To prevent multidrug-resistant germs, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Malnutrition Poor hand hygiene: one in four patients carried multidrug-resistant pathogens (MREs) on their hands when admitted to a U.S. rehab facility. Foreign travel: Of 574 travelers who were free of multidrug-resistant pathogens before traveling to tropical countries, … Multidrug-resistant Germs: Prevention
The following symptoms and complaints/illnesses may indicate multidrug-resistant germs: Therapy-resistant infections: Respiratory infections Urinary tract infections Skin infections (wound infections and abscesses/encapsulated pus cavities).
Pathogenesis (development of disease) Multidrug-resistant problem germs are: New Delhi metallo-β-lactamase 1 (NDM-1) strains: involves bacterial strains (gram-negative enterobacteria Escherichia coli and Klebsiella pneumoniae) with the NDM-1 gene that are reported to be resistant to all antibiotics known to date, with the exception of tigecycline and colistin. Methicillin-resistant Staphylococcus aureus (MRSA) strains: involves Staphylococcus aureus … Multidrug-resistant Germs: Causes
General measures Observance of the general rules of hygiene! One of the easiest ways to keep yourself and others healthy is to wash your hands regularly. Hands should be washed under clean running water for at least 20 seconds. Nicotine restriction (refrain from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; … Multidrug-resistant Germs: Therapy
The following are the most important diseases or complications that can be caused by multidrug-resistant germs: Respiratory system (J00-J99) Pneumonia (pneumonia) Skin and subcutaneous (L00-L99) Wound infections and abscesses (encapsulated pus cavities). Infectious and parasitic diseases (A00-B99). Sepsis (blood poisoning) Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Intraabdominal (“within the abdominal cavity”) abscesses. … Multidrug-resistant Germs: Consequential Diseases
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of eye) [wound infection?, abscesses (encapsulated pus cavity)?] Oral cavity Pharynx (throat) Abdomen (abdomen) Shape of the abdomen? Skin … Multidrug-resistant Germs: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Differential blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics for sensitivity … Multidrug-resistant Germs: Lab Test
Therapeutic target Rehabilitation or cure of the patient Therapy recommendations MRE (multidrug-resistant pathogens): isolate patient (single room; surgical face mask; work procedures according to infection control manual) [critics of isolated rooms point out that isolation units often increase bacteremia rates due to contamination of glove boxes → with disposable gloves, pathogens are passed via intravenous … Multidrug-resistant Germs: Drug Therapy
Optional medical device diagnostics – depending on the results of the medical history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification. Abdominal sonography (ultrasound examination of abdominal organs) – for basic diagnostics.
In cases of pharyngeal (“affecting the throat (pharynx)”) MRSA detection that persists despite multiple attempts at sanitation, tonsillectomy (tonsillectomy) is an option worth considering.
Medical history (history of illness) represents an important component in the diagnosis of multidrug-resistant germs. Family history What is the general health status of your relatives? Social history What is your profession? Current medical history/systemic history (somatic and psychological complaints). Do you suffer from treatment-resistant wound infections or abscesses? Do you have treatment-resistant respiratory infections? … Multidrug-resistant Germs: Medical History
Respiratory System (J00-J99) Respiratory tract infections due to mono- or polyresistance. Skin and subcutaneous (L00-L99). Wound infections and abscesses (encapsulated pus cavities) due to mono- or polyresistance. Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99). Urinary tract infections due to mono- or polyresistance.
