tailieunhanh - INFECTIOUS DISEASES - PART 5

Bệnh nhân tiếp xúc cần được quan sát chặt chẽ, phân của họ nên được nuôi cấy cho các sinh vật gây bệnh, và họ nên được tách ra từ trẻ sơ sinh chưa phơi sáng. Trong một vườn ươm sinh, nhiễm trùng EPEC được coi là một mối nguy hiểm nghiêm trọng, | is essential for limiting spread. Exposed patients should be observed closely their stools should be cultured for the causative organism and they should be separated from unexposed infants. In a newborn nursery EPEC infection is considered a serious hazard and strict enteric precautions should be maintained. Traveler s Diarrhea. Traveler s diarrhea has been associated with many E coli pathogens including ETEC EAEC and EIEC . It usually is acquired by ingestion of contaminated food or water and is a significant problem for people traveling in resource-limited countries. Diarrhea attributable to STEC is rare in travelers. Travelers should be advised to drink only bottled or canned beverages and boiled or bottled water travelers should avoid ice raw produce including salads and fruit that they have not peeled themselves. Cooked foods should be eaten hot. Antimicrobial agents are not recommended for prevention of traveler s diarrhea. Although several antimicrobial agents such as trimethoprim-sulfamethoxazole doxycycline and ciprofloxacin can be effective in decreasing the incidence of traveler s diarrhea the benefit usually is outweighed by the potential risks including allergic drug reactions antimicrobial-associated colitis and the selective pressure of widespread use of antimicrobial agents leading to antimicrobial resistance. If diarrhea occurs packets of oral rehydration salts can be added to water and ingested to help maintain fluid balance. If diarrhea in a traveler is moderate or severe or is associated with fever or bloody stools empiric antimicrobial therapy may be indicated until symptoms resolve empiric therapy should be continued for no more than 3 days. Recreational Water. People with diarrhea caused by these potentially waterborne pathogens should not use recreational water venues eg swimming pools lakes rivers the ocean for 2 weeks after symptoms resolve. Giardia intestinalis Infections Giardiasis Clinical Manifestations Symptomatic infection causes a .