According to the Centers for Disease Control and Prevention (CDC), nearly two million patients in the United States get an infection in a hospital each year, and 90,000 of those patients die as a result of their infection. More than 70% of the bacteria that cause hospital-acquired infections are resistant to at least one of the drugs most commonly used to treat them. Patients infected with drug-resistant organisms are more likely to have longer hospital stays and require treatment with second- or third-choice drugs that may be less effective, more toxic, or more expensive.

Institutional Consequences

Antibiotic resistance not only significantly impacts a patient’s health, but it also has profound effects on hospital procedures. Trish M. Perl, MD, MSc says the presentation of antibiotic resistance has a domino effect throughout the hospital setting. \"When a patient acquires multi-drug resistant or multi-antimicrobial resistant organisms, medical centers will often isolate patients to prevent transmission of the bug. In most cases, the patient will be put in a private room and healthcare workers will be directed to wear gowns and gloves when they are in contact with the patient. We may be forced to move as many as 12 patients to get the infected patient into a private room, which compromises a hospital’s efficiency. In high volume hospitals, it can be quite burdensome to find the resources to isolate patients safely and efficiently, but studies confirm that the isolation approach to treating a patient with a drug-resistant infection is effective.\"

Antibiotic resistance is associated wth increased length of hospital stay, often meaning fewer beds are available for new admissions. An adverse effect upon the nurse/patient ratio is another hospital-wide consequence of antibiotic resistance, according to Perl. \"Because some organisms are so difficult to manage, some institutions prohibit nursing staff from working with other patients in an effort to avoid transmission of the bugs. This has a profound effect considering we already have a nursing shortage.\"

Educational Need

\"Some clinicians who handle hospital-acquired infection cases are not using the most recent evidence-based knowledge to aid in their treatment of patients,\" Perl explains. \"Others may not be properly diagnosing patients with these bugs because of limitations in their knowledge, or because of a lack of time or resources. When there is no evidence of infection, clinicians may prescribe antibiotic therapy anyway. In cases in which the patient is already on antibiotics, clinicians will sometimes fail to recommend the antibiotic therapy be stopped. In other cases, clinicians treat colonization without evidence of systemic invasion. All of these scenarios present the absolute recipe for the development of resistant organisms that then can cause the patient to be susceptible to infections. However, research has suggested that many of these infections are preventable if infectious disease and antimicrobial resistance guidelines are followed.\"

CONTINUES........www.physweekly.com