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SUPERBUGS IN OUR HOSPITALS
SUPERBUGS IN OUR HOSPITALS
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SUPERBUGS IN OUR HOSPITALS

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SUPER BUGS IN OUR HOSPITALS

SUPER BUGS IN OUR HOSPITALS

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  • 1. SUPERBUGS IN OUR HOSPITALS Dr.T.V.Rao MD Today ourenvironment isgettinggraduallyloadedwithmanybugswhichwere responding tothe antibiotics inthe past,andmicrobes have learntthe art of livinginspite of all ourgoodand bad actions,If we sit infrontof Bacteriologyreportingbench forreportingwe find atleastone ortwo strains,are totallyresistanttomanycephalosporins, andalsothe resistance tocarbapenemison raise,as we are enteringthe eraof BUGS to SUPERBUGS, In scientificterms the title "superbug"? Means Bacteriacan carry genesthatallow themtosurvive exposure tothe antibioticswe currently have. The unprecedentedabuse of antibioticsoverthe lastseveraldecadeshascreateddrug resistantbacteria,colloquiallyreferredtoas superbugs –Asantibiotics-abuse-increases -the- creation-of-super-bugs. Thismeansthatinfectionscausedbythese bacteriaare harderto treat, althoughtheyare not necessarilymore severeorinfectious.Whatisconcerningisthatthe gene that carriesantibioticresistance canbe passedbetweenbacteria,allowingforthe creationof bacteria that carry resistance genestomanydifferentantibiotics, Neverforgettheyare carriedtoother less seriouspatients,inturnourentire hospital will be loadedwithsuperbugs,if hygienicpracticesare not implemented. InCanadaAlbertapatientwhowasdiagnosedinthe summerof 2010 withthe infectionof anNDM-1 strainsuperbugfroman Indianhospital hasattractedmuchmediaattention and alarmin the medical community. Anda handful of caseshave beenreported worldwide,but expertsfearthatthisstrainof bacteriacan threatenpatientsinhospitalsglobally. In2010 we were shyto accept the NDM linkedwithIndiaandcreatedmajorresponsesfrompolitical andscientific communities,Howeverwe are losingthe valuabletime inputtingthe mattersinorderinspite of universal agreement manyprotocolsare notfollowedbymedical fraternityandmanymanagements are leastworriedonthe importantfactorsonsafe practices, that developedcountriesgenerate manydrug resistantstrainsdue tolack awarenessonthe use of antibiotic, Examplesof Major Bacterial Superbugs, Carbapenem-resistantEnterobacteriaceae (CRE) Evadesthe strongest antibiotics,makinginfectionsalmostuntreatable. Hasa fatalityrate of upto 50%.The CDC reports that inthe last10 years,the percentage of Enterobacteriaceaethathave become resistantto antibioticshasincreasedfrom1%to 4%. One type of CRE actuallyincreaseditsresistance sevenfold inthat time period. Inthe firsthalf of 2012, about 18 percentof long-termacute-care hospitalsand 4 percentof short-stayhospitalsnationwide hadatleastone patientinfectedwithCRE. Ishouldbold to confessthatmajorityof the hospitalshave nopolicytotackle the problem. ButNDM-1 strain bacteriaare notthe firstsuperbugs.Infact,MRSA,a strainof Staphylococcusbacteriathatcarries resistance toa numberof antibiotics,hasbeenamajorprobleminhealthcare settingsforyears. MRSA bacteriaare resistanttomostof the antibioticsusedtotreatthem, makingcommon infectionsdifficulttotreat. Inthe past we are scaredwhenwe isolate aMRSA and muchattentions paidand we are able tomove many clinical practitionerstobe aware onemergingMRSA infections. Methicillin-resistantStaphylococcusaureus(MRSA) we are aware a drug-resistantphenotype that has beencirculatingforover45 years,almostas longas methicillinhasbeenonthe market. In 2007, 63% of all reportedstaphinfectionsinthe US were causedbyMRSA In 1995, about 22% of all reportedstaphinfectionswere MRSA,comparedwithonly2% in1974. Insteadof traditional antibiotics,physicianstreatMRSA with"last-resort"intravenousvancomycin. Scientistsestimate that about19,000 people inthe United Statesdie everyyearfromMRSA that's more thanthe numberof U.S. residentsandcitizensthatdie fromHIV/AIDS(about17,000 everyyear). The powerful pharmaceutical industry impressedanddominatedthe scenarioswithmany advantagesin profitmaking,andso manycompoundsare marketedinthe marketmany otherreason beingso manyformulationof Cephalosporinswhichsave many andalsoconfusedmanyof us,whatto select
  • 2. has become aconflictof Interestformanytreatingphysicians. TodayourLocal mediaissensitive to the emergingtrendsonantibioticresistance, commonmanisaware of Antibioticsandmanytimes the patientsknow toowell andcomplain,the properclinical examinationwasnotdone, andthere was no diagnosistomyillnesshe isdumpingthe Antibiotics.Itiscertainthe antibioticsreallydonot workwhenwe reallybecome sickthey willbecome lesseffective forfuture bacterial infectionsand possiblyacquire resistance genes.Asmore bacteriabecome resistanttoantibiotics,the riskof complicationsanddeathisincreased.Doctorswill havetoresortto commonlyusedantibiotics, manyof whichare less expensive andare associatedwith lesssevere side effects,without necessarilyfail totreatthe infection. The mainquestion fromcliniciansiswhat myreplyto the presentconditionis, the cliniciansshouldkeepinmindand the powerof clinical medicine isdying, Evereadywrites investigationandalmostthe clinical Medicine isadyingart whichhascreated excessivedependence oninvestigations. Be sure to understandwhenantibioticsshouldbe used. Antibioticsare onlyeffective againstbacterial infections,andtheyshouldneverbe usedforviral infectionssuchasa coldor flu.Keepgoodhygiene topreventinfection.Washinghandsbefore eatingandaftergoingto the bathroomor visitingahospital cango a longwaytowardspreventing infections. Inshort,there are simplynomore drugsoutthere to combatthis,and despite the fact that the medical communityadmitsaproblem, theyaren’tevenpretendingtolookfora solution, - WheneveranInfectioncontrol meetingendswe are all confusedwhatsoundsgoodforme is hygiene. Let us do our Part 1. Keepitclean 50% of men and25% of womendon'twashtheirhandsafterusingthe restroom. We have between2and10 millionbacteriabetweenfingertipandelbow. Damp handsspread1,000 timesmore germsthandry hands. The numberof germson yourfingertipsdoublesafteryouuse the toilet. Germs can stay alive onhandsforup to three hours. Hand washingshouldoccurat least10 timesa day. Until newweaponsare createdto fightsuperbugs,how canyoufightthem?Most medical experts recommendasimple precaution:Washyourhandswithsoapandscrub for several seconds,anddo so often. Ref www.cdc.gov/features/getsmart/ Dr.T.V.RaoMD Professorof MicrobiologyTravancore Medical CollegeKollam

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