Significant bacterial infection can be cured with judicious and expedient use of appropriate antimicrobial agents, notably antibiotics.
However, repetitive short-term exposure to antibiotics and random mutation of bacteria have resulted in resistant bacterial organisms, with few options for cure.
The long-term consequences of bacterial resistance to antibiotics is increased morbidity and mortality and increased healthcare costs. To mitigate these outcomes, the U.S. Centers for Medicare & Medicaid Services has implemented requirements regarding proper antibiotic use. The centers also are scrutinizing healthcare organizations based on new requirements focusing on resistant infections that initially occur in the hospital setting.
Infections due to Clostridium difficile, commonly called “C. diff,” and methicillin-resistant Staphylococcus aureus, known as MRSA, are specifically targeted by the CMS, as they place a large burden on patients and the healthcare system and have a propensity to be acquired during an inpatient stay.
The penalties may result in up to 1% in reduced reimbursements from CMS for some institutions. This could cost them an estimated $430 million in 2016, making reduction of these organisms a major priority of many health systems, according to a Healthcare IT News article.
How can healthcare professionals address these infection issues?
The control of resistant microorganisms is a responsibility of everyone in a healthcare setting. Collaboration and communication among key members is essential to ensure reporting is uniform, and developed policies are appropriately designed and carried out.
First, education is necessary across the board, involving not only healthcare team members but also administrators, staff and patients. With all members having a better understanding of their role and a basic knowledge of the transmission of these organisms, the ability to track and control organisms becomes easier.
Nurse.com offers a webinar, “Antimicrobial Resistance and Healthcare Acquired Infections: A New Target for CMS” to nurses, nurse practitioners, physicians, physician assistants, pharmacists and pharmacy technicians for continuing education credit regarding this important issue.
A 15% decrease in antibiotic use may be needed to decrease misuse by half, according to a recent CMAJ article, “Antibiotic overprescribing is a growing problem.” Appropriate hand hygiene, facility management and modes of infection transmission must be identified and addressed to reduce the spread of disease within the healthcare setting.
As with many medical issues, preventive measures are key to infection control. Policies and procedures should be developed that consider everything from patient transport to food services, to ensure minimal risk of microbial spread. Hand sanitization, gowning and medicine preparation are practices that should be evaluated and consistently targeted.
Finally, a dedicated means of gathering data, reviewing it and using it to develop and evaluate ways to continuously improve should be put into place.
With everyone better understanding their role in preventing the acquisition of these infections, improved reporting and institutional policies can be designed and implemented.
The overall impact on the healthcare system would be positive as patients are at a reduced risk of acquiring resistant and potentially lethal infections, and hospitals experience reductions in admissions and excessive costs.
Courses related to ‘antimicrobial resistance’
WEB339: Antimicrobial Resistance and Healthcare Acquired Infections: A New Target for CMS
(1 contact hr)
Rising trends in antimicrobial resistance is a costly and significant contributor to negative health consequences in the United States and worldwide. The Center for Medicare and Medicaid Services recognizes this impact and will now penalize hospitals with high rates of acquired Methicillin-resistant S. aureus (MRSA) and C. difficile infections in an effort to promote proper antimicrobial stewardship and infection control policies. With proper education, development and use of effective protocols, and close monitoring, the interprofessional care team can have a substantial impact on improving patient outcomes and reducing healthcare costs.
60040: Infectious Microbes and Disease
(1.4 contact hrs)
Each year, the bacterium Streptococcus pneumoniae is a significant cause of morbidity and mortality in the U.S. despite the availability of a vaccine. Until 2000, at least 40% of the 60,000 cases of invasive S. pneumoniae infection were resistant to at least one drug. The Center for Disease Control and Prevention’s 2012 Active Bacterial Core Surveillance Report estimated that 3,300 cases of invasive pneumococcal infections caused by S. pneumonia were fatal. Pathogenic bacteria share the instinct to survive with their unwilling hosts. When faced with an antimicrobial attack, they rapidly assemble defensive resources. Although bacteria carry only a single chromosome, evolution has provided them with mechanisms that allow them to survive even aggressive antimicrobial treatment. Surviving bacteria are often resistant; these survivors reproduce and, by natural selection, become the dominant organism in the host. This course provides information about infections, antibiotic resistance, colonization and breaking the chain of disease.
CE725: The End of Antibiotics: Can We ‘ESKAPE’ It?
(1 contact hr)
This module provides nurses and physical therapists with an overview of the most troublesome antibiotic-resistant bacteria in hospitals. These difficult-to-treat, multidrug-resistant pathogens have become known as ESKAPE pathogens, given that they cause more than two-thirds of all hospital-acquired infections and effectively “escape” the biocidal effects of most or all available drugs. The course will discuss the latest developments related to antibiotic resistance and the increasing problem of antibiotic-resistant bacteria throughout healthcare and the community, and offer strategies for reducing the spread of resistance.