Isolation and infectious diseases policy - Hampshire Hospitals NHS ...

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Winchester & Eastleigh Healthcare NHS Trust Policy for Isolation and Infectious Diseases Policy Transmission within hospitals is mainly on hands contaminated by contact with colonised or infected patients. Hand washing is extremely important as a means of controlling infection. The environment in close contact with the patient may also be contaminated, especially is the patient has diarrhoea, and serves as a source of contamination of staff hands. Thorough cleaning of the environment is essential. When a patient with GRE is identified, the patient and their contacts within the ward must be screened for GRE. Faeces are the most useful screening specimen for outbreak situations. A GRE screen includes Rectal swab and a perineum swab Stool sample Wound swabs – leg ulcers, IV cannula, tracheostomy sites CSU Patients at risk of having GRE are A history of previous hospitalisation Recent antibiotic therapy and/or multiple antibiotic therapies Underlying disease especially hepatobilary disease Permanent indwelling invasive devices e.g. PEG and urinary catheter Patients in ITU / HDU Infection Control Precautions Isolate in a side room and barrier nurse Wear gloves and yellow apron each time you enter the room. Deep clean the contact bay after the affected patient has been moved out Close the bay to admissions and transfers Barrier nurse the remaining patients in the bay Screen the contacts Treatment GRE lives in the bowel and research indicates that eradication attempts have not been successful or worthwhile. On occasions it will be necessary to teat a patient’s clinical infection with GRE. Advice must be sought from the Microbiologist. Patients with GRE who are having surgery or insertion of invasive devices may require different prophylactic antibiotics from those recommended in the Antibiotic 32 Authorities Document Control Information Author: Sponsor: Date: Dr Kordo Saeed microbiologist Sue Dailly Lead Nurse Infection Prevention and Control Paula Shobbrook Director of Infection Prevention and Control 01/08/11 Type: Scope: Reference: Issue No: Status: Policy Major CP022 (IC 04) 4 Published
Winchester & Eastleigh Healthcare NHS Trust Policy for Isolation and Infectious Diseases Policy Prescribing Guidelines. Clinicians are requested to discuss each case with the microbiologists prior to prescribing. Appendix 6:ESBL – Information Sheet Extended Spectrum Beta Lactamase producing coiforms Coliforms such as Escherichia coli and Klebsiella are very common bacteria that normally live harmlessly in the gut. They sometimes cause infections, most commonly urinary tract infections, and also bacteraemia/septicaemia e.g. due to biliary sepsis which can be life threatening. Extended-Spectrum Beta-Lactamases (ESBLs) are enzymes that can be produced by coliforms making them resistant to almost all β lactma antibiotics including coamoxiclav, piperacillin/ tazobactam and cephalosporins e.g. cefuroxime, cefotaxime and ceftazidime - which are widely used antibiotics in many hospitals. Some coliforms carry resistant genes to other classes of antibiotics including ciprofloxacin and aminoglycosides. This makes treating the infections they cause very difficult to manage. There are a number of different organisms that produce ESBL enzymes and E. coli and Klebsiella are two of the commonest. A number of patients with ESBL are identified in the community. These bacteria can be acquired in the community not just in hospital. Route of Spread The source of the spread is the site on the patient which is colonised or infected. Person to person directly Faecal oral spread Hand contact Although ESBL can be spread on equipment the most common route is by contact with an infected or colonised patient, which emphasises the importance of good hand hygiene before and after patient contact. Infection Control Precautions Isolate in a single room or in a cohort bay Gloves and yellow apron for all patient contact 33 Authorities Document Control Information Author: Sponsor: Date: Dr Kordo Saeed microbiologist Sue Dailly Lead Nurse Infection Prevention and Control Paula Shobbrook Director of Infection Prevention and Control 01/08/11 Type: Scope: Reference: Issue No: Status: Policy Major CP022 (IC 04) 4 Published
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