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Methicillin-Resistant Staphylococcus Aureus (MRSA) Ready Reference for Microbes 4th Edition About APIC APIC’s mission is to create a safer world through prevention of infection. The association’s more than 15,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Ready Reference for Microbes Disclaimer © 2018, Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THE INFORMATION AND MATERIALS PROVIDED IN THIS BOOK All rights reserved. Use of this APIC publication does not grant any right of ownership ARE PROVIDED ON AN “AS-IS” BASIS AND MAY INCLUDE ERRORS, or license to any user. OMISSIONS, OR OTHER INACCURACIES. THE USER ASSUMES Printed in the United States of America THE SOLE RISK OF MAKING USE OF AND/OR RELYING ON THE First printing, March 2018 INFORMATION AND MATERIALS PROVIDED IN THIS BOOK. ISBN: 978-1-933013-72-5 APIC MAKES NO REPRESENTATIONS OR WARRANTIES ABOUT THE SUITABILITY, COMPLETENESS, TIMELINESS, RELIABILITY, All inquiries about this publication or other APIC products and services may be LEGALITY, UTILITY, OR ACCURACY OF THE INFORMATION addressed to: AND MATERIALS PROVIDED IN THIS BOOK OR ANY PRODUCTS, APIC SERVICES, AND TECHNIQUES DESCRIBED IN THIS BOOK. 1400 Crystal Drive, Suite 900 ALL SUCH INFORMATION AND MATERIALS ARE PROVIDED Arlington, VA 22202 WITHOUT WARRANTY OF ANY KIND, INCLUDING, WITHOUT Telephone: 202-789-1890 LIMITATION, ALL IMPLIED WARRANTIES AND CONDITIONS OF Fax: 202-789-1899 MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, Email: [email protected] AND NON-INFRINGEMENT. Web: www.apic.org IN NO EVENT SHALL APIC BE LIABLE FOR ANY INDIRECT, PUNITIVE, INCIDENTAL, SPECIAL, OR CONSEQUENTIAL DAMAGES ARISING OUT OF OR IN ANY WAY CONNECTED WITH THE USE OF THIS BOOK OR FOR THE USE OF ANY PRODUCTS, SERVICES, OR The Association for Professionals in Infection Control and Epidemiology, its affiliates, TECHNIQUES DESCRIBED IN THIS BOOK, WHETHER BASED IN directors, officers, and/or agents (collectively, “APIC”) provides this book solely CONTRACT, TORT, STRICT LIABILITY, OR OTHERWISE. for the purpose of providing information to APIC members and the general public. The material presented in this book has been prepared in good faith with the goal of providing accurate and authoritative information regarding the subject matter covered. However, APIC makes no representation or warranty of any kind regarding any information, apparatus, product, or process discussed in this book and any linked or referenced materials contained therein, and APIC assumes no liability therefore. Acknowledgments Development of this book required input REVIEWERS PROJECT MANAGEMENT and expertise from authors with expertise in Carolyn Fiutem, MSOL, MT(ASCP), Elizabeth Nishiura microbiology. The Association for Professionals CIC, FAPIC Managing Editor in Infection Control and Epidemiology Infection Prevention Officer Chicago, IL acknowledges the valuable contributions from TriHealth Susan F. Sandler the following individuals. Cincinnati, OH Director, Practice Resources AUTHORS Lela Luper, BS, RN, CIC, FAPIC Association for Professionals in Infection Control 4TH EDITION Infection Preventionist and Epidemiology Catherine Alesich Chachere, Chickasaw Nation Department of Health Elizabeth Garman CLS(ASCP)CM, RN, CIC Ada, OK Vice President, Communications and Practice Resources Infection Prevention Coordinator Jianping Xu, PhD Association for Professionals in Infection Control Woman’s Hospital Professor and Associate Chair of Graduate Studies and Epidemiology Baton Rouge, LA Department of Biology, McMaster University PRODUCTION Angela S. Hernandez, MPH, MT(ASCP) Hamilton, ON, Canada Sarah Vickers Infection Preventionist Elizabeth Monsees, MSN, MBA, RN, CIC, Art Director (cover art) Presbyterian Healthcare Services FAPIC, and Steven J. Schweon, MPH, MSN, Association for Professionals in Infection Control Albuquerque, NM RN, CIC, HEM, FSHEA, FAPIC, reviewed and Epidemiology 3RD EDITION Appendix G: Quick Facts: Antimicrobial Project Design Company Stewardship. Kathy Brooks, RN, PhD, CPHQ Text Design and Layout Chief, Quality Management (retired) Washington, DC Overton Brooks VA Medical Center ModernLitho Shreveport, LA Printing Jefferson City, MO Declarations of Conflicts of Interest The authors have no potential conflicts of interest to declare. Ready Reference for Microbes iii iv Ready Reference for Microbes Contents Preface ..............................................................................................v Appendix D: Quick Facts: Seasonal Influenza (Flu) ..................... 153 How to Use This Reference .............................................................vi Appendix E: Quick Facts: Isolation Precautions ........................... 155 Chapter 1: Bacteria .......................................................................... 1 Appendix F: Quick Facts: Antibiograms ...................................... 158 Chapter 2: Common Commensals ................................................ 45 Appendix G: Quick Facts: Antimicrobial Stewardship ................. 160 Chapter 3: Fungi ........................................................................... 57 Abbreviations Used in This Reference .......................................... 162 Chapter 4: Parasites ....................................................................... 74 Index ........................................................................................... 165 Chapter 5: Viruses ......................................................................... 92 Chapter 6: Bioterrorism Agents ................................................... 118 Chapter 7: Antimicrobial Therapy ............................................... 134 Appendix A: Quick Facts: Common Bacterial Pathogens by Body Site ................................................. 147 Appendix B: Quick Facts: Methicillin-Resistant Staphylococcus aureus (MRSA) ...................................................... 149 Appendix C: Quick Facts: Clostridium difficile ...................................................................... 151 Preface Healthcare-associated infections (HAIs) are becoming more deadly This 4th edition of Ready Reference for Microbes has been updated and difficult to treat as a result of multidrug-resistant organisms. to describe current and known emerging pathogens. As a quick According to the World Health Organization, “Of every 100 reference, it provides straightforward information to IPs and hospitalized patients at any given time, 7 in developed and 10 in healthcare professionals on medically common and clinically developing countries will acquire at least one HAI.” significant microorganisms found in humans: bacteria, common commensals, viruses, fungi, parasites, and organisms used as As infection preventionists (IPs), we must remain up to date on changes bioterrorism agents. It also includes a chapter on antimicrobial involving evidence-based practice, evolving microorganisms, updates to therapy, and seven “quick facts” appendixes on essential topics: guidelines, and the latest advances in the care and maintenance common pathogens by body site, methicillin-resistant Staphylococcus of medical devices. Significant strides have been made to reduce aureus, Clostridium difficile,seasonal influenza, isolation precautions, HAIs worldwide. Prevention efforts are key to further reducing antibiograms, and antimicrobial stewardship. References and HAIs and include their recognition and isolation, appropriate resources are provided at the end of each chapter and appendix to use of personal protective equipment, diligent hand hygiene, offer additional information on the discussed topics and expand the and thorough environmental cleaning. reader’s knowledge. Catherine Alesich Chachere and Angela S. Hernandez March 2018 Ready Reference for Microbes v vi Ready Reference for Microbes How to Use This Reference Each chapter of the Ready Reference for Microbes, 4th edition begins Chapter 6: Bioterrorism agents are categorized by type of microbe: with an introduction and general information. The tables in the bacteria, other (nonmicrobe), parasite, and virus. The virus chapters provide information on specific microbes (or, in the case of category includes subcategories for viral encephalitis viruses and Chapter 7, specific antimicrobials) with subheadings and general and viral hemorrhagic viruses (arenaviruses, filoviruses, and tick-borne specific notes provided where appropriate. hemorrhagic fever viruses). Within each category and subcategory, microbes are listed alphabetically. Chapter 1: Bacteria are listed in alphabetical order by genus. Microbe > Disease Name > CDC Category > Issues Related Genus > Description > Name(s) > Infections > Mode(s) to Nosocomial Transmission > Treatment > Comments of Transmission Chapter 7: Antimicrobial therapies are listed by antimicrobial class. Chapter 2: Common Commensals are listed by body site. Class > Subclass > Representative Antimicrobial(s) Body Site > Normal Flora > Special Considerations for > Antimicrobial Activity Specimen Collection Chapter 3: Fungi are listed in alphabetical order by genus. While many microbes are discussed in the APIC Text Online, the table Genus > Description > Name(s) > Infections > Mode(s) rows highlighted in blue in this book indicate topics where substantive
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