Antibiotic Resistance: An Ongoing Nationwide Crisis

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Over the course of the last few decades, antibiotics have become a mixed blessing. Playing a critical role in both the treatment and prevention of infection, misuse of these life-saving medications has created a "monster" known as multi-drug resistance. Multi-drug resistant organisms (MDROs), also known as "superbugs", are a major problem for healthcare facilities, including ambulatory surgery centers, and the community.

Organisms adapt to the medications developed to kill them, rendering the drugs ineffective. Resistance to methicillin, a drug used to treat Staphylococcus aureus, developed in the late '60s led to the emergence of methicillin-resistant Staphylococcus aureus or MRSA. Thus began the journey of "bugs versus drugs".

In 2008, the U.S. Department of Health and Human Services (HHS) established a steering committee to involve the federal government in the prevention and reduction of healthcare-associated infections (HAIs). As a result, an HHS action plan to prevent HAIs was developed, providing a roadmap for HAI prevention in acute care hospitals, which later expanded to other healthcare facilities.

On September 19, the Obama administration unveiled a plan to battle antibiotic resistance, which, according to the government, is killing at least 23,000 Americans annually.

The plan includes a $20 million contest to develop a rapid point-of-care diagnostic test to identify superbugs. Thomas Frieden, MD, MPH, director of the Centers for Disease Control and Prevention, called this issue "an urgent health threat, and a threat to our economic stability as well." According to Frieden, "antibiotic-resistant infections costs $20 billion in direct healthcare costs, and far more in lost productivity."

Antimicrobial stewardship is a coordinated program that promotes the appropriate use of drugs developed for infections. It improves patient outcomes, reduces microbial resistance and decreases the spread of infections caused by multidrug-resistant organisms. Several programs to combat the misuse of these medications have been underway amongst hospitals, the CDC as well as other organizations.

Infection control expert Phenelle Segal, RN, CIC, is a stakeholder and member of the HHS steering committee. She has served on the committee as an advisor for the HAI elimination action plan and also coordinated an antimicrobial stewardship program for the Health Care Improvement Foundation in 2012-2013. Phenelle played a clinical role and was responsible for developing outcome and process measures for participating healthcare facilities in Southeastern and Central Pennsylvania.

Phenelle continues to be actively involved in antimicrobial stewardship as it remains a vital part of preventing infections.

Phenelle Segal, RN, CIC, FAPIC

Phenelle Segal, RN, CIC, FAPIC, is the founder and president of Infection Control Consulting Services LLC (ICCS). Phenelle has more than 30 years' experience providing customized comprehensive infection control and prevention services to healthcare facilities nationwide. Her services focus on assisting hospitals, ambulatory surgery centers, dental office and oral surgery practices, doctor's offices, nursing homes and other organizations with implementing and maintaining an infection control program that: complies with The Joint Commission, AAAHC, Centers for Medicaid and Medicare Services (CMS) and other regulatory agencies; respond to situations of noncompliance; and improve the processes for reducing risk.