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Decolonization Strategies For Infection Prevention In Nursing Homes

Approximately 150,000 hospitalizations and up to 380,000 deaths occur annually in the United States due to hospital-associated infections. Residents are at high risk of hospital-acquired infections due to advanced age, injuries, medical devices, and coexisting medical conditions.

For proper prevention of infection in nursing homes, adequate strategies that provide safety and prevention of pathogens must be adequately employed, and nursing homes’ environments include social activities, long waits, and limited resources.

Decolonization In Nursing Homes

Many people have been exposed to staphylococcus aureus. These pathogens can live on the skin and in the nose, some of these pathogens are resistant to certain antibiotics. They are called methicillin-resistant staphylococcus aureus, also called MRSA. The eradication of MRSA is called “decolonization”

Decolonization can help reduce the risks of pathogens spreading to others and prevent future infection in the Hospitals, after a procedure such as surgery or from devices such as catheters or ventilators. 

Decolonization In Nursing Homes

Sometimes hospital-associated infections (HAIs) are caused by antimicrobial-resistant pathogens, making them difficult to treat.

Humans can also be exposed to pathogens without showing symptoms of infection, this is known as colonization, which means that microbes are present in the human body, live and grow there, and the colony may increase the risk of human infection. In addition, exposed people may unknowingly transmit these bacteria to others through contact or through contaminated personal surfaces in the common area.

Some people are even more at risk of infection, for example, pregnant women, it may also include patients who are seriously ill, have undergone surgery, or transplant, are in intensive care units, and have weakened immune systems.

Patients sometimes can be colonized while receiving treatment in the hospital, this situation will prolong patients’ stay in the hospital or sometimes lead to the transmission of other infectious diseases from the hospital to the patient.

Decolonization Of Patients And Health Care  Workers To Prevent MRSA

Universal decolonization is often carried out on healthcare workers and patients to reduce the efficacy of healthcare-associated infections and HAIs.

Care-associated infections are associated with long hospital stays, mortality, and increased costs. Critically ill patients have historically faced various invasive treatments that can compromise the integrity of the mucosal skin, and critically ill patients have suppressed immune systems that can increase the risk of infection.

Most medical doctors do recommend universal decolonization to prevent HAIs, some of the strategies often recommended include chlorhexidine bathing, hand hygiene, reverse Intestinal dysbiosis, and antibiotics stewardship

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Reduction Of HAIs Through Chlorhexidine Bathing

Washing with chlorhexidine reduces the risk of bacterial infection. In intensive care units, daily washing with chlorhexidine can reduce the density of hospital-associated infections and methicillin-resistant staphylococcus aureus (MRSA) and Vancomycin-resistant enterococci (VRE).

In a surgical intensive care unit, washing with 2% chlorhexidine can reduce the risk of HAIs by 44.5%. Compared with targeted decolonization ( screening, isolation, and decolonization of MRSA carriers). Universal decolonization reduced MRSA culture and bloodstream infections.

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Intestinal Dysbiosis Needs Universal Decolonization

There are many bacteria in the gut that have no adverse effects. The bacterial barrier is one of the most important barriers to the Intestinal epithelium.

Critically ill patients are always present with acute gastric injuries (AGI) with intestinal dysbiosis. Intestinal dysbiosis can cause bacterial proliferation, luminal bacteria become virulent and damage the immune system.

Early Nutrition EN Improves Intestinal Function

EN could not only improve Intestinal motility, reduce the adhesion of microorganisms in the Intestinal epithelium, reduce toxic bacteria, and reduce the elimination of pathogenic bacteria, but also stimulate Intestinal blood flow, maintain the integrity of the Intestine and the abundance of secretory lgA immunocyte produced. The benefits of Early Nutrition are equal to Intestinal universal decolonization.

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