Opinion Former Article

World MRSA Day - October 2nd - should remind us that antibiotic resistance is a threat to medicine as we know it

MRSA Action UK are at the Infection Prevention 2014 conference in Glasgow. We are under no illusion, and never have been, about the growing threats of antibiotic resistance. At the conference today professionals reminded us about the numbers of people who were being affected by MRSA, and the huge successes we have had with the screening and infection prevention precautions to reduce the numbers of people in hospital with MRSA blood steam infections.

The conference heard from facilities in the USA where highly resistant cases of what is known as KPC Klebsiella pneumonia were brought under control. The mortality rate for the disease is very high and stringent procedures had to be adhered to in order to eliminate this dangerous bacteria from the care facilities involved. It is evident that the organism can be found in patients who have no symptoms and transmitted in care facilities, so the importance of screening and rapid diagnosis plays its part in preventing transmission.

We heard from Public Health England about the need to identify and understand carbapenem resistant organisms. If a patient is found to be either infected or carrying the bacteria, then we need to respond by using enhanced precautions and give the appropriate antibiotic treatment. We are now seeing organisms that can stop the absorbtion of antibiotics and in doing so evolve their mechanisms to produce resistance, so we have a real battle ahead of us. Tracking the transfer of patients from healthcare facilities, or from nursing homes is important and flagging this on patients notes plays a vital role in protecting patients who are being cared for in the same facilities.

In the case of the USA examples, even enhanced cleaning meant it was difficult to remove the highly resistant bacteria from the environment. Hydrogen peroxide vapour is having to be used to totally eliminate the bacteria, intensive care units with all the complex equipment are particularly vulnerable, and of course the very vulnerable patients that are treated in the units.

Ensuring adherence to infection prevention and control practice is very important, and delegates asked pertinent questions relating to the use of camera surveillance in hospital facilities to see if interventions were working. Some thought this was too invasive for the patient, however our view is that if we are in a situation where outbreaks are going to result in high numbers of patients not surviving their stay in intensive care or on the ward where they are being treated, then may be we should consider it, this measure should not be ruled out.

The speaker from the USA was unable to be at the conference and did her presentation on line. She was preparing her facility to receive a nurse who was being flown home from Africa after becoming infected with the ebola virus. This virus certainly reminds us of just how important the expertise of our healthcare workers' infection prevention and control practice is.

Derek Butler
MRSA Action UK
email: derek.butler@mrsaactionuk.net
telephone: 07762 741114

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