December 2012 Issue 1, Vol. 1. Healthcare-associated. Infections (HAI)

Transcription

1 ewsletter December 2012 Issue 1, Vol. 1 Infections (HAI)

2 Infections (HAI) H ealthcare-associated infections (HAI) are infections caused by a wide variety of common and unusual bacteria, fungi, and viruses during the course of receiving medical care. Medical advances have brought lifesaving care to patients in need, yet many of those advances come with a risk of HAI. These infections related to medical care can be devastating and even deadly. As our ability to prevent HAIs grows, these infections are increasingly unacceptable. Recent successes in HAI elimination have been very encouraging. Reductions have been demonstrated for other HAIs as well, but much more remains to be done. Wherever patient care is provided, adherence to infection prevention guidelines is needed to ensure that all care is safe care. This includes traditional hospital settings as well as outpatient surgery centers, long-term care facilities, rehabilitation centers, and community clinics. The information on this website is intended to inform patients and healthcare personnel and help move healthcare systems toward elimination of HAIs. The Burden infections (HAIs) are infections that patients acquire during the course of receiving healthcare treatment for other conditions. These infections related to medical care can be devastating and even deadly. As the nation s health protection agency, CDC is committed to helping all Americans receive the best and safest care when they receive healthcare services. CDC strives to understand how HAIs happen and to develop appropriate interventions. HAIs are an important public health problem. Approximately 1 out of every 20 hospitalized patients will contract an HAI. The following documents provide information about the problem of HAIs in the United States. The Direct Medical Costs of Healthcareassociated Infections in U.S. Hospitals and the Benefits of Prevention [PDF KB] (HERE: Scott_CostPaper.pdf) This report uses results from the published medical and economic literature to provide a range of estimates for the annual direct medical hospital cost of treating HAIs in the United States. Estimating Infections and Deaths in U.S. Hospitals, Public Health Reports [PDF KB] (HERE: deaths.pdf) In 2002, the estimated number of HAIs in U.S. hospitals, adjusted to include federal facilities, was approximately 1.7 million: 33,269 HAIs among newborns in high-risk nurseries; 19,059 among newborns in wellbaby nurseries; 417,946 among adults and children in intensive care units (ICUs); and 1,266,851 among adults and children outside of ICUs. Diseases and Organisms in Healthcare Acinetobacter Acinetobacter [asz in ée toe back ter] is a group of bacteria commonly found in soil and water. Outbreaks of Acinetobacter infections typically occur in intensive care units and healthcare settings housing very ill patients. While there are many types or species of Acinetobacter and all can cause human Continued on page 3 2 American Home Health Newsletter December 2012

3 Infections (HAI) Continued from page 2 disease, Acinetobacter baumannii [asz in ée toe back ter bō maa nee ie] accounts for about 80% of reported infections. Acinetobacter infections rarely occur outside of healthcare settings. Burkholderia cepacia Burkholderia cepacia [burk-hōld er ee-uh si pay shee uh] is the name for a group or complex of bacteria that can be found in soil and water. Burkholderia cepacia bacteria are often resistant to common antibiotics. Burkholderia cepacia poses little medical risk to healthy people; however, it is a known cause of infections in hospitalized patients. People with certain health conditions, like weakened immune systems or chronic lung diseases (particularly cystic fibrosis), may be more susceptible to infections with Burkholderia cepacia. [Burkholderia cepacia is also called B. cepacia] Clostridium difficile Clostridium difficile [klo strid ee um dif uh seel] is a bacterium that causes an inflammation of the colon; this condition is called colitis. Diarrhea and fever are the most common symptoms of Clostridium difficile infection. Overuse of antibiotics is the most important risk for getting Clostridium difficile infection. [Clostridium difficile is also called C. difficile, C. diff, and CDI (Clostridium difficile infection), CDAD(Clostridium difficileassociated disease)] Clostridium Sordellii Clostridium sordellii [klo strid ee um sore dell ee I] is a rare bacterium that causes pneumonia, endocarditis, arthritis, peritonitis, and myonecrosis. Clostridium sordellii bacteremia and sepsis (bacteremia is when bacteria is present in the bloodstream; sepsis is when bacteremia or another infection triggers a serious bodywide response) occur rarely. Most cases of sepsis from Clostridium sordellii occur in patients with other health conditions. Severe toxic shock syndrome among previously healthy persons has been described in a small number of Clostridium sordellii cases, most often associated with gynecologic infections in women and infection of the umbilical stump in newborns. [Clostridium sordellii is also called C. sordellii] Enterobacteriaceae (carbapenemresistance) Carbapenem-resistant Enterobacteriaceae are a family of germs that are difficult to treat because they have high levels of resistance to antibiotics. Klebsiella species and Escherichia coli (E. coli) are examples of Enterobacteriaceae, a normal part of the human gut bacteria, that can become carbapenem-resistant. In healthcare settings, CRE infections most commonly occur among patients who are receiving treatment for other conditions. Patients whose care requires devices like ventilators (breathing machines), urinary (bladder) catheters, or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics are most at risk for CRE infections. Hepatitis The word hepatitis means inflammation of the liver and also refers to a group of viral infections that affect the liver. The most common types are hepatitis A, hepatitis B, and hepatitis C. The delivery of healthcare has the potential to transmit hepatitis to both healthcare workers and patients. Outbreaks have occurred in outpatient settings, hemodialysis units, longterm care facilities, and hospitals, primarily as a result of unsafe injection. Human Immunodeficiency Virus (HIV/ AIDS) Human immunodeficiency virus (HIV) is the virus that can lead to acquired immune deficiency syndrome (AIDS). HIV destroys blood cells called CD4+ T cells, which are crucial to helping the body fight disease. This results in a weakened immune system, making persons with HIV or AIDS at risk for many different types of infections. Transmission of HIV to patients while in Healthcare Settings is rare. Most exposures do not result in infection. [Human immunodeficiency virus is also called HIV] Influenza Influenza is primarily a community-based infection that is transmitted in households and community settings. Each year, 5% to 20% of U.S. residents acquire an influenza virus infection, and many will seek medical care in ambulatory healthcare settings (e.g., pediatricians offices, urgent-care clinics). In addition, more than 200,000 persons, on average, are hospitalized each year for influenza-related complications. influenza infections can occur in any healthcare setting and are most common when influenza is also circulating in the community. Therefore, influenza prevention measures should be implemented in all healthcare settings. Supplemental measures may need to be implemented during influenza season if outbreaks of healthcareassociated influenza occur within certain facilities, such as long-term care facilities and hospitals. Klebsiella Klebsiella [kleb see ell uh] is a type of Gramnegative bacteria that can cause healthcareassociated infections including pneumonia, bloodstream infections, wound or surgical site infections, and meningitis. Increasingly, Klebsiella bacteria have developed antimicrobial resistance, most recently to the class of antibiotics known as carbapenems. Klebsiella bacteria are normally found in the human intestines (where they do not cause disease). They are also found in human stool (feces). In healthcare settings, Klebsiella infections commonly occur among sick patients who are receiving treatment for other conditions. Patients who have devices like ventilators (breathing machines) or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics are most at risk for Klebsiella infections. Healthy people usually do not get Klebsiella infections. Methicillin-resistant Staphylococcus aureus (MRSA) Methicillin-resistant Staphylococcus aureus (MRSA) is a type of staph bacteria that is resistant to certain antibiotics called betalactams. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin, and amoxicillin. In the community, most MRSA infections are skin infections. More severe or potentially life-threatening MRSA infections occur most 3 American Home Health Newsletter December 2012 Continued on page 4

4 Infections (HAI) Continued from page 3 frequently among patients in Healthcare Settings. [Methicillin-resistant Staphylococcus aureus is also called MRSA] Mycobacterium abscessus Mycobacterium abscessus [mī kō bak tair ee yum ab ses sus] is a bacterium distantly related to the ones that cause tuberculosis and leprosy. It is found in water, soil, and dust. It has been known to contaminate medications and products, including medical devices. Mycobacterium abscessus can cause a variety of infections that require medical attention. Infections due to this bacterium are usually of the skin and the soft tissues under the skin. It can also cause lung infections in persons with various chronic lung diseases. [Mycobacterium abscessus is also called M. abscessus] Norovirus Noroviruses are a group of viruses that cause gastroenteritis [gas-trō-en-ter-ī-tis] in people. Gastroenteritis is an inflammation of the lining of the stomach and intestines, causing an acute onset of severe vomiting and diarrhea. Norovirus illness is usually brief in people who are otherwise healthy. Young children, the elderly, and people with other medical illnesses are most at risk for more severe or prolonged infection. Like all viral infections, noroviruses are not affected by treatment with antibiotics. Staphylococcus aureus Staphylococcus aureus [staf I lō-kok is aw ree us] (staph), is a bacterium commonly found on the skin and in the nose of about 30% of individuals. Most of the time, staph does not cause any harm. These infections can look like pimples, boils, or other skin conditions and most are able to be treated. Tuberculosis (TB) Tuberculosis [tuh burk yoo lō sis] is caused by a bacterium called Mycobacterium tuberculosis. Transmission of Mycobacterium tuberculosis is a recognized risk to patients and healthcare personnel in healthcare facilities. Transmission is most likely to occur from patients who have unrecognized pulmonary tuberculosis or tuberculosis related to their larynx, are not on effective anti-tuberculosis therapy, and have not been placed in tuberculosis isolation. Transmission of Mycobacterium tuberculosis in Healthcare Settings has been associated with close contact with persons who have infectious tuberculosis, particularly during the performance of cough-inducing procedures such as bronchoscopy and sputum induction. Mycobacterium Tuberculosis is spread through air and can travel long distances. Cases of multidrug-resistant tuberculosis (MDR-TB, which includes extensively drug-resistant tuberculosis [XDR-TB]), have been recognized and are more difficult to treat. [Tuberculosis is also called TB] Vancomycin-intermediate Staphylococcus aureus and Vancomycin-resistant Staphylococcus aureus Vancomycin [vank ō mī sin]-intermediate Staphylococcus aureus [staff u lu kaw kus aw ree us] (also called S. aureus) and vancomycin-resistant Staphylococcus aureus are specific staph bacteria that have developed resistance to the antimicrobial agent vancomycin. Persons who develop this type of staph infection may have underlying health conditions (such as diabetes and kidney disease), devices going into their bodies (such as catheters), previous infections with methicillin-resistant Staphylococcus aureus, and recent exposure to vancomycin and other antimicrobial agents. [Vancomycin-intermediate Staphylococcus aureus is also called VISA and vancomycinresistant Staphylococcus aureus is also called VRSA] Vancomycin-resistant Enterococci (VRE) Vancomycin [van kō mī sin]-resistant Enterococci [en ter ō kō kī] are specific types of antimicrobial-resistant bacteria that are resistant to vancomycin, the drug often used to treat infections caused by enterococci. Enteroccocci are bacteria that are normally present in the human intestines and in the female genital tract and are often found in the environment. These bacteria can sometimes cause infections. Most vancomycin-resistant Enterococci infections occur in hospitals. [Vancomycin-resistant Enterococci is also called VRE] Types of Infections Modern healthcare employs many types of invasive devices and procedures to treat patients and to help them recover. Infections can be associated with the devices used in medical procedures, such as catheters or ventilators. These healthcare-associated infections (HAIs) include central line-associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia. Infections may also occur at surgery sites, known as surgical site infections. Additionally, Clostridium difficile can cause gastrointestinal infection; patients can be exposed to this bacterium through contaminated surfaces or the spores can be transferred on unclean hands of others. Central line-associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia account for roughly two-thirds of all HAIs. CDC works to monitor and prevent these infections because they are an important threat to patient safety. 1. Central Line-associated Bloodstream Infection (CLABSI) 2. Catheter-associated Urinary Tract Infections (CAUTI) 3. Surgical Site Infection (SSI) 4. Ventilator-associated Pneumonia (VAP) 5. Clostridium difficile Infection More coming soon Source: 4 American Home Health Newsletter December 2012

5 Open Enrollment Benefits Health, Dental, Long Term Disability & Optional Life Insurance We are in our open enrollment season. This is the time that you can make your elections for Health, Dental, Long Term Disability and Optional Life Insurance. Initial forms have been mailed dealing with the health portion, and they MUST be returned by November 16, All questions and concerns should be directed to the HR department. Our phone number is and our address is 401(k) If you are eligible to enroll, January 1, 2013 is the time that you can do so. Also, keep in mind that you can only increase or decrease your elective deferral contributions twice a year during 401(k) Open Enrollment. These times are January 1st and July 1st. Outside of these dates you cannot increase or decrease your elective deferral contributions. As you know, you can decrease your contribution to zero at any given time, but you cannot restart contribution until the next open enrollment. RNs Home Health Nurses Wanted American Home Health is seeking experienced Home Health/ Intermittent RNs with strong IV experience. Positions available in: Cook, DeKalb, DuPage, Grundy, Kane, Kendall, Lee, and Will County. CPR CLASS For: All American Home Health Employees Where: 1660 N. Farnsworth Ave., Suite 3 Aurora, IL When: January 14, 2013 Time: 10:00 A.M. hr@ahhc-1.com Fax: (630) Call: (800) EEO M/F/D/V AHHC Newsletter Editors: Karen Centowski & Edward Lara Designer: Edward Lara Contributions: Edward Lara, Jan Fulfs For Contributions, please hr@ahhc-1.com or write to 1660 N. Farnsworth Ave., Ste.3, Aurora, IL For reservations call or HR@ ahhc-1.com. Seats are limited, so reserve today. 5 American Home Health Newsletter December 2012

6 Word Search Puzzle Infections R E R S Y N C A T W A S R M E O G K N H N D P S W O S Q T C M S N O I T C E F N I Q C E P A C I A C T U S G N I T T E S N M U I D I R T S O L C N S U I T A A E Z D S X M U I R E T C A B O C Y M P S W S E D B I P N M D S C I S I N F L U E N Z A S O K U A O A C Y H J S I T I T A P E H C Q M O B K C W S I O J I C I C C O C O R E T N E T Y P E S K I O S R S A F S S M J W I L F W Q L H A Z N J K J A L E E M D E O C H G X T S U C C O C O L Y H P A T S C D S G D O S Y F A L L E I S B E L K Y E P L E T S L I L O E D Z U A I D S S U E R U A J O L R D N B O N F N E N T E R O B A C T E R I A C E A E Q W A H A B U N I L L I C I H T E M N U Z A L A V I S M K G K M H L D T U B E R C U L O S I S L M V B U T R R W M N I C Y M O C N A V H Z B A W A A O H R W U O D I S E A S E S I I L L E D R O S F K P J I J B W G P S U R I V O R O N H E A L T H C A R E V ABSCESSUS AIDS ASSOCIATED AUREUS BURKHOLDERIA CEPACIA CLOSTRIDIUM DISEASES ENTEROBACTERIA- CEAE ENTEROCOCCI HEALTHCARE HEPATITIS IMMUNODEFICIEN- CY INFECTIONS INFLUENZA KLEBSIELLA METHICILLIN MRSA MYCOBACTERIUM NOROVIRUS ORGANISMS SETTINGS SORDELLII STAPHYLOCOCCUS TUBERCULOSIS TYPES VANCOMYCIN VIRUS Follow us on YouTube. Our channel is You Tube 6 American Home Health Newsletter December 2012