Wednesday, October 26, 2016

Antimicrobial Resistance: Part 3

In his book The Antibiotic Paradox: How Miracle Drugs Are Destroying the Miracle, Levy states, “Part of the responsibility for appropriate antibiotic use certainly rests on all of us. The consequences of misuse affect ourselves, our families, and our communities. . . . The consequences of antibiotic misuse come back to haunt the misuser as well a multitude of innocent bystanders in the community, most notably other family members.”

Actions Individuals Can Take to Thwart Resistance

Antibiotic resistance is reaching calamitous proportions. Levy noted, “We must take responsibility for using antibiotics properly, since this will protect the future health of ourselves, our families, and our whole society.” Here are some of the things we, as individuals, can do to improve the situation.
  • Wash your hands. Keeping your body, particularly your hands, and your environment clean helps to keep pathogens at bay, which means less need for antibiotics. In his book The Secret Life of Germs: Observations and Lessons from a Microbe Hunter, Tierno noted, “. . . proper handwashing and food hygiene would dramatically reduce the rate of infectious disease and thus the rate of antibiotic prescriptions.”
  • If you are sick, stay home. The less infection circulating, the less need for antibiotics. Avoid being around people who are infectious.
  • Keep vaccinations up to date.
  • Do not try to persuade your doctor to prescribe antibiotics inappropriately; for instance, if you have a cold or the flu. Antibiotics kill bacteria; they do not kill viruses. Antibiotics are killers. They also kill off the good bacteria that help protect us from infection; so, don’t use them if you don’t need them.
  • If prescribed antibiotics, complete the course, unless you have serious adverse effects, in which case you should consult your doctor. Courses of antibiotics that are not completed allow bacteria to survive and mutant antibiotic-resistant pathogens to breed. The next time you need the antibiotic, it may not work. You may have developed resistance to it because you used it inappropriately.
  • Do not share antibiotics. This could lead to two people harboring resistant strains instead of one.
  • Do not self-medicate or self-diagnose. In some countries, people may acquire antibiotics from a pharmacy without a doctor’s prescription. Bacterial infections require certain antibiotics and should be prescribed by a medical professional who has reason to believe a bacterial infection is indeed the cause of illness. Easily available antibiotics foster misuse and abuse of antibiotics that can lead to resistance. Levy advised, “Knowing the kind of bacteria causing the disease helps the physician decide what kind of disease symptoms and signs to expect and what kind of drug to use.”
  • Wash fresh fruits and vegetables thoroughly with water to help remove antibiotics.
  • Buy antibiotic-free meat, eggs, and produce. This sends a message to farmers. Many farmers already are voluntarily withdrawing use of antibiotics, seeking alternatives to keeping their plants and produce healthy, such as more natural farming methods.
  • Wash meats and cook them well to kill bacteria.
  • Prepare uncooked fruits and vegetables on different surfaces than meat and fish.

Actions Medical and Science Professionals Can Take
Antimicrobial stewardship plays a major role in preventing antimicrobial resistance. Prevention of infectious disease also is key. The CDC cites four core actions that health care can take against antibiotic resistance: 1) prevent infections; 2) track resistant bacteria; 3) improve use of antibiotics; 4) promote the development of new antibiotics and develop new diagnostic tests for resistant bacteria. A CDC Vita Signs report added that cultures should be obtained early so that antibiotics can be started promptly, noting that healthcare workers should understand when to stop antibiotic treatment.

The World Health Organization (WHO) tells us it is important that healthcare workers and pharmacists fight resistance by 1) enhancing infection prevention and control in medical facilities; 2) only prescribing and dispensing antibiotics when truly necessary; 3) prescribing and dispensing the right antimicrobial for the appropriate illness. Better diagnostics can help supports points 2 and 3, because when antimicrobial treatment is appropriate it could be started sooner and because use of antibiotics where they are not needed could be eliminated.
Antimicrobial stewardship also includes the following measures:
  • Provide up-to-date education to prescribers and users of antibiotics. Doctors should educate their patients on proper use. Professionals can present information at meetings and attend lectures.
  • Healthcare providers should not succumb to pressure from patients to prescribe antibiotics inappropriately, such as for viral infections like the common cold or flu; instead, educate patients. Make it personal. Explain to them the impact that spread of antimicrobial resistance can mean to them and their family.
  • Epidemiologists can help identify areas of endemic resistance through surveillance of clinical isolates on a regular basis. Surveillance helps doctors to choose appropriate antibiotics. It also provides a benchmark that can show improvement in reduction of resistant organisms or escalation of numbers and strains of resistant organisms.
  • Pharmaceutical companies should be encouraged to discover new antibiotics.
  • Medical professionals can turn to alternatives to antibiotics, such as vaccines. Preventing infectious disease is always more desirable than reacting to it.
  • Research scientists and drug manufacturers should understand the mechanisms of resistance and how it is spread to enable them to design ways to prevent spread of resistance.

Other options include limiting spread of resistant organisms in the environment by using products that can kill pathogenic bacteria without breeding resistance. Seal Shield’s products, designed for our touch-dependent life, are impregnated with an inorganic antimicrobial that can help to control spread of resistant organisms. Seal Shield’s medical keyboards, medical mice, and universal TV remotes are 100% waterproof. They can be soaked in bleach, washed in a sink, or cleaned in an automatic dishwasher. Alternatively, they can be cleaned with sprays or wipes, without being disconnected or powered down.

Seal Shield’s screen protectors with Antimicrobial Product Protection features a protective film for surgical monitors, touch screens, computers, and tablets that can withstand harsh chemicals used in medical-grade disinfectants, including bleach. The chemical disinfectants will not cause discoloration or clouding. 

Seal Shield SKY™ UV Disinfection for Tablet Computers & Mobile Phones achieves a 3- to 6-log reduction (99.9% to 99.9999%) in harmful pathogens such as methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, multidrug-resistant gram-negative organisms, norovirus, and Clostridium difficile spores. SKY uses high-intensity (254-nanometer wavelength) ultraviolet light in the “C” spectrum (UVC) at close proximity to disinfect mobile devices thoroughly. The high-intensity UVC penetrates into the cells of pathogens, viruses, bacteria, and spores, breaking the DNA strand at the point responsible for cell replication, rendering organisms inactive.

Seal Shield also can add antimicrobial protection to your products. Silver Seal™ protection can be added into plastic, silicone, paint, powder coats, textiles, and numerous varied polymers, by using its 5-step antimicrobial solution process. Get in touch with Seal Shield today to discuss your particular antimicrobial needs.

The Bottom Line

The CDC reports that least 2 million illnesses and 23,000 deaths in the United States each year are caused by antibiotic-resistant bacteria. Some reports insist those numbers are understated. Estimates of deaths due to antibiotic resistance worldwide are reported to be approximately 700,000 annually. New superbugs resistant to the last line-of-defense antibiotics are popping up with alarming frequency, so we can expect those mortality numbers to rise. The cost of lives and money is astronomical and it’s growing. Antimicrobial resistance is a global emergency that requires all hands on deck. We have to stop antimicrobial resistance in its tracks now, while we still can. Do your part. It could be your life or those of your loved ones that you save.

Susan Cantrell, ELS 
Infection Control Corner
Contributor Writer
Other articles by this author:

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:

Monday, October 3, 2016

10 Facts About Viruses

Can you believe that there is a day dedicated to appreciating viruses? Why would we celebrate something that can affect us so negatively?  National Virus Appreciation Day was created to take a step back and look at viruses from a more philosophical view, to appreciate the sophistication and power of something that is so small.

In honor of these microorganisms, we’ve put together a list of 10 things that you might not know about them!
  1. Viruses are not alive, as they do not have cells, cannot turn food into energy, and are basically just capsules containing genetic material, however, they aren’t dead either – as they have genes, can reproduce, and evolve. In contrast, bacteria are one-celled, living organisms.
  2. In order to reproduce, viruses invade cells and act as a hijacker, often destroying the invaded host cells.
  3. Viruses are responsible for numerous diseases, including the Common Cold, Influenza, Ebola, Measles, AIDS, Rabies, Polio, and Chickenpox.
  4. Antibiotics have no effect on viruses, which is why overprescribing is such a problem and it’s imperative to only take antibiotics when needed.  Your best line of defense against common viruses like the flu is standard infection control methods like proper handwashing and getting a flu vaccine.
  5. The word “virus” comes from the Latin word for “poison” or “toxin”.
  6. Viruses can infect animals, fungi, protozoa, archaea, and bacteria.  There has even been evidence that suggests they may be able to infect other viruses!
  7. Humans are half viruses.  Viruses infected and embedded themselves in our ancestors’ egg and sperm cells and therefore half of all human DNA originated from them!
  8. Viruses are considered the most abundant biological entity on the planet – almost every ecosystem contains them.
  9. There are some “good” viruses that will protect their host from harmful bacteria, such as E.coli.
  10. One of the oldest and well-documented stories revolving around a virus is the history behind Smallpox.  Documented human cases go back 3,000 years! 
At the end of the day we can all agree on one thing – viruses are definitely not something to sneeze at!