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Nursing Responds to New Superbugs

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Antibiotic resistance is a health care crisis. In this article the author shares some ideas about nurses' responses to help combat the crises.

Nursing Responds to New Superbugs

Nursing Responds to New Resistant Germs

C. Diff, MRSA, VRE, CRE, VRSA, Neisseria Gonorrhoeae, Tuberculosis—the list of drug-resistant microbes and fungi continues to grow at an alarming rate. The Centers for Disease Control (CDC) goes so far as to call "antibiotic resistance the biggest public health challenge of our time." (Centers for Disease Control and Prevention (CDC) Biggest Threats and Data). In its report, the CDC lists 18 different bacteria and fungi that are threatening and grades them as to whether they are urgent, serious or concerning. To this already long list of deadly and difficult to treat diseases, we add Candida Auris (C. Auris) a fungus that has led to recent outbreaks around the world, most recently in New York.

Candida Auris presents a significant threat to global health for several reasons:

  • It’s often resistant to a variety of treatment options
  • It’s easy to misidentify and therefore mistreat.
  • It seems to thrive in healthcare settings which makes it more dangerous to our patients.

New York State’s health officials are reacting by working together to contain C. Auris’ spread, uniting to identify and fight this new threat. The state’s commissioner of health and the experts from CDC met in May 2019 with 60 hospital leaders to propose new guidelines in their state to stop the spread. Some of the challenges they are facing include having adequate lab resources to accurately identify the organism, and the difficulty in containing C.auris geographically as it seems to stick to surfaces and be hard to clean. "One hallmark of C. Auris is that it can be very difficult to clean from equipment or clothing, and it may spread through the air. Officials suspect that the spores can be shaken loose from bedding and they have been known to cling to walls and ceiling tiles." (To Fight Deadly Candida Auris, New York State Proposes New Tactics)

Additionally, other states are beginning to see evidence of outbreaks. From New Jersey to Illinois a number of cases have been reported. One significant problem is the culture of secrecy that surrounds finding C.auris in facilities. The reluctance to report may contribute to the problem of containment as hospitals and care facilities find themselves facing fear from the public.

In an article on the global threat of fungal diseases, Matthew Fisher states:

To avoid a global collapse in our ability to control fungal infections and to avoid critical failures in medicine and food security, we must improve our stewardship of extant chemicals, promote new antifungal discovery and leverage emerging technologies for alternative solutions.

As drug-resistant microbes proliferate, nursing may need to change and adapt to combat the challenge. We may need to take an even stronger leadership role in preventing the spread of disease. As professional nurses, we are always compliant with the rules related to careful handwashing and isolation precautions, but we may need to become even more fastidious about the most minor points that could contribute to the spread of these super-bugs.

Since the time of Florence Nightingale, we have been at the forefront of promoting cleanliness as part of the active healing process. In more modern times, cleanliness, careful technique and strict adherence to disease prevention protocols can be a strong defense against these hospital-acquired infections (HAI) that can quickly compromise our patients’ care.

General guidelines for stopping the spread of infectious disease are basic to nursing practice and include:

  • Using good hand washing hygiene
  • Practicing careful and consistent aseptic technique
  • Methodical and thorough cleaning and disinfection practices
  • Standard precautions and safety devices
  • Education
  • Bundle strategies for infection prevention
  • Being healthy (fit for duty) when at work

(Adapted from: Nursing Made Incredibly Easy! Your role in infection prevention

Besides being careful in our adherence to great nursing protocol and care, what can we do as citizens of this country and of the world? It might be helpful to consider writing our Representatives in Congress and other leaders to request that they allocate additional funds into government-sponsored research to develop new treatments for these super-bugs. Since the potential returns for these short term treatment medications is less, it is hard for pharmaceutical companies to have the long term vision to invest what is necessary to develop drugs to treat infection. It is also important for us as individuals to take precautions to minimize our own use of antibiotics and to help others understand why, as well.

In a culture where bad news travels even faster than a wayward resistant microbe, we can only combat fear with true knowledge and excellent technique, prodding one another to continuous excellence without any possibility of incorrect procedure. When we work with assistants, students and other ancillary workers, our willingness to help them understand the critical nature of what we are doing can help us do our best to fight the battle against the spread of HAI. As thoughtful professional nurses, we can take a real leadership role to inspire and motivate our peers, the team of physicians and our entire care group in moving to contain and discourage the spread of these difficult to treat germs.

Joy is a Faith Community Nurse and has worked as a nurse for 35 + years in a variety of settings. She enjoys writing, taking long walks, and spending time with her grandkids. She has published a children's book, two Bible studies and maintains a blog.

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Quote

the difficulty in containing C.auris geographically as it seems to stick to surfaces and be hard to clean. "One hallmark of C. Auris is that it can be very difficult to clean from equipment or clothing, and it may spread through the air. Officials suspect that the spores can be shaken loose from bedding and they have been known to cling to walls and ceiling tiles."

Where in the Harry Potter sorcery hell did this bug come from?

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myoglobin has 11 years experience as a ASN, BSN, MSN and specializes in ICU, trauma, neuro.

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C. Auris thrives in a "high blood sugar" environment, and the fact that probably 50% of Americans are either diabetic, prediabetic, or insulin resistant, doesn't help. Many other "super bugs" are fed not only by the over use of antibiotics by physicians, but also their overuse in the farm industry to make chickens, pigs, and cows grow bigger more quickly.  Only a holistic approach that look at many modalities (not just the acute care setting) will ultimately change the course of this challenging issue.

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6 hours ago, myoglobin said:

C. Auris thrives in a "high blood sugar" environment, and the fact that probably 50% of Americans are either diabetic, prediabetic, or insulin resistant, doesn't help. Many other "super bugs" are fed not only by the over use of antibiotics by physicians, but also their overuse in the farm industry to make chickens, pigs, and cows grow bigger more quickly.  Only a holistic approach that look at many modalities (not just the acute care setting) will ultimately change the course of this challenging issue.

Thank you for your comment and the additional information. This has to be a joint effort with the worldwide community working together.

 

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