1.0 Introduction: Gram-positive bacterial pathogens remain a very common cause of healthcare associated infections (HCAIs) and represent a major target for antimicrobial chemotherapy. The most important Gram-positives of clinical interest are staphylococci, enterococci, streptococci, and Clostridium difficile, although other species (e.g., Listeria and Corynebacterium) may also play a role in some settings. The range of infections caused by Gram-positives is very broad, including skin and skin structure infections (SSSIs), upper and lower respiratory tract infections, bloodstream infections (BSIs) and endocarditis, surgical site infections (SSIs), bone and joint infections, diabetic foot infections, central nervous system infections, urinary …show more content…
Methicillin-resistant Staphylococcus aureus (MRSA) is a well-known paradigm of difficult-to-treat Gram-positive multi-resistant pathogens capable of global-scale diffusion, which have attained high proportions in several epidemiological settings. Resistance problems remain overall lower with streptococci and other Gram-positives, although relatively high proportions of penicillin- and/or macrolide-resistant Staphylococci are reported in many countries (EARS-Net 2010; Linares et al. 2010; Darabi et al. 2010).
The scope of this chapter is to provide an overview of related studies on Staphylococcus aureus, a methicillin resistant Gram-positive pathogen emerging as a cause of healthcare associated infections (HCAIs) and to briefly discuss other aspects of it.
1.1.0 Brief History: Methicillin- resistant Staphylococcus aureus, or MRSA, a type of bacteria has for the past 40 years progressed from the state of being controlled into a challenging public health
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aureus (PRSA). It was first described in the 1960s, and has been traditionally regarded as a nosocomial pathogen, endemic in hospitals and health-care facilities of most countries. Hospital-associated MRSA (HA-MRSA) characteristically colonizes or infects hospitalized individuals with predisposing risk factors such as surgery, presence of indwelling medical devices (IMDs), an immuno-compromised state or prior antibiotic exposure. It is often isolated from wound infections, line associated bacteremia and ventilator associated pneumonia. The strains are usually multidrug-resistant
Hospital-acquired infections (HAI) are preventable and pose a threat to hospitals and patients; increasing the cost, nominally and physically, for both. Pneumonia makes up approximately 15% of all HAI and is the leading cause of nosocomial deaths. Pneumonia is most frequently caused by bacterial microorganisms reaching the lungs by way of aspiration, inhalation or the hematogenous spread of a primary infection. There are two categories of Hospital-Acquired Pneumonia (HAP); Health-Care Associated Pneumonia (HCAP) and Ventilator-associated pneumonia (VAP).
Anguzu JR, Olila D (2007) Drug sensitivity patterns of bacterial isolates from septic post-operative wounds in a regional referral hospital in Uganda. Afr Health Sci.7:148-54.
However, increasing antibiotic resistance patterns among intensive care unit pathogens, cultivated by empiric-broad spectrum antibiotic regimens, characterizes the variable concerns. Recent literature point that antibiotic use before the development of VAP is associated with increased risk for potentially resistant gran-negative infections and Methcillin-resistant Staphylococcus auereus (MRSA)
Pseudomonas aeruginosa (P. aeruginosa) is a gram-negative, rod-shaped aerobic bacterium. It is a primary cause of hospital-acquired infections. P. aeruginosa is primarily a nosocomial pathogen. It also acts as an opportunistic pathogen, which can only infect a host that is immunocompromised, due to an underlying disease or medication. Although, P. aeruginosa can cause damage to virtually any tissue in the body, it almost never affects the tissues of healthy individuals. It is a problematic pathogen in hospitals; infecting individuals with cancer, burn wound, catheters and cystic fibrosis. P. aeruginosa is most recognized for its resistance to a wide range of antibiotics. In its planktonic form, P. aeruginosa has been found to have many virulence factors. However, P. aeruginosa within biofilms have been found to have a resistance to antibiotics 1,000 times greater than that of its planktonic counterparts [4]. Infections that are caused by bacterial biofilms are very persistent and very difficult to treat.
According to the Centers for Disease Control and Prevention (2013), MRSA is easily transmitted from person to person or from touching materials or surfaces that had previous contact with the infection. Using the implementation of infection control along with patient education will help in the decrease of the spread and help in the prevention in MRSA as well as get patients involved in their own care. The purpose of this paper is to present the problem of MRSA as well as include the rationale and history, review the proposed solution, integrate an implementation plan, summarize the literature review, establish an implementation plan, use a nursing theory to support the implementation plan, use a change theory to support the implementation plan, discuss how the project will be evaluated, and create a dissemination
There are many reasons why you should know the differences and similarities between viruses, bacteria, and prions. With this knowledge, you can determine how to make yourself feel better if you are sick, or how to prevent getting sick in the first place. This being said, there are many similarities and differences between these three.
Clinical Infectious Diseases, 49(3), 438-443. Doi:10.1086/600391. See full address and map. Medicare.gov/Hospital Compare - The Official U.S. Government Site for Medicare (n.d).
Nurses should take a leading role in reducing the impact of disease on patients and influence the expansion of evidence based infection prevention practice. Antimicrobial resistance prevention must remain a huge priority. In times of opposing priorities concerning patient safety, progress has been made in undertaking these bacteria’s and infections. The outlook of a near future without helpful antibiotics should not be dismissed, and all us in positions of influence should encourage and educate the conscientious use of antimicrobials seriously and do what we can to stop the situation from spreading.
Life History and Characteristics: Staphylococcus aureus is a gram positive bacterium that is usually found in the nasal passages and on the skin of 15 to 40% of healthy humans, but can also survive in a wide variety of locations in the body. This bacterium is spread from person to person or to fomite by direct contact. Colonies of S. aureus appear in pairs, chains, or clusters. S. aureus is not an organism that is contained to one region of the world and is a universal health concern, specifically in the food handling industries.
Patient education is of paramount importance if MRSA is to be reduced to its lowest minimum. According to Noble 2009, patient’s education stands a critical component of managing MRSA therefore; nurses are expected to be prompt in educating patients on specific measures in limiting and reducing the spread of MRSA by person to person contact. (Noble, 2009) The specific measures includes definition of MRSA, mode of transmission, the damage it can do to the body, specific treatments available and the process of treatment. This is to help the patient take part in the care. Noble 2009 explains that during care giving nurses and all other healthcare provider involve in giving care to a patient should communicate to patient all the precaution that will prevent the transmission of MRSA, and also giving the scientific rationale for the use of any precaution that is been used in the cause of care giving. (Noble, 2009.)
Resistant strains are no joke, for years my mother has been dealing with MRSA (methicillin-resistant staphylococcus aureus). My mother has had MRSA so bad that at one time she was covered in MRSA sores much like when a person breaks out in hives. Watching her suffer the way she has worries me as I am also a healthcare worker and know what these resistant strains are capable of. I know these strains exist because of a lack of proper patient education. Proper patient education is key to the use of antibiotics and prevention of resistance-bacteria strains.
Hospital acquired infections are one of the most common complications of care in the hospital setting. Hospital acquired infections are infections that patients acquired during the stay in the hospital. These infections can cause an increase in the number of days the patients stay in the hospital. Hospital acquired infections make the patients worse or even cause death. “In the USA alone, hospital acquired infections cause about 1.7 million infections and 99,000 deaths per year”(secondary).
Bacterial cells, like plant cells, are surrounded by a cell wall. However, bacterial cell walls are made up of polysaccharide chains linked to amino acids, while plant cell walls are made up of cellulose, which contains no amino acids. Many bacteria secrete a slimy capsule around the outside of the cell wall. The capsule provides additional protection for the cell. Many of the bacteria that cause diseases in animals are surrounded by a capsule. The capsule prevents the white blood cells and antibodies from destroying the invading bacterium. Inside the capsule and the cell wall is the cell membrane. In aerobic bacteria, the reactions of cellular respiration take place on fingerlike infoldings of the cell membrane. Ribosomes are scattered throughout the cytoplasm, and the DNA is generally found in the center of the cell. Many bacilli and spirilla have flagella, which are used for locomotion in water. A few types of bacteria that lack flagella move by gliding on a surface. However, the mechanism of this gliding motion is unknown. Most bacteria are aerobic, they require free oxygen to carry on cellular respiration. Some bacteria, called facultatibe anaerobes can live in either the presence or absence of free oxygen. They obtain energy either by aerobic respiration when oxygen is present or by fermentation when oxygen is absent. Still other bacteria cannot live in the presence of oxygen. These are called obligate anaerobes. Such bacteria obtain energy only fermentation. Through fermentation, different groups of bacteria produce a wide variety of organic compounds. Besides ethyl alcohol and lactic acid, bacterial fermentation can produce acetic acid, acetone, butyl alcohol, glycol, butyric acid, propionic acid, and methane, the main component of natural gas. Most bacteria are heterotrophic bacteria are either saprophytes or parasites. Saprophytes feed on the remains of dead plants and animals, and ordinarily do not cause disease. They release digestive enzymes onto the organic matter. The enzymes breakdown the large food molecules into smaller molecules, which are absorbed by the bacterial cells. Parasites live on or in living organisms, and may cause disease. A few types of bacteria are Autotrophic, they can synthesize the organic nutrients they require from inorganic substances. Autotrophic bacteria are either photosynthetic or Chemosynthetic. The photosynthetic bacteria contain chlorophyll that are different from the plant chlorophyll. In bacterial photosynthesis, hydrogen is obtained by the splitting of compounds other than water.
Infection control is very important in the health care profession. Health care professionals, who do not practice proper infection control, allow themselves to become susceptible to a number of infections. Among the most dreaded of these infections are: hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). Another infection which has more recently increased in prevalence is methicillin-resistant Staphylococcus aureus (MRSA). These infections are all treated differently. Each infection has its own symptoms, classifications, and incubation periods. These infections are transmitted in very similar fashions, but they do not all target the same population.
MRSA is a major source of healthcare associated diseases, increased hospital mortality, and leading surgical site infection (Jennings, Bennett, Fisher, & Cook, 2014, p. 83). With the implementation of active surveillance screening and contact isolations program, an overall decrease in hospital associated MRSA infections has been observed (Jennings, Bennett, Fisher, & Cook, 2014, p. 83). The author of this paper will identify a theory that can be used to support the proposed intervention i.e., reduce the transmission of MRSA by active screening in patients at high-risk for MRSA on admission. This paper will then describe the selected theory, and rational for the selection, and how this theory will support the proposed solution and how to incorporate this theory in this project.