Monthly Archives: August 2014

About Antimicrobial Resistance: A Brief Overview from the CDC website

About Antimicrobial Resistance: A Brief Overview

Antibiotics and similar drugs, together called antimicrobial agents, have been used for the last 70 years to treat patients who have infectious diseases. Since the 1940s, these drugs have greatly reduced illness and death from infectious diseases. Antibiotic use has been beneficial and, when prescribed and taken correctly, their value in patient care is enormous. However, these drugs have been used so widely and for so long that the infectious organisms the antibiotics are designed to kill have adapted to them, making the drugs less effective. Many fungi, viruses, and parasites have done the same. Some microorganisms may develop resistance to a single antimicrobial agent (or related class of agent), while others develop resistance to several antimicrobial agents or classes. These organisms are often referred to as multidrug-resistant or MDR strains. In some cases, the microorganisms have become so resistant that no available antibiotics are effective against them.

Drug Resistance Is Everywhere

Antimicrobial drug resistance occurs everywhere in the world and is not limited to industrialized nations. Hospitals and other healthcare settings are battling drug-resistant organisms that spread inside these institutions. Drug-resistant infections also spread in the community at large. Examples include drug-resistant pneumonias, sexually transmitted diseases (STDs), and skin and soft tissue infections.

The Effects of Antimicrobial Drug Resistance Are Far-Reaching

People infected with drug-resistant organisms are more likely to have longer and more expensive hospital stays, and may be more likely to die as a result of the infection. When the drug of choice for treating their infection doesn’t work, they require treatment with second- or third-choice drugs that may be less effective, more toxic, and more expensive. This means that patients with an antimicrobial-resistant infection may suffer more and pay more for treatment.

Trends in Drug Resistance

  • Reports of methicillin-resistant Staphylococcus aureus (MRSA)—a potentially dangerous type of staph bacteria that is resistant to certain antibiotics and may cause skin and other infections—in persons with no links to healthcare systems have been observed with increasing frequency in the United States and elsewhere around the globe.
  • The agricultural use of antibiotics in food-producing animals also contributes to the emergence, persistence, and spread of resistant bacteria. Resistant bacteria can be transmitted to humans through the foods we eat.
    • Multi-drug resistant Klebsiella species and Escherichia coli have been isolated in hospitals throughout the United States.
    • Antibiotic-resistant Streptococcus pneumoniae infections have significantly declined, but remain a concern in some populations.
    • Antimicrobial resistance is emerging among some fungi, particularly those fungi that cause infections in transplant patients with weakened immune systems.
    • Antimicrobial resistance has also been noted with some of the drugs used to treat human immunodeficiency virus (HIV) infections and influenza.
    • The development of antimicrobial resistance to the drugs used to treat malaria infections has been a continuing problem in many parts of the world for decades. Antimicrobial resistance has developed to a variety of other parasites that cause infection.

     

    http://www.cdc.gov/drugresistance

Hospitals are dangerous places to be

 From a July 24th blog post on MRSAid by Greg Pond.

In his luncheon address at the National Press Club in Washington, DC, this Tuesday, Tom Frieden, MD, Director of the Centers for Disease Control and Prevention, put this question to the audience:

“What do these 6 organisms have in common besides the fact that they’re all infectious diseases? MERS [a viral-caused respiratory illness that kills about 1/3 of the people who get it], Ebola [viral-caused internal bleeding], measles, multi-drug resistant TB, C. difficile [gut bacteria that causes severe diarrhea], and CRE [the new ‘nightmare bacteria’ that kills half the people who get it].”

The audience was stumped so he offered a clue: “It has to do with how they spread,” he said. Still, no one got it.

The answer is: “They’re all – very importantly – spread in hospitals. We [hospital personnel] can be part of the problem if we’re not careful,” he said.

Tom Frieden was being candid about a subject we’ve addressed many times before, namely, that the hospital is an inherently dangerous place. For example, we’ve reported that: there is sometimes a surprisingly high rate of infection carried by hospital staff; Hospital-Acquired Infections cause more deaths in Canada each year than breast cancer, HIV/AIDS, traffic accidents, and homicides combined; lab coats, stethoscopes, smartphones and tablet computers used by doctors and nurses are magnets for bad bugs; on the high rate of physician non-compliance with hand hygiene protocols; hospitals are built in such that they aid and abet the spread infections, and, finally; the ease with which hospital cleaning procedures can actually spread pathogens instead of getting rid of them, summed up in this superb and highly infectious video, THE BUG ZONE, made by, and featuring, some creative hospital staff in Winnipeg, Canada.

“I do think that people need to understand that the hospital is an inherently dangerous place and it’s not because hospitals are dirty or doctors are lazy or anything like that. Think about it this way. You’re taking the sickest people in society, crowding them into one building, tearing new holes in their bodies that they didn’t use to have by placing plastic catheters in their bloodstream, their bladder, putting tubes into their lungs that can breathe for them, and we’re using very large quantities of antibiotics to treat infections. So that’s a perfect breeding ground to generate antibiotic resistant bacteria.”

There’s a saying among hospital physicians: “The longer you stay the longer you stay.” That is, because hospitals are so full of germs – susceptible and resistant – the longer you stay the greater the risk that they will get hold of you and make you sick, or worse.

So as it turns out, the trick to a successful hospital stay is much the same as the trick to a successful bank robbery – get in and get out as quick as you can.

Summing up this article, more people are killed by hospital acquired infections (HAI’s) each year than by than breast cancer, HIV/AIDS, traffic accidents, and homicides combined. The vectors of transmission mentioned; which include smartphones, lab coats, and stethoscopes are all able to be treated with Nano Shield antimicrobial. One application of Nano Shield will keep these surfaces protected from microbes for up to 90 days. Antimicrobial barriers are the future of infection control in medical settings.

Hand sanitizers don’t work in schools

According to this article which appeared on the CNN health blog THE CHART on August 12th alcohol hand sanitizers were found to be ineffective as a way to prevent the spread of sickness among children in schools.

 

August 12th, 2014

04:38 PM ET

Hand sanitizer doesn’t help in schools

School children get low marks when it comes to spreading germs, often sharing bugs with their classmates. So scientists wondered if putting hand sanitizers into elementary school classrooms would lead to fewer absences.

The study

Researchers in New Zealand set out to discover if using alcohol-based hand sanitizers, in addition to regular hand washing, would cut back on absentee rates in schools.

They recruited 68 primary schools, and all students were given a half-hour hygiene lesson. They then assigned half of the schools to a control group where children washed their hands with soap and water. The schools in the intervention group did the same, but were also asked to use classroom hand sanitizers when they coughed or sneezed, and before meals.

When children missed school, calls were made to find out if the child was sick. The research team checked-in with the caregivers of more than 2,400 children, keeping track of the type and length of their illnesses during 20 weeks of school.

The results

Absentee rates between the two groups were virtually the same, the study authors found.

“These findings suggest that, in high-income countries where clean water for hand washing is readily available, putting resources into extra hand hygiene by providing hand sanitizer in classrooms may not be an effective way to break the child-to-child transmission of infectious diseases,” an accompanying editorial in the journal concluded.

Caveats

An unexpected flu epidemic during the course of the study may have affected the findings. Heightened awareness about the benefits of clean hands during the epidemic may have led to more hand washing overall, making it more difficult to see if hand sanitizers gave added benefit, says Dr. Jennifer Shu, a pediatrician in Atlanta who was not involved with the study.

But the study authors say that the impact of hand sanitizer would be particularly important during an influenza pandemic, and they found “providing hand sanitizer was not an effective mechanism for reducing illness absence.”

So what is the takeaway message for schools and parents? The Centers for Disease Control and Prevention says it’s best to have children wash their hands with soap and water. If a sink is not available, hand sanitizers with an alcohol concentration of at least 60% are a good second choice.

The bottom line, do what it takes to rub those germs away.