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Infectious Diseases: Resistant Organisms Presented by: APS Healthcare Southwestern PA Health Care Quality Unit (HCQU). September 2010 cjp. Disclaimer.
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Infectious Diseases: Resistant OrganismsPresented by: APS HealthcareSouthwestern PA Health Care Quality Unit(HCQU) September 2010 cjp
Disclaimer Information or education provided by the HCQU is not intended to replace medical advice from the consumer’s personal care physician, existing facility policy or federal, state and local regulations/codes within the agency jurisdiction. The information provided is not all inclusive of the topic presented. Certificates for training hours will only be awarded to those who attend a training in its entirety. Attendees are responsible for submitting paperwork to their respective agencies.
Note of Clarification While mental retardation (MR) is still recognized as a clinical diagnosis, in an effort to support the work of self-advocates, the APS SW PA HCQU will be using the terms intellectual and/or developmental disability (ID/DD) to replace mental retardation (MR) when feasible.
Objectives Upon completion of the session the participant will: Define antibiotic resistance Identify three common antibiotic resistant organisms Describe preventative measures to reduce spread of antibiotic resistant organisms
Antibiotic Resistance Definition Organism (bacteria) able to resist antibiotic effects Bacteria survive Bacteria multiply and cause harm
How Bacteria are Becoming Resistant Agricultural use of antibiotics Taking antibiotics for viral infections Improper use of antibiotics Not taking antibiotics as prescribed Taking antibiotics prescribed for someone else Taking antibiotics left over from previous illness
Common Resistant Pathogens MRSA C Diff VRE ESBL E. Coli MDR TB Acinetobacter baumannii
MRSA Methicillin Resistant Staphylococcus Aureus Type of Staph infection Resistant to certain antibiotics Methicillin Oxicillin Penicillin Amoxicillin Tetracycline
MRSA: Signs and Symptoms Skin lesion – Red, swollen, painful (boil) Shortness of breath Fever Chills
MRSA: Types and Transmission Healthcare Associated Infected while in the hospital setting Contaminated hands Community Associated Infected outside of the hospital setting Contaminated hands Close skin to skin contact
MRSA: Treatment Drain abscess / boil Antibiotics after culture and sensitivity
MRSA: Prevention Hand washing Standard precautions Protective equipment Private room Proper hygiene Clean environment Do not share personal items
Clostridium difficile (C Diff) Bacteria normally found in the intestine Can multiply when taking antibiotics Opportunistic infection Causes diarrhea Resistant to Cipro, Levaquin and Clindamycin
C Diff: Signs and Symptoms Mild to Moderate C Diff Diarrhea Mild cramping 3 or more episodes of watery diarrhea for 2 or more days Severe C Diff Diarrhea Severe cramping Weakness Dehydration Fever Nausea / vomiting Blood or pus in stool 10-15 episodes of watery diarrhea a day
C Diff: Transmission Spore-forming bacteria Fecal-oral route
C Diff: Treatment Tests Stool test Tissue culture Colon exam CT Scan Antibiotics Flagyl Vancomycin Probiotics Benefits still being researched Florastor Drink fluids Keep hydrated
C Diff: Prevention Proper hand washing Standard precautions Thorough cleaning Prudent use of antibiotics
Vancomycin Resistant Enterococcus (VRE) Enterococci are bacteria present in Female genital tract Human intestines Vancomycin Strong antibiotic used to treat infections caused by enterococci Vancomycin Resistant Enterococcus (VRE) Eneroccoci become resistant to vancomycin
VRE Infections: Signs and Symptoms Urinary Tract Infections Burning sensation upon urination, urgency, fever Bloodstream infections Fever, chills, nausea, vomiting, fatigue Wounds Redness, swelling, drainage
VRE: Transmission Direct contact Individual carrier
VRE: Treatment Antibiotics other than Vancomycin Removal of urinary catheters
VRE: Prevention Wear gloves Wash hands Keep environment clean
Extended Spectrum Beta-lactamase producing E. coli(ESBL E. coli) Antibiotic resistant Foodborne illness Bacteria that lives in intestines of animals and humans
ESBL E. coli: Signs and Symptoms Diarrhea Abdominal cramps Nausea / vomiting
ESBL E. coli: Transmission Ingesting contaminated food Contaminated hands
ESBL E. coli: Treatment Stool or urine sample to determine effective antibiotics
ESBL E. Coli: Prevention Hand washing / hygiene Infection control Prudent use of antibiotics Proper food handling / consumption
Multi-Drug Resistant Tuberculosis (MDR TB) Infectious disease that usually attacks the lungs Can be found in any area of the body
MDR TB: Signs and Symptoms General symptoms of TB Feelings of sickness / weakness Weight loss Fever Night sweats TB symptoms of the lungs Coughing Chest pain Coughing up blood
MDR TB: Transmission Airborne
MDR TB: Diagnosing Purified Protein Derivative (PPD) Skin Test Determines exposure, not disease Chest x-ray Indicated if PPD is positive Sputum tests Indicated if PPD is positive and signs and symptoms present
MDR TB: Treatment Antibiotic choices vary according to type of TB infection
MDR TB: Prevention Standard infection control Follow isolation policy for active cases of TB Be aware of signs and symptoms Appropriate testing
Acinetobacter baumannii Bacteria commonly found in soil and water and on skin of healthy people Acinetobacter infections are most often found in healthcare settings Causes a variety of diseases Pneumonia Blood and wound infections
Acinetobacter baumannii: Signs and Symptoms Pneumonia: Fever Chills Cough Blood and wound infections: Fever Chills
Acinetobacter baumannii: Transmission Person-to-person contact Contaminated surfaces Environment
Acinetobacter baumannii: Treatment Culture Antibiotics
Acinetobacter infections: Prevention Hand Hygiene Clean environment
How to Help Consult a physician Take medication as directed Use standard precautions
References Questions & Answers: Sickness caused by E. coli (2006, December), Centers for Disease Control and Prevention. Retrieved March 15, 2010, from www.cdc.gov/ecoli/qa_ecoli_sickness.htm Drug-resistant Acinetobacter Infections in Healthcare Settings (2004, September), Centers for Disease Control and Prevention. Retrieved March 17, 2010, from www.cdc.gov/ncidod/dhqp/ar_acinetobacter.html Fact Sheet. Extensively Drug-Resistant Tuberculorsis (XDR TB) (2009, June), Centers for Disease Control and Prevention. Retrieved March 16, 2010, from www.cdc.gov/tb/publications/factsheets/drtb/xdrtb.htm Get Smart: Fast Facts About Antibiotic Resistance CDC. (2009, June), Centers for Disease Control and Prevention. Retrieved February 15, 2010, from www.cdc.gov/getsmart/antibiotic-use/fast-facts.html
References VRE: Information for the Public About VRE (2008, April), Centers for Disease Control and Prevention. Retrieved March 15, 2010, from www.cdc.gov/ncidod/dhqp/ar_VRE_publicFAQ.html Get Smart: Antibiotic Resistance Questions and Answers (2009, June), Centers for Disease Control and Prevention. Retrieved March 13, 2010, from http://www.cdc.gov/getsmart/antibiotic-use/anitbiotic-resistance-faqs.html C. difficile, (2009, November), MayoClinic.com. Retrieved March 15, 2010, from www.mayoclinic.com/health/c-difficile/DS00736/METHOD=print
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