SUPERBUGS IN OUR HOSPITALS
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
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
Let us do our Part
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
Dr.T.V.RaoMD Professorof MicrobiologyTravancore Medical CollegeKollam