How can I prevent MRSA infection
Measures to be taken in the event of an infection
As long as there are no symptoms, colonization with multi-resistant pathogens, also referred to as colonization, is not clearly recognizable. But it can always harbor the risk of infection and transmission to contact persons. That is why regular checks are carried out in the vicinity of people at risk, in hospitals and in intensive care units.
Evidence of colonization
The proof of a germ colonization is easily possible through a painless examination. For this purpose, certain areas of the body such as B. smears taken from the nasopharynx and then examined microbiologically in the laboratory. In order to prevent the spread of multi-resistant germs in many hospitals, these examinations are part of the standard of hygiene management in hospitals. They mainly take place during the inpatient admission of high-risk patients. If an MDRO colonization is found in the hospital, check-ups are carried out on the person affected and on patients who have had close contact with him.
If certain multi-resistant pathogens are detected, the usual hygiene measures in the hospital are tightened. Depending on the risk of spread - pathogens such as MRSA, which are transmitted via contact infection, are particularly critical - it may be necessary to move the affected patient to a single room. Medical staff and visitors must then wear special protective clothing, possibly also mouth and nose protection, when entering the room and of course disinfect their hands immediately after each patient contact.
If a patient is colonized with a resistant pathogen (e.g. in the nasopharynx with MRSA), it may be necessary to "rid" the patient of this pathogen before a planned operation in order to reduce the risk of infection or transmission of germs reduce. One then speaks of redevelopment or decolonization. In the case of colonization with MRSA, the patient washes or showered completely every day, including the hair, with a special antimicrobial soap. He has to clean his nose three times a day and then apply an antibacterial ointment in and around the nose. In addition, after each time you brush your teeth, at least twice a day, the mouth is rinsed with an antibacterial solution or the denture is placed in this medical solution.
The renovation usually takes about 1 week. Patients do not necessarily have to be cared for in hospital during this time. The rehabilitation can also take place in the home or at home before the admission, if the referring or operating doctor has thought of screening the risk patient. It is important that the treating family doctor is informed about the status of treatment and can accompany and monitor the remedial measures. In addition, further hygiene measures should be carried out in the home environment (see info box). If patients are cared for by relatives or an outpatient care service, all caregivers must be fully informed about the sanitation and hygiene measures. This is the only way to ensure that the renovation is successfully completed. This is the case if the smears taken during the check-ups no longer contain any resistant germs. If there is evidence of colonization of the intestine with multi-resistant bacteria, there is no such remediation option.
In order to prevent the pathogen from spreading, stricter hygiene guidelines apply in hospitals. Patients who are discharged from the hospital and whose MRSA sanitation has not yet been completed should, in accordance with the attending physician, follow the necessary extended hygiene measures for the remaining sanitation period (see info box). In addition, the doctors providing further treatment and, if necessary, supervisors and nurses are informed so that they can also take appropriate preventive measures.
Extended hygiene measures in the home environment as long as the MRE refurbishment has not yet been completed:
- Daily change of bed linen, towels, clothes
- Wash the laundry at temperatures of at least 60 ° C
- Wash dishes with hot water, preferably in the dishwasher at at least 60 ° C
- Regular cleaning of surfaces that are often touched, e.g. B. light switches and doorknobs, faucets, with disinfectants
- Disposal of personal hygiene and cosmetic items that were used before the renovation, e.g. B. Toothbrush, roll-on deodorant, wet razor
Drug therapy for infections
In addition to the rehabilitation and hygiene measures described, drug therapy is often necessary in the case of an infection with MDRO.
The difficulty lies in choosing the right drug. That is why the microbiological laboratory examination of the smear not only determines the exact type of pathogen, but also creates a so-called antibiogram. It is tested to determine which antibiotics the pathogen has developed resistance to and which of these drugs are effective. In this way, the appropriate antibiotics can be administered specifically for therapy. Experience has shown that good results can be achieved with antibiotics that have novel active principles and thus bypass the resistance mechanisms of bacteria. The therapy often consists of a combination of different antibiotic agents.
Every antibiotic therapy follows a precisely specified treatment and dosage regimen, which should be strictly adhered to as directed by a doctor. The duration of the therapy is usually between 1 and 2 weeks, possibly longer in the case of seriously ill patients. It can be started in the hospital and, with some infections, continued on an outpatient basis with tablets.
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