Hospitals and health care homes in California and Illinois have a surprisingly simple strategy against dangerous, antibiotic-resistant super teeth that kill thousands of people every year: they wash patients with special soap.
Efforts funded by about $ 8 million from the Federal Government's Centers for Disease Control and Prevention are being conducted in 50 sites in these two countries.
This new approach recognizes that super-teeth do not remain isolated in a hospital or nursing home, but move quickly through the community, says Dr. John Jennifer, who runs the CDC's office to investigate healthcare-acquired infections.
"No health facility is an island," said Jennifer. "We are all in this complex network.
At least 2 million people in the US are infected with antibiotic-resistant bacteria every year and about 23,000 die of these infections, according to the CDC.
People in hospitals are vulnerable to these bugs, and people in homes are particularly vulnerable. Up to 15% of hospital patients and 65% of the nursing home population have drug-resistant organisms, though not all of them will develop an infection, says Dr. Susan Huang, an infectious disease specialist at the University of California.
"Superbugs are scary and they are unassailable," Huang said. "They are not gone."
Some of the most common bacteria in healthcare establishments are resistant to methicillin Staphylococcus aureus, or MRSA, and carbapenem-resistant Enterobacteriaceae, or CRE, often referred to as "nightmare bacteria." E. coli and Klebsiella pneumoniae are two common embryos that can fall into this category when they become resistant to antibiotics known as carbapenems. CRE bacteria cause approximately 600 deaths each year, according to the CDC.
CREs are "widely distributed" among healthcare providers in the Chicago area, said Dr. Michael Lin, an infectious disease specialist at Rush University Medical Center, who runs the CDC-funded efforts there. "If MRSA is a superstar, it's the ultimate super supercomputer."
Containing dangerous bacteria is a challenge for hospitals and nursing homes. As part of the CDC's efforts, doctors and health workers in Chicago and Southern California use the antimicrobial chlorhexidine soap that has proven to reduce infections when patients bathe with it. Although chlorhexidine is often used for bathing in hospital intensive care units and as mouthwash for dental infections, it is used less frequently for bathing in nursing homes.
In Chicago, researchers work with 14 nursing homes and long-term acute care hospitals where staff check people for CRE bacteria on arrival and bathe them daily with chlorhexidine.
The Chicago project, which began in 2017 and ends in September, includes a campaign to encourage hand washing and enhanced communication between hospitals for whom drug-resistant organisms are treated.
The work on infection control was new to many nursing homes that do not have the same resources as hospitals, Lynn said.
In fact, three quarters of US nursing homes have been quoted for infection control issues for a period of four years, according to Kaiser Health News, and facilities with repetitive quotations have almost never been fined. Residents of the nursing home often return to hospitals for infections.
In California, healthcare staff carefully monitor CRE bacteria that are less prevalent there than elsewhere in the country and try to prevent CRE from arrest, said Dr. Matthew Zan, medical director of Orange County Healthcare Epidemiology. agency. "We do not have much time," he said. "Taking a chance to try to make a difference in the CRE trajectory is now really important."
The CDC-funded project in California is based in Orange County, where 36 hospitals and nursing homes use antiseptic wash along with iodine-based nose pads. The goal is to prevent new people from getting drug resistant bacteria and to keep those who already have bacteria on their skin or elsewhere to develop infections, says Huang, who runs the project.
Huang launched the project by examining how patients move between different hospitals and homes in Orange County and found they do so much more than they imagined. This has prompted a key question: "What can we do to protect our patients and protect them when they start moving everywhere?" She remembers.
Previous studies have shown that patients with MRSA bacteria that used chlorhexidine for bathing and mouthwash and have wounded their nose with a nasal antibiotic can reduce the risk of developing MRSA infection by 30%. But all the patients in this study, published in the New England Medical News in February, were already spelled out by hospitals.
The goal now is to target patients who are still in hospitals or nursing homes and to extend work to CRE. Traditional hospitals involved in the new project focus on patients in intensive care units and those who have already had drug-resistant bacteria. inhabitant.
A recent morning at the Coventry Health Center, a nursing home in Anaheim, California, 94-year-old Neva Shinley patiently sat in her wheelchair. Licensed nurse Ioan Bartholome wiped her nose and asked if she remembered what she had done.
"He's killing the microbes," Shell said.
– That's right – it prevents you from infection.
In the next room, UC-Irvine's senior project coordinator Raveena Singh talks to 71-year-old Caridad Coca, who recently arrived at the club. She explained that Coca would be bathed with chlorhexidine rather than plain soap. "If you have an open wound or cut, it helps to protect yourself from infection," Singh said. "And we not only protect you, one person. We protect everyone in the home.
Coca said he had a cousin who spent months in the hospital after receiving MRSA. "Fortunately, I never did," she said.
Coventry Administrator Shaun Dahl said he was eager to participate because people arrived at the MRSA home or other bugs. "They were sick and sick here," Dahl said.
The results of the project in Chicago are forthcoming. The preliminary results of the Orange County project, which ends in May, show it looks like it works, Huang said. After 18 months, the researchers noticed a 25% drop in drug-resistant organisms in the nursing home population, 34% in patients with long-term acute treatment settings and 9% in patients with a traditional hospital. The most dramatic falls are in CRE, although the number of patients with this type of bacteria is smaller.
Preliminary data also shows a promising wave effect in non-effort facilities, a sign that the project may be starting to change the situation in the county, Zan said in the Orange County Health Agency.
"In our community we are seeing an increase in antimicrobial-resistant infections," he said. "This allows us to interfere and bend the curve in the right direction."