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Tackling superbugs that attack drugs moving into nursing homes: tools



A nurse qualified assistant will rub against Neva Shinkle with chlorhexidine, an antimicrobial washing. Shinkle is a patient in the Coventry Court Health Center, a foster home in Anaheim, Calif., Which is part of a multi-center research project aimed at preventing the prevention of MRSA and CRE – two varieties of bacteria against t most antibiotics.

Heidi de Marco / KHN


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A nurse qualified assistant will rub against Neva Shinkle with chlorhexidine, an antimicrobial washing. Shinkle is a patient in the Coventry Court Health Center, a foster home in Anaheim, Calif., Which is part of a multi-center research project aimed at preventing the prevention of MRSA and CRE – two varieties of bacteria against t most antibiotics.

Heidi de Marco / KHN

Nurses and nursing homes in California and Illinois are experimenting with a remarkable strategy to halt the dangerous, antibiotic giants which kill thousands of people each year: clearing patients t with a soap special.

The efforts, which are funded by around $ 8 million from the Marine Government Control and Prevention Centers – are held at 50 facilities in these two states.

This new collaboration recognizes that supermarkets are not housed separately in a single hospital or nursing home but can move quickly through the community, said Prof. John Jernigan, who leads the CPC's office on the investigation of disease with healthcare.

"Not the island of healthcare is island," Jernigan says. "We are all in this complex network."

At least 2 million people in US get disease with a type of bacteria to attack antibiotics every year, and around 23,000 die of these diseases, according to the CPC.

People in hospitals are vulnerable to these bugs, and people in nursing homes are especially vulnerable. There are up to 15 per cent of patients in the hospitals and 65 per cent of residents in a nursing home carrying organic goods to drugs, although not all have developed. any disease, Dr Susan Huang, who is particularly involved in infectious diseases at the University of California, Irvine.

"Superbugs are awkward and don't bother them," said Huang. "They don't leave."

Some of the most common bacteria in Staphylococcus aureus healthcare facilities, or MRSA, or MRAP carbapenem-in-carbosmenem, or CRE, often referred to as "night bacteria". E.Coli and Klebsiella pneumoniae It is two common bites that can be in this category when they occur the fight against ultimate antibiotics called carbapenems. Bacteria bacteria the result was around 600 deaths a year, according to the CPC.

The CRE has 'spread far and wide' in the healthcare network in the Chicago area, according to Dr Scott. T Michael Lin, an infectious disease specialist at the Rush University Medical Center, is leading the CDC funded effort. “If MRSA is the superbug, this is the real prize – the great superbug.” T

The bacteria are dangerous in challenging hospitals and nursing homes. As part of the CPC's efforts, doctors and health care staff in Chicago and Southern California use the antimicrobial chlorhexidine soap, which has been shown to reduce infections when patients are affected with t .

The Control of Illness and Prevention Centers, which cost a total of 36 hospitals and nursing homes, use the antiseptic glue to run in California, based in Orange County, along with an iodine-based stripe swab. patients to stop deadly deaths.

Heidi de Marco / KHN


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Heidi de Marco / KHN

The Control of Illness and Prevention Centers, which cost a total of 36 hospitals and nursing homes, use the antiseptic glue to run in California, based in Orange County, along with an iodine-based stripe swab. patients to stop deadly deaths.

Heidi de Marco / KHN

While hospital care units often rely on chlorhexidine to prevent infections, this is not used for swimming in nursing homes. Chlorhexidine is also sold over the counter; the FDA in 2017 has resulted in rare but bad reactions.

In Chicago, researchers work with 14 short-term nursing homes and hospitals, where staff visit people for the CRE bacteria when they import and bath each. day with chlorhexidine.

The Chicago project, which started in 2017 and is coming to the end of September, includes a campaign to encourage washing and more communication amongst hospitals about whether patients are carrying the organisms. T there are anti-drugs.

The protocol on control of new diseases was for many nursing homes, which is not the same as hospitals, Lin says.

In fact, three-quarters of nursing homes were received in Ms. S. mention of disease control problems over four years, according to the Kaiser Health News study, and the resources with repetitions that have never been repaid. Nursing home residents are often sent back to hospitals as a result of diseases.

In California, health officers look closely at the CRE bacteria, which are more common in other parts of the country, and they're trying to stop the CRE from saying, t Dr. Matthew Zahn, medical director in cardiology at Orange County Health Care Agency

"We don't have an unexpected time," said Zahn. “It is really important to allow for a difference in the CRE's route now.”

The CDC-funded project is based in Orange County, where 36 hospitals and nursing homes use the antiseptic cleaning as well as an iodine-based stripe swab. The aim is to stop newcomers from taking drugs and those who already have bacteria on the skin or elsewhere from diseases that have developed, Huang, t in charge of the project.

Professional nurse under the license of Joana Bartolome restricting nose with an antibodterial solution, iodine-based at the Coventry Anaheim Health Center. Inspections discover that a patient can throw anti-drug types into the nose that they have not yet made.

Heidi de Marco / KHN


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Heidi de Marco / KHN

Professional nurse under the license of Joana Bartolome restricting nose with an antibodterial solution, iodine-based at the Coventry Anaheim Health Center. Inspections discover that a patient can throw anti-drug types into the nose that they have not yet made.

Heidi de Marco / KHN

Huang began the project by examining how patients move among hospitals and different nursing homes in Orange County – she found that they were doing far more than expected. before. That helped a really important question, it says: "What can we do to just protect our patients but to protect them when they start moving around?"

Her previous research showed that fallen patients There was a MRSA bacterium on their skin or in their nose, for example, for six months, the use of chlorhexidine for fluid and as mouthlet, and rubbing their nose with antibiotic. the risk of reducing MRSA infection by 30%. But all patients in that survey were published in February Medicine Journal New England, which was already released from hospitals.

The aim now is to target patients who are still in hospitals or nursing homes and to extend their work to CRE. The traditional hospitals which take part in the new project are aimed at patients in intensive care units who collect bacteria against antisocial drugs already, while at home. nurses and the long-term care hospitals achieve all the cleaning – known as decolonizing – for all residents.

One morning recently at Coventry Court Health Center, a nursing home in Anaheim, Calif., Neva Shinkle, who is 94 years old, sat patiently in the wheelchair. An occupational nurse with the permission of Joana Bartolome sent her nose and asked if she remembered what she had done.

"It kills the germs," ​​answered Shinkle.

"That's right – it's protecting you from diseases."

In a nearby room, project co-ordinator, Raveena Singh, from UCI spoke to Caridad Coca, 71, who had recently arrived at the center. She explained that Coca was run by chlorhexidine rather than regular soap. “If you have a form of open prey, or you've cut it, it helps you to protect you from getting a disease,” said Singh. "And it is not just protecting you, one person. We protect everybody in the nursing home."

Coca said she had a cousin who spent months in hospital after being given MRSA. "Fortunately, I was never there," she said.

The administrator of Coventry Court, Shaun Dahl, says he wanted to take part because people were reaching the nursing home to carry MRSA or other bugs. "They were sick there, and they are sick here," Dahl said.

Results are due from the Chicago project. The initial results of the Orange County project, which ends in May, show that it seems to work, Huang says. After 18 months, researchers saw a 25 per cent reduction in drug organisms in foster home homes, 34 per cent of hospital patients in long-term care and 9 per cent in traditional hospital patients. T . The CRE's dramatic numbers were dramatic, although the number of casualties with this type of bacterium was smaller.

The starting data also shows the severe consequences of resources not part of the drive, a signal that the project is beginning to make a difference in county, according to Zahn from the Orange Healthcare Group. County.

“In our community, we have seen an increase in the disease against being opposed to philosophy,” he says. "This allows the transition and the loop to be moved in the right way."

Kaiser Health News is a non-profit news service, and an independent, independent Kaiser Family Foundation program. KHN is not connected to Kaiser Permanente.


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