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 difficile Infection
A spore-forming, Gram-positive anaerobic bacillus The bacteria are found in the feces. Associated with ABX use.

16. 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

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 -> hydrops fetalis

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 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 – 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

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

31. 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

32. 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

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

34. 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