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Aquitania
Superbugs
Repeated contact with the healthcare system Previous colonization of a multidrug-resistant org. Advanced age
EMRSA (Epidemic)
Prevention
Avoid any kind of contact Good hand hygiene
Combination
vancomycin and linezolid trimethoprimsulfamethoxazole, doxycycline, and clindamycin x Clindamycin may develop resistance Dont stop in the middle of medication
TX:
"First-line treatment for mild abscesses is incision and drainage. (CDC) "If antibiotic treatment is clinically indicated, it should be guided by the susceptibility profile of the organism." (CDC)
Vancomycin-resistant Enterococci
Enterococcus faecium Enterococcus faecalis with E. faecium Resistance: Plasmid (acquired DNA piece)
Able to transfer vancomycin resistance to unrelated bacteria such as MRSA
Vancomycin-resistant Enterococci
Person-to-person contact
Hospital or chronic care facility
Complications:
MENINGITIS PNEUMONIA ENDOCARDITIS
May exist without causing infection Invade bloodstream, or spread locally = abdominal abscess or UTI Open wound
COMPROMISED CONDITION
CANCER DIABETES KIDNEY FAILURE
Vancomycin-resistant Enterococci
S&S (SEPSIS)
FEVER FAST HEART RATE FEEL SICKLY UTI: Burning with urination , Back pain, Fever
TX [Combination]
Teicoplanin and amoxicillin Ampicillin, Polycillin, Imipenem, and vancomycin Can be cured in most patients
CONTROL
Transmission Practice of good hand hygiene
Beta-lactamase inhibitors (clavulanic acid, sulbactam, and tazobactam) generally inhibit ESBL producing strains.
Bush Class B
TRANSMISSION
Hospital acquired (Nosomial)
CONTROL
Transmission Practice of good hand hygiene
Mycobacterium tuberculosis
Tuberculosis TB
Infectious airborne disease Major global health problem
x x x x x Each year: 9M new cases; 2M deaths All countries are affected but 85% cases occur in: Africa 30% Asia 55% India & China 35%
Mycobacterium tuberculosis
Global Plan to Stop TB 2006 2015 Developing new TB vaccines (Health Protection Agency)
Increase immunity from BCG Modification of BCG by adding immunogenic components Oral delivery of existing BCG strains Construction of safe and stable attenuation of M. tuberculosis