Monday Medical: Help prevent the spread of superbugs
July 24, 2015
If "Superbugs" were a movie, the villain would be a gang of organisms endangering humankind. Enter the heroes, a team of medical professionals determined to halt the growing health threat. Can science find a way to thwart the rapidly evolving bacteria?
Though this scenario may seem overly dramatic, it is far from a fictitious film script. Instead, it is a reality-based scene that plays out every day in physicians' offices and hospitals across America. Antibiotic-resistant bacteria are on the rise, and Yampa Valley Medical Center is responding vigilantly and proactively.
Just what are these superbugs, and why are they multiplying? YVMC Laboratory Section Head and Infection Prevention Coordinator Paul Hill describes them as bacteria that are evolving to stay alive in an environment of antibiotic medications.
"Most people have heard of one prominent strain, methicillin-resistant staphylococcus aureus, or MRSA," Hill said. "But there are many more that are just as significant, if not more, such as CRE and VRE."
Not all bacteria are created equal. Inside your digestive tract are "good" bacteria, which are crucial to the process of converting food into energy. They maintain a balance with "bad" bacteria. This harmony can be disrupted when your body is attacked by an infection and you take an antibiotic. The drug fights off the infection, but it also kills many of the helpful bacteria in your gut.
"Killing off the bacteria that are competing against 'superbugs' opens the door for proliferation of drug-resistant strains of bacteria," YVMC Pharmacy Director Wes Hunter said.
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Drug-resistant bacteria can live on the skin and in the gut. This is known as colonization. These organisms do not pose a problem unless there is some type of cut, sore, scrape or breakdown in the immune system.
"Imagine that a high school student gets treated with antibiotics for a sinus infection," Hill said. "The antibiotic may help with the infection, but it may also result in breeding one of the superbugs, resulting in his being colonized with MRSA. He then gets injured while playing a sport. His wound becomes infected with antibiotic-resistant bacteria, and he is in close contact with other athletes. It is easy for the infection to spread."
Recognizing the danger posed by overuse and misuse of antibiotics, YVMC took a proactive step in 2008, forming the Antibiotic Stewardship Committee. This group meets weekly to review every prescribed use of antibiotics within the hospital. Current members include Hunter, Hill, pharmacist Kristin Lambert and internal medicine specialist Dr. Mark McCaulley.
"We discourage use of some antibiotics that have lost their effectiveness, and we educate providers about more effective choices," Hunter said. "The hospital has seen a 75 percent decrease in use of some broad-spectrum antibiotics in the past five years."
YVMC's program has gained attention. Last month, Hunter spoke at a forum, educating other Colorado hospitals about setting up antibiotic stewardship programs in rural settings.
Hunter and Hill said there are three main reasons to use antibiotics appropriately. First, it prevents selection of superbugs, which breed more rapidly when other bacteria are killed.
"Second, we want to reduce the risk of 'C. diff,' a gastrointestinal infection that is common after antibiotic use and which, in extreme cases, can be deadly," Hill said. "We see three or four C. diff cases per month. It has always been possible to treat them, and we have never seen a tragic case, but it could happen."
Third, new research is suggesting that overuse of antibiotics and the resulting disruption of individuals' normal bacteria may be contributing to the rising incidence of a whole range of chronic diseases.
Vigilance against superbugs is likely to intensify, given the recent executive order issued by President Barack Obama. Titled "Combating Antibiotic-Resistant Bacteria," the edict cites Centers for Disease Control and Prevention estimates that at least 2 million illnesses and 23,000 deaths are caused annually by antibiotic-resistant bacteria in the United States. The Colorado Hospital Association already has recommendations in place, and Hunter and Hill predict that national standards will be forthcoming.
Everyone can play a role in combating this serious health risk, Hunter said.
"Be mindful of when you truly need antibiotics, and have that discussion with your doctor," he said. "Ask, 'Are antibiotics really needed?' Carefully clean any cuts or scrapes, and avoid sharing personal items, such as towels or razors. If you do have to take an antibiotic, it probably wouldn't hurt to eat active-culture yogurt. It's a natural food that can help keep your bacteria in balance."
Christine McKelvie is a writer/editor for Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.
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