Multi-resistant hospital germs

definition

Multi-resistant germs are bacteria or viruses that have developed resistance to many or almost all antibiotics or antivirals. They are therefore insensitive to these drugs.

Multi-resistant germs are frequent triggers of infections that are acquired during a hospital stay (nosocomial infections).

Important representatives of multi-resistant hospital germs are: MRSA, VRE, 3-MRGN and 4-MRGN.

How high is the risk of infection?

The Risk of contagion having a hospital germ is especially then highwhen the patient already showing signs of infection having. The most common hospital germ infections are Wound infections, pneumonia and urinary tract infections.

The exact pathogen can only be identified by means of smear to be established. As long as the Detectable germ is, so is the patient contagious. If infections are detected, the risk of infection can be reduced through measures such as Isolation in the single room, hand disinfection and wearing Protective gown and Mouthguard be reduced.

Even if there are no obvious infections, there may be a risk of contagion. Hospital germs, like MRSA, can also contribute healthy people occurrence, without to complaints respectively. This is called colonization. There are no symptoms, but as a carrier you can infect other people, which is especially dangerous for those with a weak immune system. The colonization can lead to an infection through operations, whereby the pathogens can get into the bloodstream, or through a weakening of the immune system.

What are the signs of a hospital germ infection?

Multi-resistant hospital germs can cause a variety of complaints. The signs of infection or the symptoms depend on the pathogen in question:

• the most common hospital germ infections are Wound infections. These are mainly triggered by MRSA or Pseudomonas aeruginosa. This delays wound healing, especially after operations.
• Urinary tract infections show up mainly through problems and pain when urinating
• are another common hospital germ infection Pneumonia. Signs of this are fever, cough with yellowish-greenish sputum and pain when breathing.
• the Blood poisoning (sepsis) is a dreaded disease that can also be triggered by hospital germs.

Not everyone with multi-resistant germs also has complaints. One distinguishes one here colonizationin which the person carries the germs and can transfer them to others, but does not show any signs of an illness himself and an infection in which such signs occur.

However, when colonizing with multi-resistant pathogens there is also a higher risk of infection. If, for example, the person's immune system is weakened or if they undergo an operation, the germs can use this and an infection occurs.

causes

The development has multi-resistant germs various causes:

• Will be a Antibiotic therapy stopped earlyn, so be not all pathogens killed. The survivors, who already have a certain resistance to the drug through mutation, can now multiply without competition and form a resistant strain.
• Another factor is that often unnecessary use of antibioticse.g. for viral infections or the use of strong antibiotics for banal infections. Antibiotics do not help against viruses, but this way bacteria come into contact with the drug, can develop resistance and later emerge as pathogens.
• The use of antibiotics in the food industry also contributes to the development of resistance. Antibiotics are added to animal feed and later humans ingest them in small quantities when eating meat. The bacteria are again selected according to their resistance and a resistant strain can be formed.

Multi-resistant germs can be transmitted and multiply quickly in the hospital due to the frequent contact between different patients and the nursing staff.

Read more about the topic here: Antibiotic resistance

Number of deaths in Germany from hospital germs

Each year stuck in Germany roughly 500,000 patients with hospital germs. Some of these pathogens are multi-resistant and therefore difficult to treat with antibiotics. The number of Deaths in Germany through hospital germs is approx. 15,000 per year.
Across Europe, according to a study, the number is 91,000 deaths and around 2.6 million infections per year.

The most common infections are wound infections, urinary tract infections, pneumonia and blood poisoning (sepsis). Approximately one third this infection is considered avoidablee.g. through stricter hygiene measures.

What is MRSA?

MRSA means methicillin-resistant Staphylococcus aureus or multi-resistant Staphylococcus aureus.
This germ was discovered in 1961 and is now considered a classic multi-resistant pathogen. It is a variant of Staphylococcus aureus, a representative of the staphylococci, which are bacteria. Staphylococcus aureus occurs almost everywhere in nature and in humans mainly on the skin and the mucous membranes of the mouth, nose and throat.

As a rule, Staphylococcus aureus does not cause any symptoms in humans.
If the immune system is weak or other factors favor the spread of the bacterium, symptoms of the disease can occur, such as Skin inflammation, muscle diseases, pneumonia, wound infections, up to blood poisoning (sepsis).

If resistance to several different antibiotics (MRSA) develops, it is difficult to eliminate the pathogen. As a result, MRSA can also become a problem for other people or patients when it is transmitted to other people, especially if there is an immune deficiency.

Read more about the topic here: MRSA and Staphylococcus aureus.

What is VRE?

VRE means Vancomycin-resistant enterococci. It is mostly a variant of the Enterococcus faecium bacterium with a resistance towards the antibiotic Vancomycin.

Vancomycin is called Reserve antibiotic used. That means it is only used for pathogens with resistance to other antibiotics such as MRSA, or in the case of severe infections in which the effect of the antibiotic must be certain, e.g. Inflammation of the meninges (meningitis). Use for simple infections would lead to a faster development of bacteria resistance to vancomycin and is therefore not considered.

Enterococcus faecium is in humans Part of the healthy intestinal flora and when it escapes from the intestine, symptoms such as Urinary tract infections or blood poisoning (sepsis).

The vancomycin-resistant enterococci are particularly important immunocompromised Patients to infections. Since VRE is often not only resistant to vancomycin but also resistant to other antibiotics, it is a problematic germ that can be difficult to eliminate.

What is the transmission route of hospital germs?

The most common route of transmission of hospital germs is through direct skin contact with a contaminated person. This can be done either directly from patient to patient happen or via that Nursing staff and the doctors, handing out food and changing bandages during activities such as taking blood. Since most of the transmission occurs via the hands, regular hand disinfection is an important preventive measure.

Another way of transmission is Contact with objects and surfacesthat were previously contaminated with the pathogens. Objects that are often used by several different people, such as doorknobs or tables, are particularly affected. A preventive measure against the transmission of germs in this way is the regular disinfection of these objects and surfaces.

Transmission through the air is a so-called Droplet infectionin which, e.g. by Sneezing or coughingthat get pathogens on surfaces or directly on other people. A preventive measure against this transmission route is wearing a face mask.

How long is the incubation period with a hospital germ?

The incubation period of hospital germs, using the example of MRSA, is approx. 4 to 10 days. The incubation period is the period between infection with a pathogen and the appearance of the first symptoms.

3-MRGN and 4-MRGN

MRGN stands for multi-resistant gram-negative pathogens. It is a collective term for several different bacteria that are also found in healthy people in the body. examples for this are Pseudomonas aeruginosa or E. coli.

What these bacteria have in common is resistance to many antibiotics, so it is difficult to find a suitable drug to eliminate them in the event of an infection.

A distinction is made between 3-MRGN and 4-MRGN, this refers to the Resistance to various antibiotics:

• 3-MRGN are resistant to three groups of antibiotics
• 4-MRGN are resistant to four groups of antibiotics. They are therefore even more difficult to treat.

Since resistance occurs particularly in areas where many antibiotics are used, these pathogens are a major problem, especially in hospitals.

As with MRSA, a distinction is made between MRGN and one infection and one colonization. When colonized, the bacteria do not trigger any symptoms of the disease, but they can be transmitted. Surgery or an immune deficiency can then lead to an infection.

Hospital germs after an operation

Even with otherwise healthy peoplewho are one Standard operation such as appendectomy or knee surgery can result in hospital germs cause problems. The pathogens enter the patient's bloodstream via the wound caused by the intervention and thus nestle in the wound. It comes to one infection and thus to one Delay in wound healing. Depending on the pathogen, the infection must be treated with antibiotics. However, this can be difficult as some of the hospital germs Resistance to a wide variety of antibiotics has developed. This means that the process of wound healing can be delayed even further.

Wound infections after surgery are among the most common hospital infections (nosocomial infections).

The germs can either be present in the patient before the procedure, but have not yet triggered any symptoms (colonization), or they are only acquired in hospital by e.g. Contact with other patients or the nursing staff.

An important measure against wound infections after an operation strict hygiene measures.

Diarrhea from hospital germs

Diarrhea in the hospital is not uncommon and is often caused by viruses such as the norovirus. The norovirus causes gastrointestinal inflammation with nausea, vomiting and diarrhea and can be transmitted quickly, especially in hospitals.

It can also develop after antibiotic treatment Diarrhea come. The bacterium is responsible for this Clostridium difficile, a frequent hospital germ. The natural intestinal flora is partly killed by antibiotics and Clostridium difficile can multiply unhindered. It forms poisons (toxins) and thus attacks the intestinal mucosa. This can have different effects depending on the patient, from mild diarrhea to, under certain circumstances life-threatening, toxic megacolon.