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
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