Enterobacter infection

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at October 9, 2016
StartDiseasesEnterobacter infection

Enterobacter infections are infections caused by the enterobacter, a genus of bacteria. There are a number of different kinds of infections that are caused by this kind of bacteria including urinary tract infections, lower respiratory tract infections, osteomyelitis, various skin infections, bacteremia (an infection of the blood), septic arthritis, and endocarditis.

Contents

Definition & Facts

Enterobacter infections describe bacterial infections that most frequently occur while a patient is hospitalized. Enterobacter infections are among the top eight most common kinds of pathogens that cause hospital-acquired infections. Antimicrobial resistance plays a major role in the frequency and severity of these kinds of infections. Certain strains are resistant to carbapenem (these are identified as CRE: carbapenem-resistant Enterobacteriaceae) and represent a public health concern.

They can infect the respiratory system, central nervous system, and urinary tract. Enterobacter infections can be the source of pneumonia, especially cases of the illness associated with ventilators and lung transplants.

Symptoms & Complaints

Symptoms of enterobacter infections depend on the location and type of infection, and each patient experiences different symptoms depending on the extent of infection.

Symptoms of bacteremia can include cyanosis (blue skin), hypotension, chills, tachycardia (fast heart rate), ecthyma gangrenosum (a skin infection), and shock.

Symptoms of respiratory infections caused by enterobacter can include tachypnea (fast breathing), hypoxemia, and hypothermia. Crackles (rattling noises produced by the lungs) may also occur as may pleural effusion which is when fluid accumulates in space (the pleural cavity) which surrounds the lungs.

Septic arthritis presents as red, swollen joints. The patient will also experience warmth in their joints.

Causes

Enterobacter infections often occur when a patient is hospitalized and they do not frequently cause infection in healthy people. Those who are elderly and who have a weakened immune system are at significantly greater risk of having an enterobacter infection.

Infected catheters can cause these infections in the bloodstream. Infected urinary catheters can cause infections of the urinary system such as cystitis. In addition to catheters, contaminated stethoscopes, the hands of hospital personnel, thermometers, and donated blood are all possible sources of infection.

Chronic obstructive pulmonary disease is a risk factor for infection of the respiratory system. Lung abscess is another risk factor.

Skin infections may also be acquired in the hospital setting. Surgical wound infections as well as cellulitis may result from wounds becoming infected. Burn victims may be particularly susceptible to these types of skin infections.

Sometimes peritonitis can be a result of enterobacter infections as well as cholecystitis (gallbladder infection). Septic arthritis is sometimes caused by enterobacter, and prosthetic joints can be affected.

Diagnosis & Tests

Diagnosis involves a physical examination, medical history (especially recent history of hospitalizations), family history, various medical imaging scans, and laboratory tests. During the physical examination, the physician will assess whether the patient has a fever, low blood pressure, the presence of crackles, and whether or not he or she is breathing rapidly.

The physician will do a complete blood count, check creatinine levels, and clinical urine tests. Computed tomography (CT) scans, magnetic resonance imaging (MRI)s, and positron emission tomography (PET) scan]]s may be necessary to assess whether the patient has a respiratory infection, abdominal infection, bone infection, or infection of the urinary tract. Echocardiography may also be necessary to examine whether or not a patient has endocarditis.

Treatment & Therapy

Antibiotics are used to treat enterobacter infections. Beta-lactams, carbapenems, quinolones, and aminoglycosides are all antibiotics that may be used to treat enterobacter infections.

Valve replacement may be required for cases of severe endocarditis caused by enterobacter infection. Joint fluid may need to be drained in the case of septic arthritis. Draining pus that has possibly accumulated may be necessary in cases of osteomyelitis.

Prevention & Prophylaxis

Preventing enterobacter infections involves preventing hospital-acquired infections as enterobacter infections are commonly associated with hospitals. Hand washing among all hospital staff is the cornerstone of preventing infections. Faucets that dispense water without requiring the person to physically touch the faucet are considered hygienic. The use of liquid soap as opposed to bar soap and paper towel dispensers for drying are also components of hand hygiene that may prevent infections.

Heath care workers are advised to rub their hands with alcohol regularly unless their hands are visibly dirty in which case they are advised to wash them with soap and water. The use of adequate disinfectants is also important when engaging in routine cleaning in the hospital setting.

In addition, health care workers should change gloves after caring for each patient. They should also change their gloves when handling a different part of the patient's body. Sterile gloves should be worn when the health care worker is performing procedures such as catheter insertion.

Equipment should not be reused for more than one patient unless it has been properly sterilized and cleaned. Items that are intended for single-use should be discarded by health care workers. Various masks can help prevent airborne and droplet infections.

In order to prevent pneumonia caused by ventilators, health care workers should avoid intubation whenever possible. Catheter-related bloodstream enterobacter infections can be prevented by applying an antiseptic to the skin before insertion of catheter. Sterile gauze should be applied to where the catheter is inserted.

Urinary tract infections can be prevented by applying an antiseptic at the site of insertion. Promptly removing the catheter when it is unnecessary is an important preventative measure against enterobacter UTI's.