Antibiotic Resistant Bacteria

Tutor: I guess you know that antibiotic resistant bacteria, by definition, are not controlled by antibiotics. But how can this be prevented?

Trainee: Oh, by minimizing unnecessary prescription or over-prescription of antibiotics, the correct use of antibiotics, and good hygiene and infection control.

Tutor: Can you give me some examples of bacteria that developed resistance to antibiotics?

Trainee: Generally, the Staphylococcus aureus (the golden staph) and Neisseria gonorrhoeae that cause gonorrhoea. But why are these bacteria dangerous?

Tutor: They are resistant to most antibiotics and can cause major public health problems, the most important examples of which are the methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, multi-drug- resistant Mycobacterium tuberculosis and carbapenem-resistant Enterobacteriaceae.

Trainee: Oh, difficult to pronounce! But are there any specific ways to prevent bacteria transmission then?

Tutor: The classical measures to prevent bacterial resistance aim at reducing nonessential prescription and avoiding the overuse of antibiotics for conditions that do not require them, even if some patients tend to expect their doctors to prescribe them automatically, for example concerning viral illness. Also, patients should complete the entire course of any prescribed antibiotic so that it can be fully effective and not trigger resistance. And of course, practice good hygiene such as hand-washing and the use appropriate infection control procedures.

Trainee: Ok, but then again what about the transmission of antibiotic resistant bacteria in hospitals?

Tutor: The common ways in which bacteria can be passed from person to person include the contact with contaminated hands of the staff, with contaminated surfaces (door handles, over-bed tables and call bells), or with contaminated equipment, like stethoscopes and blood pressure cuffs.

Trainee: Do the same prevention measures apply?

Tutor: Standard precautions in hospitals, like good personal hygiene, that’s hand washing before and after patient contact and the appropriate use of alcohol-based hand rub solutions, the use of barrier equipment like gloves, gowns, masks and goggles, the appropriate handling and disposal of sharp objects like needles, the correct management of medical waste generated during patient care, and the use of aseptic techniques, prevent bacterial transmission even in high-risk situations. However, other precautions are adapted to the particular pathogen and route of transmission, which may include the use of a single room with ensuite facilities, the use of special care equipment, and the restriction of movement of the person and their health caregivers.

Trainee: Ok. Now what about transmission of antibiotic resistant bacteria in the community?

Tutor: Well, the usual measures like washing hands each time for meals and when using the toilets, plus covering the nose and mouth when sneezing and coughing.