Superbug Invades Hospitals

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Healthcare providers can’t just wash their hands of this.

HEALTH Some antibiotic-resistant bacterial infections result from unhygienic environments. The superbug that is now spreading across the country is called carbapenem-resistant Klebsiella pneumoniae (CRKP). It is now responsible for 60 percent of all ICU infections.

Officially reported in 36 states (unofficially perhaps in 14 others), CRKP is a nosocomial infection only contracted in hospitals and nursing homes. There aren't an abundance of options when treating CRKP. In fact, according the CDC, colistin is the only defensive antibiotic. And it isn't always effective with kidney damage as a possible side effect. [1,2]

From Where Did This Superbug Originate?

A superbug is a bacterial infection resistant to antibiotics. It can be spread from patient to patient when hands are not washed as frequently as they should be but that is not the sole factor. Paradoxically, CRKP is thought to be prevalent because antibiotics have been overprescribed or not taken properly.

WebMD, April 5, 2011 : The battle against the superbugs continues with the FDA approval of fidaxomicin for the treatment of Clostridium difficile.

Doctors in the past routinely prescribed broad-spectrum antibiotics for some infections like acute bronchitis. Patients became accustomed to this treatment so they began demanding antibiotics at the first sign of bronchitis. Antibiotics are effective against bacterial pathogens, certain fungal infections, and some kinds of parasites. Most often, colds, influenza, and bronchitis are viral.

Taking an antibiotic for a viral infection doesn't help recovery and may contribute to antibiotic resistance. If you give a certain organism a broad-spectrum antibiotic like a carbapenem that covers that organism and 10 others, that organism learns how to fight off that antibiotic. It is most effective to prescribe a specific antibiotic determined after a sputum culture is examined in a laboratory when a bacterial infection is suspected with bronchitis, parasite, or sinus infection. [3]

Sometimes people begin to feel better after taking a prescribed antibiotic after just a few days so they stop. This is problematic because the antibiotic may wipe out only some of the bacteria. The surviving bacteria become more resistant and can be spread to other people. This gives birth to a superbug. The failure of first- and second-line antibiotics forces doctors to resort to less conventional and more costly medications that may be associated with more serious side effects. For instance, the drugs needed to treat drug-resistant tuberculosis (TB) are much more expensive than the prescriptions used to treat nonresistant TB. The course of this treatment lasts up to two years with potentially more severe side effects. [3-5]

Hand washing cannot kill CRKP or MRSA but it can minimize infections that make patients susceptible to antibiotic-resistant bacterial infections. Prevention includes diligent hand washing, proper use of antibiotics, and replenishment of good bacteria following antibiotic treatment with probiotics. Some things are within the patient's control. Why not start a handwash campaign in your office? The "Clean Your Hands" campaign among healthcare workers in England and Wales has more than doubled the rate of hand hygiene, according to the agency that runs the program [6].

Tags: epidemiology, dermatology, disease, germs, microbiology, staph infection

References
  1. Superbug found in California hospitals. CNN.com
  2. 'Superbug' spreading to Southern California hospitals. LATimes.com
  3. Better use of antibiotics will help reduce spread of drug-resistant 'superbugs.' LATimes.com
  4. Antibiotics: Misuse puts you and others at risk. MayoClinic.com
  5. Drug-resistant tuberculosis now at record levels. World Health Organization
  6. Hand gels: Are they replacing soap and water? CNN.com


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