x000cnfectx008bon v Cox008eonx008bx009catx008bonResistantOrganismsManagementTermCareFacilitiesWorkshopOfficePublicHealthcareAssociatedInfections Obx008cectx008bvespresentation ID: 961587
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Infection nfect‹on v. CoŽon‹œat‹onResistantOrganismsManagementTermCareFacilitiesWorkshopOfficePublicHealthcareAssociatedInfections ObŒect‹vespresentation,attendeesDefinecolonizationDifferentiatecolonizationfrominfectionsappropriatelaboratorytest presencemicroorganismshost Colonizationpresencemicroorganismhost, growthmultiplicationorganism,interactionbetweenhostorganismclinicalexpression, Subclinicalunapparentinfection:presence microorganisminteractionbetweenhostmicroorganismclinicalresponse,response).Often surfaceinanimate Infection harborsmicroorganismabsenceclinicalservepotentialsourceinfection.maycolonizedinfectedasymptomaticbeforeconvalescentfromacutestatusmaylengthy. carrierSourceExplanationforpersonapparentlyinfected nfect‹onreplicationorganismshostmaycauseInfectiondefinesentrancedevelopment infectiousagentanimalbody,whetherdevelopsintoCausedinfectiousagentmicromacroorganisms capableproducinginfectioninfectiousInfectiouscausedinfectious agenttoxicproductresultsfromtransmissionagentproductfrominfectedperson,animal,reservoirsusceptiblehost Spectru: No Ešposure âEšposure âCoŽon‹œat‹on ânfect‹on âD‹sease Host+InfectiousagentNofoothold:ExposedFoothold,noreactionColonizationFoothold:epithelialattachmentMultiplication:InfectionDirectcytotoxicityToxinsTis
suedisruptionTissueinjuryAsymptomaticSymptomatic What is Exposed ?Means of transmission: Being in the same room as an infectious tuberculous patient or with a person with HIVSpecific information: Eating a meal or eating the contaminated food item?Exposure definition relies on information that may not be all known. OROPHARYNXStreptococcus viridansStreptococcus pyogenesStreptococcus pneumoniaeStaphylococciMoraxella catarrhalisNeisseriaCorynebacteriumHaemophilusCandida albicans SKINStaphylococciCorynebacteriaPropionibacteriaMalasseziafurfur CONJUNCTIVAStaphylococciCorynebacteria Staphylococci, StreptococciEnterococciLactobacillus spp, CorynebacteriumNeisseriaspp, AnaerobesCandida albicans UPPER INTESTINE NASOPHARYNXStaphylococciMoraxella catarrhalisNeisseriaHaemophilus LOWER INTESTINEAerobic G-bacilli: E.coliEnterobacter, Proteus, SerratiaProvidencia, Bacteroides, AnaerobicEnterococci, StreptococciFŽora at CoŽon‹œat‹on S‹tes Infection S‹n and FŽora RESIDENTFLORASurvivesthemorethanhoursremoved,hoursCompletestelirizationimpossibleLowStaphylococci,diphteroides,mostlyGramveryfewGram TRANSIENTFLORASurvivehoursEasilyremovedwaterAcquiredcontactscontaminatedareasnose,perinealarea,genitals,area,catheter,bedpan,patientcare casualcontactMayhavevirulenceEnterobacteriaGramPseudomonas... SŠ‹fts ‹n CoŽon‹�
09c;at‹on FŽora GeneraltowardsGramnegativeflorahospitals,LTCFcarefacilitiesModificationenvironmentchangesstillunderstoodInvasiveproceduresprovidesportalentrydifferentfloraAntibiotictherapy:studypatientstermRx,colonizedresistantEnterobacteriaecontrolsonly CoŽon‹œat‹on Protects tŠe ost Normalfloraprotectsagainstinfectiousdiseasesoriginatingatmucousmembranes.ThereareseveralmechanismsforprotectionNonspecificstimulationofimmuneresponsivenessSpecificcrossreactiveimmunizationCompetitivebacterialinterference freerearedsuccumbrapidlyfromoverwhelmingwhentransferredwithhealthyNumberbacteriacolonizeNormal free CŽ‹n‹caŽ nfect‹onClinicalinfectionClinicalinfectionmayresult symptoms.mayobviousveryminor.symptomsasymptomaticinfectionsubclinicalinfection.Asymptomaticinfectionthatallquiet. maycoververyactiveprocessesasymptomaticHIVinfection,tuberculosisinfection,hepatitiscarrierstate. Infection True nfect‹on NOT CoŽon‹œat‹on Infectionsareaccompaniedsymptoms:fever,malaiselocalizedinfections:swellinginflammation,pain,erythema(tumor,dolor,rubor,calor)definitionsestablishcharacteristicsforinfectionRememberImmunocompromisedpatientsshowinfectionpatients.Neutropenicpatientsneutrophilsshowpyuria,purulentlittleinfiltratelarge
consolidationchest NO nfect‹on at T‹e of Ad‹ss‹on establishnegativityhistory,symptomsdocumentedtestschestraysnormalphysicalexaminationabsencesymptomsnormalchestraynegativeculturecultureExample:culturesarecollecteddayhospitalizationwascollectedbefore,infectionwerepresentbefore Excluded:TransplacentalinfectionsReactivation of old infections (ex Shingles)Infections considered extensions of infections present at admission Suff‹c‹ent T‹e to DeveŽop nfect‹on hospitalincubationnumerousinfectionshavewellset(forexample,staphylococci,E.coliinfections)infectionsrarelydevelopdayscriterion:Infectionpresentafter3rdhospitalday(dayhospitalday MetŠ‹c‹ŽŽ‹nâRes‹stant StaphylococcusaureusÈMRSAÈColonizationApproximatelycolonizedMRSAOrganismlivesforgenerallywarm,areasThroatSouthborderInfectionOccursbacterialstrainundergoesuncontrolledgrowthlocalizedareaspreadthroughbloodstream(bacteremia) Infection ColonizationAsymptomatictheabsencesymptomsinfectioncolonizedpatientsthansymptomaticcasesamonghospitalpatientsAbsencecolonoscopichistopathologicpseudomembranouscolitisDetectionCDIFFPresenceCDIFFtoxinsInfectionPresencesymptomsunformedstoolsStooltestspositivefortoxinsDetectiontoxigenicColonoscopicfindingsdemonstratingulcerativecolitis testscure!!!! Carbapeneâres
b;stant EnterobacteriaceaColonizationOrganismcanfoundcausinganysymptomsStrainscancauseinfectionssterilesitesGenerallycolonizedtractInfectionCauseinfectionstheyenterthroughmedicaldeviceslikecentralcatheters,woundsTreatmenttigecycline,colistin,polymixinB Vanco›c‹nâres‹stant Enterococc‹ ÈVREÈColonizationAcquiredsusceptiblehostsenvironmentratepatientcolonizatione.g.intensivecareinfectionpatientInfectionWeakenedhostshaveincreasedlikelihooddevelopinginfectionfollowingcolonizationdetectinfectionsoutbreaks Ur‹nar› Tract nfect‹onsprevalenceasymptomaticbacteriuria(ASB),colonizationtheurinarytractlocalsymptomsinfection,rangesfromnoncatheterizedresidentsamongthosetermurinarycatheters.Differentiatingfromsymptomaticcaninappropriateantibioticrelatedcomplications.prevalencethechallengesdiagnosingsymptomaticresidentshaveantibioticoverusethispopulation.increasesthelikelihoodadverseeventscomplicationspreviousantibiotictreatment(e.g.,alongemergence,transmission,acquisitionAppropriatediagnosismanagementsymptomaticcriticallyimportantthesetting. Infection Ur‹nar› Tract nfect‹onsRecommendationsnottextasymptomaticpatientsnotsterileBacteriaarepresentlowlevelsthehealthypeoplenotsufferingfromurinarytractinfection SeekandInappropriatesurveillancetractinfectionsAppropriatesurveillancetractinfectionsScreeningallpatientsurine,regardless
presencesymptoms,uponadmitfacility.organismsareidentified,youcompelledtreatpeoplewhoarenotexperiencingdisease.Testtheurinesymptomaticpersons(fever,dysuria,frequency,etc.)thatyoususpecthaveurinarytractinfections. MuŽt‹drugâres‹stant StreptococcusÈMDRSPÈColonizationAsymptomaticnasopharyngealcolonizationInfectioninvasivesepsis,ResistantbroadmacrolidesfluroquinolonesPreventionthroughPneumococcalvaccinesagainstbacteriaStreptococcuspneumoniae Test‹ng MetŠods Suar› OrganismTestingIndicationAppropriateSpecimenMRSAWoundinfectionpussdrainageCulturemoleculartestdrainageClostridiumDiarrhealepisodesofmorestoolsconsecutiveperiodLoose/waterystoolsthatformshapecontainerCREDependsonsiteinfection,generallyaches,pain,feverVariesdependingsiteinfectionVREBackpain,troubleurinating,fever,chills,bodyred/warmwoundswellingdrainageCultureperirectal/analswabsstoolMDRSPFever,chills,sweats,pains,malaisesputumGramstainsantigentestslikelycoordinatedacutecarehospital Transferr‹ng pat‹ents to otŠer fac‹Ž‹t‹esImplementsystemsdesignatepatientsknowncolonizedinfectedtargetedNotifyreceivinghealthcarefacilitiespersonneltransferpatientsbetweenfacilities Infection eneraŽ recoendat‹ons for aŽŽ ŠeaŽtŠcare sett‹ngs MakepreventioncontrolorganizationalpatientsafetyImp
lementsystemscommunicateinformationaboutreportablestateparticipationfacilitycoalitionscombatemerginggrowingproblemsProvideeducationtrainingriskspreventiontransmissionorientationeducationalupdatesforhealthcarepersonnelantimicrobialsusceptibilityreports Pat‹ent PŽaceent ‹n TCFspatientroomsareavailable,forroomspatientsknownsuspectedcolonizationinfectionhighestpatientshaveconditionsmayfacilitatetransmission,e.g.uncontainedsecretionsexcretionspatientroomsareavailable,cohortpatientsroompatientcareareacohortingpatientspatientsroomspatientsarelowforassociatedoutcomesfrominfectionarelikelyhavelengths Infectionmeansgermsaremake youresultssymptomsfever,fromwound,whitecount,Colonizationmeansgermsaremake youPeoplearecolonizedhavesymptoms.surveillancescreeningpracticesareessentialantibioticstewardshipcauseconcern,theymaymanagedappropriatelyacrossprovider ReferencesBogaertD,GrootHermansPW.Streptococcuspneumoniaecolonisation:thekeypneumococcalLancetInfectCentersforControlPrevention.resistantEnterobacteriaceae(CRE)infection:FAQs.Availablehttps://www.cdc.gov/hai/organisms/cre/cre clinicianfaq.html CentersforControlPrevention.Preventiontransmissionresistantorganisms.Availablehttps://www.cdc.gov/hicpac/mdro/mdro_5.html AsymptomaticClostridiumdifficilecolonization:clinicalimplications.InfectZirakzadehAPatelVancomycinresistantenterococci:colonization,infection,detection,treatment.MayoCli