Resistant Strain Bacteria's

Spatialized · Aug 19, 2008

I'm guessing that it should be Acinetobacter. Here's a Wikipedia article on it. Brief terms, is gram-negative, usually found on skin or in soil. Various forms can cause pneumonia, bacteremia and VAP.

As for isolation, well, even though it is hard being the new kid on the block, try leading by example, gowning up, following protocol and mildly suggesting others do the same. If nothing more, you're covered.

Going up the chain of command is the way to go, charge nurse, manager, et. al. if things continue. People have a hard enough time getting well, we shouldn't be contributing to that!

Good luck!

Tom

links:

CDC

eMedicine

SusanKathleen, RN · Aug 19, 2008

Hey, could it be Acinetobacter baumannii? It's gram negative (I think), and common in ICUs. Frequently nocosomial.

Misty1334 · Aug 19, 2008

Thanks for the quick info! - And the advice!

I have another question: Do you think it's common to have so many iso pts on such a small floor - or is the bad practices causing this?

Also, You're so right, it's hard to be new, esp when you don't know anything except the basics - and it's hard to tell veterans that they're forgetting those lol! I certainly suit-up, I had a real scare once - funny story:

I was passing my first IV med alone, my instructor prepared it, and for some reason left the plastic spike on the top of the syringe - we used a needless system..... can u see where this is going lol!

I started pushing the med via a peripheral port - and suddenly I noticed the there was fluid dripping - and then - you guessed it.... blood was back-flowing everywhere!!!! It was gushing out at record speed! It took me nearly 30secs to realize what had happened!! I was so green, I thought that the drug caused it lol!!

Well, since I thought I was so important now, passing an IV med alone & all, I wasn't wearing any gloves!!! I thought, hey I'm just pushing a med.....

Therefore - I am certainly very cautious now, even if I'm just re-setting an IV in an iso room I glove & gown!!!

ICRN2008, BSN, RN · Aug 19, 2008

Pseudo refers to Pseudomonas. This is an opportunistic infection found in severely immunocompromised patients as well as those with cystic fibrosis who cannot effectively clear their secretions. It tends to be highly resistant to antibiotics.

http://www.emedicine.com/med/topic1943.htm

Acinetobacter has the potential to be highly resistant to antibiotics as well

http://www.cdc.gov/ncidod/dhqp/ar_acinetobacter.html

http://www.emedicine.com/MED/topic3456.htm

As a student, I would suggest that you voice your concerns to your clinical instructor or faculty member if you have specific concerns about your learning environment.

You seem to have a good handle on basic infection control procedures. Don't let your preceptor's poor example allow you to develop bad habits. :)

Spatialized · Aug 19, 2008

I have another question: Do you think it's common to have so many iso pts on such a small floor - or is the bad practices causing this?

It could just be bad luck, or a natural variant, or a result of bad practice. Some days we have isolation row, others it feels like nearly everyone is on some sort of precautions, but it ebbs and flows.

Tom

BelleKat, BSN, RN · Aug 25, 2008

If someone is on contact precautions nothing should be coming in and out of the rooms including COWs,thermometers,accucheck,etc. unless it is thoroughly cleaned with the bactericidal wipes that should be in the units.Some people cover the thermomters/accuchecks with gloves. People should be gown and gloved if they go into the room. Infection control is getting so much more lax than it should be. I learned about most micro organisms from working in the Burn Center then BMTU.

You are probably right about their lax methods spreading the resistant organisms. Do you have an infection control nurse in your facility? If not a nurse educator,ask around and try to go up the chain of command. Keep your eyes open. Good job:yeah:

coola · Mar 3, 2009

here's looking at you, kid... :nurse:

Extended-spectrum β-lactamase (ESBL)-producing gram-negative bacteria are emerging pathogens. Clinicians, microbiologists, infection control practitioners, and hospital epidemiologists are concerned about ESBL-producing bacteria because of the increasing incidence of such infections, the limitations of effective antimicrobial drug therapy, and adverse patient outcomes.

from Toronto east General Hospital website:

"What are ESBL organisms?

ESBL organisms are bacteria that are found in the bowel, urine, blood, skin wounds or sputum. There are several different types of these bacteria. They produce enzymes that break down some antibiotics rendering the antibiotics useless. ESBL organisms can be detected on routine culture of blood, sputum, urine, or stool specimens and can be detected in rectal or wound swabs. We treat infections caused by ESBL organisms with antibiotics the bacteria are sensitive to, but colonization of the bowel is not treated as it does not cause illness.

How can ESBL organisms be spread?

ESBL organisms can be spread directly by person-to-person contact and indirectly from contaminated surfaces to a person."

for example: ESBL-producing Escherichia coli and Klebsiella- (Klebsiella pneumonia tends to affect people with underlying diseases, such as alcoholism, diabetes and chronic lung disease. Classically, Klebsiella pneumonia causes a severe, rapid-onset illness that often causes areas of destruction in the lung.)