Page 186 - policy and procedure infection control
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Policies and Procedures on Infection Control
13. SPECIFIC ORGANISM RELATED INFORMATION
13.1 Multi-Resistant Organism
13.1.1Introduction
Multi-resistant organisms are bacteria that have developed resistance to more than 2
different groups of any used antibiotics. Development of multi-drug resistance has been
associated with inappropriate and over use of antibiotics
Resistant organisms of significance in healthcare settings include Pseudomonas
aeruginosa, Acinetobacter and Extended-spectrum beta lactamase (ESBL)-producing
bacteria which are most commonly produced among Escherichia coli (E. coli), Klebsiella
and Proteus.
13.1.1.1 ESBLs and ESBL Infection
• ESBL are bacterial enzymes that have conferred resistance to second and
third generation cephalosporins antibiotics. ESBLs are the cause of multi-
drug resistant gram negative bacteria around the world.
•· Treatment of choice includes carbapenems and tigecycline
13.1.1.2 Pseudomonas aeruginosa
• Pseudomonas aeruginosa is a gram-negative bacterium normally found in
soil and water. It rarely affects healthy people, but can cause serious illness
in immunocompromised people (HIV or cancer patients).
• In healthcare settings it contaminates wet reservoirs e.g. indwelling catheters
and can cause serious bloodstream infections.
13.1.1.3 Acinetobacter
• Acinetobacter is a gram-negative bacterium, normally lives in soil and water
and can sometimes be found on the skin, posing no risk to healthy people.
•· It can live in the environment for several days. There are several species and
a few can cause infections in people who are already unwell.
13.1.2Transmission
• The transmission of multi-resistant organisms in hospital and community is by person
to person spread either directly via staff, patient or visitor unwashed hands that have
been contaminated by contact with colonised or infected patient or indirectly from
contaminated equipment and surfaces.
• ESBLs can also be transmitted via the faecal oral route.
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