Fighting Superbugs With Multipronged Pushback

Laura Arenschield

May 20, 2019

Better education, more advanced pharmaceuticals, and stronger cleaning protocols for healthcare facilities are needed to fight superbugs, according to Kamna Giare-Patel, MS, RN, senior director of global continuation engineering and innovation at DSM Biomedical.

"We are realizing how agile these organisms are, and they are mutating," she told Medscape Medical News. "And we're learning that there is not one solution" for dealing with them. It will take education, awareness, and a lot of hand-washing. And each strategy has "many pieces that need to be looked at."

Each year, 2 million people in the United States are infected with a drug-resistant superbug and 23,000 people die from those infections, Giare-Patel reported at the Infusion Nurses Society 2019 Annual Conference in Baltimore.

And on any given day in the United States, one in 31 patients has at least one healthcare-related infection caused by a superbug, she added.

Associated costs can be prohibitive. Infections caused by drug-resistant bacteria are responsible for about $20 billion in excess healthcare costs and about $35 billion in lost productivity, annually, in the United States alone, Giare-Patel said.

"The thing that bothers me the most is that mortality associated with infection-related causes is preventable, yet so many patients in medical facilities or outside, in the social environment, die," she said.

Giare-Patel knows this from personal experience; she lost a family member to an infection caused by a superbug, a personal loss that has galvanized her interest in helping others.

Urgent Threats

The Centers for Disease Control and Prevention currently recognizes 18 superbugs as threats to public health. Three of these — Clostridium difficile, carbapenem-resistant Enterobacteriaceae, and drug-resistant Neisseria gonorrhoeae — are considered urgent threats.

Healthcare providers became aware that superbugs could evolve during the early years of antibiotic use. As early as the 1950s, penicillin-resistant strains of Staphylococcus aureus started appearing in hospitals. By 1985, the word "superbug" — conjuring images of comic-book villains — was in use.

And these bacteria can thrive anywhere — in hospitals, nursing homes, schools, daycare centers, and in people's homes.

Educating Patients

Teaching patients about the appropriate use of antibiotics is vital in the fight, said Giare-Patel. The drugs should be taken only when needed and, when they are, the entire prescribed course should be finished.

"If people don't finish their course, they give the bacteria room to evolve and become resistant to that antibiotic," she said.

But hand-washing is perhaps the simplest, and most underutilized, tool, said Giare-Patel.

Drug-resistant bacteria were found on the hands of 14% of hospital patients tested in a recent study reported by Medscape Medical News. In addition, superbugs were found on one-third of the things patients commonly touch in their hospital rooms.

That study shows how prevalent these bacteria are, and how critical it is that hospitals educate patients about hand-washing, said Lona Mody, MD, from the University of Michigan in Ann Arbor, who was lead author of that study.

"Patients should practice regular hand hygiene, especially when they are in the hospital," Mody told Medscape Medical News. And hospital staff should be aware that they can pass superbugs from one patient to another if they don't wash their hands properly.

But hand-washing alone won't stop the spread.

To limit contamination, better collaboration between environmental services and infection-control departments in individual healthcare facilities is needed, Giare-Patel said. In addition, proper and frequent cleaning schedules should be established and access to personal protective equipment and hand-cleaning stations should be easily available.

"The healthcare industry needs to take a part in the education of clinicians" and in the cleaning of the facilities, she said. And "pharmaceutical companies need to get involved to come up with new drugs."

"It's a multipronged approach to tackling this problem that will help us solve it."

Giare-Patel and Mody have disclosed no relevant financial relationships.

Infusion Nurses Society (INS) 2019 Annual Conference. Presented May 19, 2019.

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