Fighting Deadly Superbugs
http://thedianerehmshow.org/shows/2013-03-07/fighting-deadly-superbugs
The Centers for Disease Control and Prevention are warning about the rise of a so-called "nightmare bacteria" in U.S. hospitals. The director of the CDC calls the Carbapenen-Resistant Enterobacteriaceae -- or CRE -- bacteria a triple threat. They are resistant to almost all antibiotics, they can transfer their invincibility to other bacteria and they are deadly. Infection with CRE has a fatality rate as high as 50 percent. So far, these infections are still relatively rare. They’ve only been seen in hospitals and long-term care facilities. But the fear is that they could soon to spread to the wider community, and the proportion of drug-resistant bacteria has quadrupled in the last decade. Diane and her guests discuss the rise of superbugs and how public health officials are trying to stop their spread.
Guests
Dr. Michael Bell
Associate Director for Infection Control, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention
Dr. Anthony Fauci
Director, National Institute of Allergy and Infectious Diseases at the National Institutes of Health.
Dr. Brad Spelberg
Associate Professor of Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
Dr. Neil Fishman
Associate Chief Medical Officer, University of Pennsylvania Health System.
Comments
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Please discuss infection control practices, especially linked to the environment. About a year ago, I presented a UV disinfection system to Michael Bell that uses xenon to produce a UV flash. We have confirmed that this system can kill CRE organisms. Many of our customers are using it as part of their response to CRE.
Please discuss the role that all the antibiotics in our meat and dairy supply affect our ability to use antibiotics when we really need them
This is why patients should not get antibiotics for colds, bronchitis, URIs, etc. And why patients should not be overprescribed broad spectrum antibiotics in the hospital if at all possible.
Our device is at use at UCLA to help protect between patients. They use it to make sure the rooms are 100% clean before putting a new patient in the room. (xenex.com).
My family member was hospitalized on and off since summer at both a major cancer center and a community hospital. At one point she was dx with Clostridium Difficile at the community hospital. Precautions were posted outside door and gowns/gloves available. Her son, with a degree in allied health field, did not follow precautions and no staff intervened. We did not get Patient Education in the seriousness of following precautions. How many other patients did he put at risk? The hospital needs to be more vigilant in the 1) education of family/visitors and 2) enforcement.
I work in a long term care facility and am very interested in knowing more about the use of fecal transplants to cure C-diff and CRE. As a health care professional, I wonder how often blood tests are performed in order to diagnose and treat? Also, could there be a standard of practice to introduce probiotic ingestion daily in order to prevent these outbreaks? I am also aware of the use of oregano oil and colloidal silver as natural antibiotics. Could these be introduced as very inexpensive alternatives to antibiotics?
How is this "Superbug" any different than C. Difficile that is rampant in hospitals today and effects the intestine, is antibiotic resistant and can be fatal as well? My wife suffered from that after a simple appendectomy and was only in the hospital for less than a day. Doctors told her it was their use of a broad spectrum antibiotic during surgery that caused the imbalance of bacteria in her colon. She underwent treatment for two months.
I have been responsible for managing the health care needs of an elderly parent. She contracted MRSA during a hospital stay and I witnessed her being subjected to descrimination as a result of this when it came to future hospital stays and transfer to rehab facilities. Please discuss this in regard to CRE.
A clarification, people who do not generally take antibiotics or use antibacterial gels, soaps etc are less likely or unlikely to contract this bacterial infection? IF we know the harm, why is there no effort to remove antibacterial products from store shelves? Is there any effort to get ranchers to reduce the amount of antibiotics used raising beef?
Can you please discuss CDIF?
My husband got it in the hospital a number of years ago and got it there. He almost died from it. He very, very seldom used antibiotics but the doctors had a great deal of difficulty treating it. The antibiotic that finally worked was $1800 for 10 days. Now he's at risk if he ever needs antibiotics again...
So many over the counter products contain antibiotic or supercleansing products (like triclosan, hexachlorophene) that we are creating resistance when it is not necessary. Soap and water do an excellent job when used, but manufacturers have promoted the idea that this not effective against germs - or even sufficient to clean one's hands or body. Even toothpaste contains these high powered types of ingredients. Some families are substituting alcohol cleansers for the soap on their bathroom sink.
Please discuss the role of the availability of carbapenems any many other antibiotics in an over the counter setting in many countries and what is being done about it.
I have a child who was recently put on daily prophylactic antibiotics - due to IgA deficiency and chronic sinus and respiratory infections. Can you discuss the risks and best preventative methods for these types of patients?
Is it possible that these bacteria are being spread via linens and improper cleaning of linens in hospitals?
A family member is in the hospital today due to a staph infection she contracted after giving birth, needing IV antibiotics for a virulent infection while attempting breast feeding. Is it possible she was infected by linens and hospital gowns worn while in the hospital giving birth? Same for the baby. Is it possible the baby was infected by linens.
How are hospital gowns, and blankets washed in the hospital?
Could these serious bacteria be spread through washers and dryers in hospitals? Thank you for your program and the distinguished guests on board today.
Could acid destroying medication have an impact on the appearance of this bacterial overgrowth?
Could probiotics help as a preventative?
Could macrophages help in treatment? I heard about these on Science Friday, as a way to treat bacteria.
Many of the questions and confusion of callers stems from the fact that the good doctors are assuming that everyone understands how the bacteria is transferred from one person to another.
Bacteria can transfer through direct contact or can be airborne. Is this one an airborne bacteria?
If it is a contact bacteria then the reason why plastic tubing is a concern is because it's harder to kill the bacteria physically when it's clinging to one of these.
Personnel like nurses, EMTs can transfer from one patient to another. That is why the handwashing is important.
Might Ms. Rehm ask her guests whether any have reconsidered the logic of long term care facilities in light of their role in culturing anti-biotic resistant bacteria. Are there decentralized ways to care for people with these kinds of illnesses, ways less amenable to breeding these diseases?
Hi Diane - thanks for another GREAT show!
In 2005 my Mother suffered a debilitating stroke, and was eventually (after 2 different hospitalizations) sent to rehab. There she developed a MRSA Infection. The family was never notified until I walked in one day and discovered a bright orange sheet on the door that said "No Entrance - Check In at the Nurses Station".
the staff was exc3eedingly blase about the infection, they thought it was funny that I was paying attention to the sign and we were never given ANY information about the MRSA despite asking many times.
The take home message here is that human behavior MUST be changed - similar to the rules enforced regarding spitting in the streets, covering your mouth/nose when you sneeze to prevent re-curring infections.
New behaviors will take a LOT of work and effort, countless PR and Advertising campaigns to move the public and the helath care professionals to ensuring that super bugs stay out of the general population -
Thanks
This problem is a result the success of our medical system where people who would have died from other problems are now surviving to the point where they contract these untreatable infections. In other countries death of severly impaired people is seen as the natural end to life, hopefully well lived.
This problem is a result the success of our medical system where people who would have died from other problems are now surviving to the point where they contract these untreatable infections. In other countries death of severly impaired people is seen as the natural end to life, hopefully well lived.
Is there risk for patients who are ambulatory, and use Oxygen at home?
WHY HAS NOT MORE ATTENTION BEEN GIVEN TO BACTERIOPHAGE THERAPY? i UNDERSTAND THE SPECIFICITY ISSUES, BUT, PAST EXPERIENCE ILLUSTRATES EFFICACY.
As a long term nurse and case manager, I can tell you that Long term care facilities and Skilled nursing facilities will refuse to take patients with infectious disease. I have seen it with MRSA, C Diff and VRE. Private rooms are at a premium in these facilities and state law has restrictions on how patients with infectious disease can be placed.
In addition, despite education, you will find many visitors sitting on the beds of patients with MRSA and VRE. Visitors walk in and out without washing their hands or washing them ineffectively. I think some restrictions should be placed on visitors for these patients.
To GaleSTL:
We faced the same issue. $1500 for a 10-day dose. But we found that a liquid version of the same drug was covered by our insurance and cost $65. And later, after two months of treatments, we found that there is a "fecal implant" that is about 90% effective. All of the information we received was by searching on the internet. None of it was available from our physicians or pharmacists.
please comment on the implementation (or lack thereof) of six-sigma applications and methodologies in the prevention of nosocolial infections
My child has the same issue. Glad you asked this question! She has been one antibiotics since kindergarten, and now in 7th grade. This is very scary to me.
1. People are familiar with the super bug concept, but when it comes to whether they should get an antibiotic or not, there's a huge disconnect.
2. My father is 100 and living in a nursing home. With the minimal training and supervision of CNAs, who do most the direct care, that's very scary that they would admit a patient with known CRA.
Using multiple approaches to control the spread of microbes that do not contribute to the development of resistant strains must be included in the strategies to control this growing problem. Biomimicry- emulating nature to solve our challenges sustainably offers such solutions. One example already in product form is Sharklet Technologies" textured surfaces for hospitals mimicking shark skin which retards the growth of microbes and biofilms without contributing to increased resistance of microbial strains.
Many other organisms offer us examples of how to control microbes without contributing to their increased resistance.
Linda Paisley
Biomimicry Specialist
Amazing to think that the NIH will have a 5% cut but the foreign aid that Israel receives will not. Israeli citizens more important than US citizens to our own government. Hmmm
Please have a show on the need to stop using antibiotics as growth promoters in the meat industry, which your guests today stated was a dangerous contributor to antibiotic-resistant bacteria, and which is prohibited in Europe.