SUPERBUGS IN OUR HOSPITALS

Dr.T.V.Rao MD
Today our environment is getting gradually loaded with many bugs which were responding to the
antibiotics in the past, and microbes have learnt the art of living in spite of all our good and bad
actions, If we sit in front of Bacteriology reporting bench for reporting we find at least one or two
strains, are totally resistant to many cephalosporins, and also the resistance to carbapenem is on
raise, as we are entering the era of BUGS to SUPERBUGS, In scientific terms the title "superbug"?
Means Bacteria can carry genes that allow them to survive exposure to the antibiotics we currently
have. The unprecedented abuse of antibiotics over the last several decades has created drug
resistant bacteria, colloquially referred to as superbugs As antibiotics-abuse-increases -the-
creation-of-super-bugs. This means that infections caused by these bacteria are harder to treat,
although they are not necessarily more severe or infectious. What is concerning is that the gene that
carries antibiotic resistance can be passed between bacteria, allowing for the creation of bacteria
that carry resistance genes to many different antibiotics, Never forget they are carried to other less
serious patients, in turn our entire hospital will be loaded with superbugs, if hygienic practices are
not implemented. In Canada Alberta patient who was diagnosed in the summer of 2010 with the
infection of an NDM-1 strain superbug from an Indian hospital has attracted much media attention
and alarm in the medical community. And a handful of cases have been reported worldwide, but
experts fear that this strain of bacteria can threaten patients in hospitals globally. In 2010 we were
shy to accept the NDM linked with India and created major responses from political and scientific
communities, However we are losing the valuable time in putting the matters in order in spite of
universal agreement many protocols are not followed by medical fraternity and many managements
are least worried on the important factors on safe practices, that developed countries generate
many drug resistant strains due to lack awareness on the use of antibiotic, Examples of Major
Bacterial Superbugs, Carbapenem-resistant Enterobacteriaceae (CRE) Evades the strongest
antibiotics, making infections almost untreatable. Has a fatality rate of up to 50%.The CDC reports
that in the last 10 years, the percentage of Enterobacteriaceae that have become resistant to
antibiotics has increased from 1% to 4%. One type of CRE actually increased its resistance seven fold
in that time period. In the first half of 2012, about 18 percent of long-term acute-care hospitals and
4 percent of short-stay hospitals nationwide had at least one patient infected with CRE. I should bold
to confess that majority of the hospitals have no policy to tackle the problem. But NDM-1 strain
bacteria are not the first superbugs. In fact, MRSA, a strain of Staphylococcus bacteria that carries
resistance to a number of antibiotics, has been a major problem in health care settings for years.
MRSA bacteria are resistant to most of the antibiotics used to treat them, making common
infections difficult to treat. In the past we are scared when we isolate a MRSA and much attentions
paid and we are able to move many clinical practitioners to be aware on emerging MRSA infections.
Methicillin-resistant Staphylococcus aureus (MRSA) we are aware a drug-resistant phenotype that
has been circulating for over 45 years, almost as long as methicillin has been on the market. In
2007, 63% of all reported staph infections in the US were caused by MRSA In 1995, about 22% of all
reported staph infections were MRSA, compared with only 2% in 1974. Instead of traditional
antibiotics, physicians treat MRSA with "last-resort" intravenous vancomycin. Scientists estimate
that about 19,000 people in the United States die every year from MRSA that's more than the
number of U.S. residents and citizens that die from HIV/AIDS (about 17,000 every year). The
powerful pharmaceutical industry impressed and dominated the scenarios with many advantages in
profit making, and so many compounds are marketed in the market many other reason being so
many formulation of Cephalosporins which save many and also confused many of us, what to select
has become a conflict of Interest for many treating physicians. Today our Local media is sensitive to
the emerging trends on antibiotic resistance, common man is aware of Antibiotics and many times
the patients know too well and complain, the proper clinical examination was not done, and there
was no diagnosis to my illness he is dumping the Antibiotics. It is certain the antibiotics really do not
work when we really become sick they will become less effective for future bacterial infections and
possibly acquire resistance genes. As more bacteria become resistant to antibiotics, the risk of
complications and death is increased. Doctors will have to resort to commonly used antibiotics,
many of which are less expensive and are associated with less severe side effects, without
necessarily fail to treat the infection. The main question from clinicians is what my reply to the
present condition is, the clinicians should keep in mind and the power of clinical medicine is dying,
Eveready writes investigation and almost the clinical Medicine is a dying art which has created
excessive dependence on investigations. Be sure to understand when antibiotics should be used.
Antibiotics are only effective against bacterial infections, and they should never be used for viral
infections such as a cold or flu. Keep good hygiene to prevent infection. Washing hands before
eating and after going to the bathroom or visiting a hospital can go a long way towards preventing
infections. In short, there are simply no more drugs out there to combat this, and despite the fact
that the medical community admits a problem, they arent even pretending to look for a solution, -
Whenever an Infection control meeting ends we are all confused what sounds good for me is
hygiene.
Let us do our Part
1. Keep it clean
50% of men and 25% of women don't wash their hands after using the restroom.
We have between 2 and 10 million bacteria between fingertip and elbow.
Damp hands spread 1,000 times more germs than dry hands.
The number of germs on your fingertips doubles after you use the toilet.
Germs can stay alive on hands for up to three hours.
Hand washing should occur at least 10 times a day.
Until new weapons are created to fight superbugs, how can you fight them? Most medical experts
recommend a simple precaution: Wash your hands with soap and scrub for several seconds, and do
so often.
Ref www.cdc.gov/features/getsmart/
Dr.T.V.Rao MD Professor of Microbiology Travancore Medical College Kollam