Infectious Diseases: Multidrug-Resistant Organisms (MRSA, VRE, CRE, ESBL) for Progressive Care Certified Nurse (PCCN)

Infectious Diseases: Multidrug-Resistant Organisms (MRSA, VRE, CRE, ESBL)

Definition/Etiology:

• Bacterial infection by an organism that is hard to treat as it is not sensitive to many antibiotics

Pathophysiology:

• MRSA, VRE, CRE, ESBL in
  • Blood
  • Lungs
  • UTI
  • Wound
  • Skin
  • Surgical Site

Noticing: Assessment & Recognizing Cues:

• Assessment (general)
  • Fever
  • Chills
  • S/S specific to system
• Assessment (site)
  • Redness
  • Painful
  • Swollen
  • Drainage

Interpreting: Analyzing & Planning:

• Complete Blood Culture
  • WBC
• Culture fluid
  • UTI – urine
  • PNA -sputum
  • Septicemia- Blood
  • Wound -drainage

Responding: Patient Interventions & Taking Action:

• Targeted antibiotics
  • Start broad spectrum (1 or 2)
  • Targeted- once culture comes back
• Symptom management
  • Fever
  • Cough
  • Pain 

Reflecting: Evaluating Patient Outcomes:

• Symptom improvement
• Prevention- Handwashing!
• Avoid antibiotics if possible
• Prevent sepsis

Linchpins (Key Points):

• An infection is an infection. Be careful with antibiotics.
• Infection = general s/s infection
• System-specific= s/s specific to system affected
• Treatment= hard to treat. Be careful with antibiotics. Don’t use if not needed