Wednesday , December 8 2021

The hospital infections m & # 39; longer exclusive to hospitals


When Alexander Fleming discovered penicillin in 1928, which made it possible to cure many bacterial diseases and save millions of & # 39; lives, nobody had suspected that this reaction will be converted to a new challenge in the century 21.

The World Health Organization states that currently, the antimicrobial resistance is configured as a real problem on a planetary scale. It is a bacterium that also evolving and choice do these microorganisms acquire resistance to those drugs that were originally vulnerable.

So, just not enough to develop new medicines as bacteria, through the process of & # 39; selective pressure, always find a way to stop responding and become resistant to ordinary treatment, which can & # 39; lead to long-term illness b & # 39; & # 39 highest risk; death

The WHO (WHO) estimates that every year about 700,000 people die around the world because of this case and, if no action is taken, this figure will reach 10 million by the year 2050. "The change can not wait. era & # 39; antibiotics ended ", was one of the last communications & # 39; the world health body.

He also explained that the systematic misuse and abuse of & # 39; these drugs in medicine and food production in place & # 39; risk all the nations. There are few new antimicrobial & # 39; replacement phase of & # 39; research and development. Without harmonized and immediate measures worldwide, moving towards the era after antibiotic which common infections may become fatal.

This scientific community concerns grow day after day, whereas the rate of & # 39; resistance to molecules with & # 39; usual antibiotic action is very high, which has an impact on mortality and morbidity of patient, fundamentally & # 39; hospitals and can contract an "infection associated with health care" (formerly called nosocomial or hospital).

The change in name comes a new paradigm: because of the changes that have worked in care arrangements, we found patients assisted with & # 39; many procedures, not only in the hospital, but also in hospital & # 39; day , hospitals and geriatric hospital at home.

The experts who met at the VIII Congress of the Argentina Society of Bacteriology, Mycology and Parasitology Clinical (SADEBAC) explained that the focus of the problem is not only in the hospital and sanatorium but also includes health centers like hospitals & # 39; day, geriatric hospitals and home hospitalization.

This represents a new paradigm in the global level, where human health, & # 39; animals and & # 39; the environment are interrelated, involving the combination of & # 39; germs between the three.

"Those associated with healthcare infections (IACS) are closely related to the use of & # 39; he did not have prior medical equipment, highly advanced medicine, so more patients & # 39; compromised immune systems (transplanted, oncological, etc.) exposed many times for invasive procedures which inevitably entail the risk of obtaining infections associated with their use ", said Dr. Jaime Kovensky Pupko, bijokimist, a specialist in bacteriology clinical UBA and coordinator -Sottokumitat of & # 39; Argentina Antimicrobial Society & # 39; Bacteriology, Mycology and Parasitology Clinic (SADEBAC).

F & # 39; this area, one of the issues that concern mainly the scientific community is the low rate of & # 39; adherence to wash by hand & # 39; health personnel, which at & # 39; country does not exceed 30 percent.

"The biggest problem & # 39; hand washing is the transmission of bacteria b & # 39; horizontal way", said Dr. Adriana Sucari, bijokimist, vice president of Microbiology Association (AAM) and president -SADEBAC. "Doctors, nurses, kinesjoloń°isti and all health personnel to assist a patient who is a carrier & # 39; resistant bacterium can jxerrduh to the next patient if they cleaned their hands between them", he added.

One of the actions that tend to contain the advance of & # 39; multiresistant bacteria is to reduce the IACS. Experts agree that there is much work & # 39; can & # 39; done to reduce the rate of & # 39; associated with healthcare infections.

"Any medical institution shall design and implement a & # 39; surveillance including the search for carriers & # 39; multiresistant bacteria and the application & # 39; standard precautions and contact isolation program, to avoid T- horizontal transmission, that occur from patient to patient, or generally by staff of the care and use of & # 39; living items such as a stethoscope, thermometers, etc. the hand washing is part of standard precautions , others are using & # 39; gloves, mask, goggles and gowns. Kovensky.

The acceleration observed in recent decades on the emergence and spread of antimicrobial resistance is linked to abuse and / or misuse of antibiotics. "In 2016, antimicrobial resistance was the health issue addressed in Presidents Summit organized by the United Nations." For the first time, the heads & # 39; state undertook to adopt a coordinated and broad approach to address root causes of antimicrobial resistance (AMR) in human health, animal health and agriculture ", remarked Kovensky.

Argentina was one of the first to implement a national strategy to control & # 39; RAM. Thus, in 2015 created the National Commission for the Control of Antimicrobial Resistance (CoNaCRA), f & # 39; shared act between the Ministries of Health and Livestock, Agriculture and Fisheries. This commission is composed of representatives of both ministries and official organizations such as & # 39; expertise in the subject and scientific societies involved in RAM.

According to what has been done by experts meeting in CoNaCRA, the problem of antimicrobial resistance exceeds human health margins and represents a new paradigm, created in recent years around the world. This problem states that both human health as well & # 39; animal and environmental health are the same and the connection between the vectors between the three.

The term coined by the WHO is "Single Health": "tailored approach to design and implement programs, policies, laws and research in which multiple sectors communicate and collaborate to achieve better results for public health."

"This commission (CoNaCRA) trying different articulate policies and actions to carry with ADR, strategies to any antibiotic resistance are complex and involve limiting the use of antimicrobials in animal production ., especially as growth promoters and, on the other hand, is set program & # 39; surveillance & # 39; antimicrobial resistance in & # 39; animals that did not exist the & # 39; now ", said Kovensky .

"One of the points is working hard at CoNaCRA is the problem of antimicrobials in the environment and, b & # 39; in particular, in water", said Sucari. "F & # 39; terms & # 39; food, the use of & # 39; antibiotics in fish industry stands out because of the impact is due to the fact that it is the meat is the most consumed raw or raw, as in the case of & # 39; sushi or ceviche. "

The indiscriminate use of & # 39; antibiotics and the lack of & # 39; Cooking can & # 39; lead to increased consumption & # 39; and antibiotic-resistant bacteria.
With regard to cattle, sheep and pigs, Kovensky explained that the problem lies in farmed b & # 39; intensively, limited f & # 39; places are very busy. "F & # 39; country, this is the way to enhance poultry, mainly broiler chickens or laying hens and, f & # 39; a much lower percentage, feedlot kastra or release. "

These animals receive antibiotics as growth promoters, and get confrontational drug with bacteria of the microbiota of the gut food. Bacteria, to adapt to survive in the presence of & # 39; these substances, made resistant by genetic mechanisms that can be transmitted to other bacteria.

Then, when animals dispose of their droppings, to be filled by resistant bacteria, contaminating the environment jiddejjaw and hands of agricultural workers, and also meet the effluent water, contaminating the water of -tisqija and fish to develop them. Therefore, added the specialist, "the problem is not just antibiotics may be in animal meat, but includes the option & # 39; antibiotic-resistant bacteria in their intestines to deliver."

On the other hand, specialists agreed to affirm that it is necessary to work seriously in & # 39; compliance with the regulation existing in selling & # 39; antibiotics in human level. "Antibiotics should be prescribed by a doctor that the prescription must be presented at the pharmacy, there are studies showing that the lack of & # 39; compliance with & # 39; this rule reaches 80 percent in province & # 39; Buenos Aires ", stressed.

This sale without a prescription in most respond to self-medication, f & # 39; situations where the antibiotic is not necessary because it is viral, and f & # 39; other dosing times or the length of inadequate care, and produce selection & # 39; resistant bacteria in infectious focus or intestinal mikrobjota to live with us. "We all take care of the ecology of our own microbial flora if we let alone in advance of antimicrobial resistance", they concluded.

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