Materiały źródłowe

• #1 Anthrax – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507773/

  Anthrax is an infectious disease caused by an encapsulated, spore-forming, gram-variable bacteria called Bacillus anthracis. […] This activity illustrates the evaluation and management of anthrax and explains the role of the interprofessional team in improving care for patients with this condition. […] The CDC has developed detailed recommendations for patient evaluation by suspected anthrax exposure and clinical syndrome. […] All cases of inhalation anthrax should be considered a bioterror event and appropriate decontamination steps should be in place. […] The best outcomes will occur if an interprofessional team approach is used to evaluate and treat patients with an anthrax infection.

• #2 Anthrax | Health.mil

  https://www.health.mil/Military-Health-Topics/Health-Readiness/Immunization-Healthcare/Vaccine-Preventable-Diseases/Anthrax

  Anthrax is a serious infectious disease caused by gram-positive, rod-shaped bacteria known as Bacillus anthracis. It forms spores that can be found naturally in soil, commonly affecting domestic and wild animals around the world. Although it is rare in the United States, people can get sick with anthrax if they come in contact with infected animals or contaminated animal products. […] When anthrax spores get inside the body, the bacteria can multiply, spread out in the body, produce toxins (poisons), and cause severe illness. Anthrax can enter the body through the skin (cutaneous); through ingesting contaminated food or water (gastrointestinal); intravenously (rare); or by inhalation, the deadliest form of the disease and the one most likely to be used as a biological weapon. […] The anthrax vaccine has been licensed in the U.S. since 1970, and has been proven safe and effective at preventing anthrax disease, regardless of the route of exposure. The immunization is required for deployment to U.S. Central Command and the Korean Peninsula, as well as for designated NORTHCOM personnel, emergency response and other units. It is given in a five-dose series at 0, 4 weeks, 6 months, 12 months and 18 months, with yearly boosters to maintain immunity. […] Vaccination and antibiotics, such as ciprofloxacin, doxycycline, and amoxicillin, are the most important therapeutic interventions for any form of anthrax exposure.

• #3 Anthrax – Medical Information | Occupational Safety and Health Administration

  https://www.osha.gov/anthrax/medical-information

  Anthrax is rare in the United States. However, clinicians should be vigilant for cases in travelers from countries with higher prevalence rates and in workers who handle animal products from areas where anthrax is endemic (i.e., found regularly). […] Antibiotic and antitoxin therapy are available for treating patients with anthrax in or out of a hospital setting. Antibiotic treatment targets all types of BA infection. Antitoxin treatment helps eliminate the toxins BA release into an infected person’s body, rather than targeting the bacteria causing the disease. Antitoxin therapy is useful alone and in combination with other treatment options. […] Hospitalization for anthrax depends on the severity of the case and the need for supportive treatment, such as continuous fluid drainage and mechanical ventilation.

• #4 Anthrax Nursing Care Management & Care Plan – Nurseslabs

  https://nurseslabs.com/anthrax/

  Nursing management for a patient with anthrax include the following: […] Nursing assessment for a patient with anthrax include: […] Based on the assessment data, the major nursing diagnosis for anthrax are: […] The major nursing care planning goals for a patient with anthrax include: […] The following are the nursing interventions for patients with anthrax: […] Nursing goals are met for a patient with anthrax as evidenced by: […] Documentation in a patient with anthrax include: […] Patients with isolated cutaneous anthrax without systemic involvement (ie, without edema, fever, cough, headache, etc) or complications may be treated on an outpatient basis with antibiotic monotherapy. […] The emergency department workup includes rapid initiation of intravenous antibiotic therapy; patients can be admitted to a normal hospital room with barrier nursing procedures (ie, gown, gloves, mask) and secretion precautions (ie, special handing of potentially infectious dressings, drainage, and excretions).

• #5 Anthrax – RNpedia

  https://www.rnpedia.com/nursing-notes/communicable-diseases-notes/anthrax/

  Monitor vital signs and hemodynamic parameters closely for circulatory collapse. […] Monitor temperature for response to antibiotic therapy. […] Auscultate chest for crackles, indicating need for better secretion mobilization. […] Monitor oxygen saturation and arterial blood gases periodically to determine oxygenation status and acid-base balance. […] Monitor level of consciousness and for meningeal signs such as nuchial rigidity. […] Provide supplemental oxygen or mechanical ventilation, as needed. […] Position for maximum chest expansion and reposition frequently to mobilize secretions. […] Suction frequently and provide chest physiotherapy to clear airways, prevent atelectasis, and maximize oxygen therapy. […] Administer I.V. fluids to encourage oral fluid intake to replace the fluid lost through hyperthermia and tachypnea. […] For G.I. anthrax, maintain G.I decompression, monitor emesis and liquid stool output, and medicate for abdominal pain, as needed. […] Advice the patient and family that anthrax is not transmitted person to person; one must come in contact with the spores to contact infection.

• #6 Anthrax – Nurses Revision

  https://nursesrevisionuganda.com/anthrax/

  Nursing care focuses on: […] Monitoring vital signs: Closely monitor the patient\s respiratory status, blood pressure, heart rate, and temperature. […] Respiratory support: Provide oxygen therapy and assist with mechanical ventilation if necessary. […] Fluid and electrolyte balance: Maintain adequate hydration and monitor electrolyte levels. […] Wound care: For cutaneous anthrax, provide appropriate wound care to promote healing. […] Infection control: Strict adherence to infection control protocols to prevent transmission. […] Psychological support: Provide emotional support to the patient and their family. […] Management up to Discharge: […] Continue antibiotic therapy as prescribed. Monitor for any signs of relapse or complications. Provide patient education on medication, wound care (if applicable), and follow-up appointments. […] Advice on Discharge: […] Complete the entire course of antibiotics. […] Monitor for any recurrence of symptoms. […] Report any new symptoms to healthcare provider. […] Follow-up appointments as scheduled.

• #7

  http://www.bccdc.ca/health-info/diseases-conditions/anthrax

  Skin infections account for 95% of all anthrax infections reported worldwide. Disease usually occurs 1 to 7 days after contact with an infected animal or animal product. A small bump appears on the skin which turns into an open wound with a black centre. In a digestive infection, symptoms may include fever, loss of appetite, vomiting, and diarrhea. Lung infections are the most serious type of infection. Symptoms include fever and sore throat followed by difficulty breathing. […] […] Anthrax does not spread from person-to-person. It can spread in one of these ways: From infected animals or animal products. Humans can become infected with skin anthrax by handling products such as animal hides from infected animals. Digestive infections occur by eating undercooked meat from infected animals. Lung anthrax has been reported in factories where people breathe in spores from contaminated animal skins or wool. […]

• #8 Cutaneous Anthrax Nursing Care Plan | PDF | Anthrax | Nursing

  https://www.scribd.com/document/411929317/Cutaneous-Anthrax-Nursing-Care-Plan

  The 24-year-old patient presented with a painless lesion on his right arm after accidentally slashing it while working on his farm. The lesion has a black center and has been worsening over time. The nurse will provide antibiotics to treat the cutaneous anthrax infection while monitoring the patient’s vital signs and ensuring a comfortable environment. The goal is for the lesion to reduce in size or be cured after completing the prescribed antibiotic regimen over a short period. Regular evaluation will assess whether the treatment is effectively resolving the infection.

• #9 Anthrax: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/anthrax/?srsltid=AfmBOop9pBmemt_0RB-UgdhcBNaNddzMp0ZcStTE2fOZ4slvO10c2JUh

  Signs and symptoms of anthrax vary by form but may include: […] Nursing diagnoses include: Ineffective airway clearance, Ineffective breathing pattern, Impaired swallowing, Diarrhea, Impaired tissue integrity, Hyperthermia. […] Interventions include: Auscultate lungs: Regular monitoring for respiratory changes, Positioning: Ensure the individual is sitting upright to facilitate breathing, Monitor bowel movements: To detect and manage diarrhea, Medication adherence: Ensure the individual follows the prescribed antibiotic regimen. […] Expected outcomes include: Improved airway patency: Ensure clear and unobstructed airways, Effective swallowing: Prevent aspiration and ensure adequate nutrition, Stable breathing pattern: Maintain normal respiratory function, Restored tissue integrity: Prevent progression of cutaneous lesions, Resolution of diarrhea: Return to normal bowel function, Reduced hyperthermia: Maintain normal body temperature.

• #10 Anthrax: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/anthrax/?srsltid=AfmBOop9pBmemt_0RB-UgdhcBNaNddzMp0ZcStTE2fOZ4slvO10c2JUh

  Individual/caregiver education includes: Proper positioning: Importance of sitting upright to aid breathing, Coughing and deep breathing exercises: To clear airways and prevent lung infections, Vaccination benefits: Understanding the role of vaccination in preventing anthrax, Medication adherence: Emphasize the importance of completing the antibiotic course, Monitoring skin changes: Recognize when to seek medical attention for worsening symptoms.

• #11 Anthrax – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anthrax/diagnosis-treatment/drc-20356209

  The standard treatment for anthrax is use of antibiotics, and in some cases antitoxin. The specific antibiotic chosen will depend on a range of factors, including if theres a need to treat many people. Which single antibiotic or combination of antibiotics, and the length of treatment, will be most effective for you depends on how you were infected with anthrax, the strain of anthrax, your age, your overall health and other concerns. Treatment is most effective when started as soon as possible. […] Since the 2001 attacks in the United States, researchers have developed antitoxin therapies raxibacumab and obiltoxaximab for inhalation anthrax. Instead of going after the bacteria that causes the disease, these medications help eliminate the toxins caused by the infection. Anthrax immunoglobulin also may be used to neutralize the toxins. These medications are given in addition to antibiotics and are available to doctors through the U.S. Centers for Disease Control and Prevention. […] Along with antibiotics, people with anthrax may be treated with intensive supportive care including ventilators, fluids and medicines to tighten blood vessels and raise blood pressure (vasopressors).

• #12 Anthrax Treatment & Management: Approach Considerations, Cutaneous Anthrax, Prehospital Care

  https://emedicine.medscape.com/article/212127-treatment

  Patients with isolated cutaneous anthrax without systemic involvement (ie, without edema, fever, cough, headache, etc) or complications may be treated on an outpatient basis with antibiotic monotherapy. The treatment of choice has been outlined as recommended by the CDC, IDSA, and AAP. […] All patients with suspected systemic anthrax should be begun immediately on IV antibiotics with co-administration of an antitoxin (raxibacumab or anthrax IgG) and should receive aggressive supportive care. All patients with suspected systemic illness should be admitted to inpatient for treatment. Early diagnosis and clinical suspicion are critical to improving outcomes. Workup should include standard fever workup pending the clinical situation, often including blood cultures and urine samples. […] The emergency department workup includes rapid initiation of intravenous antibiotic therapy. If risk of exposure is considerable, initiate PEP. […] Patients can be admitted to a normal hospital room with barrier nursing procedures (ie, gown, gloves, mask) and secretion precautions (ie, special handing of potentially infectious dressings, drainage, and excretions).

• #13 Anthrax: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001325.htm

  Antibiotics are usually used to treat anthrax. Antibiotics that may be prescribed include penicillin, doxycycline, and ciprofloxacin. […] Inhalation anthrax is treated with a combination of antibiotics such as ciprofloxacin plus another medicine. They are given by IV (intravenously). Antibiotics are usually taken for 60 days because it can take spores that long to germinate. […] Cutaneous anthrax is treated with antibiotics taken by mouth, usually for 7 to 10 days. Doxycycline and ciprofloxacin are most often used. […] When treated with antibiotics, cutaneous anthrax is likely to get better. But some people who do not get treated may die if anthrax spreads to the blood. […] People with second-stage inhalation anthrax have a poor outlook, even with antibiotic therapy. Many cases in the second stage are fatal.

• #14 Anthrax: Disaster Management Resources

  https://www.aap.org/en/patient-care/disasters-and-children/disaster-management-resources-by-topic/anthrax/?srsltid=AfmBOopw8xGPcEykjC-k7suJJw0bvRYJh-TYttLYxL77b19CY0XJ3D4l

  Either Anthrax Immune Globulin or raxibacumab antitoxin is indicated in patients with anthrax systemic disease, particularly children with severe disease, including those with new onset of organ system failure. […] Corticosteroids should be used in children with more severe systemic disease in doses that are consistent with those currently used for meningitis. […] Once therapy has been completed for any form of systemic or cutaneous anthrax infection in children involved in an aerosol B anthracis dispersal event, appropriate oral antimicrobial agents should be provided as PEP to complete a full 60 days of therapy.

• #15 CDC Updates Interim Guidelines for Anthrax Exposure Management and Antimicrobial Therapy | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/1201/p1901.html

  The highest priority is to identify at-risk persons and initiate appropriate interventions to protect them. […] A high index of suspicion and rapid administration of effective antimicrobial therapy is essential for prompt diagnosis and effective treatment of anthrax. […] Two or more antimicrobial agents predicted to be effective are recommended because of the mortality associated with inhalational anthrax. […] Toxin-mediated morbidity is a major complication of systemic anthrax. Corticosteroids have been suggested as adjunct therapy for inhalational anthrax associated with extensive edema, respiratory compromise, and meningitis. […] For cutaneous anthrax, ciprofloxacin and doxycycline are first-line therapy. […] Antimicrobial treatment may render lesions culture negative in 24 hours, but progression to eschar formation still occurs.

• #16 Cutaneous anthrax | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/cutaneous-anthrax-16689676.html

  Anthrax is caused by the bacterium Bacillus anthracis that primarily affects herbivores (sheep, goats, cows, camels, horses, etc.). Humans may become infected through contact of broken skin with a dead or sick animal. People at risk include livestock farmers and those that manipulate skins, wool or carcasses of infected animals. […] Do not excise the eschar; daily dry dressings. […] Antibiotic treatment for 7 to 10 days: First-line antibiotics: ciprofloxacin PO (including in pregnant or breastfeeding women and children) Children: 15 mg/kg (max. 500 mg) 2 times daily Adults: 500 mg 2 times daily or doxycycline PO (except in pregnant or breastfeeding women) Children under 45 kg: 2 to 2.2 mg/kg (max. 100 mg) 2 times daily Children 45 kg and over and adults: 100 mg 2 times daily. […] Combined antibiotic treatment for 14 days: Do not mix the two antibiotics in the same infusion bag (incompatibility). […] Intensive care: symptomatic treatment of shock (see Shock, Chapter 1); tracheostomy and ventilatory support may be necessary. […] Antibiotic prophylaxis in case of known skin exposure: treat for 10 days PO as for uncomplicated cutaneous anthrax.

• #17 Anthrax: Disaster Management Resources

  https://www.aap.org/en/patient-care/disasters-and-children/disaster-management-resources-by-topic/anthrax/?srsltid=AfmBOopw8xGPcEykjC-k7suJJw0bvRYJh-TYttLYxL77b19CY0XJ3D4l

  Treatment will vary by clinical manifestation. […] Cutaneous anthrax without systemic involvement that occurs in the context of an anthrax release should be treated with a single oral antimicrobial agent. […] Unless breastfeeding mothers have untreated cutaneous lesions on their breasts, breastfeeding should continue for infants of mothers who require antimicrobial treatment or prophylaxis or anthrax vaccine. […] Systemic anthrax infection is generally not considered contagious, and standard precautions should be used for routine patient care. […] Cases should be treated with at least 2 intravenous antimicrobial agents: a bactericidal agent, and a protein synthesis inhibitor, with the provision of oral stepdown therapy for children whose signs and symptoms of systemic infection have resolved.

• #18 Controlling Spread of Anthrax | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/anthrax/controlling

  Standard Precautions are recommended for use for healthcare providers when caring for a patient with anthrax. This includes use of gloves and gowns if soiling of clothing is possible and when in contact with any open wound. […] In the event of death, it should be assumed that all body fluids of the deceased person have very high concentrations of B. anthracis. Gloves and gowns should be worn when placing the body in a body bag. Contaminated dressings and bedclothes of cases should be burned or steam sterilized to destroy spores. The patient room may require fumigation, depending on the perceived level of contamination. […] Individuals at significant on-going risk of acquiring anthrax (e.g., laboratory workers) should be vaccinated. Employees who work with hides of potentially infected animals should be educated about anthrax and how to minimize exposures and possibly receive vaccine.

• #19 Anthrax – Control and Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/anthrax/control-prevention

  Ensure that supervisors and all potentially exposed workers are aware of the symptoms of anthrax. […] Workers potentially exposed to BA or who develop symptoms of anthrax should seek medical evaluation. […] Workers may continue working after exposure if able since anthrax is not contagious, and transmission primarily occurs through contact with the BA spores. […] Train all emergency response workers to recognize and report early symptoms and signs of anthrax, understand the importance of immediate medical attention, know how to access emergency medical care, know about potential adverse effects and interactions with food and drugs if taking antibiotics, and understand the potential adverse effects of the anthrax vaccine and the amount of time necessary to develop an immune response if using the vaccine as a preventive measure.

• #20 Anthrax – Control and Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/anthrax/control-prevention

  Infection with Bacillus anthracis (BA), which causes anthrax, occurs through direct exposure to active bacteria or bacterial spores. […] Adaptation of infection control strategies based on a thorough hazard assessment is necessary for implementing infection prevention and control measures, including engineering and administrative controls, safe work practices, and personal protective equipment (PPE). […] Employers whose workers will be involved in emergency response operations for releases of, or substantial threats of releases of, hazardous substances (including BA) regardless of the location of the hazard must comply with OSHA’s HAZWOPER standard (29 CFR 1910.120). […] This page provides specific information for categories of workers OSHA has identified as having a higher risk of exposure to BA.

• #21 Anthrax: Disaster Management Resources

  https://www.aap.org/en/patient-care/disasters-and-children/disaster-management-resources-by-topic/anthrax/?srsltid=AfmBOopw8xGPcEykjC-k7suJJw0bvRYJh-TYttLYxL77b19CY0XJ3D4l

  Because B anthracis (anthrax) has the potential to be used as a biological weapon and can rapidly progress to systemic anthrax with high mortality in those who are infected and untreated, the American Academy of Pediatrics (AAP) offers clinical guidance that can be quickly implemented when needed. […] The AAP clinical report Pediatric Anthrax Clinical Management provides further guidance. […] Public health authorities plan to provide a 10-day course of antimicrobial prophylaxis to people likely to have been exposed to spores. […] For children younger than 6 weeks of age (who are not candidates for AVA), antimicrobial prophylaxis should begin immediately, but the vaccine series should be delayed until the child reaches 6 weeks of age. […] Although not strictly contraindicated, AVA should not be coadministered with standard childhood vaccinations during an anthrax event. Immunization of children exposed to aerosolized B anthracis spores with AVA is a priority, above routine immunizations.

• #22

• #23 Anthrax (Bacillus Anthracis): Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/10853-anthrax

  Most forms of anthrax respond well to treatment. If you think you’ve been exposed, call your healthcare provider immediately. Fast treatment with antibiotics can stop the infection from developing. Anthrax treatments include: […] Antibiotics are the first line of treatment for this potentially deadly infection. There are other treatments, including a vaccine. […] The anthrax vaccine is 90% effective at preventing infection. The vaccine is only available to people between the ages of 18 and 65 who work in high-risk professions, such as farmers and livestock handlers, military members, researchers who study the bacteria, veterinarians and others as listed above. You receive five doses of the vaccine over 18 months. Afterward, you’ll need an annual booster shot. The vaccine also stops infection if you’ve knowingly been exposed to anthrax.

• #24 Anthrax – Control and Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/anthrax/control-prevention

  Follow good infection control practices (e.g., standard precautions) for preventing contact with BA. […] Standard precautions include hand hygiene and use of appropriate PPE to avoid direct contact with BA. […] Protect workers from exposure when tasked with cleaning surfaces and equipment potentially contaminated with BA. […] PPE includes appropriate respiratory protection, protective garments (e.g., coveralls, boot covers, chemical-resistant or -impermeable suits), eye and face protection, and gloves (nitrile or vinyl). […] Employers should base the use of PPE on the situation and tasks involved, including to the degree of contamination, risk of exposure, exposure pathway, and anticipated level of exposure. […] Worker protection from exposure to infectious agents, including BA, is necessary when work tasks involve handling, treatment, transport, and disposal of medical, laboratory and other potentially contaminated waste.

• #25 Department of Public Health – Acute Communicable Disease Control

  http://publichealth.lacounty.gov/acd/Diseases/Anthrax.htm

  Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. […] If you suspect that a patient is infected with Anthrax, immediately call Acute Communicable Disease Control to assist with diagnosis and implementation of infection control. […] CDC Anthrax Healthcare Providers: Anthrax Clinical Care. […] CDC MMWR: Guidelines for the Prevention and Treatment of Anthrax, 2023.

• #26 Anthrax

  https://www.michigan.gov/michiganprepares/az/az2/anthrax

  Antibiotics are used to treat all three types of anthrax. Early identification and treatment are important. […] Treatment is different for a person who is exposed to anthrax, but is not yet sick. Health-care providers will use antibiotics (such as ciprofloxacin, levofloxacin, doxycycline, or penicillin) combined with the anthrax vaccine to prevent anthrax infection. […] Treatment is usually a 60-day course of antibiotics. Success depends on the type of anthrax and how soon treatment begins. […] The Michigan Department of Health and Human Services works closely with physicians and laboratories to make them aware of the signs and symptoms of anthrax and to be able to identify anthrax. Increased surveillance by local health departments is incredibly important in our efforts to detect bioterrorism, investigate potential cases and ensure that patients will be cared for properly. Hospitals, health care providers, and health departments throughout the state are prepared to follow the protocols and recommendations for care set by the Centers for Disease Control and Prevention to ensure patient safety.

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