Acinetobacter baumannii - Case Study Example

?Topic: Containing Acinetobacter Baumannii Introduction Acinetobacter baumannii or A.baumannii in short, is anaerobic type of bacteria resistant to most antibiotics. It is associated with severe pneumonia and infections of the bloodstream and other parts of the body. Due to its resistance to drugs, it causes many deaths in areas where it exists. It is also associated with opportunistic infections like in people undergoing treatment due to injury wounds. This organism is associated with the case occurring in the period from May 2009 to February 2010 since having been isolated in tests and resisting all first-line antibiotics it marched the characteristics already associated with it. The pneumonia cases area further proof that indeed it was A.baumannii (Winn and Koneman, 2006, p. 102). Among those most likely to get infected are those who recently had a surgical procedure, those with weak immune systems, those recently from an intensive care unit, and those with poor health. Someone who recently took antibiotics has a catheter or came into contact with another one harbouring the bacteria also has a high chance of getting infected. It is genetically transmitted from other organisms and found in pairs or in groups. It causes many life-threatening illnesses among them blood infection where it either enters through a catheter placed in one’s vein or when an infection spreads from another part of the body to the blood. It also causes meningitis especially after brain or spinal cord surgery; it could also occur if one has a drain or a shunt in their brain (Bruijn, 2011, p. 129). Catheters used to drain urine put one at the risk of contracting A.baumannii and getting a urinary tract infection. Pneumonia is another disease caused by this particular bacteria strain. Since A.baumannii is resistant to most first-line antibiotics among them Ciproflaxin, Gentamicin and Colistin and dessication, containing an outbreak is usually a hard task for the health authorities (Mayers, Lerner, Ouellette, and Sobel, 2009, p. 29). Besides requiring expensive drugs for its control, a lot of care needs to be taken to avoid further spread of the same. Research into its characteristics is also expensive, requiring a lot of equipment to isolate and test it. Since it also puts those inflicted by wounds at a higher level of infection, it is hard containing it in places with many injured people like wars. It also presents another hurdle in controlling it by causing diseases that have other causes. Unless keen investigation is undertaken, many lives would be lost while the wrong treatment is being administered (Bergogne-Berezin and Fewson, 1991, p. 119). It is thus a complex type of bacteria to deal with and its occurrence a most dreaded incidence. Diagnosis Diagnosis of the virus is done by several methods three of which shall be illustrated. The first is culturing where a sample of blood, urine or tissue undergoes a lab test under given conditions to determine its presence. It takes some to obtain results with this method. A second method is lumbar puncturing where a fluid from around the patient’s spinal cord is taken and tested. It usually reveals infections and presence of blood around the spinal cord. A third method is use of x-rays to determine if the lungs and the heart show any signs of pneumonia (Schlossberg, 2008, p. 87). The three tests could be done simultaneously if one isn’t satisfactory. Treatment With A.baumannii presenting pneumonia-like symptoms and being resistant to most first-line antibiotics, treating this type of bacteria is a hard and expensive task. Unless it is isolated and its presence confirmed, efforts made to contain it might prove to be mostly futile (Bowden, Ljungman, and Snydman, 2010, p. 28). Symptoms of its infection include skin blisters in orange patches, fever, a burning sensation during urination, chest pain, coughs and a stiff neck among others. A.baumannii has exhibited reduced motility in blue light. This photosensitivity could be harnessed to reduce its effect in infected patients while further treatment is administered. It could also be a way of killing it since with reduced motility it feeds less and would most likely die from undernourishment (Roy and Fraunfelder, 2007, p. 38). Further tests are being carried out to find ways of utilising its photosensitivity in treating patients. Available Drugs Having resisted most first-line antibiotics, better suited drugs in containing an infection by A.baumannii are tigecycline, polymyxins and aminoglycosides. The three drugs are quite costly to purchase although they are among the few drugs resistant to this notorious type of bacteria. It is advised to test the patient’s response to a given drug since cases of allergic reactions have been reported. It allows treatment of patients across the board without compromising on the quality of treatment (Bendinelli, 2008, p. 78). The drugs may be administered singularly or in combination as prescribed by the health official. A control measure still under testing is the use of a specific type of bacteriophage against A.baumannii. The downside to the usage of bacteriophage in dealing with bacteria is that there would be a high level of pneumonia. If the patient is strong enough to withstand the harsh pneumonia, this would be an ideal method of keeping A.baumannii under check (Grody, Nakamura, Kiechle, and Strom, 2009, p. 219). Ways of reducing the pneumonia occurring due to the use of bacteriophage are under testing. This would allow this treatment method to be administered to a wide range of patients. Antipyretics are also used to decrease a fever in infected patients. These drugs reduce the body temperature whose rise is the result the bacterial infection. Other fever-reducing drugs could be used provided they don’t have effect on the main drugs’ effectiveness (Rello, Kollef, and Diaz, 2007, p. 119). Pain reducing medicine is usually administered due to the pain that accompanies the bacterial infection. Since pneumonia symptoms are in most cases exhibited, painkillers come in handy to make the patients comfortable even in illness (Gould, 2012, p. 100). Most painkillers used in this case cause dizziness thus patients taking them should be aware to avoid accidents. It is also advised that patients be put in the care of another person to help them move around without much bumping into objects. Curbing the Spread Of A.baumannii The best way to contain the effect of bacteria that is as infectious as A.baumannii is by keeping its rate of spreading as low as possible. Being a hard-to-treat strain of bacteria, it is better prevented than cured (Murray and Rosenthal, 2005, p. 87). The hard part about this type of bacteria is that it is usually found in health facilities thus easier to get to people. Great care is therefore taken to keep it under control. A.baumannii spreads in many ways among them coming into contact with the infected, having a catheter and since it causes urinary tract infections, there is chance for sexual transmission. Curbing its spread thus comes high on the priority list of containing the bacterial spread. Simple hand-washing with antiseptic is one of the most effective ways of curbing A.baumannii’s spread. One has to wash their hands after a visit to the toilets, after sneezing and before touching any food. This reduces the bacteria’s spread besides keeping at bay all kinds of germs. If one is infected, care should be taken not to infect others by covering one’s mouth when sneezing, using particular utensils and, in the most severe cases, being isolated until the infection is within manageable levels (Gillespie and Hawkey, 2006, p. 77). Staff in the hospital in the above case can take care of preventing the spread of the bacteria by this same method. Babies born in this hospital can be screened to determine those who are infected and those who are not. This would make it easier to separate the infected from the uninfected to prevent further spread of the infection. It is an effective way of containing the bacteria since treatment costs are avoided (Tomashefski and Dail, 2008, p. 176). Training staff on ways of keeping the disease under control will have a long-term effect. Since each nurse takes care of at least two babies, utmost care should be taken not to pass on an infection from one child to the next. Washing hands as discussed earlier on could be employed between sessions of handling babies (Miller, Vandome, and Mcbrewster, 2010, p. 29). All equipment should be sterilized before and after any use. Since it is staff members who are the links between the babies, great focus should be placed on their general hygiene since the bacteria A.baumannii thrives in unhygienic conditions. Great care should be taken in any form of transferring equipment or babies in and out of the natal department since it has the highest chance of spreading the bacteria to the babies (Filippis and McKee, 2013, p. 29). Any equipment should be sterilized before being moved from one area of the natal department to another. Those who handle the equipment should also wash hands with antiseptic in between the transfers. The source of the bacteria should be quickly established as it does little curbing its spread while leaving the source intact. This would be equal to treating symptoms instead of the real disease. All facilities and equipment in the hospital should first be screened before the search goes outside. This will keep the infection level under check since all concerned will be on high alert. The incubators are also too close together to say there is safety from the bacteria’s spread (Mainous, 2010, p. 19). Research has shown that the virus can move about and even though a metre is a big distance for microscopic bacteria, the best solution would be not only a bigger distance between the incubators but also reducing any interconnections between the incubators as much as possible. Conclusion A program that clearly states how to deal with another outbreak should be put into place to reduce the time taken to put a hold on the spread of the infection before it does much harm. All health officials and the whole staff in general should have sufficient knowledge concerning the ways in which the bacteria can be controlled (Engelkirk, and Duben-Engelkirk, 2008, p. 37). The community around the hospital should also be sensitized on the symptoms associated with bacterial infection. It is thus a noble task to make effort to keep everyone in the know. References Bendinelli, M., 2008. Acinetobacter Biology and Pathogenesis. Chicago: Springer. Bergogne-Berezin, E. and Fewson, C., 1991. The Biology of Acinetobacter: Taxonomy, Clinical Importance, Molecular Biology, Physiology, Industrial Relevance. Chicago: Springer. Bowden, R., Ljungman, P. and Snydman, D., 2010. Transplant Infections. New York: Lippincott Williams & Wilkins. Bruijn, F., 2011. Handbook of Molecular Microbial Ecology I: Metagenomics and Complementary Approaches. New York: John Wiley & Sons. Engelkirk, P. and Duben-Engelkirk, J., 2008. Laboratory Diagnosis of Infectious Diseases: Essentials of Diagnostic Microbiology. Chicago: Lippincott Williams & Wilkins. Filippis, I. and McKee, M., 2013. Molecular Typing in Bacterial Infections. New York: Springer. Gerischer, U., 2008. Acinetobacter: Molecular Biology. New York: Horizon Scientific Press. Gillespie, S. and Hawkey, P., 2006. Principles and Practice of Clinical Bacteriology. New York: John Wiley & Sons. Gould, I., 2012. Antibiotic Policies. New York: Springer. Grody, W., Nakamura, R., Kiechle, F., and Strom, C., 2009. Molecular Diagnostics: Techniques and Applications for the Clinical Laboratory. New York: Academic Press. Mainous, A., 2010. Management of Antimicrobials in Infectious Diseases. New York: Springer. Mayers, D., Lerner, S., Ouellette, M. and Sobel, J., 2009. Antimicrobial Drug Resistance. New York: Springer. Miller, F., Vandome, A. and Mcbrewster, J., 2010. Acinetobacter Baumannii. New York: Alphascript Publishing. Murray, P. and Rosenthal, K., 2005. Review of Medical Microbiology. New York: Elsevier Health Sciences. Rello, J., Kollef, M. and Diaz, E., 2007. Infectious Diseases in Critical Care. Chicago: Springer. Roy, F. and Fraunfelder, F., 2007. Roy and Fraunfelder's Current Ocular Therapy. Chicago: Elsevier Health Sciences. Schlossberg, D., 2008. Clinical Infectious Disease. Cambridge: Cambridge University Press. Tomashefski, J. and Dail, D., 2008. Dail and Hammar's Pulmonary Pathology. New York: Springer. Winn, W. and Koneman, E., 2006. Koneman's Color Atlas and Textbook of Diagnostic Microbiology. New York: Lippincott Williams & Wilkins. Read More