION is KEY
WEST NILE VIRUS
Viral infection spread by a vector
Peaks in summer-fall
Incubation period – 3-14 days
Transmission: mosquitos that feed on infected birds
Not contagious among humans
WEST NILE VIRUS CONT…
S/S:
80% no s/s
20% fever, HA, body aches, N/V, swollen lymph nodes, skin rash
1/150 serious illness – high fevers, neck stiffness, stupor, altered mental status, convulsions, vision loss, paralysis
WEST NILE VIRUS CONT…
Treatment: supportive
Complications: encephalitis, meningitis, polymyelitis
high risk groups - >50 age, comorbidities, outdoors workers,
LEGIONNAIRES DISEASE
Causative agent: bacteria Legionella pneumophilia
Found in H2O distribution systems
Causes respiratory infection
Incubation period: 2-14 days
Transmission: Droplet
S/S; fever, HA, cough, malaise, GI symptoms
Treatment: Antibiotics