The Bacter Factor

[dorimar, BSN, RN]

Have you all seen alot of Acintobacter infections? What is your protocal, besides of course, strict contact isolation. At my facility, we try to only pair them with another acintobacter patient (if there is one), and definitely do not pair them with a fresh post op or patient with wounds. I was told last night that hospital policy really doesn't even want them paired with another vented patient. They end up many times being 1:1, even if they really don't need to be for the acuity. Then you only have one patient, and aren't really supposed to be in the rooms of many of the other patients, so you cant help out alot. It sucks. Just wondering what everyone else is doing, and how much of it you're seeing?

[TennRN2004]

Have you all seen alot of Acintobacter infections? What is your protocal, besides of course, strict contact isolation. At my facility, we try to only pair them with another acintobacter patient (if there is one), and definitely do not pair them with a fresh post op or patient with wounds. I was told last night that hospital policy really doesn't even want them paired with another vented patient. They end up many times being 1:1, even if they really don't need to be for the acuity. Then you only have one patient, and aren't really supposed to be in the rooms of many of the other patients, so you cant help out alot. It sucks. Just wondering what everyone else is doing, and how much of it you're seeing?

This is the first I've heard of it, but I looked up a little onfo on it, and the article below seems to suggest that colonization occurs more than actual infection, and that an ID doc is useful to determine if your patient has an actual infection from it. It also says that the organism is not that virulent and that the patient's underlying health status is more of a factor of morbidity/mortality that the actual infection itself. What are you seeing with these infections that makes your hospital consider them to only be paired together or 1:1 if no other patients with this infection are in the unit? I didn't really do a lot of searching on it, so it may be a lot more serious than what this article implies. What type of unit do you work in?

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

[dorimar, BSN, RN]

Yes, just like VRE, it is usually colonization, and not infection. However, the organism can be highly resistant. There has been a wide spread outbreak of it especially coming form long term vent facilities (@ least here in phoenix). When it was first idientified here, they were actually closing down units.

[JiffyGriff]

Honestly I've never seen that infection up my way, here in cincy. We get lots of c-diff, mrsa, and every now and then a vre or pseudomonas. All of our superinfection or drug resistant patient's earn a contact isolation sign and cart. They get a dedicated stethescope, thermometer, and bp cuff, and nothing leaves their room except to go to dirty utility. We don't have any 1:1 ratio protocol but what will happen is that the nurse's second patient will have a very low risk of contracting it; such as no open wounds, etc.... never even heard of that infection actually.

[TennRN2004]

Yes, just like VRE, it is usually colonization, and not infection. However, the organism can be highly resistant. There has been a wide spread outbreak of it especially coming form long term vent facilities (@ least here in phoenix). When it was first idientified here, they were actually closing down units.

Wow, like our ICU patients don't have enough against them already without a new type of infection to worry about. It makes sense for the isolation though because one patient may colonize it, but if you take care of another patient next door, you may take it in to them, and they may end up with an actual infection from it. Scary stuff, is it as easy to spread as CDiff? I know the big deal with my units and CDiff when we had big outbreaks is reminding everybody the alcohol based hand gels didn't kill the CDiff spores, so we'd have it spread from patient to patient too often. Staffing is a big enough headache also without having to keep a patient with low to medium acuity one to one simply because of an infection.

[dorimar, BSN, RN]

i honestly don't know a great deal. I am told it is easily spread. There is a resistant version and I think a non- resistant version. Obviously, the resistant one is the concern. But, yes I believe it is very easy to spread. For a while they were isolationg every vented patient in our icu until sputum cultures came back negative.