Washington State University study: Poor hygiene is significant risk for antimicrobial-resistant bacteria colonization

15 Aug

JAMA published “Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011” led by Katherine Fleming-Dutra, MD, estimated portions of antibiotic use that may be inappropriate in adults and children in the United States. – See more at: http://www.ajmc.com/newsroom/understanding-inappropriate-prescribing-of-antibiotics#sthash.lYnWSCqB.dpuf 

This study found:  “During 2010-2011, there were 506 annual antibiotic prescriptions per every 1000 population, but only 353 were likely appropriate.” Further, the study found:

Findings
The researchers used 2 annual surveys in 2010 and 2011 to collect data about patients’ demographic characteristics and symptoms, physicians’ diagnoses, and medications ordered, including antibiotics. They found that out of the 184,032 visits, 12.6% of encounters were associated with antibiotic prescriptions. Furthermore, 30% of outpatient prescriptions were in fact unnecessary and inappropriate.

See more at: http://www.ajmc.com/newsroom/understanding-inappropriate-prescribing-of-antibiotics#sthash.lYnWSCqB.dpuf

The practice of over-prescribing antibiotics has serious consequences.

Matthew C. Freeman. Meredith E. Stocks et al. wrote in the abstract of Systematic review: Hygiene and health: systematic review of handwashing practices worldwide and update of health effects:

Abstract

Objective

To estimate the global prevalence of handwashing with soap and derive a pooled estimate of the effect of hygiene on diarrhoeal diseases, based on a systematic search of the literature.

Methods

Studies with data on observed rates of handwashing with soap published between 1990 and August 2013 were identified from a systematic search of PubMed, Embase and ISI Web of Knowledge. A separate search was conducted for studies on the effect of hygiene on diarrhoeal disease that included randomised controlled trials, quasi‐randomised trials with control group, observational studies using matching techniques and observational studies with a control group where the intervention was well defined. The search used Cochrane Library, Global Health, BIOSIS, PubMed, and Embase databases supplemented with reference lists from previously published systematic reviews to identify studies published between 1970 and August 2013. Results were combined using multilevel modelling for handwashing prevalence and meta‐regression for risk estimates.

Results

From the 42 studies reporting handwashing prevalence we estimate that approximately 19% of the world population washes hands with soap after contact with excreta (i.e. use of a sanitation facility or contact with children’s excreta). Meta‐regression of risk estimates suggests that handwashing reduces the risk of diarrhoeal disease by 40% (risk ratio 0.60, 95% CI 0.53–0.68); however, when we included an adjustment for unblinded studies, the effect estimate was reduced to 23% (risk ratio 0.77, 95% CI 0.32–1.86).

Conclusions

Our results show that handwashing after contact with excreta is poorly practiced globally, despite the likely positive health benefits.                                                                                                  https://onlinelibrary.wiley.com/doi/full/10.1111/tmi.12339

Resources:

EFFECT OF POOR SANITATION PRACTICE ON PUBLIC HEALTH projectchampionz.com.ng/2018/07/13/effect-poor-sanitation-practice-public-health/

The Effects of Poor Personal Hygiene https://oureverydaylife.com/the-effects-of-poor-personal-hygiene-12233739.htm

Healthcare Hygiene Magazine wrote in Poor Hygiene is Significant Risk for Antimicrobial-Resistant Bacteria Colonization:

See,  https://drwilda.com/tag/antibiotics/

Healthcare Hygiene Magazine wrote in Poor Hygiene is Significant Risk for Antimicrobial-Resistant Bacteria Colonization:

Scientists have found clear indicators for how the interaction of poor hygiene and antibiotic use contribute to the colonization of antimicrobial-resistant (AMR) bacteria in humans, a problem that contributes to hundreds of thousands of deaths annually.

The findings by researchers at Washington State University’s Paul G. Allen School for Global Animal Health (Allen School) and Universidad del Vale de Guatemala (UVG) were published in the journal Scientific Reports.

“Coupled with antibiotic stewardship, these new findings support the critical need to improve sanitation and hygiene as an intervention to slow the spread of antimicrobial-resistant bacteria,” said co-author Dr. Mark Caudell, AMR coordinator, Food and Agriculture Organization of the United Nations. “Poor sanitation has a primary effect on antimicrobial resistance so investing in better infrastructure will help reduce the incidence of AMR infections.”

This collaborative effort lead by WSU and UVG in Guatemala, is part of a larger research program to understand how prevailing patterns of antibiotic use and regulations, access to human and animal healthcare services, and sanitation impact AMR patterns in high- and low-income countries.

Surveying households in rural and urban Guatemalan communities, they examined how the distribution of antimicrobial-resistant Escherichia coli was related to population density, access to antibiotic therapies, sanitation and hygiene indicators such as access to clean water and prevalence of open defecation, and food preparation and milk consumption practices.

Results confirmed that AMR was associated with increasing frequency of antibiotic use, poor household hygiene levels, milk consumption, and diarrhea episodes…..                              https://www.healthcarehygienemagazine.com/poor-hygiene-is-significant-risk-for-antimicrobial-resistant-bacteria-colonization/

Citation:

Brooke M. Ramay et al, Antibiotic use and hygiene interact to influence the distribution of antimicrobial-resistant bacteria in low-income communities in Guatemala, Scientific Reports (2020). DOI: 10.1038/s41598-020-70741-4

Here is the press release from WSU:

Poor hygiene is significant risk for antimicrobial-resistant bacteria colonization

August 14, 2020PULLMAN, Wash. – Scientists have found clear indicators for how the interaction of poor hygiene and antibiotic use contribute to the colonization of antimicrobial-resistant (AMR) bacteria in humans, a problem that contributes to hundreds of thousands of deaths annually.

The findings by researchers at Washington State University’s Paul G. Allen School for Global Animal Health (Allen School) and Universidad del Vale de Guatemala (UVG) were published Thursday in the journal Scientific Reports.

“Coupled with antibiotic stewardship, these new findings support the critical need to improve sanitation and hygiene as an intervention to slow the spread of antimicrobial-resistant bacteria,” said co-author Dr. Mark Caudell, AMR coordinator, Food and Agriculture Organization of the United Nations. “Poor sanitation has a primary effect on antimicrobial resistance so investing in better infrastructure will help reduce the incidence of AMR infections.”

This  collaborative effort lead by WSU and UVG in Guatemala,  is part of a larger research program to understand how prevailing patterns of antibiotic use and regulations, access to human and animal healthcare services, and sanitation impact AMR patterns in high- and low-income countries.

Surveying households in rural and urban Guatemalan communities, they examined how the distribution of antimicrobial-resistant Escherichia coli was related to population density, access to antibiotic therapies, sanitation and hygiene indicators such as access to clean water and prevalence of open defecation, and food preparation and milk consumption practices. Results confirmed that AMR was associated with increasing frequency of antibiotic use, poor household hygiene levels, milk consumption, and diarrhea episodes.

“Improved antibiotic stewardship, including control of unregulated access to antibiotics is critical to reducing the prevalence of antimicrobial-resistant bacteria, but stewardship alone will not successfully impact the prevalence of resistance when hygiene is compromised,” stated Dr. Brooke Ramay, co-lead researcher and professor with Allen School and UVG.

These findings with additional research will be used to inform intervention practices that can be implemented in coordination with local public health authorities, including the Guatemalan Ministry of Health. 

Media contacts:

Guatemala: Brooke Ramay, UVG, +502 2507-1500, brooke.ramay@wsu.edu

US: Laura Lockard, WSU Paul G. Allen School for Global Animal Health, +1 206-861-6884, laura.lockard@wsu.edu

In many cases antibiotic use may not be appropriate.

FamilyDoctor.org offers the following advice:

How do I know when I need antibiotics?

The answer depends on what is causing your infection. The following are some basic guidelines:

  • Colds and flu. Viruses cause these illnesses. They can’t be cured with antibiotics.
  • Cough or bronchitis. Viruses almost always cause these. However, if you have a problem with your lungs or an illness that lasts a long time, bacteria may actually be the cause. Your doctor may decide to try using an antibiotic.
  • Sore throat. Most sore throats are caused by viruses and don’t need antibiotics. However, strep throat is caused by bacteria. Your doctor can determine if you have strep throat and can prescribe an antibiotic.
  • Ear infections. There are several types of ear infections. Antibiotics are used for some (but not all) ear infections.
  • Sinus infections. Antibiotics are often used to treat sinus infections. However, a runny nose and yellow or green mucus do not necessarily mean you need an antibiotic.  Read more about treating sinusitis.

What else do I need to know?

If your doctor does prescribe an antibiotic for you, make sure you take all of the medicine, even if you feel better after a few days. This reduces the chance that there will be any bacteria left in your body that could potentially become resistant to antibiotics.

Never take antibiotics without a prescription. If, for whatever reason, you have antibiotics leftover from a time when you were previously sick, do not take them unless your doctor tells you it’s okay. The leftover antibiotics may not work on whatever is making you sick. If they do work, there probably will not be enough leftover medicine to completely kill all the bacteria in your body. Not only will you not get better, but this increases the chance that the bacteria will become resistant to antibiotics.

You can prevent catching infections in the first place by practicing good hygiene. Wash your hands with soap and water, especially after using the restroom, coming into contact with feces (for example, from a pet or from changing a baby’s diaper) and before eating.                                                                              http://familydoctor.org/familydoctor/en/drugs-procedures-devices/prescription-medicines/antibiotics-when-they-can-and-cant-help.html

Always consult a physician before taking antibiotics.

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