| Theme | Dealing with infections in hemodialysis facilities | |
|---|---|---|
| Title | Management of MRSA, VRE, and PRSP infections | |
| Publish Date | 2018/06 | |
| Author | Takashi Harada | Nagasaki Kidney Hospital |
| Author | Osamu Sasaki | Nagasaki Kidney Hospital |
| Author | Hiroshi Ichinose | Nagasaki Kidney Hospital |
| Author | Kenji Sawase | Nagasaki Kidney Hospital |
| Author | Junichiro Hashiguchi | Nagasaki Kidney Hospital |
| Author | Satoshi Funakoshi | Nagasaki Kidney Hospital |
| [ Summary ] | Methicillin-resistant Staphylococcus aureus (MRSA) transmission is preventable by minimizing contact, and hand hygiene is a particularly important standard precaution. The individual use of portable hand sanitizers is effective in preventing transmission. Previous studies showed that active surveillance is useful in preventing the transmission of MRSA from outside the hospital. Glycopeptide, aminoglycoside, oxazolidinone, and cyclic lipopeptide antibiotics are used in the treatment of MRSA infection. These agents vary in terms of their mechanism and mode of action; different types of anti-MRSA agents are indicated for different patients. The widespread use of glycopeptide antibiotics has led to an increase in the number of carriers and in the incidence of nosocomial infections caused by vancomycin-resistant enterococci (VRE). Although VREs are multidrug resistant, oxazolidinone antibiotics may be effective. A diagnosis of VRE infection must be reported to a local public health center within 7 days. Penicillin-resistant Streptococcus pneumoniae (PRSP) accounts for approximately 50 % of isolates from pneumococcal infections, including those exhibiting moderate resistance, and many of these organisms are multidrug resistant. A 23-valent polysaccharide vaccine and a 13-valent conjugated vaccine are available as pneumococcal vaccines, and vaccination against pneumococcus has been shown to be effective in patients undergoing dialysis. A diagnosis of PRSP infection must be reported to a local public health center within 7 days. |
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