Infection Control and Antibiotic Resistant Organisms.
Last year I had the privilege of delivering some infection control training at one of the hospitals in the outer London area. They have their own infection control team who are usually responsible for infection control made up of microbiological consultants nurses and technical staff, they outsourced the training to an organisation that I train on behalf of and that is how I found myself delivering training a wide range of medical staff from consultants, doctors and cleaning operatives.
What is emerging is that the medical professionals and microbiologists are very concerned with the increasing level of certain types of micro-organisms being resistant to antibiotics, the concern being that certain illnesses will no longer be treatable using antibiotics and therefore increased levels of fatalities from infections.
The worry is a lot of these organisms are what are termed HCAIs (Hospital and Care Acquired Infections). Therefore rather than being cured of the illness you went into the hospital with in the first place, you end up with an infection and it is the infection that makes the situation worse or even worse results in fatality.
Among these organisms are:
MRSA – Methicillin Resistant Staphylococcus Aureus. This bacteria is normaly found on a human being in moist areas such as the nose, groin area, armpits, the danger is if it enters the blood stream resulting in MRSA bacteraemia.
VRE- Vancomycin Resistant Enterococcus. These belong to the genus Enterocccus and are resistant to the antibiotic vancomycin. They live in the intestines and infections can occur in the intestines, urinary tract and wounds and infections will tend to affect those with weak immune systems such as those who are ill and in hospitals. Infections are more likely when antibiotics such as Vancomycin are used often.
CPO- Carbapenemase Producing Organisms- belonging to the enterobacteriacea group of bacteria that include E.coli and normaly being harmless in the gut but in the wrong place such as the bloodstream can result in serious infections. These CPOs, produce the enzyme carbapenemase which ends up destroying the carbapenem antibiotics regarded by WHO as critical anti biotics.
Therefore the advice is about very high standards of hygiene and in a hospital environment isolation of patients and other measures are use of Personal Protective Equipment, safe handling and disposal of waste, Care in handling blood and body fluids and cleaning that involves decontamination and the environment.
One key recommendation is for doctors is to be judicious in prescribing antibiotics, and for us is use those antibiotics only if it is necessary, over use can result in high levels of resistance