Infections in Acute Care: Still More to Do

A sharply increased focus on hospital-acquired infections (HAIs).

This month marks the 14th anniversary of the National Healthcare Safety Network (NHSN), the CDC’s data repository for health care–associated infections. Since 2005, when a limited number of hospitals began reporting infections data, the health care community has sharply increased its focus on the prevention, early recognition, and treatment of infections in the hospital. Research on risk factors, closer attention to limiting device use (urinary catheters, central lines), and support for meticulous hand hygiene and environmental cleaning protocols have decreased rates of CAUTIs, CLABSIs, and surgical site infections.

The risk is always there.

Still, as nurses well know, hospitalized patients remain at increased risk for developing infections, especially if they are immunosuppressed or have diabetes, need invasive devices, have many comorbidities, or stay in a critical care unit.

The current evidence reviewed.

In “Infection in Acute Care: Evidence for Practice” in this month’s AJN, Douglas Houghton reviews the latest evidence on common infections in acute care settings, including community- and hospital-acquired pneumonia, surgical site infections, and C. difficile. […]

2019-10-09T10:09:54-04:00October 9th, 2019|infection control, Nursing|1 Comment
Read More

The Real and Evolving Threat of Superbugs: A Primer

pillsinspaceJust how super is the latest superbug? The good news is that the infected U.S. patient has recovered. The bad news:  mcr-1, the resistance gene identified in this strain of E. coli, has brought us another frightening step closer to a “post-antibiotic” era.

In recent years, antimicrobial resistance among Gram-negative bacteria (E. coli, Klebsiella, Pseudomonas, Acinetobacter, Salmonella, and others) has been a growing public health concern. Most of the increase in resistance has been the result of mobile genetic elements that can easily transfer resistance from one bacterium to another, allowing bacteria to “catch” antibiotic resistance from one another.

To make matters worse, resistance enzymes are often packaged together. One genetic “cassette” can carry multiple resistance determinants, thereby spreading resistance to more than one class of antibiotics at the same time.

Early on, we relied on the carbapenem class of antibiotics to treat infections caused by multidrug-resistant (MDR) organisms such as the “ESBLs” (extended-spectrum beta-lactamase-producing organisms). But carbapenemase-producing organisms soon developed, and resistance to carbapenems spread quickly.

In 2009, the emergence of a “super” kind of carbapenem resistance gene, ndm-1 (New Delhi metallo-beta-lactamase) was found to be highly resistant to many antibiotic classes, including:

  • the carbapenems and other beta-lactams (penicillin derivatives and cephalosporins)
  • the fluoroquinolones (ciprofloxacin, levofloxacin, et al)
  • the aminoglycosides (gentamicin, amikacin, et al).

These antibiotic classes include the main drugs used to […]

2016-11-21T13:01:11-05:00June 6th, 2016|infectious diseases, Nursing, Public health|1 Comment
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
Go to Top