Wednesday, October 12, 2016

Antimicrobial Resistance: Part 2

In the Healthcare Setting

Antimicrobial-resistant pathogens can be passed easily from healthcare worker (HCW) to patient. Patients who are seriously ill or immunocompromised are more susceptible. Often, HCW hands are the culprit, but it also can be passed when the patient comes into contact with objects in the patient environment that have not been cleaned effectively.

Hands—particularly when dry and cracked, as so many HCWs’ are, due to repeated cleansing—are very efficient breeders of germs when not consistently cleaned well after patient contact. If you think like a pathogen, it’s easy to see that hands provide a multitude of crevices and crannies for pathogens to snuggle in and reproduce faster than rabbits. Colonized hands can transmit antimicrobial-resistant pathogens to their patients during routine care. Any time the patient’s skin integrity is broken, such as during placement of an IV, the patient is at greater risk of contracting an infection.

It is important to hold down opportunities to pass antimicrobial-resistant bugs to patients. Handwashing is a very important part of the picture, but it is just not enough. More opportunities exist for reducing cross-contamination.

Electronics, such as tablets and cell phones, are increasingly being used in the healthcare environment. Mobile phones and touch screens are documented sources of microbial contamination. Seal Shield offers a complete line of antimicrobial screen protectors. Also available are Seal Shields, polyurethane, form-fitted bags that seal devices so that they can be disinfected with healthcare-grade cleaners.

Seal Shield’s ElectroClave™ is like an autoclave for mobile devices. Devices can be tracked and managed while being securely charged, synced, and sanitized with UVC LED technology. The ElectroClave™ holds up to eight mobile devices, but can be daisy-chained to support an unlimited number of devices. The ElectroClave™ supports all brands of devices, without proprietary shelving or special adapters.

In the Community

At one time, we only saw antimicrobial-resistant pathogens in a medical setting. About 20 years ago, we began to see more resistant bugs rearing their ugly little heads in the community. Outbreaks began to pop up in the general public in places such as health clubs and schools.

Recently, the Washington Post reported the case of a woman in Pennsylvania found to have bacteria in her urine resistant to antibiotics of last resort. No one knows where she picked it up. The article noted, “A top U.S. health official said . . . it’s likely that more people will be found to be carrying a newly discovered superbug.”

Antimicrobial Misuse

Misuse of antibiotics plays a large part in the appearance of resistant bacteria. We contribute to the problem by insisting our doctor prescribe an antibiotic for infections that antibiotics don’t work on, like the common cold or the flu. Those are viruses, and antibiotics don’t work on viruses. In the meantime, the antibiotic is killing off susceptible, nonpathogenic bacteria that protect us from pathogenic bacteria.

We contribute to antimicrobial resistance when we don’t complete a prescribed antibiotic, allowing the mutant pathogens to flourish. The next time you need that antibiotic, it may not work due to resistance.

Another way we contribute to antimicrobial resistance is by not keeping our bodies, particularly our hands clean. We touch constantly touch many things in our environment, without even realizing it. We may touch a doorknob or computer keyboard that has been contaminated by someone carrying an antibiotic-resistant bug, and then we touch our faces; then we touch things that other people will come behind us and touch, and so on.

Plant and animal contributions

Antibiotics are used to treat diseases in animals and plants as well as humans; in fact, the volume of antibiotics used in plant and animal care greatly exceeds that used to treat humans.

Antibiotics are used to control diseases in plants and trees, often by spraying. The scary thing about that is that the antibiotic is delivered not to a single infected plant but to an area, where susceptible, as well as pathogenic, bacteria are treated, contributing the emergence of resistant bacteria in an environment shared by humans.

It gets worse. In the document “Antibiotic Resistance Threats in the United States, 2013,” CDC notes, “Fertilizer or water containing animal feces and drug-resistant bacteria is used on food crops. Animals get antibiotics and develop resistant bacteria in their guts. . . . Drug-resistant bacteria in the animal feces can remain on crops and be eaten. These bacteria can remain in the human gut. Drug-resistant bacteria can remain on meat from animals. When not handled or cooked properly, the bacteria can spread to humans.”

Food animals excrete a much larger volume of resistant bacteria than humans, and the bacteria in their environment moves to new places and hosts via contact with other animals, humans, insects, and produce. Like humans, the bacteria in food animals’ intestines and on their skins can be resistant to many different types of antibiotics.

Clearly, our environment is a source of antimicrobial resistance. The beauty of Seal Shield’s antimicrobial agent is that it does not contribute to the resistance problem as it kills pathogens. The agent is inorganic, so it does not provide pathogens an opportunity to mutate. Further, it does not leach into the environment, creating yet more opportunity for resistance to rear its ugly head. That’s optimization of pathogen-killing resources at its finest.

Coming up

In our final installment exploring antimicrobial resistance, we will examine what we can do about this global, life-threatening problem. A final international review, chaired by British economist Lord Jim O'Neill, concluded that antimicrobial resistance could kill 10 million people every year by 2050; that’s 1 person every 3 seconds. No one’s family would be unaffected. We cannot afford to return to the pre-antibiotic age.

Susan Cantrell, ELS 
Infection Control Corner
Contributor Writer

Other articles in this series:
Antimicrobial Resistance: Part 1

Other articles by this author:

No comments:

Post a Comment