Carbapenem-Resistant Enterobacteriaceae Information
WHAT IS CRE?
CRE stands for carbapenem-resistant Enterobacteriaceae. CRE infections are caused by a type of Enterobacteriaceae bacteria that is no longer affected by carbapenem antibiotic medicines (drug-resistant bacteria). Carbapenems are a group of antibiotics that are frequently used to treat serious infections.
Small amounts of Enterobacteriaceae bacteria normally live in the intestines of some people, and it usually does not cause problems. However, if the bacteria enter the body through a cut, wound, or break in the skin, an infection can happen. CRE infections can be very serious or even life threatening. They can occur in various areas of the body, such as the urinary system, bloodstream,
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You may have gotten CRE if you:
• Had recent or frequent contact with healthcare facilities within the previous year.
• Had a long-term hospital stay, especially in an intensive care unit or burn unit.
• Have been on antibiotics.
• Had a surgery or procedure.
• Usually carry CRE in your intestines without developing illness.
• Are on kidney dialysis.
• Use a breathing machine (ventilator).
• Have a short-term or long-term vascular access device, such as a catheter or IV tube.
• Have a weakened immune system.
HOW ARE CRE INFECTIONS PREVENTED?
Your health care team will take steps to help prevent the spread of CRE bacteria, including:
• Wearing gloves when working with patients. Different pairs of gloves will be used for each patient.
• Washing hands after touching blood, body fluids, or other contaminated items, even when gloves are worn.
• Using mouth, nose, and eye protection during procedures or tasks that may cause splashes or sprays of blood or body fluids.
• Wearing a gown during procedures or regular patient care if contact with blood or body fluids is possible.
• Disposing of single-use patient equipment, such as needles or
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CRE infections are treated with antibiotics that are given through a vein or by mouth. Although CRE bacteria are resistant to many types of antibiotics, certain types of antibiotics can generally be used to treat your infection. In the case of serious skin infections, your health care provider may perform surgery to drain the infected area.
Treatment varies depending on how serious, how deep, and how extensive the infection is. Your health care team will decide which treatments are best for you. Talk with your health care provider if you have any questions.
HOW SHOULD I CARE FOR MYSELF AT HOME?
Medicines
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Take over-the-counter and prescription medicines only as told by your health care provider.
Wound Care
• Check your wound every day for signs of infection. Check for:
○ More warmth, redness, or tenderness around your wound site.
○ A red line that spreads from your infection site.
○ A dark color in the area around your infection.
○ Wound drainage that is tan, yellow, or green.
○ A bad smell coming from your
Education of the patient will begin. Depending on the size of the abscess and how extensive the procedure was the patient may need a relative or friend to drive them back home. Not only would the patient need a ride back home, they may need to be watched for 24 hours. As part of pain management pain medication may be given to the patient to decrease pain. Antibiotics may be given to fight or prevent infection caused by the bacteria. The patient will also need to list all medications that they are taking so there will not be any contraindications with the medications that the patient is given. Advise the patient that more than one follow-up appointment will be necessary in order to properly treat the wound. Before the end of the appointment, the medical assistant should give the patient written instructions along with an emergency number and the number to the practice incase the patient has any questions or concerns. Advise the patient to return to the practice if they experience any fever, chills, or the abscess returns. If red streaks appear around the wound tell the patient to call the emergency department immediately. After the the procedure and patient education has been completed, make sure all the step of the procedure has been documented in the patient’s record and all follow-up procedures have been
Enterococcus faecalis is a genus of gram positive cocci and form short chains or are arranged in pairs. They are nonmotile, facultative anaerobic organisms and can survive in harsh conditions in nature. There are over 15 species of the Enterococcus genus but about 90% of clinical isolates are E. faecalis. E. faecalis is a nosocomial pathogen because it is commonly found in the hospital environment and can cause life-threatening infections in humans. It is a bacterium that normally inhabits the intestinal tract in humans and animals but when found in other body locations it can cause serious infections. The most common sites for E. faecalis infections are the heart, bloodstream, urinary tract, and skin wounds. Due to vancomycin-resistant Enterococci, many antibiotics have been shown ineffective in the treatment. In this paper, I will describe the ecology and pathology of E. faecalis; the antibacterial resistance; treatment; and, what you can do to prevent Enterococcus infection.
A common hospital acquired condition that nurses see now days is clostridium difficile. This bacterium usually invades patients who have been on long-term antibiotics that have killed off bacteria that protect them from infection. C. diff is passed from host to host by both direct and indirect contact making it readily moved from patient to patient in hospital settings (Mayo, 2013, 1). Nurses can use the QSEN competencies and KSAs to help treat and prevent hospital acquired conditions such as C.diff.
Kasie said while she is working she has to reconstitute medication, compounding IV/fluid drips, pull single dose P.O. medications and oral syringes for patients to be delivered to med rooms, check for expired drugs, and package unit dose medication. She said she enjoys working in the environment very much. The dress code is to wear vestex scrubs, which are antimicrobial and bodily fluid/fluid resistant.
A study in Hong Kong also evaluates the use of double-gloving during surgery (Guo, 2012). This study fouses more on nurses instead of surgeons. They also focus more on glove perforation as opposed to sensitivity and dexterity. Guo states that “the purpose of our study was to assess the effectiveness of double-gloving in protecting perioperative nurses from having contact with patients’ blood and body fluids during surgery by comparing the frequency of glove perforation between single-gloving and double-gloving groups” (Guo, 2012).
Treatment: Chemotherapy is on treatment method. Most infected people benefit from the treatments. To of the best drugs for treatment are Praziquantel and Oxamniquine. The side effects are mild and transient, some of then are as followed:
The medical assisting extern needed to wash her hands before preparing the room for a patient to prevent cross contamination.
Be sure to take medication exactly as directed and do not stop therapy without speaking to health care provider. The nurse should evaluate the effectiveness of any antibiotic treatment to be sure the infection is going away and not getting worse. Improving of the signs and symptoms of infection should be seen by 5 days.
"Preventing Exposures to Bloodborne Pathogens among Paramedics." Workplace Solutions (2010): n. pag. National Institute for Occupational Safety and Health. Web. 9 Feb. 2014.
For the health care force: prescribe the right antibiotic to treat the illness. Only prescribe and dispense antibiotics when they are truly needed. Do what is in your power to enhance infection prevention and control.
Cystitis cause by bacterial infection is generally treated with antibiotics. Treatment for noninfectious cystitis depends on the underlying cause.
Safety is focused on reducing the chance of harm to staff and patients. The 2016 National Patient Safety Goals for Hospitals includes criteria such as using two forms of identification when caring for a patient to ensure the right patient is being treated, proper hand washing techniques to prevent nosocomial infections and reporting critical information promptly (Joint Commission, 2015). It is important that nurses follow standards and protocols intending to patients to decrease adverse
(2014) shed light on two key components for infection control, which includes protecting patients from acquiring infections and protecting health care workers from becoming infected (Curchoe et al., 2014). The techniques that are used to protect patients also provide protection for nurses and other health care workers alike. In order to prevent the spread of infections, it is important for health care workers to be meticulous and attentive when providing care to already vulnerable patients (Curchoe et al., 2014). If a health care worker is aware they may contaminate the surroundings of a patient, they must properly clean, disinfect, and sterilize any contaminated objects in order to reduce or eliminate microorganisms (Curchoe et al., 2014). It is also ideal to change gloves after contact with contaminated secretions and before leaving a patient’s room (Curchoe, 2014). Research suggests that due to standard precaution, gloves must be worn as a single-use item for each invasive procedure, contact with sterile sites, and non-intact skin or mucous membranes (Curchoe et al., 2014). Hence, it is critical that health care workers change gloves during any activity that has been assessed as carrying a risk of exposure to body substances, secretions, excretions, and blood (Curchoe et al.,
The most effective way to combat pathogenic bacteria which invade the body is the use of antibiotics. Overexposure to antibiotics can easily lead to resistant strains of bacteria. Resistance is dangerous because bacteria can easily spread from person to person. Simple methods for preventing excessive bacterial spread are often overlooked. Not all preventative measures are even adequate. Doctors and patients often use antibiotics unnecessarily or incorrectly, leading to greater resistance. Antibiotics are used heavily in livestock and this excessive antibiotic use can create resistant bacteria and transfer them to humans. In order to reduce resistant bacteria,
Hospital acquired infections are spread by numerous routes including contact, intravenous routes, air, water, oral routes, and through surgery. The most common types of infections in hospitals include urinary tract infections (32%), surgical site infections (22%), pneumonia (15%), and bloodstream infections (14%). ( book). The most common microorganisms associated with the types of infections are Esherichila coli, Enterococcus species, Staphylococcus auerus, Coagulase-negative staphylococci, or Pseudomonas aeruginosa.(secondary) Urinary tract infections occur when one or more of microorganisms enter the urinary system and affect the bladder and/or the kidneys. These infections are often associated improper catheterization technique. Surgical site infections occur after surgery in the part of the body where the surgery took place. These infections may involve the top of the skin, the tissue under the skin, organs, or blood vessels. Surgical site infections sometimes take days or months after surgery to develop. The infections can be cause by improper hand washing, dressing change technique, or improper surgery procedure. Pneumonia can also become a hospital acquired infection. Ventilator-associated pneumonia is a type of lung in...