Niagara Gazette

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May 3, 2013

GUEST VIEW: Practicing proper infection control

Niagara Gazette — Recently, local media have been discussing relatively new forms of antibiotic-resistant bacteria that are making their way around the world called carbapenemase-producing Enterobacteraciae (CRE). In layman’s terms, this group represents a number of related microorganisms that have genes inside them that code for resistance to most, if not all, known antibiotic medicines. When exposed to different antibiotics, some bacteria develop resistance to the drug and can pass these resistance genes onto future generations of bacteria. Previously more prevalent overseas where the use of antimicrobial medicines can sometimes be more brazen and are often available without a prescription, they are now making their way to the US and Canada. At this point they usually, but not always, tend to cause disease in patients who are in poorer health or are otherwise compromised, such as those who have cancer or have undergone surgery. Nonetheless, they are quite worrisome and create an impetus to ensure we do all that we can to practice proper infection control, both in the community and the hospital setting.

The mechanisms behind the evolution and expression of these genes, while fascinating, are beyond the scope of this article. Suffice it to say that they are posing an enormous challenge. Treatment of patients infected with these organisms is very difficult and requires the use of salvage and/or toxic medications that often carry dangerous side effects. Despite the use of these drugs, mortality still remains very high. Unfortunately, the types of bacteria that carry these resistance genes are frequent causes of common infections such as those involving the urinary tract and surgical sites. Take, for example, the very common occurrence of a young lady contracting a urinary tract infection. Now imagine that it is caused by one of these bacteria and not being able to easily treat it, if at all, and you can start to appreciate the serious nature of this problem.

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