\In-fact, mutations and genetic changes result in defence mechanisms against antimicrobials, where the majority of these changes are a direct result of selection pressure on bacteria to develop resistance.[25, 26] In addition, bacteria may obtain these genes through the process of conjugation where bacteria trade plasmids which contain resistant genes. Plasmids are an extra chromosome element of DNA which are found in the cytoplasm of a bacterium, as illustrated in Figure 2.[25] The process of conjugation is also referred to as horizontal gene transfer.[26]
Resistance is affected by a variety of factors which are primarily due to human contribution and the use of antimicrobials.[8, 18, 22, 27] One of these factors is known as poor compliance.
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Antimicrobials in Surgeries
Skin and mucosal surfaces are natural barriers against pathogens and infections, the majority of surgical procedures cause a break in the skin which may lead to a post-operative bacterial infection referred to as surgical site infections (SSIs).[29,
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The direct effect of resistance on the development of SSIs in specific operations with the use of prophylactic antimicrobials is illustrated in Figure 5.
4.2 Cost of Antimicrobial Resistant Related SSIs
The cost of SSIs is directly related to the type of infection and increase with the depth. Treatment can range from $400 for superficial incisional SSIs to more than $30,000 for organ or space SSIs per case.[39] In many cases, SSIs increase the length of stay by seven to ten days and increase mortality rates three-fold.[40]
Resistant infections result in increased antimicrobial usage, prolonged hospitalisation and increased costs.[41] Antimicrobial resistant influenced infections can necessitate additional investigation, complex and expensive treatments, longer hospital stays and lead to greater mortality.[39]
In contrast, a study conducted by Engemann et al. analysed data for 479 patients to determine the impact of methicillin-resistant staphylococcus aureus (MRSA) SSIs on patient
Methicillin-resistant Staphylococcus aureus is similar to regular hospital acquired MRSA in that it is resistant to cefazolin, and antibiotics similar to cefazolin. However, it differs from MRSA in that it doesn't display MRSA’s common risk factors, and is susceptible to other various antibiotics.
Bacterial resistance to antibiotics has presented many problems in our society, including an increased chance of fatality due to infections that could have otherwise been treated with success. Antibiotics are used to treat bacterial infections, but overexposure to these drugs give the bacteria more opportunities to mutate, forming resistant strains. Through natural selection, those few mutated bacteria are able to survive treatments of antibiotics and then pass on their genes to other bacterial cells through lateral gene transfer (Zhaxybayeva, 2011). Once resistance builds in one patient, it is possible for the strain to be transmitted to others through improper hygiene and failure to isolate patients in hospitals.
Antibiotic-resistant bacteria are created when mutations in the pathogen's genetic code occurs, changing the protein in the bacteria that the antibiotics normally go after into a shape that the antibiotic can not recognize. The average bacteria divides every twenty minutes, so if a contaminated spot has one single bacteria in the morning, there could be trillions on that same spot at the end of the day. That means that when counting all the possibilities of mutations, the amount of mutated offspring that the bacteria might have formed during those replications could be as high as in the millions. Fortunately though, this does not happen so frequently that it is normally an issue. The amount of non-mutated bacteria vastly outnumbers the mutated ones and many of the mutations occurring in the bacteria usually have either a harmful effect, or not effect at all on its function. That means that the pathogen is still relatively less harmful than it c...
In one of the studies healthcare workers were provided a questionnaire only 27.3% responded that no other healthcare worker had ever talked to them about MRSA (Raupach-Rosin, et. al, 2016). This study proves that healthcare workers need to be more educated on the topic of MRSA, how it spreads to the patients, and how the intervention of infection control and patient education will assist in reducing the amount of MRSA cases acquired. In one study, patients underwent a MRSA screening for nasal colonization. Out of the 29,371 patients, 3,262 had MRSA colonization. (Marzec & Bessesen, 2016). The study conducted allowed healthcare providers to see the effects of how easily MRSA is spread and how many patients could easily contract
Acquired antimicrobial resistance generally can be ascribed to one of five mechanisms. These are production of drug-inactivating enzymes, modification of an existing target, acquisition of a target by-pass system, reduced cell permeability and drug removal from the cell. (Sefton) Also a bacterium that was once prone to an antibiotic can gain resistance through alt...
The principle sites of nosocomial infections in patients, in order from most common to least common are: urinary tract, surgical wounds, respiratory tract, skin, blood, gastrointestinal tract, and central nervous system (Abedon). According to the CDC, the most common pathogens that cause nosocomial infections are Staphylococcus aureus, Pseudomonas aeurginosa, and Escherichia coli (EHA). Methicillin resistant Staphylococcal aureus (MRSA) is a strain of bacteria that is commonly...
Patient education is of paramount importance if MRSA is to be reduced to its lowest minimum. According to Noble 2009, patient’s education stands a critical component of managing MRSA therefore; nurses are expected to be prompt in educating patients on specific measures in limiting and reducing the spread of MRSA by person to person contact. (Noble, 2009) The specific measures includes definition of MRSA, mode of transmission, the damage it can do to the body, specific treatments available and the process of treatment. This is to help the patient take part in the care. Noble 2009 explains that during care giving nurses and all other healthcare provider involve in giving care to a patient should communicate to patient all the precaution that will prevent the transmission of MRSA, and also giving the scientific rationale for the use of any precaution that is been used in the cause of care giving. (Noble, 2009.)
MRSA is a major source of healthcare associated diseases, increased hospital mortality, and leading surgical site infection (Jennings, Bennett, Fisher, & Cook, 2014, p. 83). With the implementation of active surveillance screening and contact isolations program, an overall decrease in hospital associated MRSA infections has been observed (Jennings, Bennett, Fisher, & Cook, 2014, p. 83). The author of this paper will identify a theory that can be used to support the proposed intervention i.e., reduce the transmission of MRSA by active screening in patients at high-risk for MRSA on admission. This paper will then describe the selected theory, and rational for the selection, and how this theory will support the proposed solution and how to incorporate this theory in this project.
On the other hand, cells that have resistance from the start or acquire it later may survive. At the same time, when antibiotics attack disease-causing bacteria, they also attack benign bacteria. This process eliminates drug-susceptible bacteria and favors bacteria that are resistant. Two things happen, populations of non-resistant and harmless bacteria are diminished, and because of the reduction of competition from these harmless and/or susceptible bacteria, resistant forms of disease-causing bacteria proliferate. As the resistant forms of the bacteria proliferate, there is more opportunity for genetic or chromosomal mutation (spontaneous DNA mutation (1)) or transformation, that comes about either through a form of microbial sex (1) or through the transference of plasmids, small circles of DNA (1), which allow bacteria to interchange genes with ease.
The most effective way to combat pathogenic bacteria which invade the body is the use of antibiotics. Overexposure to antibiotics can easily lead to resistant strains of bacteria. Resistance is dangerous because bacteria can easily spread from person to person. Simple methods for preventing excessive bacterial spread are often overlooked. Not all preventative measures are even adequate. Doctors and patients often use antibiotics unnecessarily or incorrectly, leading to greater resistance. Antibiotics are used heavily in livestock and this excessive antibiotic use can create resistant bacteria and transfer them to humans. In order to reduce resistant bacteria,
These naturally occurring processes allow for lateral gene transfer between prokaryotes. For instances, prokaryotes are capable of taking up DNA from their environment in a process called transformation, transfer genes through transduction with phage particles, and many other gene transfer processes (Ku and Martin, 2016). The transfer of genes may increase the mutation rate in the genomes of these organisms with the insertion of new DNA segments into their own genome with deleterious, beneficial or silent effects with the potential to increase the rate of change in organisms and thus the rate of
These infections are often associated with improper catheterization techniques. Surgical site infections occur after surgery in the part of the body where the surgery took place. These infections may involve the top of the skin, the tissue under the skin, organs, or blood vessels. Surgical site infections sometimes take days or months after surgery to develop. The infections can be caused by improper hand washing, dressing change technique, or improper surgery procedure.
Although the importance of aseptic technique has been continually reiterated, I have realised its substantial role in the perioperative environment. Aseptic technique refers to the practice of creating and maintaining a sterile environment used for sterile procedures (Laws, 2010a). This is incredibly important as repetitive minor breaches of the sterile environment is one of the major factors increasing the risk of surgical site infection (Harrop et al., 2012).
Infection control is very important in the health care profession. Health care professionals, who do not practice proper infection control, allow themselves to become susceptible to a number of infections. Among the most dreaded of these infections are: hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). Another infection which has more recently increased in prevalence is methicillin-resistant Staphylococcus aureus (MRSA). These infections are all treated differently. Each infection has its own symptoms, classifications, and incubation periods. These infections are transmitted in very similar fashions, but they do not all target the same population.
Exposure to antimicrobials fundamentally alters microbial ecosystems of humans, animals and the environment, which may lead to the development of antimicrobial resistance.