Infection Control Part 1

I found that it will be appropriate for the first post in this blog to be related to infection prevention and treatment. One of the biggest struggles in the healthcare field is the management of bacterial infections. Infections can occur anywhere in the body. Wounds, surgical sites, and invasive lines (such as urinary catheters or intravenous lines) all open a port through which bacteria can enter the body and settle within. However, these bugs can also enter through other means, such as the lungs, bladder, intestines, etc. without the use of a invasive line. Believe it or not, health care facilities seem to be packed with many different pathogens, based on the fact that the patients within them are infected with different bugs. In the home setting, you are usually only exposed to your own bacteria, which you might already have immunity against. But, in the hospital you are exposed to the bugs of other people to whom you might not be protected against. Medical scientists have found ways to prevent the spread of infections; however, it recently has become a problem of both professional and patient compliance with these regulations.

HAND WASHING-
Hand washing has been declared as the most powerful tool against the spread of infections. This makes sense. As a nurse, I interact directly with many of my patients without the use of protective equipment such as gloves. Shaking a patients hand, touching his or her things, moving them from the bed to the wheel chair, all these interactions expose my hands to microbes. Since my hands are not visibly soiled, I can assume that they are clean and transfer those bugs to the next patient I see. Washing one's hands not only removes the bacteria from the skin surface, but if an antimicrobial soap is used, it also kills them. Oh but how do you have time to wash your hands? Especially when you are so busy! That is a valid point. As a nurse, I confess that washing my hands between patients is sometimes impossible. I resort to a most time conserving approach: hand sanitizer. Unlike hand washing, hand sanitizing does not remove the microbes from your hands. The effectiveness of the hand sanitizers relies on their ability to kill the bacteria and viruses through the use of alcohol. Hospitals and other healthcare facilities have invested much in the installation of hand washing and hand sanitizing stations throughout their patient care areas. So not having time to squirt some hand sanitizer between patients is not an excuse health care professionals can use anymore. In my opinion, and efficient way of maintaining one's hands clean is to wash them when soiled or before and after performing a "dirty task" (such as changing a dirty brief, performing wound care, bathing a patient) and utilizing a hand sanitizer when after performing a clean task (administering medication, shaking a patients hand, helping a patient move up in bed).

As a patient, I recommend that you always ask your health care providers if they washed their hands before interacting with you. Doctors seem to be the worst at hand cleaning between patients. It is for your benefit to not acquire an infection while at the hospital, so do not be shy at demanding this from the people who's job is to keep you healthy.

ANTIBIOTIC USE
I place antibiotic use under this blog post because of the ability of bacteria to acquire immunity against antibiotics. Antibiotics function by interrupting with the life processes of bacteria and thus resulting in their death. However, sometimes bacteria obtain the ability to resist the destructive effects of the drug. Imagine that you have a rodent infestation in your home. To get rid of them, you place traps all around your house. You manage to kill all the rodents except for a couple that learn how to deactivate your traps without being killed, and then eat the bait. These rodents go on an reproduce, and eventually you face another infestation. However, this time the rodents are learned from their parents how to deactivate your traps and you find that the traps are no longer effective. This analogy is similar to how bacteria acquire resistance against antibiotics. After a round of antibiotics, some bacteria might survive, reproduce, and develop a colony of bacteria who are resistant to the antibiotic used on their original ancestors.
When someone presents himself/herself with an infection, typically the doctor will order a culture and sensitivity test. Wether from urine, blood, wound secretions, sputum, etc. the sample is grown in a culture medium to grow. The colonies that form are identified. This is the "culture" part of the test. The "sensitivity" is done by exposing the bacteria colonies to different antibiotics and measuring their ability to resist the drugs. The doctor is then presented with a report of the identity of the bacteria and the different antibiotic sensitivities. He/she then prescribes the appropriate antibiotic. The test usually takes up to 2 days or more. I do not want to say that doctors usually bypass this exam, but it in my experience I have seen antibiotics prescribed without the test being run or before results are drawn. This exposes the bacteria to an antibiotic that they might be resistant or one in which they might be acquiring resistance to. Practitioners have been known to prescribe antibiotics freely, and this has been determined as a culprit in the development of antibiotic resistant bacteria.
Another reason why infections of antibiotic resistance bacteria have increased relies on patient noncompliance with treatment. Many patients do not correctly consume their medications as prescribed. Most of the time, the error relies on the fact that the patient decides to stop taking their medication once they feel better. This exposes the bacteria within them to the antibiotic, without killing them entirely. The surviving bacteria then acquire antibiotic resistance and recolonize. In order to prevent development of antibiotic resistant bacteria, it is important that patients understand their prescription instructions and follow them.