ESBL E.coli has a carriage duration of three months to four years.
Again this long period of carriage increases the risk of transmission.
Many residents may be colonized with more than
one type of antibiotic resistant bacteria.
This suggests that nursing homes can become reservoirs for
multiple strains of antibiotic resistant bacteria
when persistently colonized residents are accepted and transferred from many
different outside facilities like other nursing homes or hospitals.
Given that there is a high rate of colonization in nursing homes,
how is it that some residents become colonized while others do not?
When colonized residents are compared to non colonized residents,
a variety of factors have been associated with an increased risk
of colonization with antibiotic resistant bacteria.
These include an underlying illness, presence of an invasive device,
like a feeding tube, an IV, or
a urinary catheter, prior antibiotic use, the presence of wounds,
a decline in functional status, and an increased intensity of nursing care.
Another contributing factor in nursing homes for
residents acquiring antibiotic resistant bacteria is colonization pressure.
Colonization pressure occurs when there is a large reservoir
of residents with resistant bacteria, creating more opportunities for these
bacteria to be passed from an infected resident to a non-infected resident.
As we discussed in a previous slide there are already a lot of residents
in nursing homes who are already colonized or infected when they are admitted to
a facility making for a ready source of transmission.
Residents get bad bugs from multiple sources.
The main way these bad bugs are spread is by the hands of healthcare personnel.
The hands of healthcare personnel can spread bad bugs by touching one infected
resident and then touching another resident without washing their hands.
It can also occur by indirect contact
when a healthcare provider touches a contaminated surface or
piece of equipment and then touches a resident without washing their hands.
Similarly, residents can spread bad bugs in the same way to each other
if they fail to wash their hands after they become contaminated.
When a resident is found to be colonized or infected with a bad bug,
a delicate balance is required to protect the residents quality of life,
while protecting other residents from getting a bad bug.
Let's check back at Sunnyside to see how they managed this delicate balance.
>> Previously on Gowns & Gloves, nurse Priscilla breaks the news to
Mr.Houston that his wife has been exposed and colonized with MRSA.
Will Elaine become infected with MRSA?
And what's going on between Dimitri and Priscilla?
Find out on Gowns & Gloves.
[MUSIC]
[SOUND] >> Hi, I'm Vanessa.
Priscilla's with another resident.
