Chapter 74 – Enterobacteriaceae

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Darlene Miller, DHSc, MPH, MA, SM(ASM), CIC
Research Assistant Professor
Bascom Palmer Eye Institute
University of Miami
Miami, Florida

APIC recognizes and appreciates the contributions made to this chapter by prior authors.

ABSTRACT

Enterobacteriaceae are a large, diverse group of facultative Gram-negative rods, recovered as natural inhabitants of the environment and the large intestines of humans and animals. They are important pathogens in healthcare-related and community-acquired infections in the United States and worldwide. Spectrum of infection includes bacteremias, pneumonias, surgical site infections, and urinary tract infections. Patients at greatest risk include those in medical and surgical intensive care units, infants, the elderly, and the immunocompromised. In developing countries, Enterobacteriaceae are among the leading cause of diarrheal disease and death of children aged less than 5 years. Increasing resistance to third-generation cephalosporins and fluoroquinolones results in diminished treatment choices for the prevention and management of these healthcare-associated infections. Several members of this group may also be used to launch biological terrorism attacks. Strategies for prevention include healthcare worker education and training, checklists, surveillance, and culture of zero tolerance for noncompliance with evidence-based best practices. Adoption and monitoring of patient and quality improvement outcomes are essential to reducing infections and developing a culture of patient safety.

Last Revised: 12/13/09 10:49 PM

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