Antibiotic resistant infections, otherwise known as superbugs, are one of the biggest challenges facing the healthcare system today. Antibiotic Resistance means that the medications used to fight infections do not kill certain bacteria. Many remember the story of a Nevada woman who died of an antibiotic- resistant infection in 2016. Unfortunately, she was one of close to 40,000 deaths each year in the US related to antibiotic-resistant infections. Some of the most common infections requiring contact precautions in the hospital include:
- Clostridium Difficile (CDIFF)
- Methicillin-Resistant Staphylococcus Aureus (MRSA)
- Vancomycin-Resistant Enterococcus (VRE)
- Carbapenem-Resistant Enterobacteriaceae (CRE)
- Extended Spectrum Enterobacteriaceae (ESBL)
When a hospital patient is diagnosed with an antibiotic- resistant infection, they are placed in contact precautions or sometimes referred to as isolation. This can be confusing to the patient and their loved ones because everyone who enters the room will be asked to wear protective gowns and gloves and will be given instructions on hand washing.
Why Contact Precautions?
Patients who are diagnosed with this type of infection are placed in contact precautions so that the infection is not spread to others. Families often feel they do not have to wear the protective gowns and gloves because they are around the patient all the time. Complying with the contact precautions though is not only to protect the patient’s family and visitors, but also the other patients and visitors to the hospital. Let’s think of it this way:
- Joe visits a family member with an antibiotic-resistant infection.
- Joe does not wear the gown and gloves and does not wash his hands when he leaves the room.
- Joe holds the hallway handrail, pushes the elevator buttons and goes to the cafeteria for lunch where he touches multiple surfaces including silverware.
- Everywhere that Joe touched is now potentially contaminated with the resistant bacteria.
- Other patients and visitors touch those surfaces and now carry the resistant bacteria on their hands.
- Those individuals spread the resistant bacteria to other patients and visitors.
This cycle can continue to carry on and on spreading the bacteria to hundreds or thousands of people.
How Did Antibiotic Resistance Happen?
Penicillin was discovered in 1928 by Alexander Fleming. However it was not until the 1940’s that antibiotics became widely used. Illnesses that had been devastating were now curable. Over the decades to come, antibiotics were prescribed very often. When individuals were taking antibiotics, sometimes they would stop when they felt better. What we know now is that bacteria and other microbes have a biologic objective to survive. Just like any other living thing, they adapt to their environment to make sure their offspring can continue living. Bacteria and microbes do this by developing the ability to resist the effects of antibiotics. Over prescribing antibiotics, not using the right antibiotics for an illness and patients not taking the medication as prescribed have all contributed to antibiotic resistant microbes.
How Can I Prevent Antibiotic-Resistant Infections?
It is important to take precautions against any type of infection by taking simple precautions:
- Wash your hands! Hand washing can prevent about 30% of diarrhea-related sicknesses and about 20% of respiratory infections (e.g., colds)
- Use antibiotics as directed and only when necessary. If your doctor does not think an illness warrants antibiotics, follow their instructions for alternate treatment.
- Do not take someone else’s antibiotics
- Prepare food safely
The bottom line is antibiotic resistant infections are becoming more common. If you or a loved one is in the hospital with such an infection, it is important to follow the contact precaution instructions. It is also very important to speak up if you see that any of the healthcare workers are not following the contact precaution instructions.
Below is a table outlining some of the statistics related to the antibiotic-resistant bacteria listed at the start of this post. All of this information was obtained from the CDC. There are many more types of resistant microbes that you can read about here.
Clostridium Difficile (CDIFF)
|· Approximately 500,000 infections in the US per year
· Contributes to 15,000 deaths
· Causes about $4.8 million in excess medical costs per year
|Methicillin-Resistant Staphylococcus Aureus (MRSA)
|· Just over 72,000 cases per year
· Just over 11,000 deaths per year
|Vancomycin-Resistant Enterococcus (VRE)
|· 20,000 infections per year
· 1,300 deaths attributed
|Carbapenem-Resistant Enterobacteriaceae (CRE)
|· 9,000 infections per year
· 600 deaths
· Resistant to nearly all antibiotics
|Extended Spectrum Enterobacteriaceae (ESBL)
· 26,000 Infections
· 1,700 deaths
· Over $million in excess costs related to resistant infections