MRSA is a strain of Staphylococcus aureus that lives harmlessly in the nose and skin of a person. However patients in hospitals have a weaker immune system and acquiring this infection into the body can be fatal. MRSA was discovered in 1961 and has dramatically increased as a hospital pathogen, it now accounts for 120 000 hospital infections each year. Recent data from the Health Protection Agency show that cases fell by 4.3% between 2005 and 2006 and believe it has now reached a plateau (Star, 2007). Despite this there is still the belief that infection rates remain high and not enough is being done for prevention. MRSA was originally treated by the antibiotic penicillin however the strain become resistant to it just 4 years after the drug was mass produced. This lead to the use of glycopeptide antibiotics, such as vancomycin. However in the late 1990s treatment started to fail because some strains acquired decreased susceptibility to vancomycin, they had intermediate levels of resistance (4-8ug/ml). In 2002 the first fully resistant (>16ug/ml) strain to vancomycin was reported.
The oxazolidinones antibiotics, such as linezolid became available in the 1990s. They were hailed as a new class of antibiotics used to treat MRSA, until in 2003 linezolid resistance in staphylococcus aureus was documented.
VRE is a bacterium from the species enterococcus and is resistant to all available microbials and antibiotics including Vancomycin. VRE can infect wounds, blood and the urinary tract. It is a fairly new infection as it was only discovered in 1985. However the amount of cases has risen considerably since then and it is now responsible for 10% of all hospital acquired infections. The first resistance to Enterococcus was that of penicillin in 1983, followed by VRE in 1985. In the late 1990s Linezolid-Resistant Enterococcus (LRE) was reported.
The main reason for antibiotic resistance in drugs is the overuse of antibiotics. Bacteria can pick up mobile resistant genes by mutation and then transfer them. Bacterial loops of DNA known as plasmids can move from bacteria to bacteria, they pick up and deposit bits of genetic material as they move. If the plasmid contains a bit of genetic material that codes for antibiotic resistance this can be spread to many other bacteria.
Future advancements in medicine may produce a new drug which could combat these infections. However this is unlikely as major pharmaceutical companies are more focused on the profitable drugs used to treat long term conditions. In the meantime simple measures like hand washing could prevent a further increase in these infections. Washing hands is an important part of infection control but sadly it is not always carried out or is done so incorrectly. Wearing a disposable apron will also reduce the risk of infection if changed between patients. Gloves also play a key role and act as a barrier, preventing the spread of pathogens (Kelvens et al, 2007). Clostridium difficile produces spores that many hospital disinfectants fail to kill, however the use of detergents has been proven to destroy the bacterium. Therefore this could be implemented as a preventative measure. Recent control measures are only having a limited effect therefore more needs to be done like implementing a stricter method of the control of antibiotic use in hospitals and improve surveillance on antibiotic resistant infections (Struelens, 1998).
In conclusion it seems there has been an increase in hospital acquired infections and will continue to be until stronger preventatives are put in place. One of the main reasons for this increase is bacteria have become unaffected by antibiotics. There is a vicious cycle happening, the more infections there are means the more antibiotic overuse which in turn leads to them becoming more resistant. Antibiotics kill the defenseless bacteria but leaves behinds those that are impervious to it, creating a more resistant strain that will multiply into the predominant microorganism. Also the poor hygiene and practice of staff and visitors greatly assist the rise of these infections. Sufficient guidelines have not yet been developed to prevent hospital acquired infections and the standards that are already in place are vague. From the research gathered a conclusion can be reached that there is a continuous increase in the rise of superbugs and not much of a fall. Superbugs may hit a plateau but they will never be completely eradicated. Unless there is a change in the fundamental properties of bacteria they will continue to evolve and resist further microbial techniques.
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