Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
What precautions should caregivers take when tending to infected persons in their homes?
Outside of healthcare settings, there is little risk of becoming infected
with VRE. In the home, the following precautions should be taken:
Caregivers should wash their hands with soap and water after physical contact
with the infected or colonized person, and before leaving the home.
Towels used for drying hands after contact should be used only once.
Disposable gloves should be worn if contact with body fluids is expected, and
hands should be washed after removing the gloves.
Linens should be changed and washed on a routine basis, and if they are
soiled.
The patient's environment should be cleaned routinely, and when soiled with
body fluids.
Notify doctors and other healthcare personnel, who provide care for patients,
if an individual is colonized or infected with a multidrug-resistant organism.
SOURCE:
National Institute of Allergy and Infectious
Diseases, National
Institutes of Health
What are vancomycin-resistant enterococci (VRE)?
Enterococci are a group of
gram-negative, round-shaped bacteria that commonly live in the gut, although they
can cause infection anywhere in the body. They are resistant to several
antibiotics, but in the past, physicians could rely on the drug vancomycin to
effectively treat enterococcal infections. In recent decades, however, some
enterococci have become resistant to vancomycin. The two main species that cause
problems are vancomycin-resistant Enterococcus faecium and vancomycin-resistant
Enterococcus faecalis, with E. faecium being the most common.
Vancomycin resistance is acquired when a sensitive Enterococcus acquires a
special piece of DNA called a plasmid. The new strain is called
vancomycin-resistant enterococci (VRE). One concern is that VRE appears able to
transfer vancomycin resistance to unrelated bacteria such as MRSA
(methicillin-resistant Staphylococcus aureus). In addition, VRE organisms are
usually resistant to more than one antibiotic.
VRE can also be spread from person to person and are an increasing problem in
hospitals and chronic-care facilities. Approximately 30% of all enterococcal
infections are now caused by vancomycin-resistant strains (VRE).
What causes a vancomycin-resistant enterococcal (VRE) infection?
VRE can
exist in the body without causing infection, in which case a patient is said to
be colonized with VRE. Colonization usually occurs in the bowel. If the number
of VRE bacteria increases, they can invade the bloodstream or spread locally to
cause an abdominal abscess or urinary infection. Once in the bloodstream, VRE
can cause meningitis, pneumonia, or infection of a heart valve (endocarditis).
VRE may also be introduced directly into an open sore or wound, causing a wound
infection. The bacteria produce several substances, including proteases that help
them break down the normal barriers between the gut tissue and the bloodstream.
Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not
everyone with a UTI has symptoms. Common symptoms include a frequent urge to
urinate and a painful, burning when urinating.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
Staphylococcus or Staph is a group of bacteria that can cause a multitude of diseases. Staph infections can cause illness directly by infection or indirectly by the toxins they produce. Symptoms and signs of a Staph infection include redness, swelling, pain, and drainage of pus. Minor skin infections are treated with an antibiotic ointment, while more serious infections are treated with intravenous antibiotics.
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
MRSA (methicillin resistant Staphylococcus aureus) bacteria causes skin infections with the following signs and symptoms: cellulitis, abscesses, carbuncles, impetigo, styes, and boils. Normal skin tissue doesn't usually allow MRSA infection to develop. Individuals with depressed immune systems and people with cuts, abrasions, or chronic skin disease are more susceptible to MRSA infection.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Sepsis (blood poisoning) is a potentially deadly infection with signs and symptoms that include elevated heart rate, low or high temperature, rapid breathing and/or a white blood cell count that is too high or too low and has more than 10% band cells. Most cases of sepsis are caused by bacterial infections, and some cases are caused by fungal infections. Treatment requires hospitalization, IV antibiotics, and therapy to treat any organ dysfunction.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Encephalitis is a brain inflammation that causes sudden fever, vomiting, headache, light sensitivity, stiff neck and back, drowsiness, and irritability. Meningitis is an infection that causes inflammation of the meninges that surround the brain and spinal cord. Symptoms of meningitis include high fever, headache, nausea, vomiting, and stiff neck.
Medical shock is a life-threatening medical condition. There are several types of medical shock, septic shock, anaphylactic shock, cardiogenic shock, hypovolemic shock, and neurogenic shock. Causes of shock include heart attack, heart failure, heavy bleeding (internal and external), infection, anaphylaxis, spinal cord injury, severe burns, chronic vomiting or diarrhea. Low blood pressure is the key sign of sock. Treatment is dependant upon the type of shock.
ICU psychosis is a disorder (also a form of delirium or acute brain failure) in which patients in an intensive care unit or a similar setting experience a cluster of serious psychiatric symptoms. These symptoms include anxiety, reastlessness, hearing voices, hallucinations, nightmares, paranoia and more. Causes of ICU psychosis are generally from a combination of environmental and medical conditions.
Endocarditis, a serious infection of one of the four heart valves is caused by growth of bacteria on one of the heart valves; leading to an infected massed called a "vegetation." The infection can be caused by having bacteria in the bloodstream after dental work, colonoscopy, or other similar procedures. Endocarditis symptoms include fever, fatigue, weakness, chills, aching muscles and joints, night sweats, edema in the legs, feet, or abdomen, malaise, shortness of breath and small skin lesions. Treatment for endocarditis is generally aggressive antibiotic treatment.
Drug resistance (antimicrobial resistance) is the ability of bacteria, fungi, parasites, and viruses to grow, even in the presence of a drug that would normally kill it (or limit it's growth). Drug resistance is a growing problem, particularly for infections such as MRSA, VRE (vancomycin-resistant enterococci), tuberculosis, HIV, STDs, gonorrhea, flu, pneumonia, malaria, E. coli, salmonella, Campylobacter, which causes diarrhea and gastroenteritis. Learn how to protect yourself from resistance to drugs.
A computerized axial tomography scan is an x-ray procedure that combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. Computerized axial tomography is more commonly known by its abbreviated names, CT scan or CAT scan. A CT scan is used to define normal and abnormal structures in the body and/or assist in procedures by helping to accurately guide the placement of instruments or treatments.
A large donut-shaped x-ray machine takes x-ray images at many different angles around the body. These images are processed by a computer to produce cross-sectional pictures of the body. In each of these pictures the body is seen as an x-ray "slice" of the body, which is recorded on a film. This recorded image is called a tomogram. "Computerized Axial Tomography" refers to the recorded tomogram "sections" at different levels of the bod...
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