Case Study Exercise 33 isolation and Identification of 281 CASE STUDY are a grea
ID: 253324 • Letter: C
Question
Case Study Exercise 33 isolation and Identification of 281 CASE STUDY are a great place to catch an infection. It is where together the sick, the wounded, the immuno- the population routinely found in long-term-care facilaties reviewed the records of the nurs- GAS outbreaks in such facilities generaly have a ity rate. When the PDOH the microorganisms. This confluence of and opportunistic hosts makes for a bad ing facility, it ldentified a total of 23 cases ef and as much as we try to emphasize infec previous year. Of the 23 infections, 13 nto we almost always find room for improvement. were noninvasive, and 2 resulted in death. The PDOH ometimes a lot of room. Read the case below and answer with the CDC, initiated an investigation to assess and infection control procedures at the facility gested that GAS had been introduced into the vulnerable population of the facility on more than one occasion, a theory borne out when molecular characterization of GAS of diseases, especially those that are contagious isolates revealed four different strains of the bacterium Invasive Group A Streptococcus in a Skilled Nursing or especially virulent, are deemed reportable. When cases of Residents of the facility were screened for GAS carrlage by are encountered, healthcare providers obtaining specimens from the oropharynx, wounds, and the to regional or state health depart skin surrounding various indwelling devices (catheters, tra- ments, who in turn often forward the information to the cheostomies, central lines, etc.) while staff specimens were allows for epidemiologiobtained from oropharyngeal swabs. Of 436 of individual infections and alerts health officials residents and 297 staff members) one resident and four staff 2010 a skilled nursing facility in members had positive GAS cultures. All five carriers received antibiotic therapy recommended for GAS decolonization. in patients of the facility and reported Questioning and observation of staff members revealed proper hand hygiene (hand washing or use of alcohol-based Familiar to most of us as the cause of strep throat or hand sanitizers) was found to be 32%. Hand-sanitizing sta- impetigo, noninvasive Group A Streptococcal infections are tions were located in every resident's room but were often not thought of as particularly serious; annoying and painful broken or empty, and sinks were not available in central yes, but generally not life-threatening. Invasive GAS, on the locations such as nursing stations. Potentially infectious when the bacterium enters sites material such as biohazard bags containing soiled bandages in the body that are normally sterile, is truly a cause for con were routinely moved from room to room. streptococcal toxic shock syndrome (not to be confused ment personnel, provided training to to tampons) kills more than 35% of those affected. The bac- ment of functioning hand-sanitizer dispensers in an infected person or through contact with infected woundsthe difficulty of completely eliminating GAS, being able to spread the disease without suffering from in residents of one unit of the hospital. Rescreening At the time of the investigation, a "flesh-eating bacteria," has a mortality rate of 25%, while ventionist, along with CDC, state and local health depart- with staphylococcal toxic shock syndrome often connected proper infection control practices. After training and place terium is spread through direct contact with mucous from hand hygiene compliance improved to 70%. Emphasizing on the skin. Additionally, many people are carriers of infections, two new invasive GAS infections were Those most at risk of developing GAS infection are peo- three residents and four stalf members to cal devices (respirators, catheters), and the elderly, precisely since December 2010, no additional cases dents and 112 staff members assigned to this unit revealed All seven carriers were treated with antibiotics, andExplanation / Answer
1. Carriers of GAS must be treated with antibiotics even when they display no signs and symptoms of the disease because they are able to spread the disease among other people while showing no signs and symptoms for the same. The bacteria might be spread through sores or infected wounds or through any direct contact with the skin. Moreover, people with surgeries, wounds, elderly person with less immunity always pose a risk in developing the disease from the carriers. So, treatment with antibiotics would help in prevention of the disease.