Hospital defends against invasion of the “superbugs”
By ELISABETH MURRAY
Whidbey Examiner Staff
November 21, 2012 · Updated 9:31 AM
Whidbey General Hospital — and its patients — have been very lucky.
So far deadly “superbugs” resistant to all antibiotics have not set-up shop in this facility and the hospital is committed to keeping it that way, said Shannon Wolfe, infection prevention specialist at WGH.
In the medical community, these dangerous organisms are referred to as multi-drug resistant organisms.
What makes these “superbugs” scary is that they are resistant to multiple types of antibiotics that doctors normally rely on to combat an infection. Some have even become resistant to all treatments.
“Our primary mission is patient safety,” said LaJolla Peters, the learning and performance coordinator for the hospital.
Having a specialist on staff gives WGH a leg-up compared to other similarly sized hospitals that often do not have this position, she said.
One superbug that Wolfe keeps a lookout for is known to most people by its acronym, MRSA, because its actual title is a mouthful: Methicillin-resistant Staphylococcus aureus, the “staph” germ.
But this drug-resistant bacteria is not the only one or the most dangerous. Carbapenum-resistant bacteria, which includes Klebsiella pneumoniae carbapenemase, or KPC, is also becoming well known.
These bacteria usually live harmlessly in the intestinal tract, but in patients with weakened immune systems the bacteria can turn deadly when they develop antibiotic resistance.
The National Institutes of Health Clinical Center in Bethesda, Md., garnered national attention when 19 patients at the facility contracted this type of antibiotic resistant bacteria. The superbug evolved while at the center and became completely resistant to all antibiotics.
The outbreak was linked to a patient admitted to the hospital in 2011 who had been carrying the bacteria and it continued to infect other patients — even after this person had been discharged.
NIH has taken aggressive measures beyond typical infection control such as tossing reusable gear such as blood pressure cuffs to stop its spread to new patients.
As that hospital’s experience shows, once these organisms move in, they are really difficult to evict.
WGH has taken steps to ensure that one patient’s illness does not get transferred to another visitor.
The Infection Prevention Department at WGH has responsibility for the surveillance of patients that have infections and it works with all inpatient and outpatient departments to ensure that infections are treated properly to prevent the spread of infection to other patients, employees or the community, Wolfe said.
The hospital follows proper cleaning and disinfection of the healthcare environment and equipment, she said.
It also posts signage to warn of the multi-drug resistant organisms so the proper personal protective equipment such as gowns, gloves and masks will be worn by staff.
And patients with MDROs or other contagious infections (like the flu) are moved into a private room, said Wolfe.
The department also screens all Intensive Care Unit patients for MRSA, conducts daily surveillance of inpatients and outpatients as well as Operating Room and Emergency Department patients to track disease trends in the hospital and community, Wolfe said.
At WGH, when combatting an infection, the doctor starts with an antibiotic. If the patient does not begin healing as they should, then the doctor tries a combination of medicines. If that still doesn’t work, then the medical professionals turn to the intravenous delivery of medication, Wolfe said.
“Antibiotic resistance makes treating the patient harder even when the infection is not very severe,” she said.
At the National Institute of Health, KPC outsmarted the antibiotics, and doctors had very few options — and then none — to battle the infection.
These organisms exist in nearly every health care setting, as well as in the general environment, and most often infect people with immune problems or those who are very ill, Wolfe said.
Unfortunately, antibiotic resistance is on the increase.
The bacteria inherit the ability to survive as the gene that carries the antibiotic resistance gets passed between the different strains of bacteria, Wolfe said.
According to Wolfe, the best actions to stop the spread of these organisms are to decrease the unnecessary use of antibiotics and to use good hand hygiene.
The increasing prevalence of antibiotic-resistant bacteria stems from antibiotic misuse and overuse, she said.
When antibiotics are used to treat conditions other than bacterial infections, like the flu or a cold, or are not taken as prescribed, they become less effective for treating future bacterial infection. The flu is a virus and will not respond to antibiotics.
And when the doctor prescribes medication for a set number of days, patients need to take the full course — even if they begin to feel better before the meds are used up.
There is also the issue of overuse of antibiotics in the mass-production of meat products, which is producing a nasty soup of genetic exchange among bacterial strains, Wolfe said.
“New antibiotics would help improve the situation,” Wolfe said. “But despite the push for new products, there has been a decline in the number of newly approved drugs.”