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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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infection control in health care agencies
Infection Control in Health-Care Agencies
  • Community-acquired Infection
  • Nosocomial Infection
  • Hand Hygiene
nosocomial infections
Nosocomial Infections
  • Infection from Stay in Health-care Agency
  • Risk Factors
    • Host’s Condition
    • Multiple Antibiotic Therapy
    • High-risk Units
nosocomial infections cont d
Nosocomial Infections (cont’d)
  • Common Pathogens
    • Escherichia coli (E. coli)
    • Staphylococcus aureus
    • Pseudomonas aeruginosa
hand hygiene
Hand Hygiene
  • Before and After
    • Patient Contact
    • Glove Use
slide7
MRSA
  • Methicillin Resistant staphylococcus areus
  • - a bacteria
  • Common sites :
    • Nares
    • Skin

Colonized

treatment
Treatment
  • I & D
  • Contact ISO Precautions
  • Clindamycin
  • Tetracyclines
  • Rifampin
  • Linezolid
  • Mupirocin ointment for topical tx
prevention
Prevention
  • Hand Hygiene
  • Decolonization
decolinization
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
slide11
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
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
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.
treatment1
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
Clostridium difficileInfection
  • A spore-forming, Gram-positive anaerobic bacillus
  • The bacteria are found in the feces.
  • Associated with ABX use.
s s of clostridium difficile infection
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
the risk for disease increases in patients with
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
treatment2
Treatment
  • The infection can usually be treated with an appropriate course of antibiotics,
  • including metronidazole, vancomycin, or recently approved fidaxomicin.
  • Fecal Transplant
slide19

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
Community Acquired Infections
  • An infection acquired outside health care settings, such as in the home.
fifth disease
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
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
slide23
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
slide24
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
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
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
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 disease
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
lyme disease cont
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
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
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 cont1
West Nile Virus cont…
  • Treatment: supportive
  • Complications: encephalitis, meningitis, polymyelitis
  • high risk groups - >50 age, comorbidities, outdoors workers,
legionnaires disease
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