Sample Research Paper on Infectious Conjunctivitis

1: Background of the Case Study

Infectious conjunctivitis refers to the inflammation of the conjunctiva a membrane
covering sclera due to viral or bacterial infection. Infectious conjunctivitis caused by
bacteria is known as Bacterial conjunctivitis while viral conjunctivitis is caused by
contagious viruses. Common symptoms associated with infectious conjunctivitis are
reddening of the eye and sensitivity to light. Bacterial conjunctivitis can be treated by the
use of antibiotic eye droplets as well as gentle washing and cleaning of the eyelids with a
warm wet face washcloth. A severe degree of viral conjunctivitis can be treated by the
use of corticosteroid eye drops Roat M. (2019).
The likely micro-organism to cause John’s eye infection is Staphylococcus aureus
which is a bacterial micro-organism. The remaining micro-organisms are highly unlikely
to cause infectious conjunctivitis since; Legionella pneumophila is a type of bacteria that
causes lung infection and subsequently acute pneumonia WC Jr. (19960. Plasmodium
ovale is a species of plasmodia parasitic protozoa that causes human malaria. Lastly,
Adenoviruses can affect the lining of the eyes but their symptoms are distinctive from
John's symptoms since an individual infected by these viruses exhibit fever, coughs, pink
eye, and or diarrhea.

Question 2: Mechanism of Action and Adverse Reactions.
Gentamicin is a bactericidal antibiotic made up gentamicin C 1 , C 1a , and C 2
components and its mechanism of action that entails inhibition of synthesis of bacterial
proteins by the aminoglycoside component of gentamicin which bind the 30S ribosomes
as well as causing increased misreading of messenger RNA which is highly dependent on
the concentration of the antibiotic Tangy F., et al (1984). This mechanism of action is

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responsible for killing bacteria their functional proteins have been rendered nonfunctional
and these proteins are essential for growth and repair Bullock, S., & Manias, E. (2017).
At low levels of concentration of gentamicin, the polysomes are less affected while the
ribosomes are highly affected, on the other hand, high concentration levels of gentamicin
the polysomes are highly inhibited while the ribosomes are less inhibited. Their functions
in synthesis are being recovered slowly by slowly.
When gentamicin antibiotic is administered to a person with infectious
conjunctivitis it may lead to the following adverse side effects; burning or stinging
sensation of the ocular but only temporarily and in cases where the side effects are
extreme the individual should see a doctor as soon as possible for further medical
checkup. The drug might cause serious allergic reactions that prompt an individual to also
see a doctor who will provide suitable treatment for the individuals reacting to
gentamicin treatment. According to Cunha, J. (2019), continued use of gentamicin may
lead to fungal eye infections. Burchum, J. R., & Rosenthal, L. (2019) indicate that the use
of gentamicin may lead to damage to the eighth cranial nerve. As much as gentamicin is
an effective drug in treating infectious conjunctivitis it is clear that it exhibits several side
effects.

Question 3: Physiological Basis of Signs

Basing on the case study, John had red, swollen eyes, pain in the eye and had a
purulent sticky discharge from his eye. This is enough evidence to conclude that John
was suffering from bacterial conjunctivitis. This claim is backed up by Haq A., Wardak
H, and Kraskian N. (2013) who attributed to the fact that common symptoms of bacterial
conjunctivitis are red eye accompanied by the discharge of a purulent sticky substance

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from the eye. The main causative agent of these symptoms is the bacteria Staphylococcus
aureus which attaches itself to the host’s eye tissues and eroding his/her immune
response. Staphylococcus aureus is both aerobic and facultative anaerobic organism that
forms large yellow or white colonies that attach themselves on nutrient-rich agar media.
The bacterial organism is characterized by being hemolytic in the blood agar thus being
the reason behind John’s red-eye. Staphylococcus aureus has strains that produce
coagulase enzymes that are sticky and purulent hence explaining the presence of the same
discharge on John's eye.
The swelling of John's eye is attributed to the fact that Staphylococcus aureus is a
salt-tolerant bacterium that can thrive well in the saline/salty nature of the eye caused by
tears. It oxidizes negatively and catalyzes positively.

Question 4: Infection Control Issues

Infection control attempts to look into factors that relate to the spread of
infections in a health care setting as well as prevention methods of the same, monitoring
and management Minhas S., et al (2011). Elderly people in nursing homes are susceptible
to being attacked by numerous infections on account of their weakened immune system.
A study carried out by Boustcha, E., & Nicolle, L. E. (1995) to determine the incidences,
preventive measures, and etiology of conjunctivitis in residents of a long term care
facility it was found out that conjunctivitis was common in facilities with increased
occurrences in highly impaired residents more. Basing on John’s age (88) years old, his
immunity is likely to be affected by the age and that’s why he probably got infected with
bacterial conjunctivitis.

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In nursing homes especially for the elderly case of conjunctivitis, the infection
may be sporadic or outbreak-associated Smith P., et al (2008). Upon carrying out
bacterial isolation the bacteria Staphylococcus aurous responsible for causing infectious
conjunctivitis appeared the most in the isolate, therefore in a nursing home residents are
likely to be infected by conjunctivitis as it spreads rapidly. The nursing home in the case
study might have had a sporadic or outbreak-associated case of conjunctivitis transmitted
majorly by hand cross-contamination. This is highly supported Australian Government
Department of Health and Ageing National Health and Medical Research Council (2013)
that living in communally in nursing homes increases contact between people and also
the risk of infection mostly when the residents have experienced difficulties in
performing day to day activities.

Question 5: Transmission of Infection

In nursing homes, the spread of infectious bacteria is high as both residents and
staff members play a focal role in carrying and transmitting the infections majorly
through body contact. Therefore there is a need to practice proper sanitation measures
like washing of hands and disinfecting of surfaces.
In the case study, a patient Mary living next door to John was diagnosed with the
same eye infection as John. This could have occurred probably due; to contact between a
health care worker taking care of John and Mary. She might have not cleaned her hands
and taken proper safety measures after handling John's eye problem. Therefore she acted
as an agent for the spread of the infection to Mary.
Staphylococcus aureus can land of surfaces or objects residents may pick these
bacteria from the contaminated surfaces unknowingly and contribute to the spread and

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infection of conjunctivitis. There might have been some contact between John and Mary
hence the infection might have occurred when his Staphylococcus aurous contaminated
hand skin scales were shed onto surfaces Mary touched or onto Mary’s hands.
Sharing of newspapers, books, and other readable materials by the residents of the
nursing homes could lead to transfer of the infectious conjunctivitis from one person to
the other. In this case, it could be possible that John and Mary might have shared reading
materials without proper sanitation of their hands or the materials. In this chain of
infection, health workers are susceptible to getting infected too in case they don't take the
necessary precautions while handling the infected patients.
Question 6: Breaking Chain of Infection

Once a chain of infection has been discovered of a certain disease necessary
measures have to be taken to inhibit further spread by breaking the chain of infection.
Boland, M., Santall, J & Video Education Australasia. (2011) indicate that controlling
infections in a health care setting is a vital responsibility that should be taken and shared
by all health staff. Centers for Disease Control and Prevention (2016) explained a chain
of infection as when a microorganism exits from the host via an exit portal and enters into
a susceptible host through an entry portal. Shaw K (2016) attributes that since nurses are
ever in contact with patients and carry out many intervention measures, each contact and
intervention plays a key role in inhibiting the rise of the spread of infection. Measures
that nurses can adopt to break the chain of infection in the nursing home mentioned in the
case study are:
Establishing the number of cases of infectious conjunctivitis as well as infection
trends of the same. In this case, John was the noted patient to have been diagnosed with

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bacterial conjunctivitis; therefore the best measure would have been isolation and
treatment of the eye problem accompanied by taking safety measures while handling the
patient. Such safety measures are ensuring high levels of sanitation for both the patient
and the nurse handling John's problem. Cleaning of surfaces likely to be touched by the
patient is necessary. When nurses have taken proper safety measures one link for
infection will have been broken hence the spread of the infection will be prevented.
According to Shaw K (2016), this is true as when one or more links of infections are
broken then the infection will not take place.
Decontamination and washing of patients'/residents' personal effects such as eye
drop medicines, wash cloths, and towels. These are items that contribute to the spread of
infectious conjunctivitis if shared between residents. Nurses are to ensure that they use
clean and different wash clothes for different patients when treating bacterial
conjunctivitis. In this case study, the nurse handling John or Mary should ensure that
sharing of their personal effects does not happen as well as ensuring high levels their
decontamination. Nurses should have on their protective gear like gloves while handling
the two residents of the nursing home. These gloves have to be disposed of and new fresh
gloves used for the next patient. According to Lehne, R. A., Moore, L., Crosby, L., &
Hamilton, D. (2013), the best way for decontamination is cleaning of hands with lots of
water and soap as well as contaminated surfaces. Upon employing the use of these
measures the chain of infection here will be broken in a nursing home.

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References

Australian Government Department of Health and Ageing National Health and Medical
Research Council (2013). Prevention and control of infection in residential and
community aged care.
Boland, M. (Director), Santall, J. (Presenter), & Video Education Australasia. (2011). Infection
control in healthcare [Videorecording]. Bendigo, Australia: VEA. Retrieved from
https://www.worldcat.org/title/infection-contro-in-
healthcare/0clc/808309911?loc=94043&tab=holdings&start_holfing=7
Boustcha, E., & Nicolle, L. E. (1995). Conjunctivitis in a long-term care facility. Infection
Control and Hospital Epidemiology, 16(4), 210-216. Retrieved from
https://pubmed.ncbi.nlm.nih.gov
Bullock, S., & Manias, E. (2017). Fundamentals of pharmacology (8th ed.). Frenchs Forest,
Australia: Pearson Australia.
Burchum, J. R., & Rosenthal, L. (2019). Lehne’s pharmacology for nursing care (10th ed.). St.
Louis, MO: Elsevier/Saunders
Centers for Disease Control and Prevention (2016). Chain of Infection. Retrieved from
www.nursingtimes.net
Cunha, P. J. (2019 February, 5 th ). Genoptic Side Effects. Retrieved from
https://www.rxlist.com/genoptic-side-effects-drug-center-htm#consumerfdb
Drancourt, M. (2010). Infectious Diseases. 3 rd Edition. Retrieved from.
https://www.sciencedirect.com/topics/medicine-and-dentistry/bacterial-conjunctivitis.
Lehne, R. A., Moore, L., Crosby, L., & Hamilton, D. (2013). Pharmacology for

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nursing care (8th ed.). St. Louis, MO: Saunders/Elsevier. Retrieved from.
https://www.worldcat.org/title/pharmacology-for-nursing-care/oclc/803339627