The Spread of Superbugs

superbugs on the riseThe U.S. Centers for Disease Control and Prevention has just published a first-of-its-kind assessment of the threat the country faces from antibiotic-resistant organisms.

And the news is not good.  In fact it’s downright scary. The agency’s overall conservative assessment of the problem includes frightening statistics such as:

  • Each year, in the U.S., 2,049,442 illnesses caused by bacteria and fungi that are resistant to at least some classes of antibiotics
  • Each year, out of those illnesses, there are 23,000 deaths
  • Each year, those illnesses and deaths result in $20 billion of additional healthcare spending
  • Each year, an additional $35 billion lost to society in foregone productivity.

The report marks the first time the agency has provided hard numbers for the incidence, deaths and cost of all the major resistant organisms. It also represents the first time the CDC has ranked resistant organisms by how much and how imminent a threat they pose, using seven criteria:

  • health impact
  • economic impact
  • how common the infection is
  • how easily it spreads
  • how much further it might spread in the next 10 years
  • whether there are antibiotics that still work against it
  • whether things other than administering antibiotics can be done to curb its spread

antibiotic resistant bacteriaOut of that matrix, their top three “urgent” threats they identified were:

multi-drug-resistant-pseudomonas-aeruginosa-horizontal-galleryIn addition, the CDC identified 12 resistant bacteria and fungal infections which the agency dubs “serious” i.e., requiring “prompt and sustained action.”  They include the hospital-acquired infections  Acinetobacter, Pseudomonas aeruginosa, and Vancomycin-Resistant Enterococcus (VRE) ; the foodborne organisms CampylobacterSalmonella and Shigella; MRSACandida and TB.

The last category, “concerning” i.e., requiring “careful monitoring and prevention” includes rare but potent vancomycin-resistant staphylococcus aureus  (VRSA), as well as strains of streptococcus resistant to two different categories of drugs.

For each organism, the report explains why it is a public health threat, where the trends are headed, what actions the CDC is taking, and what it is important for health care institutions, patients and their families, and states and local authorities to do to help.

Commenting on the report, Ed Septimus MD, professor of internal medicine at Texas A&M Health Sciences Center in Houston says “It’s up to us to make the recommendations in this report happen. If we do nothing but say, ‘Here’s the problem,’ then the problem will continue to grow.”

Well said Doctor, well said.

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Leave No Egg Uncooked

In recent months, SRxA’s Word on Health has noticed a flurry of Internet sites touting raw egg drinks or shakes as “primal and powerful,” with others suggesting uncooked eggs be blended with vanilla or avocado for a tasty, healthy snack.  Such sites are rife with comments insisting that the connection between raw eggs and salmonella is a myth.

Suzy Weems, Ph.D., a national food expert and chair of Baylor University’s family and consumer sciences department, has this advice for health-seekers: “Under no circumstances eat a raw egg.”

While only a tiny percentage of eggs are contaminated, virtually every egg has had some contact with salmonella. Because the bacteria can lead to food poisoning and the fever, diarrhea and dehydration that accompany it “it’s best to be proactive,” cautions Weems.

Extolling the virtues of raw eggs is nothing new.  Nutrition guru Bernarr Macfadden advocated them as far back as the 1890s while modern proponents claim that heating the egg changes its chemical shape and destroys many of its nutrients and proteins.

Although relatively few people are tempted to wolf down raw eggs, those who love eating raw cookie dough need to be aware that it too is risky because it contains uncooked eggs.

There are a lot of old recipes floating around that call for raw eggs, but people need to realize if the recipe is based on one from when Grandma gathered her eggs, then Grandma gathered them locally. There wasn’t much of a time lag,” Weems said. “Now, eggs are much more likely to sit for a time before being used, and that gives salmonella the chance to grow.”

Risk of salmonella contamination lessens with eggs from cage-free, organically fed chickens, and salmonella generally is not life-threatening. Most at risk are children, senior citizens, pregnant women and people with compromised immune systems.

So, the bottom line – eggs can still be incredible, just make sure they’re cooked.

Now Wash Your Hands Please

Word on Health was horrified to learn that when you meet someone and shake their hand, there’s a one in five chance that they didn’t wash their hands after going to the toilet.

A recent study of 2,000 adults found that more than half did not clean up before eating and even more worryingly, 3:1 men and almost 1:5 women said they also often failed to wash their hands after going to the toilet.

Of those, almost a quarter said they were not worried about hygiene after using their toilet at home because they would only be picking up germs from other members of their family, while one in five said their hands already looked clean without the need to wash them under a tap.

Although 88% of those questioned could correctly name at least one food bacterium such as salmonella, E. coli or campylobacter, many did not realize how easy they were to pick up.

According to the Centers for Disease Control and Prevention (CDC) and leading public health officials, hand washing is the single most important method of preventing the spread of infection.

Perhaps it’s because hand washing is so basic that it’s often taken for granted. Yet the quantity and variety of germs that we carry on our hands everyday is astounding. Each square inch of our skin contains about 5,000 different bacteria.  When we forget to wash our hands, or don’t wash our hands correctly, we can spread these germs to other people.

The importance of hand washing cannot be overstressed. It is so simple and yet forgetting to do it can have such serious consequences.” says Sir John Krebs, chairman of the UK’s Food Standards Agency.

And it’s not just children or the general public that forget to wash their hands, seems health workers are just as guilty.  In the US it is estimated that hand washing alone could prevent 20,000 patient deaths per year. Despite this, studies have shown that hand washing compliance among health-care workers is poor.

Things, it seems, are so bad that  Loyola University Health System has just hosted a forum led by hand-hygiene authority Professor Didier Pittet, MD, MS, and President of The Joint Commission Mark R. Chassin, MD, FACP MPP, MPH.

This forum was designed to educate healthcare leaders about proper hand washing techniques as well as provide strategies to overcome challenges to achieving a highly effective hand-hygiene program.

For those of you who missed the forum, SRxA’s word on Health is pleased to bring you some simple hand hygiene tips:

Always wash your hands before:

  • Preparing food
  • Eating
  • Treating wounds or giving medicine
  • Touching a sick or injured person
  • Inserting or removing contact lenses

Always wash your hands after:

  • Preparing food, especially raw meat or poultry
  • Using the toilet
  • Changing a diaper
  • Touching an animal or animal toys, leashes or waste
  • Blowing your nose, coughing or sneezing into your hands
  • Treating wounds
  • Touching a sick or injured person
  • Handling garbage or something that could be contaminated, such as a cleaning cloth or soiled shoes

Of course, it’s also important to wash your hands whenever they look dirty…or before you come to shake one of ours!

For more on hand hygiene we suggest you check out the CDC’s Clean hands save lives site.