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MSALI: INFECTIONS

MSALI: INFECTIONS. Infection Control in Health-Care Agencies. Community-acquired Infection Nosocomial Infection Hand Hygiene . Nosocomial Infections . Infection from Stay in Health-care Agency Risk Factors Host’s Condition Multiple Antibiotic Therapy High-risk Units.

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MSALI: INFECTIONS

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  1. MSALI: INFECTIONS

  2. Infection Control in Health-Care Agencies • Community-acquired Infection • Nosocomial Infection • Hand Hygiene

  3. Nosocomial Infections • Infection from Stay in Health-care Agency • Risk Factors • Host’s Condition • Multiple Antibiotic Therapy • High-risk Units

  4. Nosocomial Infections (cont’d) • Common Pathogens • Escherichia coli (E. coli) • Staphylococcus aureus • Pseudomonas aeruginosa

  5. Hand Hygiene • Before and After • Patient Contact • Glove Use

  6. Antibiotic Resistant Infections

  7. MRSA • Methicillin Resistant staphylococcus areus • - a bacteria • Common sites : • Nares • Skin Colonized

  8. Treatment • I & D • Contact ISO Precautions • Clindamycin • Tetracyclines • Rifampin • Linezolid • Mupirocin ointment for topical tx

  9. Prevention • Hand Hygiene • Decolonization

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. Clostridium difficileInfection • A spore-forming, Gram-positive anaerobic bacillus • The bacteria are found in the feces. • Associated with ABX use.

  16. S/S of Clostridium difficileinfection? • watery diarrhea (at least three bowel movements per day for two or more days) • fever • loss of appetite • nausea • abdominal pain/tenderness

  17. 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

  18. Treatment • The infection can usually be treated with an appropriate course of antibiotics, • including metronidazole, vancomycin, or recently approved fidaxomicin. • Fecal Transplant

  19. 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.

  20. Community Acquired Infections • An infection acquired outside health care settings, such as in the home.

  21. 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

  22. 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 -> hydropsfetalis

  23. SARS • Severe 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

  24. 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.

  25. 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.

  26. 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

  27. 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

  28. Lyme Disease • Caused by spirochete bacteria – Borreliaburgdorferi • 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

  29. Lyme Disease cont… • Diagnosis: Elisa Blood Test, Western Blot • Treatment: Doxycycline, Rocephin • Complications: Arthritis, Bell’s Palsy, Cardiac Arrhythmias • PREVENTION is KEY

  30. 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

  31. 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

  32. West Nile Virus cont… • Treatment: supportive • Complications: encephalitis, meningitis, polymyelitis • high risk groups - >50 age, comorbidities, outdoors workers,

  33. 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

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