Posted by: Chris Maloney | April 9, 2012

10 Things Doctors and Patients Should Know about Infectious Diseases.

Antibacterial Finished Acrylic Medium Weight Yarn

Antibacterial Finished Acrylic Medium Weight Yarn (Photo credit: Time N Love42)

10 Things Hospitalists Should Know about Infectious Diseases :: Article – The Hospitalist.

I’ve summarized the summary a bit more.  These are good for all of us to think about.

1)  Antibiotic resistance is rising and we have no new antibiotics in the pipeline.

“The FDA faucet is really dry,” says Dr. Bartlett, a world-renowned speaker on ID topics and a frequent speaker at SHM annual meetings. “There are no new antibiotics to speak of, no new antibiotics for resistant bacteria. And there’s not likely to be any for several years.”

2)  It is possible to really identify what you are trying to kill with the antibiotic, rather than firing in the dark.

“They have to be aware that there are methods that are very sophisticated and very sensitive and specific,”

3) Staph. aureus in the blood is always bad.

“an important tidbit regarding S. aureus is that when it’s isolated from blood culture, it should never be considered a contaminant; it’s the real thing”

4) Clostridium difficile is a top threat.

“be familiar with the evidence-based guidelines for C. diff treatment—the use of metronidazole for mild to moderate cases, or vancomycin for severe cases…“Glove use has been proven to be one of the most effective measures at reducing transmission of C. diff,”

5) Don’t have an I.V. line if you don’t need it.

“Leaving a line in just for blood draws is probably not OK,” Dr. Chansolme says. “Nowadays, you’re just seeing way too many of those infections.”

6) Remove catheters as soon as possible.

7) All catheters develop bacterial growth, not always infection.  Get a culture and urinalysis at the same time.

Once a catheter has been in for three or four days, most patients will have “all kinds of bacteria and fungus growing in their urine,” Dr. Allen says.

“A urinalysis lets you assess for the presence of pyuria or other signs of urinary tract inflammation,” he says. “That’s how you determine whether a germ growing in the urine is a colonizer or a true pathogen.”

8) Bactrim does not treat strep infections.

“They’ll go home, and a couple days later they’ll be back because it was in fact a strep infection, not a staph infection,”

9) Watch out for norovirus

it affects people of all ages, is especially common to closed or semi-closed communities (i.e. hospitals, long-term care facilities, cruise ships), and spreads very rapidly either by person-to-person transmission or contaminated food.

“If a healthcare provider becomes ill with sudden nausea, vomiting, or diarrhea, that’s consistent with possible norovirus. They should stay home for a minimum of 48 hours after symptom resolution before coming back to work.”

Read the above and think how many hospitals could function if their staff followed that guideline.

10)  Never swab an ulcer unless it is clearly infected.

“Just because a patient has a bedsore doesn’t mean it’s infected,” Dr. Allen says. “Usually, they’re not infected. But they’re going to have a dozen different germs growing in them.”

Culturing and treatment without signs of infection, he says, often leads to “inappropriate antibiotic use and probably increased length of stay.”

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Responses

  1. One of the most important things when you have urinary problems is finding the right catheter supplies. When my grandfather had issues after a surgery, it was stressful but finding the right stuff and having enough so he wasn’t getting infections on top of already being uncomfortable really helped.


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