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Doctors
Control Spread
of Antibiotic-Resistant Bug
NEW
YORK (Reuters Health) - Doctors were able to control the spread
of an antibiotic-resistant bacteria through hospitals in the Midwest
by implementing simple infection control methods, according to
a report.
In the Siouxland
region of Iowa, Nebraska and South Dakota, bacteria known as enterococci
that are resistant to the commonly used antibiotic vancomycin
were first detected in 1996 and became widespread in the 32 hospitals
in the region.
Antibiotic
resistance is a major problem worldwide, and hospitals are ground
zero since infections and antibiotics are part of everyday life
in these settings.
``Antibiotic
resistant bacteria are increasing in prevalence and cause many
healthcare-associated infections and are estimated to cost approximately
$4 billion annually,'' according to Dr. Belinda Ostrowsky, the
lead author of the study. ``The Siouxland Project documents that
aggressive implementation of infection control measures can control
an antibiotic-resistant bacteria.''
After the
outbreak, the Centers for Disease Control and Prevention (CDC)
set up a program in 1997 to control the spread of the bacteria
through hospitals, the authors explain in the May 10th issue of
The New England Journal of Medicine.
The program
consisted of screening patients in hospitals for vancomycin-resistant
bacteria and then isolating infected patients from others. Other
measures included rigorous hand washing by healthcare workers
and the use of gloves and gowns whenever taking care of infected
patients.
Before the
outbreak in 1996, there were no cases of vancomycin-resistant
enterococci (VRE) in the region. The overall prevalence of VRE
peaked at 40 cases in 1997. That number dropped to 26 in 1998,
and 9 cases in 1999 as a result of the control measures implemented
by the program.
``Rather than
trying to control VRE in one facility at a time, the entire healthcare
community worked together to solve the problem,'' said Ostrowsky,
from the CDC, in an interview with Reuters Health. ``This partnership
was unique. By working together, all the healthcare facilities
were able to collaborate and control the transmission of VRE.''
An important
facet of the study was to assess which patients were at risk for
contracting the resistant bacteria. The researchers found that
patients who had been in the hospital for 3 days or had been on
antibiotics for 2 weeks straight were more likely to be infected.
This provided the doctors with a direct correlation between contracting
the bacteria and treatment in a healthcare facility, underscoring
the importance of implementing the control program in a wide variety
of healthcare institutions.
The overuse
of antibiotics has been implicated in the rise of antibiotic-resistant
bacterial strains. However, the use of enhanced infection control
practices is likely to significantly reduce outbreaks, Ostrowsky
said.
``Expansion
of efforts like the Siouxland Project to other regions has the
potential to control antibiotic resistance, reduce infections
and reduce costs, but most importantly, promote better outcomes
for our patients,'' she added.
SOURCE:
The New England Journal of Medicine 2001;344:1427-1433.
Reference
Source 89
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