Thursday, September 29, 2016

Antimicrobial Resistance: Part 1


Why Be Concerned?

The CDC conservatively estimates that more than 2 million people in the U.S. become sick with antibiotic-resistant infections every year. At least 23,000 people die from those infections. Antimicrobial resistance isn’t just a national problem, it’s a global emergency.

We’re sitting on an explosive situation, and we’re running out of time. We must find a way to stop this explosion of antimicrobial resistance before people once again start dying from infections that were untreatable before the advent of antibiotics. If allowed to continue, a simple cut on the finger could turn life-threatening. No one wants to step back into that time.

How Antimicrobial Resistance Happens

From the very birth of antibiotics, it was realized that the “miracle” drug could turn sour. Alexander Fleming, the British bacteriologist who discovered penicillin, warned that misuse could result in mutant forms of penicillin-resistant bacteria. By the 1950s, approximately 30 years after penicillin came into use, about half of Staphylococcus aureus strains already were resistant to penicillin. It wasn’t particularly concerning then. Science was diligently searching for new antibiotics and could keep up with emerging resistant strains. In the early 1980s, with approximately 100 antibiotics available, there appeared to be an abundance. Pharmaceutical companies’ research and development programs turned their attention elsewhere.

It’s frightening how easily resistance develops. In some bacteria, the ability to resist may be present on the cell’s chromosome but is not normally active. A spontaneous mutation may change that. Although it can happen in multiple ways, the process often starts with transference of genes from one bacterium to another.

Within bacteria are bits of supplemental genetic information, separate from the chromosome itself. Plasmids, these independent genetic elements, are self-duplicating and can carry from 3 to 300 different additional genes. Plasmids multiply within bacteria and change constantly. Plasmids can lose, acquire, or exchange genes, empowering them to develop ways to help its bacterial host do things it could not have done alone, such as acquiring new ways to prevent the bacterium’s death. Plasmids can carry genes for antibiotic resistance, enabling the bacterial host to resist death by antibiotic. These traits can then be transferred to other bacteria. They don’t even have to be the same kind of bacteria.

Here’s one way it happens: A bacterium with the plasmid containing the antibiotic-resistance gene sidles up to another bacterium. It extends a pilus, which reaches out to the other bacterium and draws the two together. The first bacterium makes a copy of its plasmid, or plasmids, and transfers it to the other. Now, both contain a copy of the resistance plasmid. This transference creates a new resistant strain and a new bacterium capable of passing the resistance plasmid on to other, perhaps very different, kinds of bacteria.

Philip M. Tierno, Jr, PhD, in his book The Secret Life of Germs: Observations and Lessons from a Microbe Hunter, noted the speed with which this can happen. “Gene exchange between two germs can take less than an hour. The forty-to-sixty hour cycle of human digestion leaves ample time for this to occur in the human intestinal tract.” These newly resistant bacteria can travel with their hosts to new environments, such as from the gastrointestinal tracts of humans to animals. They can cross country borders—carried by humans, animals, and food—circling the world rapidly.

“Modern Medicine Is Running Out of Magic Bullets”

Virtually all of us unwittingly contribute to the problem of antimicrobial resistance, because each person taking an antibiotic potentially contributes to the pool of resistant bacteria in the environment. We shed, excrete, and otherwise spread bacteria wherever we go. Resistant bacteria easily can move to family and others. Tierno explained, “The more antibiotics are used in a particular environment—a person’s body, a household, a hospital, or the world at large—the more they will upset the natural competitive balance among germs in favor of resistant strains. For example, if a teenager takes antibiotics regularly for acne, the other members of the household will soon come to harbor high concentrations of antibiotic-resistant skin germs simply by ordinary person-to-person contact.”

In his book The Antibiotic Paradox: How Miracle Drugs Are Destroying the Miracle, Stuart B. Levy, MD, noted, “Intermittent and repeated antibiotic use . . . creates an environment not only of microorganisms resistant to the drug being used, but also of bacteria that are resistant to many different antibiotics. . . . The net result is that many previously powerful, nontoxic, inexpensive, and often lifesaving antibiotics can become useless quickly.”

Tierno had more chilling words for us. “The world’s antibiotic use has been a fifty-year experiment in self-sabotage. . . . the selective toxicity of antibiotics has bred more and more dangerous germs. Wonder drugs have produced super bugs. . . . Modern medicine is running out of magic bullets.”

Taking Action

Much of the burden of quelling the spread of antimicrobial resistance will rest on medical-related industries. Companies like Seal Shield rise to meet such challenges with innovation and advanced technology.

One action that can be taken is exploring different avenues of controlling spread of infection. The less infectious disease, the less need there is for antibiotics. Use of Seal Shield products can reduce the risk of cross-transmission of antimicrobial-resistant pathogens in the environment. The antimicrobial impregnated in Seal Shield products, such as their medical keyboards and mice, is inorganic. It is incapable of breeding resistance while it destroys pathogens. Seal Shield’s UVC products effectively kill antimicrobial-resistant pathogens on items such as cell phones and tablets.

Human transmission plays a large role in antimicrobial resistance, but plant and animal care are heavily involved as well, perhaps even more so in the larger picture. In our next blog, we will talk more about all of these elements in the spread of antimicrobial resistance.

Susan Cantrell, ELS 
Infection Control Corner
Contributor Writer

Other articles by this author:

Friday, September 23, 2016

Wash Your Hands Properly as the First Step in Infection Prevention – International Clean Hands Week 2016


Washing your hands is the single most important thing you can do to stop the spread of infection, yet it’s often overlooked or replaced with quick options like antibacterial hand sanitizers.  Even if you wash your hands regularly, are you sure that you are using proper procedures to effectively kill germs and bacteria?  In celebrating International Clean Hands Week, there’s no better time to refresh your memory and share this helpful tool with others as we also head into flu season.

Antibacterial hand soaps have been all the rage over recent years, but consistent studies have shown that there are no added health benefits for the average user (not including professionals in healthcare settings) according to the CDC.  In fact, the FDA recently ruled that a total of 19 specific active ingredients can no longer be marketed in consumer antiseptic wash products.  Unless you are a professional in the healthcare industry with specific product and procedure guidelines, plain soap and water is your most effective option for keeping germs at bay.

The effectiveness of handwashing in preventing the spread of infections was first discovered by Dr. Ignaz Semmelweis in 1846.  Dr. Semmelweis collected data from 2 wards (1 staffed by midwives and the other staffed by physicians and medical students) of the maternity clinic at the General Hospital in Vienna in order to find out why so many women were dying from puerperal fever (childbed fever).  He found that the mortality rate in the ward staffed by physicians and medical students was nearly 5 times that of the ward staffed by midwives.  After observing and comparing multiple differences between the wards, including birthing positions and bell ringing, Dr. Semmelweis learned through an experience of a fallen colleague that childbed fever could affect people other than women in childbirth.  Then realizing that the physician-staffed ward performed autopsies and the midwife-staffed ward didn’t, he instructed staff to clean their hands and instruments with a chlorine solution in addition to soap to eliminate cadaverous particles.  After implementing this new procedure, the rate of childbed fever fell dramatically.  However, Dr. Semmelweis faced many challenges in getting support and adoption of his ideas and techniques and eventually was committed to a mental asylum where he died from sepsis (you can read the whole story here).

In today’s modern world we fully recognize the importance of handwashing; however, it’s imperative that we use the right products and procedures, particularly in the healthcare industry where the World Health Organization estimates that only 38.7% of health care workers practice proper hand hygiene.  Below is a quick guide so you can become a handwashing expert!

When to wash your hands (according to the CDC):
  • Before, during, and after preparing food and before eating
  • Before and after caring for someone who is ill
  • Before and after treating a wound or injury
  • After using the restroom
  • After changing diapers or assisting a child in the restroom
  • After coughing, sneezing, or blowing your nose
  • After touching an animal (including pets), animal food or treats, or animal waste
  • After touching garbage

Additional Tips:
  • Avoid touching your face whenever possible
  • Do not cough or sneeze into your hands (use the crook of your elbow)

How to properly wash your hands (according to the World Health Organization):

Keep in mind that washing your hands properly should take about as long as singing the "Happy Birthday" song twice, while following the images below.



For kid-friendly versions, you can download posters from the CDC here.

Wednesday, September 21, 2016

Combat Germs in Low Light Environments with Seal Shield’s Silver Seal Glow™ Keyboard – Now Available!

The Silver Seal Glow™, backlit, washable keyboard is the first of its kind, and now available for distribution worldwide!

A hygienic option for frequently touched surfaces, including computer keyboards and mice, is imperative in preventing the spread of viruses, germs and bacteria, which are known to harbor in these locations. A research study conducted by the University of North Carolina showed that up to 25% of hospital keyboards are contaminated with MRSA.  Stopping the spread of super bugs such as MRSA and C.Diff is crucial in healthcare facilities (and everywhere else for that matter), and disinfecting keyboards and other commonly touched surfaces on a daily basis can reduce the risk of cross contamination.

Enter the Silver Seal Glow™ washable keyboard.  Developed by Seal Shield with the healthcare market in mind, this natural style medical keyboard is 100% waterproof and backlit.  It also contains an antimicrobial, fungistatic additive that reduces the growth of mold, mildew, and odor causing bacteria on the product’s surfaces.  The Silver Seal Glow™ is fully submersible, washable, and easy to clean with sprays, wipes, or even in an automatic dishwasher, helping healthcare facilities stop the spreading of pathogens with ease. 

“Our healthcare customers are demanding hygienic solutions for common touch peripherals, such as keyboards, to help prevent nosocomial infections in hospitals (specifically in low light areas) and we are pleased to be able to provide a solution with unique features that make it an ideal choice for any environment," states Seal Shield CEO, Brad Whitchurch.  By utilizing proprietary, waterproof LED lighting with 3 brightness settings and laser etched keycaps, the Silver Seal Glow™ is optimal for typing in operating rooms and other low light environments. 

For this reason we are excited to present the Silver Seal Glow™ washable keyboard at the 2016 OR Manager Conference this week in Las Vegas, NV!  If you are in attendance, come see the Silver Seal Glow™ and other products at Booth #1133.  We truly believe that this medical keyboard is a great fit for those in this field and we are passionate in helping these operating room heroes by providing them with this infection control solution to assist them in saving lives.

Friday, September 16, 2016

Celebrate Environmental Services Week 2016!

Seal Shield is committed to providing solutions to those in these critical and often unrecognized roles in healthcare.

 

Environmental Services, a department of some of the most unsung heroes of any hospital or healthcare organization, their role is critical in quality outcomes in healthcare and in preventing the spread of bacteria and infections.  This week served to celebrate, appreciate, and recognize all of the professionals working in healthcare environmental services who spend countless hours sustaining hospitals, monitoring performance, and working as a team to prevent infections and ensure quality care within our complex healthcare environment.

The challenges faced by those in environmental services are some of the biggest focus for us here at Seal Shield.  As medical technology and instruments advance, as well as the increase in the implementation of mobile devices in healthcare, it is imperative that professionals in this industry receive the tools, training, data tracking, and support needed to continually uphold quality standards.

According to Jahan Azizi, a retired clinical engineer for risk management at the University of Michigan and expert on cleaning medical instruments, studies evaluating the scope of the problems and links between infections and contaminated medical instruments are limited, as published in an article by Modern Healthcare.  A professor at the University of California at Davis School of Medicine and former CEO of the National Quality Forum, Dr. Kenneth Kizer also contributed, stating that finding the source of infection can be hard to pin down, and the cleanliness of instruments is not usually the first place people look.

Modern Healthcare overviews a multitude of reasons for failures in the industry and why more support is needed, including low salaries, limited ongoing training opportunities, lack of clear reprocessing instructions, and the growing complexity of medical instruments and devices.  The FDA has also issued recent guidance urging manufacturers to make devices “easy to clean and disinfect”. 

Seal Shield has taken this into account for years and is happy to answer that call.  From our waterproof keyboards that come in multiple sizes, languages, connection options, and colors, to antimicrobial screen protectors and mobile device options such as the SKY and Clean Sleeve, we are committed to reducing hospital acquired infections and helping those in environmental services and the healthcare industry as a whole better do their job by allowing them to shift focus to what’s most important – the patients and their care, and allow our products to help carry the heavy lifting of infection prevention.

As hospitals are rapidly adopting mobility, Seal Shield offers the Electroclave, which not only disinfects mobile devices such as smart phones and tablets using LED UVC, but integrates a full RFID tracking system and mobile device management portal to provide data tracking, as well as asset protection for these newly acquired devices.  On September 26th and 27th, we will be attending the Association for the Healthcare Environment (AHE) Exchange Conference in Pittsburgh, PA and will have this new revolutionary device on display.  Come visit us at Booth #227 to learn more about how we can help your organization, and visit our website to view our full product line.  Together with those in environmental services and the entire healthcare industry, we can prevent infections while advancing our healthcare technology to be among the best in the world.