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    Salmonella Infection Management

    A Quick Guide for Nurses & Healthcare Professionals

    Salmonella Infection - An Overview

    Salmonella infection also known as salmonellosis is a bacterial infection that affects the intestines. The salmonella bacteria is shed through the feces of humans and animals. Humans tend to get infected by consuming contaminated food or water.

    Generally, contaminated food is animal in origin consisting of eggs, poultry, milk, seafood and beef. However, all food groups including fruits and vegetables can be contaminated if not washed properly.

    Salmonella typhi is the type of bacterial infection that lives in the human body. It is transmitted from one human to another in the form of contaminated water or food. This bacteria tends to cause a life threatening medical condition known as typhoid fever. Treatment for this disease requires antibiotics.

    A small number of patients affected with the disease may feel better pot treatment. However, there is still a probability that the patient carries the organism and passes it in the form of feces and transmits it through water or food.

    While Salmonella may not have any symptoms, some patients may develop the symptoms such as cramping in the belly, pain, diarrhea, upset stomach and fever within 8 to 72 hours of contamination. Most patients get back to normal with adequate care and rest at home within 4-7 days. In some cases, hospitalization or tertiary acute care may be required.

    The diarrhea associated with this infection is extremely dehydrating, where prompt care is required to avoid organ damage. It has been observed that life threatening complications may develop if this infection spreads beyond the intestines. Moreover, the risk of contracting this virus increases if you travel to countries with poor sanitation.

    Salmonella - Latest US Statistics

    Here are a few statistics pertaining to Salmonella infection listed below:

    Recent cases of Salmonella Statistics in the United States:

    • As of July 28, 2020, one of the outbreak strains of Salmonella has resulted in 938 infected people belonging to 48 different states.
    • 151 people which makes 33% of the infected population have thus been hospitalized.
    • One death has been reported of Salmonella in Oklahoma.
    • The disease has affected 28% of people who are younger than the age of 5.
    • As per the different epidemiologic and laboratory evidence, poultry including chicks and ducklings are a source of this outbreak.

    Signs and Symptoms of Salmonella Infection

    The salmonella infection is caused by consuming undercooked or raw poultry, meats, and dairy products. The period for incubation of this disease can range from a few hours to several days.

    The virus can be classified as gastroenteritis which in layman terms is stomach flu. While the symptoms of this infection don't last more than a week, it can take a few months for the bowel movements to normalize.

    The common signs of Salmonella infection are:

    • Nausea
    • Vomiting
    • Abdominal cramps
    • Diarrhea
    • Fever
    • Chills
    • Headache
    • Blood in the stool

    Salmonella infection has a few varieties which can also result in typhoid fever. A deadly ailment common in developing nations.

    Salmonella Nursing Management

    Nursing Management

    The nursing care of patients suffering from salmonella is as follows:

    Nursing Assessment

    If a patient has contracted Salmonella, the assessment will focus on:

    • History: This infection can result in 1 of 3 types of syndrome namely: nontyphoidal focal disease, nontyphoidal enterocolitis, or typhoid (enteric) fever.
    • Physical exam: If you are suffering from nontyphoidal gastroenteritis, you are likely to suffer from watery diarrhea or loose stool. Moreover, those patients who are suffering from typhoid fever are likely to develop pink macules on your chest or abdomen.

    Nursing Care Planning and Goals

    The primary nursing care planning for Salmonella patients include:

    • The stool culture will be negative.
    • Patient will pass soft stools almost 3 times a day.
    • Patient likely to verbalize their understanding of the cause, transmission and symptom management of Salmonella.

    Nursing Interventions

    The nursing interventions for individuals suffering from Salmonella are:

    Relieve diarrhea:

    A nurse is supposed to teach the clients regarding the importance of hand washing after every bowel movement. Moreover, wash your hands and encourage fluid intake of 1.5 to 2.5 liters/24 hour plus 200 ml after each loose stool amongst adults. Advise the patient to eat foods rich in potassium. Moreover, the antidiarrheal medications need to be prescribed.

    Educate Patients and Their Families:

    The first thing you need to do as a nurse is to assess the knowledge of salmonellosis. They should understand the treatment and how it is transmitted. For this, you need to educate the patients regarding the importance of hand washing and perianal hygiene. Moreover, you can educate them regarding food preparation and different storage methodologies to reduce contamination.

    Prevention against Fluid Volume Deficit:

    In order to assess the signs of dehydration and assess the patient's mucous membrane and skin turgor. You will be required to monitor BP orthostatic changes. On the same scale, clients are expected to monitor their weight daily preferably on the same day.

    Improve Your Nutritional Intake:

    Start by measuring the weight of the client and keep a record of the weight, vomiting and frequency. Also monitor the food intake of the patients and offer a balanced diet to help them overcome the disease.

    Evaluation

    The goals of assessment are met for a Salmonella patient if:

    • The patient's stool test comes out negative.
    • The patient does not pass soft stool.
    • The patient has a sound understanding of the disease and transmission.
    • The patient is normovolemic with absence of orthostatic. The urine needs to be greater than 30 ml per hour with normal skin turgor.
    • Increased nutritional intake with no nausea and vomiting.

    Salmonella Nursing Care Frequently Asked Questions (FAQs)

    Is Salmonella contagious?

    Salmonella is an extremely contagious infection that is spread by the infected person even if they don't show any signs and symptoms of the disease. Antibiotic treatment is required to help combat the disease. Therefore sharing saliva, or mouth to mouth contact with someone carrying the bacteria can spread the disease. Moreover contaminated food, kissing or anal sex can also transmit the disease.

    Below is a list of articles that can carry and transmit the disease.

    • utensils, like forks or spoons
    • straws
    • cups
    • water bottles
    • lip balm
    • lipstick
    • cigarettes
    • cigars
    • pipes

    Putting an object in your mouth touched by someone carrying the salmonella infection can spread the disease.

    What are the risk factors for Salmonella infection?

    If the bacteria causing Salmonella is in small amounts, it is not likely to cause an infection. However, an infant under the age of 6 or adults above 65 with compromised immunity are likely to get affected by the infection.

    Specific medications and conditions that weaken the immunity include sickle cell disease, corticosteroids, Aids and anti-rejection medications.

    Individuals who take antacids are at a higher risk as it makes conditions favorable for the bacteria to reach the gut. The inflammatory bowel disease damages the intestinal lining making them more susceptible to the disease. You may also be at a higher risk after taking antibiotics as the gut friendly bacteria is killed, making the conditions suitable for Salmonella to nurture.

    People who take antacids are at greater risk as more ingested bacteria survive to reach the gut. Those with inflammatory bowel disease are at risk due to the damage to the intestinal lining.

    You may also be at higher risk after taking antibiotics as the friendly gut bacteria have been killed, leaving that habitat open for salmonella.

    How common is Salmonella infection in the US?

    As per an estimation by CDC, the Salmonella bacteria causes 1.35 million infections, 420 deaths and 26,500 hospitalizations in the United States per annum. Food is the common cause for most illnesses.

    • Most people suffering from Salmonella suffer from stomach cramps, diarrhea or fever.
    • Symptoms begin 6 hours to 6 days and can last from 3 to 7 days.
    • Most patients do not require antibiotic treatment. Only patients with acute conditions are treated with antibiotics.
    • Some patients may require hospitalizations.

    Is there a season for Salmonella outbreak in the US?

    There is no particular season for Salmonella outbreak in the United States but since it's a disease transmitted by bacteria, individuals can catch it when exposed to contaminants.

    Should Salmonella infection be treated with antibiotics?

    Salmonella infection can cause dehydration where the patient needs to be administered with electrolytes and fluid. Severe cases of Salmonella may require tertiary care and intravenous administration of fluids.

    Anti-diarrheal:

    In order to relieve cramping, patients are administered with loperamide but this can prolong the diarrhea caused by Salmonella.

    Antibiotics:

    In case the Salmonella infection has entered your bloodstream, your immunity might be compromised. The doctor may prescribe antibiotics to kill the bacteria. In uncomplicated cases, patients shouldn't be administered with antibiotics. In actuality, antibiotics can prolong the disease and also spread the bacteria with a higher risk of relapse.