How better home hygiene could curb antibiotic resistance

Pharmacologists and infectious disease specialists say there is an urgent need to promote good hygiene in the home and in community settings. They believe that this will be essential in reducing antibiotic use and preventing the spread of drug-resistant bacteria in the coming years.

Rates of resistance to commonly used antibiotics have already reached 40–60% in some countries outside the Organisation for Economic Co-operation and Development (OECD) and are set to continue rising fast.

In OECD countries, rates of resistance could reach nearly 1 in 5 (or 18%) by 2030 for eight different bacterium-antibiotic combinations.

By 2050, about 10 million people could die each year as a result of resistance to antimicrobial agents.

While policymakers usually focus on hygiene in healthcare settings, such as hospitals, a group of pharmacology and infectious disease experts believes that improved hygiene in homes and community settings is just as important.

The scientists have published a position paper in the American Journal of Infection Control on behalf of the Global Hygiene Council.

“Although global and national [antimicrobial resistance] action plans are in place,” they write, “infection prevention and control is primarily discussed in the context of healthcare facilities with home and everyday life settings barely addressed.”

They have also launched a manifesto that calls on health policymakers to recognize the importance of this topic.

‘More urgent than ever’

Simple hygiene measures, such as hand washing, can help reduce infections and antibiotic use, the authors argue. In turn, this will minimize the development of resistance.

“In light of the current COVID-19 pandemic and evidence presented in this paper, it is more urgent than ever for policymakers to recognize the role of community hygiene to minimize the spread of infections, which, in turn, will help in reducing the consumption of antibiotics and help the fight against [antimicrobial resistance],” says lead author Prof. Jean-Yves Maillard from the School of Pharmacy and Pharmaceutical Sciences at Cardiff University in the United Kingdom.

The World Health Organization (WHO) estimate that 35% of common infections are already resistant to currently available medicines, with this figure rising to 80–90% in some low and middle income countries.

Overuse of the drugs accelerates the development of resistance. In the United States, for example, the Centers for Disease Control and Prevention (CDC) estimate that of the 80–90% of antibiotic use that occurs outside hospitals, about half is inappropriate or unnecessary.

The authors point out that while the majority of bacteria that are multidrug-resistant (resistant to at least one agent in three or more antimicrobial classes) get picked up in hospitals, some have become prevalent in the community.

Patients leaving the hospital can carry methicillin-resistant Staphylococcus aureus (MRSA) on their skin, for example, or resistant strains of enterobacteria in their gut. Resistant bacteria can then pass to other family members.

The authors write:

“Although the precise impact of hygiene on transmission of infection between community and healthcare settings needs further investigation, it is important to recognize that reducing the need for antibiotic prescribing and the circulation of [antimicrobial-resistant] strains in healthcare settings cannot be achieved without also reducing circulation of infections and [resistant] strains in the community. We cannot allow hygiene in home and everyday life settings to become the weak link in the chain.”

 

Hand washing is a crucial measure

They argue that better hand hygiene would prevent many infections in the home and in community settings, such as schools, nurseries, and workplaces.

Only about 19% of people wash their hands after using the toilet, according to a review of research that the paper cites. The same review found that hand washing reduces the risk of diarrhea by nearly one-quarter (23%) in studies with good methodological design.

Educating people to wash their hands with ordinary soap is one of the best ways to reduce infections, according to experts. Overall, research has shown that improvements in hand hygiene lead to a 21% reduction in respiratory illnesses and a 31% reduction in gastrointestinal illnesses.

In addition, the position paper highlights the problem of foodborne pathogens, including Salmonella, Campylobacter, and Escherichia coli. These affect millions of people globally every year, causing diarrhea and other debilitating symptoms.

A 2014 study in Mexico found Salmonella in almost all cleaning cloths. Soaking these dish clothes in a 2% solution of bleach twice a day reduced the bacteria by 98%.

Key risks and strategies

The authors identify key risk moments for transmitting infections in the home. These are:

• food handling, including contaminated chopping boards and kitchen sponges
• using the toilet
• changing a baby’s diaper
• coughing, sneezing, and nose blowing
• touching surfaces that others frequently touch
• handling and laundering clothing and household linen
caring for domestic animals
• disposing of refuse
• caring for an infected family member

As key strategies to combat infection in the home, they recommend:

• soap or detergent-based cleaning together with adequate rinsing
• alcohol-based hand sanitizer
• inactivation or eradication using a disinfectant on hard surfaces
• mechanical removal using dry wiping
• heating to at least 60°C (140°F)
• UV treatment
• a combination of the above

However, they note that further research is necessary to evaluate the extent to which these practices might contribute to preventing the transmission of antimicrobial-resistant bacteria.

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Written by James Kingsland on May 25, 2020 – Fact checked by Hilary Guite, FFPH, MRCGP

Published: https://www.medicalnewstoday.com


Hygiene reduces the need for antibiotics by up to 30%

Everyday hygiene reduces the need for antibiotics by up to 30%, helping to prevent daily deaths from antimicrobial resistance (AMR), new paper reveals.

According to a new Position Paper published in the American Journal of Infection Control (AJIC) online, improved everyday hygiene practices, such as hand-washing, reduces the risk of common infections by up to 50%, reducing the need for antibiotics, by up to 30%. Global public health experts responsible for the Position Paper, are now calling for home and community hygiene to become part of strategic plans to reduce hundreds of thousands of deaths from AMR globally each year.

As witnessed during the recent global efforts to delay the spread of COVID-19, hygiene practices, including hand-washing, have become an essential part of everyone’s daily routine and are considered to be the first line of defence in reducing the spread of common infections. However, national and international AMR strategies, while focussing on the important role of hygiene in the healthcare setting, fail to recognise the key role that home and community hygiene plays.

This Position Paper, developed on behalf of the Global Hygiene Council (GHC), and published online in AJIC, explores the role of targeted hygiene in the home and everyday life settings to reduce antibiotic prescribing and its likely impact on antibiotic resistance. It provides evidence that practising hand hygiene in homes and community settings can prevent infections and therefore reduce the need for antibiotics. One intervention study demonstrated a 30% reduction of antibiotic prescriptions for common respiratory infections in a group who used hand sanitisers compared with a control group.

The Position Paper, also demonstrates the increasing prevalence of multidrug-resistant bacteria in the home and community. It is considered that 35% of common infections occurring in healthcare and the community are already resistant to antibiotics, and that in some low-and middle-income countries, resistance to antibiotics is as high as 90%,4 causing 2,000 people to die every day globally.

According to the lead author, Jean-Yves Maillard, Professor of Pharmaceutical Microbiology at the School of Pharmacy and Pharmaceutical Sciences, at Cardiff University; “In light of the current COVID-19 pandemic and evidence presented in this Paper, it is more urgent than ever for policy makers to recognise the role of community hygiene to minimise the spread of infections, which in turn will help in reducing the consumption of antibiotics and help the fight against AMR.

To coincide with the publication of the Paper, the GHC has launched a Manifesto calling upon national and international policy makers, health agencies and healthcare professionals to further recognise the importance of hygiene in the home and everyday life settings and acknowledge the following:

1/ IPC committees, responsible for implementing national AMR plans, should recognise that improved hand and surface hygiene in the home and community are key to minimise the spread of infections and as a consequence the consumption of antibiotics, which will then help in the fight against AMR. To achieve this, recommendations for improved hygiene in the wider community should be included in global AMR action plans by 2022 and in all national plans by 2025.

2/ IPC advice, guidance and education for HCPs on hand and surface hygiene and its relation to AMR should not be limited to healthcare settings, but also include recommendations to influence the wider community with immediate effect.

3/ Relevant medical associations should ensure messaging around home and community hygiene is cascaded to members through amending on-going and existing AMR training and education.

With evidence to show that home and community hygiene urgently needs to be taken more seriously, it is time for the global community to collaborate and recognise that reducing the need for antibiotic prescribing and the circulation of AMR strains in healthcare settings cannot be achieved without also reducing the circulation of infections and AMR strains in the community.

The Position Paper ‘Reducing antibiotic prescribing and addressing the global problem of antibiotic resistance by targeted hygiene in the home and everyday life settings,’ was developed on behalf of the Global Hygiene Council, following a scientific meeting in London 2019 with global hygiene, AMR and public health experts.

Published by: https://www.eurekalert.org/

References:

Curtis V, Cairncross S. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis. May 2003; 3 (5): 275-81

Azor-Martinez E, Yui-Hifume R. Effectiveness of a hand hygiene program at child care centers: a cluster randomized trial. Pediatrics. November 2018;142 (5). Available from:ncbi.nlm.nih.gov/pubmed/30297500 (Accessed 15 April 2020)

amr-review.org/

Interagency Coordination Group on Antimicrobial Resistance. No Time to Wait. Securing the Future from Drug-Resistant Infections. April 2019. Available from: https://www.who.int/antimicrobial-resistance/interagency-coordination-group/IACG_final_report_EN.pdf?ua=1. (Accessed April 15, 2020.)

Review on Antimicrobial Resistance: Tackling Drug-resistant Infections Globally. 2014. Available from: https://amr-review.org/Publications.html. Accessed July 3, 2019.


Hand hygiene a key defence in Europe’s fight against antibiotic resistance

Antimicrobial resistance (AMR), and resistance to antibiotics in particular, continues to grow in the WHO European Region and hundreds of thousands of patients die or are considerably affected each year by health care-associated infections (HAI) and diseases caused by germs that are resistant to antimicrobial medicines.

This year’s SAVE LIVES: Clean Your Hands campaign on 5 May uses the slogan “Fight antibiotic resistance – it’s in your hands” to highlight the fact that health-care workers and the public have a responsibility to prevent and control AMR and HAI, in turn helping to prevent related complications and deaths.

It is estimated that 7–10% of patients will acquire at least one HAI at any given time under treatment. A large percentage of these are preventable by improving hand hygiene practices and other infection prevention and control measures.

Taking action from many sides

HAI, including those resistant to antibiotics, are among the most common adverse events in health care delivery. Such infections can impact quality of life and lead to serious disease or even death. Action across all sectors of society is required to effectively prevent AMR. The following key recommendations will help prevent the spread of AMR and protect people in the Region from HAI:

• Health workers must clean their hands at the right times (see below).
• Chief executive officers and managers of health facilities need to support hand hygiene campaigning and infection prevention and control (IPC) programmes.
• IPC leaders should champion hand hygiene campaigns and comply with WHO’s “core components” for IPC.
• Policy-makers should stop the spread of AMR by demonstrating national support for and commitment to infection prevention programmes.

Cleaning hands at the right times

Protecting patients against HAI can be achieved by improving hand hygiene at five key moments, preferably by using an alcohol-based rub or by hand washing with soap and water if hands are visibly dirty. The “five moments” for hand hygiene comprise:

• before patient contact
• before preparing and administering injections
• after contact with body fluids
• after patient contact
• after touching patient surroundings.

Reinforcing the importance of hand hygiene through policy-making

Making infection prevention and hand hygiene a national policy priority by aligning and strengthening existing programmes will go far in combating AMR and protecting patients from resistant infections.

National authorities should implement or reinvigorate any or all of the following options according to the new WHO recommendations on core components for IPC programmes:

• establish a national IPC programme linked with other relevant national programmes and professional organizations;
• ensure that any national IPC programme supports the education and training of the health workforce as one of its core functions;
• establish an HAI surveillance programme and networks that include mechanisms for timely data feedback;
• consider hand hygiene as a key national performance indicator providing vital feedback data on health-care practices;
• have a system in place to ensure patient care activities are undertaken in a clean and/or hygienic, well-equipped environment to prevent and control HAI.

 

Building momentum in the fight against antibiotic resistance

This year’s campaign builds important momentum ahead of World Antibiotic Awareness Week (WAAW), which takes place on 13–19 November 2017. WAAW encourages all countries, health partners and the public to help raise awareness of AMR and to emphasize that we all have a part to play in preserving the effectiveness of antimicrobial medicines.

 

By WHO Europe
Publihed May 4th 2017
http://www.euro.who.int


Antibiotics cannot treat the flu or the common cold

The only common illness that affects children and requires an antibiotic every time is strep throat. Doctors won’t prescribe antibiotics if your child is sick with the flu or a cold because the treatment would be useless for those conditions.

Taking antibiotics when they’re not necessary can lead to antibiotic resistance in the body, one of the most urgent threats to public health, according to the Centers for Disease Control and Prevention (CDC).

“Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die as a direct result,” according to the CDC. “Many more die from complications from antibiotic-resistant infections.”

Antibiotics are used to treat serious infections such as pneumonia and life-threatening conditions such as sepsis. Sometimes people at high risk for developing infections also need antibiotics, such as patients who have end-stage kidney disease, patients undergoing surgery or those receiving chemotherapy treatment, according to the CDC.

But viruses that cause colds, the flu, bronchitis or runny noses cannot be treated with antibiotics.

When are antibiotics appropriate?

In short, antibiotics only work on bacteria and not on viruses.

“Using an antibiotic when you don’t need it is a problem because these drugs don’t just kill off harmful bacteria; they also take a toll on the beneficial bacteria inside your body that help to help keep you healthy,” according to Harvard Medical School.

But even some bacterial infections get better without antibiotics, according to the CDC. “Antibiotics aren’t needed for many sinus infections and some ear infections,” reports the CDC. “Antibiotics save lives, and when a patient needs antibiotics, the benefits usually outweigh the risk of side effects and antibiotic resistance. When antibiotics aren’t needed, they won’t help you, and the side effects could still cause harm.”

When children need antibiotics

For children with the common cold, the flu or an upset stomach, antibiotics are not the answer. In fact, they could cause more harm than good down the road when the body actually does need these life-saving drugs.

According to Memorial Regional Health, strep throat is really the only common illness that affects kids that requires an antibiotic every single time. For other illnesses, MRH doctors will likely tell you to keep your child home from school to rest and drink plenty of fluids.

Taking unnecessary antibiotics doesn’t just affect the person taking them — including raising the risks of side effects that could cause harm such as nausea, dizziness, rash, diarrhea and yeast infections — but they also could cause harm to the community at large. When people become resistant to these drugs, the risk of the spread of certain diseases increases, such as tuberculosis, gonorrhea, typhoid fever and Group B streptococcus, reports the World Health Organization.

So, how do you avoid getting bacterial infections in the first place? Practice good hygiene, make sure you and your children receive recommended vaccinations, reduce your risk of foodborne illness by cooking foods properly and washing your hands. And finally, don’t take antibiotics when you don’t need them.


November 13, 2019

By Lauren Glendenning/
Brought to you by Memorial Regional Health
Link to article