H Flashcards
Antimicrobial resistance is attributed to the what factors?
- Survival of the fittest, or selection.
- Use of antibiotics in animals
- Overprescribing of antibiotic medication
Resistance often occurs among normal bacterial flora in patients receiving antibiotics. If further infection requiring treatment subsequently develops, that bacterial population is more likely to become resistant than in patients who have not received treatment. Darwin’s theory of the ‘survival of the fittest’ favors selection systems. Within the microbial population there is variation amongst microorganisms, and selection occurs which favors those organisms with traits that are most advantageous in the prevailing environment.
Survival of the fittest, or selection.
The driving force behind the whole ‘resistance problem’ has been the widespread use of antibacterial drugs, and the misuse and overuse of antibiotics worldwide in the treatment of humans and animals. Antimicrobial agents are used to treat infections in animals, accounting for in excess of 50% of total antibiotic use, but in those animals bred for human consumption they are often administered prophylactically to protect whole herds from disease, and also for growth promotion.
Use of antibiotics in animals
Historically, there has been huge pressure on general practitioners to prescribe antibiotics for the treatment of minor coughs and colds and other illness because of the level of patient expectation and demand for treatment. This has led to the prescription and administration of antibiotics in situations where their use is not justified and the emergence of resistant organisms within the community, partly through poor prescribing, with the dose prescribed at sub-therapeutic levels, and partly due to poor patient compliance. Lack of regulation regarding the sale of over- the-counter antibiotics and antibiotic prescribing generally in developing countries has exacerbated the problem of resistance.
Overprescribing of antibiotic medication
In the event of a high-risk event such as an accidental sharps injury from a known or unknown source, this is used as an immediate treatment to prevent the development of disease on the inflicted patient.
Post-exposure prophylaxis (PEP)
Exposure to Sharps:
- Immediately following an exposure to blood:
* Wash needlesticks and cuts with soap and water
* Flush splashes to the nose, mouth, or skin with water
* Irrigate eyes with clean water or saline
* No scientific evidence shows that using antiseptics or squeezing the wound will reduce the risk of transmission of a bloodborne pathogen. Using a caustic agent such as bleach is not recommended. - Report the exposure
* To the department (e.g., occupational health, infection control) responsible for managing exposures.
* Prompt reporting is essential because, in some cases, postexposure treatment may be recommended and it should be started as soon as possible.
It has the highest incidence of needle stick transmission. This is why healthcare workers are often vaccinated or start vaccination before they start work.
Hepatitis B
Is there a vaccine against hepatitis C?
There is no vaccine against hepatitis C and the CDC does not recommend any mode of treatment, although certain modes of treatment are rapidly emerging. Neither immune globulin nor antiviral therapy is recommended after exposure.
Is there a vaccine against HIV?
There is no vaccine against HIV. However, results from a small number of studies suggest that the use of some antiretroviral drugs after certain occupational exposures may reduce the
chance of HIV transmission. Postexposure prophylaxis (PEP) is recommended for certain occupational exposures that pose a risk of transmission. However, for those exposures without risk of HIV infection, PEP is not recommended because the drugs used to prevent infection may have serious side effects.
