MDRO Infections Chapter 21
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Questions and Answers

What percentage of deaths are associated with multidrug-resistant organisms in hospitalized patients?

  • 20%
  • 10%
  • 1/17 (correct)
  • 5.8%

    • What is the primary mode of transmission for Methicillin-Resistant Staphylococcus Aureus?

  • Contact (correct)
  • Airborne
  • Vector
  • Vehicle

    • What is the primary factor contributing to the increased incidence of Methicillin-Resistant Staphylococcus Aureus infections?

  • Inadequate infection control practices
  • Poor antibiotic stewardship (correct)
  • Lack of personal protective equipment
  • Poor hand hygiene

    • What is the most common clinical manifestation of Methicillin-Resistant Staphylococcus Aureus infection?

    <p>Skin and soft tissue infection</p> Signup and view all the answers

    What percentage of patients acquire Methicillin-Resistant Staphylococcus Aureus infections within 48 hours of hospitalization?

    <p>68%</p> Signup and view all the answers

    What is the estimated number of severe infections caused by Methicillin-Resistant Staphylococcus Aureus per year?

    <p>70,000</p> Signup and view all the answers

    What is the primary purpose of administering antibiotics in the management of multidrug-resistant organisms?

    <p>To treat the underlying infection</p> Signup and view all the answers

    What is the primary goal of contact-isolation precautions in the management of multidrug-resistant organisms?

    <p>To reduce the risk of transmission to others</p> Signup and view all the answers

    What is the purpose of stopping the administration of the causative antimicrobial agent in the management of multidrug-resistant organisms?

    <p>To reduce the risk of antibiotic resistance</p> Signup and view all the answers

    What is the primary benefit of encouraging early mobilization in the management of multidrug-resistant organisms?

    <p>To improve clinical outcomes and reduce the risk of complications</p> Signup and view all the answers

    What is the purpose of administering supplemental oxygen in the management of multidrug-resistant organisms?

    <p>To improve oxygenation and reduce the risk of respiratory complications</p> Signup and view all the answers

    What is the primary benefit of performing wound care in the management of multidrug-resistant organisms?

    <p>To prevent the development of wound infections</p> Signup and view all the answers

    What is a potential side effect of using vancomycin to treat MRSA infections?

    <p>Nephrotoxicity and ototoxicity</p> Signup and view all the answers

    What is the first step in managing a patient with a C-Diff infection?

    <p>Stop the causative antibiotic</p> Signup and view all the answers

    A patient is diagnosed with a VRE infection. What is the next step in management?

    <p>Perform susceptibility testing to guide treatment</p> Signup and view all the answers

    A nurse is assessing a patient with a suspected MRSA infection. What would the nurse expect to find?

    <p>Fever and tachycardia</p> Signup and view all the answers

    A patient with an MDR infection is at risk for which of the following?

    <p>All of the above</p> Signup and view all the answers

    What is a key aspect of nursing management for a patient with an MDR infection?

    <p>Monitoring vital signs and oxygen saturation</p> Signup and view all the answers

    What is a potential complication of Vancomycin-Resistant Enterococci infection?

    <p>Endocarditis</p> Signup and view all the answers

    How long can Vancomycin-Resistant Enterococci remain viable on environmental surfaces?

    <p>Up to 2 months</p> Signup and view all the answers

    What is a risk factor for Vancomycin-Resistant Enterococci infection?

    <p>Prolonged hospital stay</p> Signup and view all the answers

    How is Vancomycin-Resistant Enterococci typically transmitted?

    <p>Direct contact from skin or patient care equipment</p> Signup and view all the answers

    What is a clinical manifestation of Vancomycin-Resistant Enterococci infection?

    <p>Urinary tract infections</p> Signup and view all the answers

    What is a pathophysiological mechanism of Vancomycin-Resistant Enterococci?

    <p>Antibiotic resistance</p> Signup and view all the answers

    What clinical manifestation would indicate the need for immediate intervention by the nurse?

    <p>Oliguria</p> Signup and view all the answers

    What is the underlying pathophysiology correlated with the clinical manifestation of hyperglycemia?

    <p>Inadequate insulin production</p> Signup and view all the answers

    Which of the following is a clinical manifestation of the patient's underlying condition?

    <p>Red, edematous, draining wound</p> Signup and view all the answers

    What is the correlation between the patient's symptoms and the underlying pathophysiology?

    <p>The patient's symptoms are a result of inadequate insulin production.</p> Signup and view all the answers

    What is the primary clinical manifestation that indicates the need for further teaching?

    <p>Stopping antibiotics when feeling better</p> Signup and view all the answers

    What is the correlation between the patient's clinical manifestations and the need for transitional care plans?

    <p>The patient's symptoms indicate the need for follow-up with a home-care nurse.</p> Signup and view all the answers

    What is the primary way Methicillin-Resistant Staphylococcus Aureus is transmitted?

    <p>Through skin-to-skin contact</p> Signup and view all the answers

    What is the most common multidrug-resistant pathogen?

    <p>Methicillin-Resistant Staphylococcus Aureus</p> Signup and view all the answers

    Which of the following is a risk factor for developing Methicillin-Resistant Staphylococcus Aureus infection?

    <p>Residing in a long-term care facility</p> Signup and view all the answers

    What is a common clinical manifestation of Methicillin-Resistant Staphylococcus Aureus infection?

    <p>Pneumonia</p> Signup and view all the answers

    What percentage of Staphylococcus aureus cultures are Methicillin-Resistant?

    <p>80%</p> Signup and view all the answers

    How many deaths are associated with multidrug-resistant organisms in hospitalized patients?

    <p>98,000</p> Signup and view all the answers

    Study Notes

    MDRO Epidemiology

    • 1.7 million hospitalized patients per year are affected by multidrug-resistant organisms (MDROs)
    • 98,000 deaths occur annually due to MDROs (1/17 patients)
    • MDRO cases increased with the COVID-19 pandemic:
      • 65% increase in central line-associated bloodstream infections (CLABSI) in ICUs
      • 35% increase in ventilator-associated events (VAE)
      • 43% increase in catheter-associated urinary tract infections (CAUTI)

    Methicillin-Resistant Staphylococcus Aureus (MRSA)

    • Epidemiology:
      • 80% of staph aureus cultures are MRSA
      • Most common multidrug-resistant pathogen
      • 70,000 severe infections occur annually with 9,000 deaths
      • 68% of cases are acquired within 48 hours of hospitalization due to poor antibiotic stewardship
    • Risk factors:
      • Hospitalization in the last 12 months
      • Soft tissue infection
      • Hospitalization in intensive care
      • Residing in a long-term care facility
      • Immunosuppression
    • Pathophysiology: Contact with the pathogen
    • Clinical manifestations:
      • Pneumonia
      • Skin and soft tissue infection
      • Bloodstream infection
    • Complications:
      • Increased morbidity and mortality
      • Osteomyelitis
      • Toxic shock syndrome
      • Multisystem organ failure

    Vancomycin-Resistant Enterococci (VRE)

    • Epidemiology:
      • Lower incidence in western US than eastern US
      • Higher incidence in larger teaching hospitals
      • Lower incidence with hand-hygiene compliance
      • Increased with poor antibiotic stewardship
    • Risk factors:
      • Prolonged hospital stays
      • Immunosuppressed
      • Prolonged exposure to antibiotics
      • Invasive procedures and devices
    • Pathophysiology: Direct contact from skin or patient care equipment
    • Clinical manifestations:
      • Urinary tract infections
      • Peritonitis
      • Bacteremia
      • Wound infection
    • Complications:
      • Vancomycin-resistant S. aureus
      • Prolonged hospital stay
      • Prolonged antibiotic therapy
      • Higher mortality
      • Increased cost of hospitalization
      • Endocarditis

    Management of Multidrug-Resistant Organisms

    • Medical management:
      • MSRA: Vancomycin with trough levels; Linezolid (bacteriostatic) as an alternative
      • VRE: Difficulty in treating due to resistance to penicillin and ampicillin; requires susceptibility testing
      • C-Diff: Stop causative antibiotic, oral vancomycin, probiotics, and fecal microbiota transplantation
    • Nursing management:
      • Assessment and analysis:
        • Look for typical signs of infection (fever, tachycardia, tachypnea, hypovolemia, diarrhea, wound infections)
      • Nursing diagnoses:
        • Risk for deficient fluid volume
        • Ineffective airway clearance
        • Alteration in comfort
        • Risk for perineal skin breakdown
        • Impaired tissue integrity
        • Impaired urinary elimination
        • Acute pain
      • Nursing interventions:
        • Hand hygiene
        • Isolation precautions
        • Antibiotic administration
        • Fever reduction
        • Pain management
        • IV fluid administration
        • Oxygen therapy
        • Chest physiotherapy
        • Early mobilization
        • Wound care
        • Perineal care
        • Fecal diversion systems
      • Teaching:
        • Contact-isolation precautions
        • Medication regimen
        • Clinical manifestations of infection
        • Sun protection

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    Related Documents

    Unit XIII MDO PDF

    Description

    Test your knowledge on multidrug-resistant organism infections, including epidemiology, prevention, and management. Learn about the impact of COVID-19 on MDROs and how to coordinate care for patients with these infections.

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