emerging and reemerging pathogens

Question 1

bacteriostatic

Answer 1

-slows growth of the bacteria so that the immune system has time to catch up

Question 2

bactericidal

Answer 2

kills targeted organism

Question 3

antibiotics work by

Answer 3

inhibiting specific processes that are essential for bacterium to grow

Question 4

intrinsic resistance

Answer 4

• is a result of the bacteria’s inherent mechanism of action against a particular drug
• born with it
• example: gram neg are resistant to vancomycin because the bacteria have a protective outer membrane that wont let the drug in (not on gram+)

Question 5

acquired resistance

Answer 5

• results from a change in the bacteria’s genetic composition that makes a previously effective drug ineffective
• survival of the fittest

Question 6

community acquired infections

Answer 6

• pneumoccal pneumonia- penicillin resistant
• tick-borne disease- lyme disease
• mosquito-transmitted west nile virus
• viral encephalitis
• increasing Hep C

Question 7

contributing factors to the spread of resistant infections

Answer 7

• worldwide population growth
• increased urbanization and crowding
• human disruption of animal, plant, and microbial habitats
• increasing number of elderly
• shifting sexual behaviors
• IV drug use
• decline in research for the development of new antibiotics
• lack of funding for antibiotic research and development

Question 8

contributing factors to the spread of resistant infections cont.

Answer 8

• poverty and inaccessible medical care
• ineffective infection control and compliance
• increasing number of immunosuppressed people: transplantation; indwelling catheters; chemotherapeutic drugs, aggressive surgical techniques increasing LOS

Question 9

nosocomial infections

Answer 9

• develops when a pt is admitted to a healthcare facility AND they did not have the infection before they arrived
• at least 5% of hospitalized pts each year in the US develop nosocomial infections
• many of these are preventable

Question 10

Staphlococcus Aureus

Answer 10

• Gram +
• found on skin, wounds, nose, axillae and perineum
• 90% of all staph are resistant to penicillin/methicillin
• can cause major problems in large wounds or in the respiratory system
• common in nursing homes
• 80,000 hospitalized per year

Question 11

methicillin-resistant staph aureus (MRSA)

Answer 11

• super bug
• acquired in many possible setting, especially hospitals
• health care workers exposed to MRSA can become infected and spread it to others
• MRSA can live on surfaces and clothing for days

Question 12

populations with MRSA

Answer 12

• children/elderly
• inmates
• military recruits
• HIV pts
• religious communities
• hospitals/nursing homes
• football teams
• wrestlers
• gymnasts
• fencing teams
• homeless
• immunosuppressed
• ICU’s

Question 13

Vancomycin-resistant Enterococci (VRE)

Answer 13

• gram +
• normally found in bowel, female genital tract, and environment
• spread by fecal-oral transmission
• can live in environmental surfaces for weeks
• resultants: 110000 UTI’s, 25000 bacteremias, 4000 wound infections, 1100 cases of endocarditis annually

Question 14

clostridium difficile (CDiff)

Answer 14

• spore forming Gram+ rod
• part of normal flora
• can live in the environment for up to 70 days
• pt rooms need terminal clean with bleach
• not responsive to hand sanitizers- must wash hands with soap and water

Question 15

CMV: cytomegalovirus

Answer 15

• once infected, virus remains in your body for life
• transmission through body fluids (blood, saliva, urine, semen, tears, breast milk)
• especially dangerous to pregnant women and immunocompromised individuals

Question 16

CMV cont

Answer 16

• related to the viruses that causes chicken pox, hepres simplex, and mononucleosis
• mononucleosis- like symptoms
• causes complications in the intestinal tract, liver, nervous system, and lungs

Question 17

re-emerging pathogens

Answer 17

• ebola virus disease (EVD)
• measles
• pertussis
• mumps
• diphtheria
• rubella

Question 18

ebola virus disease (EVD)

Answer 18

• formerly ebola hemorrhagic fever
• usualy severe, often fatal in humans
• EVD outbreaks have a fatality rate of up to 90%

Question 19

Ebola S/S

Answer 19

• occur 2-20 days after exposure (average 8-10)
• fever
• severe headache
• muscle weakness
• fatigue
• diarrhea
• vomiting
• abdominal pain
• unexplained hemorrhage

Question 20

measles

Answer 20

• declared eliminated in the US in the 2000s
• not true in rest of the world
• mostly unvaccinated
• current outbreak associated with travel

Question 21

measles S/S

Answer 21

• high fever
• cough
• runny nose
• red, watery eyes
• 2-3 days after- white patches in the mouth
• 3-5 days after S/S- rash outbreak

Question 22

measles complications

Answer 22

• ear infections
• diarrhea
• pneumonia
• encephalitis: convulsions, deafness, developmentally disabled
• 1-2/1000 die
• pregnant women- premature birth, low birth weight babies

Question 23

measles precautions

Answer 23

• airborn precautions
• assure 2 doses of MMR vaccine
• measles antibody titer
• 6mo-1yr= 1 dose of MMR

Question 24

nursing implications

Answer 24

• use universal precautions with all pts
• assess the pt upon admission
• monitor labs including drug susceptibility
• use isolation when appropriate
• be aware of personal heath status
• be protective of your home environment

Question 25

nursing implications cont.

Answer 25

• educate pts. about proper use of antibiotics
• educate about risks vs. benefits of vaccinations
• know the S/S of these pathogens so you can take proper precautions when caring for these pts