Learn about the role of environment in disease transmission and how to implement standard and transmission-based precautions to prevent the spread of antibiotic resistant bacteria and other infections in your facility.
1.1 Defining antibiotic resistance
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來自 The University of North Carolina at Chapel Hill 的課程
Infection Prevention in Nursing Homes
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Antibiotic Resistant Bacteria
The goal of this module is to describe and discuss antibiotic resistant bacteria and how to stop these bad bugs from spreading. To obtain CE Credit for this module: Take the Quiz and complete the evaluation at the end of the module, you will be directed to your course completion certificate.
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Evelyn CookAssociate Director
North Carolina Statewide Program for Infection Control and Epidemiology (SPICE)
Welcome to module 1, Antibiotic Resistant Bacteria.
Our ability to treat normal bacterial infections, only goes back more than 70
years to the development of prontosil, sulfa drug in the 1930s.
In that short timeframe, increasing resistance to these wonder drugs
because of overuse and misuse has led to the rise of superbugs, or
bad bugs that are not treatable by any antibiotic.
Antibiotic resistance has the potential to recreate a world where people
routinely die from simple bacterial infections.
This module will describe antibiotic resistant bacteria, how they affect
the residents in your facility, and what you can do to help control their spread.
There are five learning objectives for this module.
You should be able to define antibiotic resistant bacteria.
Identify several types of antibiotic resistant bacteria.
Define the terms colonization, and infection.
Name at least two risk factors for getting an antibiotic resistant bacteria.
Identify the #1 way to prevent the spread of antibiotic resistance bacteria.
Before we get started, it is important that we define a few key terms
that will be important throughout this module.
Antibiotics are drugs that fight infections caused by bacteria.
Antibiotics work by killing the bacteria, or stopping their growth.
Bacteria are microorganisms too small to see with the naked eye,
that exist in virtually all environments in the world.
Including on and inside the bodies of virtually every living animal on Earth.
Most bacteria are not harmful, but
some bacteria can cause infections, like strep throat.
Antibiotic resistance is the ability of bacteria to survive exposure to one,
or more antibiotics.
Antibiotic resistance occurs when bacteria change in some way that reduces, or
eliminates the ability of the drug to fight the infection.
Antibiotic resistant infections kill more Americans than HIV/AIDS, and
the number of lives claimed continues to rise.
More than 2,000,000 acquire antibiotic resistant infections in the US each year,
and more than 100,000 die as a result.
In nursing homes, the number affected is still no less shocking.
On average, there are 3.2 million residents currently in nursing homes.
Of these, 250,000 acquire infections during their stay.
Around 10%, or
27,000 of these infections are caused by antibiotic resistant bacteria.
Once antibiotic resistant bacteria, like MRSA or VRE,
are established in a facility, they are rarely eliminated.
Let's see how antibiotic resistant bacteria are affecting residents at
Sunnyside Nursing Home.
>> Previously on gowns & gloves,
a mysterious outbreak seems to be wreaking havoc in Sunnyside Retirement Home.
Will the staff get the outbreak, and their residents under control?
[SOUND] Will the residents put up with the precautions they're going to
need to follow?
And will Elaine Houston find the truth about her past?
Find out on gowns & gloves.
[MUSIC]
>> Volunteering, so give me an update.
What's going on?
>> Well, Vanessa, I think we have a problem.
We have several patients who seem to have similar infections, Mr. Lawrence, Ms.
McCoy, and Mr. Mayhall, all have infection with mersa.
>> That does seem to be an issue?
When did you first noticed the problem?
>> When I came on my shift, I look at the chart and I noticed that all the patients
have had positive cultures within the past two weeks, they all have it.
>> Slow down.
Who was the first resident to test positive?
>> When Mrs. McCoy was admitted from the hospital, she came with a mersa infection.
About four days later, her next door neighbor Mr.
Lawrence had a bed sore that became infected with mersa.
You know he's debilitated, and needs total care.
Then Mr. Lawrence's roommate, Mr. Mayhall become colonized with mersa.
And Elaine Houston, she must have become colonized when she was admitted here for
rehab for her hip surgery.
>> We need to take action.
There's an infection control breakdown somewhere.
What have we done about these residents?
Didn't we place infected residents on contact precautions?
Is anyone in this place washing their hands?
>> I know, why are we still having transmission between residents?
>> I don't know, [SOUND] what are we gonna do to stop this outbreak from happening?
>> And cut.
[SOUND] All right, good.
But this time, when we do it, I want you to do it with passion, all right?
This is serious news you're hearing.
We have a lot of sick residents here.
>> Jack is right, everyone.
Hi guys, I'm Jane Walker.
I'm the content expert here to make sure that we've
got all the information correct.
And it's not just that these residents are sick.
They have a bacterial infection called MRSA
that is resistant to most commonly used antibiotics.
And because it is resistant to many antibiotics, if they have MSRA,
it's more likely to continue to spread, and which is, like a snowballing effect.
Oh, and one more thing.
When you're saying it, we need you to say, MRSA not mersa, okay?
>> Okay, you got it, ready?
And action.
[SOUND] >> Priscilla, let's move deposited MRSA
cases down the hall, and place infected residents on
contact precautions Is there anything else we can do?
>> Cut.
>> Great job.
Okay, guys.
I need you all to focus on everyone.
Staff, and residents washing their hands.
Okay?
Now, I like to talk about the standard precautions, and contact precautions,
but good hand hygiene is the number one way to stop the spread of MRSA bacteria.
And you need to convey that to your residents.
>> So, my character is all about hand washing?
>> Yes.
Good hand washing is the single most important way to prevent
the spread of MRSA, and other antibiotic resistant bacteria.
>> And action.
>> We need to focus on hand hygiene across the board, residents and staff.
It's the only possible way Mrs. Houston could have come down with something,
since arriving here at Sunnyside.
We need to get her moved down the hall with the rest of the MRSA patients, and
get this contained as soon as possible.
>> Oh, [LAUGH] she is not going to like that.
>> No, she's not.
I'll go to get her prepped to move, as well as talk to the staff about gowning,
and gloving properly.
We need to make sure standard precaution is followed,
and that the contact precaution sign is on all of the infected residents' doors.
Oh, and make sure you talk to Mrs. Houston's husband.
He hasn't left her side all week.
Family members need to know what they can do to help prevent the spread as well.
>> Mr. and Mrs. Houston,
there's something about them I just can't quite put my finger on.
[MUSIC]
