Med-Surg: Chapter 21: Carbapenem-Resistant Enterobacteriaceae (CRE)

Question 1

Enterobacteriaceae

Answer 1

can cause infections in people in both the hospital and community

• healthy people not at risk
• “urgent” concern; 50% of hospitalized patients who develop bloodstream infections from CRE bacteria die
• Klebsiella species and Escherichia coli (E. Coli)

Question 2

CRE risk Factors

Answer 2

• weakened immune system
• disruption in the body’s natural flora
• mechanical ventilation
• indwelling devices such as Foley catheters, central venous catheters, and feeding tubes
• patients in hospitals and long-term care facilities
• older adults
• comorbid conditions: heart disease, diabetes, renal disease

Question 3

Pathophysiology of CRE

Answer 3

normally found in the intestines; not usually harmful on inside
-if spread to outside of intestine; cause UTIs, bloodstream infections, wound infections, and pneumonia

Question 4

How is CRE bacteria spread?

Answer 4

direct contact with infected or colonized people

-contact with wound or stool

Question 5

Clinical Manifestations

Answer 5

• vary depend on location (bloodstream, pneumonia, wound infection, or UTI)
• fever
• chills
• signs of sepsis if not controlled

Question 6

Complications

Answer 6

• resistant to carbapenem, a class of antibiotics typically used as a last resort for treating severe infections when other antibiotics have failed
• organisms are difficult and dangerous b/c they have become resistant to nearly all available antibiotics
• mortality is high

Question 7

Medications Given for CRE

Answer 7

ceftazidime-avibactam

Question 8

Medication given for CRE: Ceftazidime-avibactam

Answer 8

-given IV
-work through inhibition of bacterial cell-wall synthesis
-associated with ototoxicity and neurotoxicity
-monitor renal function
-assess for neurological dysfunction;
some signs are mild (dizziness, diplopia (double vision), and weakness; some serious (ataxia, dysphagia, dysphonia, psychosis, coma, and neuromuscular blockade leading to apnea)