Crusade to Forestall Antimicrobial Resistance.


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Battle to Counteract Antimicrobial Resistance. Habitats for Sickness Control and Anticipation National Place for Irresistible Illnesses Division of Medicinal services Quality Advancement. Clinicians hold the arrangement!. Connection to: Crusade to Avert Antimicrobial Resistance Online
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Crusade to Prevent Antimicrobial Resistance Centers for Disease Control and Prevention National Center for Infectious Diseases Division of Healthcare Quality Promotion Clinicians hold the arrangement! Connection to: Campaign to Prevent Antimicrobial Resistance Online Link to: Federal Action Plan to Combat Antimicrobial Resistance

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Resistant Bacteria Mutations XX Resistance Gene Transfer New Resistant Bacteria Campaign to Prevent Antimicrobial Resistance in Healthcare Settings Emergence of Antimicrobial Resistance Susceptible Bacteria

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Campaign to Prevent Antimicrobial Resistance in Healthcare Settings Resistant Strains Rare Antimicrobial Exposure Resistant Strains Dominant x Selection for Antimicrobial-Resistant Strains

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Campaign to Prevent Antimicrobial Resistance in Healthcare Settings Antimicrobial-Resistant Pathogen Prevent Infection Prevent Transmission Infection Antimicrobial Resistance Effective Diagnosis and Treatment Optimize Use Antimicrobial Use Antimicrobial Resistance: Key Prevention Strategies Susceptible Pathogen

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Campaign to Prevent Antimicrobial Resistance in Healthcare Settings Key Prevention Strategies Prevent contamination Diagnose and treat disease successfully Use antimicrobials admirably Prevent transmission Clinicians hold the arrangement!

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Campaign to Prevent Antimicrobial Resistance in Healthcare Settings Campaign to Prevent Antimicrobial Resistance in Healthcare Settings General wellbeing correspondence procedure Goals: advise clinicians, patients, and different partners bring issues to light about the heightening issue of antimicrobial resistance in human services settings propel premium and acknowledgment of interventional projects to forestall resistance

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Campaign to Prevent Antimicrobial Resistance in Healthcare Settings 12 Steps to Prevent Antimicrobial Resistance Targeted mediation programs for clinicians watching over high-chance patients - hospitalized adults -crisis patients -dialysis patients - hospitalized children -obstetrical patients -surgical patients - geriatric patients -basic consideration patients Goal: Improve clinician hones and anticipate antimicrobial resistance Partnership with expert social orders; confirmation base distributed in associate checked on claim to fame diaries Educational instruments – Web-based/instructive learning modules, pocket cards, slide presentations, and so forth

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Campaign to Prevent Antimicrobial Resistance in Healthcare Settings 12 Contain your disease 11 Isolate the pathogen 10 Stop treatment when cured 9 Know when to say “no” to vanco 8 Treat disease, not colonization 7 Treat contamination, not defilement 6 Use nearby information 5 Practice antimicrobial control 4 Access the specialists 3 Target the pathogen 2 Get the catheters out 1 Vaccinate Prevent Transmission Use Antimicrobials Wisely Diagnose and Treat Effectively Prevent Infection 12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Antimicrobial Resistance Among Pathogens Causing Hospital-Acquired Infections Vancomycin-safe enterococci Methicillin (oxacillin)- safe Staphylococcus aureus Non-Intensive Care Unit Patients Intensive Care Unit Patients Source: National Nosocomial Infections Surveillance (NNIS) System Link to: NNIS Online at CDC

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Antimicrobial Resistance Among Pathogens Causing Hospital-Acquired Infections third era cephalosporin-safe Klebsiella pneumoniae Fluoroquinolone-safe Pseudomonas aeruginosa Non-Intensive Care Unit Patients Intensive Care Unit Patients Source: National Nosocomial Infections Surveillance (NNIS) System Link to: NNIS Online at CDC

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Prevalence of Antimicrobial-Resistant (R) Pathogens Causing Hospital-Acquired Intensive Care Unit Infections: 1999 versus 1994-1998 Organism # Isolates % Increase* Fluoroquinolone-R Pseudomonas spp. 2,657 49% third era cephalosporin-R E. coli 1,551 48% Methicillin-R Staphylococcus aureus 2,546 40% Vancomycin-R enterococci 4,744 40% Imipenem-R Pseudomonas spp. 1,839 20% * Percent expansion in extent of pathogens impervious to demonstrated antimicrobial Source: National Nosocomial Infections Surveillance (NNIS) System Link to: NNIS Online at CDC

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1. Vaccinate 2. Get the catheters out 3. Target the pathogen 4. Access the specialists 5. Practice antimicrobial control 6. Use nearby information 7. Treat disease, not pollution 8. Treat contamination, not colonization 9. Know when to say “no” to vanco 10. Stop treatment when contamination is cured or impossible 11. Isolate the pathogen 12. Contain the disease 12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults 12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Use Antimicrobials Wisely Prevent Infection Diagnose and Treat Infection Effectively Prevent Transmission

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Prevent Infection Step 1: Vaccinate Fact: Predischarge flu and pneumococcal immunization of at-danger doctor\'s facility patients AND flu inoculation of medicinal services staff will avert contaminations.

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Step 1: Vaccinate Need for Hospital-Based Vaccination: US Persons Aged 65 or Older Who Report Vaccination (Behavioral Risk Factor Surveillance System, United States 1993–1999) Link to: Healthy People 2010 Goal Percent Vaccinated Link to: US Vaccination Rates...MMWR 2001;50:532-7

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Step 1: Vaccinate Need for Hospital-Based Vaccination: Postdischarge Vaccination Status of Hospitalized Adults Influenza Pneumococcal Population Vaccine Vaccine Age 18-64 years 17% vaccinated 31% inoculated with restorative risk Age > 65 years 45% vaccinated 68% inoculated Hospitalized for pneumonia 35% vaccinated 20% inoculated amid flu season Link to: CDC, National Health Interview Survey, 1997 Link to: Medicare recipients in 12 western states, 1994

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Step 1: Vaccinate Need for Healthcare Personnel Immunization Programs: Influenza Vaccination Rates (1996-1997) % Vaccinated All grown-ups > 65 yrs of age 63% Healthcare work force at high risk* 38% All medicinal services personnel** 34% * One or all the more high-hazard therapeutic conditions including diabetes, flow tumor treatment, or ceaseless heart, lung, or kidney ailment. ** Healthcare laborers included persons at present utilized in medicinal services occupations, paying little respect to setting, and persons right now utilized in social insurance settings without a human services occupation. Source: 1997 National Health Interview Survey Walker FJ, et al: Infect Control Hosp Epidemiol 2000;21:113 Link to: ACIP Influenza Immunization Recommendations

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Prevent Infection Step 1: Vaccinate Actions: give flu/S. pneumonia immunization to at-danger patients before release get flu antibody yearly Fact: Predischarge flu and pneumococcal inoculation of at-danger clinic patients and flu inoculation of medicinal services work force will counteract contaminations. Connection to: ACIP Influenza inoculation suggestions Link to: CDC certainties about flu and pneumococcal immunization Link to: ACIP: Vaccine standing requests

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Prevent Infection Step 2: Get the catheters out Fact: Catheters and other obtrusive gadgets are the #1 exogenous reason for clinic gained contaminations. Connection to: NNIS Online at CDC

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Step 2: Get the catheters out Biofilm on Intravenous Catheter Connecter 24 Hours After Insertion Scanning Electron Micrograph Link to: Biofilms and gadget related contaminations

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Prevent Infection Step 2: Get the catheters out Fact: Catheters and other obtrusive gadgets are the #1 exogenous reason for clinic gained diseases. Activities: use catheters just when key utilize the right catheter utilization legitimate insertion and catheter-care conventions evacuate catheters when not fundamental Link to: Urinary catheter disease anticipation Coming soon…guidelines for counteracting catheter-related circulatory system contaminations

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Diagnose and Treat Infection Effectively Step 3: Target the pathogen Fact: Appropriate antimicrobial treatment (right regimen, timing, measurement, course, and length of time) recoveries lives.

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Step 3: Target the pathogen Inappropriate Antimicrobial Therapy: Prevalence Among Intensive Care Patients Inappropriate Antimicrobial Therapy (n = 655 ICU patients with contamination) 45.2% 34.3% Community-gained disease Hospital-procured disease Hospital-obtained contamination after introductory group procured disease Percent Inappropriate 17.1% Patient Group Source: Kollef M, et al: Chest 1999;115:462-74

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12 Steps to Prevent Antimicrobial Resistance: Hospitalized Adults Step 3: Target the pathogen Inappropriate Antimicrobial Therapy: Impact on Mortality 17.7% mortality Relative Risk = 2.37 (95% C.I. 1.83-3.08; P < .001) No. Tainted Patients 42.0% mortality # Survivors # Deaths Inappropriate Therapy Appropriate Therapy Source: Kollef M, et a

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