The January 30th edition of The Wall Street Journal ran
an article titled “When Hospitals Become Killers” by Betsy McCaughey that
detailed an outbreak of Carbapenem-Resistant Klebsiella (CRK for short) that
infected 18 and killed 6.
Klebsiella is a gram-negative rod shaped bacteria that is
known to cause pneumonia, urinary tract infections, septicemia, and soft tissue
infections. As with other bacteria,
Klebsiella has now become resistant to several antibiotics. In particular, Klebsiella has become resistant
to the Carbapenem family of antibiotics that are used to treat life-threatening
infections caused by extremely drug-resistant gram negative pathogens; these
drugs represent the last line of defense in the antimicrobial drug arsenal
against serious or invasive infection.
Early detection through the use of targeted surveillance
and introduction of strict infection control
measures including the reinforcement of hand hygiene,
contact precautions and environmental cleaning and disinfection protocols can
help control the spread of CRK.
This is
of particular importance with nosocomial pathogens such as CRK as these
organisms can persist both in the hospital environment and can also colonize
healthy individuals who can then contaminate the environment.
During the outbreak at the National Institutes of Health
Medical Center (Bethesda, MD), the outbreak was finally contained by
implementing tougher standards such as screening all patients for CRK, strict
cohorting of colonized patients to minimize sharing of hospital equipment and
of care providers between outbreak patients and other patients in the hospital
and more rigorous cleaning.
Fancy that! More
rigorous cleaning! In fact they cleaned
the surfaces twice per day. Further
support for last week’s The Ugly Truth blog where researchers found that
bacteria grew back at alarming rates after cleaning the surfaces and found that
the optimal cleaning frequency would be every 3 hrs.
While to some, these articles may be surprising, I think
we have to come to the realization that this is the new norm. Our focus for too long has been on the
cure. We have vaccines and we have
antibiotics. But as we are seeing time
and again, we are coming up against stronger enemies. The antibiotics we rely so strongly on are
not capable of defeating the newly developing antibiotic-resistant
bacteria. Without a strong focus on
PREVENTION we will run the risk of reading headlines that highlight yet another
outbreak and with more deaths.
Is it enough to implement tougher standards after the
fact? Perhaps we need to implement
tougher standards ALL the time! Washing
our hands and cleaning the environment works.
Why don’t we just do it?
Bugging Off!
Nicole
