Other microorganisms that have become resistant to antimicrobial drugs include vancomycin-resistant enterococci (VRE) and multi-drug resistant tuberculosis (TB), which is transmitted by droplets from infected individuals or improperly cleaned bronchoscopes and anaesthetic equipment. aureus is frequently implicated in SSIs ( Lee & Bishop, 2006). MRSA has become a serious concern among hospitalised patients and can be fatal in those who are susceptible (Phillips, 2007). aureus (MRSA), which is also resistant to other categories of antimicrobials. Those of concern in the perioperative environment include methicillin-resistant S. The emergence of strains of pathogens that are resistant to currently available antimicrobial drugs represents a significant threat to surgical patients. Table 5-1 Common microorganisms found in the perioperative environmentĭevelopment of resistance to antimicrobial drugs Table 5-1 summaries the common microorganisms found in the perioperative environment. Prions are unusually resistant to conventional chemical and physical sterilising methods, and special protocols for managing instruments that have been used on infected or potentially infected patients are discussed later in this chapter ( Nicolette, 2007). The mechanism of infection that causes CJD is still unclear, although it is thought that prions have the ability to convert normal protein molecules into dangerous ones ( Burton & Engelkirk, 2000). They are implicated in unusual neurodegenerative disorders, including bovine spongiform encephalopathy (BSE) or ‘mad cow disease’ and, in humans, Creutzfeldt-Jakob disease (CJD) (Lee & Bishop, 2006). Prions are small infectious particles consisting of protein only with no nucleic acid. Staphylococci are strongly associated with healthcare-associated (nosocomial) infection (HAI). aureus can cause toxic shock syndrome which, if left untreated, can be fatal ( Lee & Bishop, 2006 Phillips, 2007). For example, they can enter the wound of a surgical patient and cause a wound infection or worse, because of their ability to develop resistance to antibiotics quickly (Lee & Bishop, 2006). These bacteria are transmitted from the hands of the host to another person, where they can subsequently have significant negative effects. Staphylococci can survive for long periods in the air, dust, bedding and clothing, making cleanliness of the perioperative environment paramount (Phillips, 2007). They can exist in these areas without any adverse effect on the host and those that live on the skin are termed ‘transient’ organisms. Staphylococcus aureus and Staphylococcus epidermidis) are round or spherical-shaped Gram-positive bacteria, and are part of the normal flora found on the skin and mucous membrane of the nasopharynx, urethra and vagina.
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