Why hospital infections and antibiotic resistance have increased

A new study from the National Institutes of Health shows the outbreak of both hospital-acquired infections and resistance to the antibiotics used to treat them. The findings are based on data collected at 120 US hospitals from January 2018 to December 2022, a five-year period that included the Covid-19 pandemic.

Dr. Nasia Safdar, professor of infectious medicine at the University of Wisconsin-Madison, discusses why infection rates have risen and how you can protect yourself as a hospital patient or visiting family member.

What diseases are related to health care?

These are infections that occur as a result of exposure to the health system. People who come for care are often very sick, so they are at risk of acquiring bacteria that can cause infections while in the hospital, or shortly after they leave the hospital.

Why do infections, especially those that are resistant to antibiotics, spread so easily in hospitals and other health care settings?

There is a certain level of bacteria and viruses that occur in health care facilities. And that condition is often bacteria that are resistant to many commonly used antibiotics.

Patients are already vulnerable and may have a compromised immune system. On top of that, add the risks associated with heavy use of antibiotics, surgery, procedures and medical devices such as urinary catheters and intravascular catheters, which enter the blood. The result is the number of people who are at risk of getting these bacteria circulating in the environment.

What does it mean for an infection to be resistant to antibiotics?

For any common infection, there can be many different treatment options. There is what is called first line treatment, which is the first antibiotic that you can go to. These are usually antibiotics that can effectively treat the infection, but without destroying the good bacteria that live in your gut.

But when bacteria become resistant to antibiotics, we have to go to broad-spectrum antibiotics, which may continue to be effective for treatment but may also have more side effects or destroy some of the bacteria. good for the gut.

What can hospitals and clinics do to prevent or reduce the spread of disease?

One is infection prevention, and the other is antibiotic stewardship, or the judicious use of antibiotics. Both work in the same way.

Within the group of infection prevention, you have hand hygiene, which is important not only for health workers but also for the patients themselves.

There is also the use of gowns and gloves, if necessary, to ensure that if one patient has an infectious condition, that path is interrupted by health workers wearing the correct PPE, or protective equipment. I also think using devices like urinary catheters or intravascular catheters when they are really needed is another way to prevent patients from getting infected.

And now, within the antibiotic control group, it is necessary to prevent the excessive use of antibiotics.

What has happened in recent years to healthcare-associated morbidity rates?

Before this outbreak, I think the field was hopeful because we were seeing reduced rates of antibiotic-resistant, equipment-related infections.

Many of those benefits were reversed after the pandemic hit. There was a lot of unnecessary use of antibiotics at that time. So now we’re seeing a dramatic increase in the number of antibiotic-resistant bacteria. This made us worry that any success we had was limited and short-lived. Now we want to make sure that we are not as vulnerable as we were during this pandemic.

Can you give us a background on Candida auris?

Candida auris is an emerging pathogen. Unlike other antibiotic-resistant organisms in healthcare systems, this is a fungus – or yeast, which is another term for it. And it is spreading rapidly in health systems.

Candida auris it persists in the environment and on the skin and can cause serious blood infections in vulnerable patients. It has been responsible for several outbreaks, and treatment options are limited compared to other infectious diseases.

When the plague came, there was a sharp increase Candida auris infectious diseases. They rose by several hundred percent nationwide after smoking for a while. That fierce wave touches us.

Can the prevalence of these diseases be reduced by controlling the gut microbiome?

Many of these parasites live in the intestines. They are generally ignored by the good bacteria that we all have in our gut. But sometimes, when we use antibiotics, or use tools or do surgery, those good bacteria are destroyed. And then these germs can find a hospitable environment and grow and cause infection.

Food plays an important role in keeping our gut microbiome healthy. Most Americans do not get enough fiber. But a diet high in fiber keeps your gut bacteria healthy and helps you build a stronger immune system when they try to attack.

What can patients or their families do to reduce the chances of getting an infection in a health care setting?

Make sure that patient and health care workers observe hand hygiene. Use hand sanitizer. It works. It should. It is easily accessible. It is a good way to prevent infection in health care settings.

But there are times when you might want to use soap and water instead. Soap and water is a good choice when hands are contaminated with blood, feces, diarrhea or other bodily fluids.

Also ask about the infection rates of the health care system. These are things that are usually tracked by health systems, and the information is often publicly available. Ask your health care team about the medications you are receiving for treatment, especially if they are antibiotics. Then ask how long you should take them, what side effects you can expect, and what effect they will have on your gut bacteria.

Look full discussion to hear more.

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Nasia Safdar is Professor of Infectious Diseases, University of Wisconsin-Madison.

This article was first published on Conversation.