Infectious Control in the Post Antibiotic Era

Abstract
There  are  enormous  challenges  facing  infection  control  in  the  21st  century.  Countries  across the  world  are  confronted  by  ageing  populations,  restricted  healthcare  resources,  demands  for modern  medicine  and  increasing  antimicrobial  resistance.  Problem  pathogens  in  the community  are  set  to  invade  hospitals,  and  those  created  in  hospitals  are  seeding  into  the community.  Continued  consumption  of  antimicrobial  agents  is  generating  and  consolidating resistance  to  nearly  all  classes  of  drugs.  New  resistance  mechanisms  arising  in  one  locality rapidly  spread  across  the  ‗global  village‘  due  to  migration,  conflict  and  international  travel. We  are  facing  unprecedented  threats  to  the  management  of  infection  both  in  healthcare  and communities  across  the  world.  This  work  summarises  the  mechanisms  by  which  bacterial resist  antibiotics  and  also  summarises  the  current  challenges  for  infection  control  and proposes  a  range  of  solutions  encompassing  novel  strategies  and  technologies  aimed  at protecting us against  untreatable  infection. 

Table of Contents

CERTIFICATION .................................................................................................................................... 2

DEDICATION ............................................................................................................................................ 3

ACKNOWLEDGMENTS ....................................................................................................................... 4

SUMMARY ............................................................................................................................................... 8

CHAPTER ONE ......................................................................................................................................... 9

1.0 INTRODUCTION ......................................................................................................................... 9

1.1 ANTIBIOTIC AND RESISTANCE ................................................................................................. 10

1.2. History of antibiotics .................................................................................................................. 10

1.3 Characteristics of Antibiotics .................................................................................................. 11

2.0 THE RISE OF ANTIBIOTIC RESISTANCE ......................................................................................... 12

2.1 How antibiotics resistance developed .................................................................................... 12

2.1.1 Mechanisms of antibiotic resistance ....................................................................................... 13

2.2 A GROWING CONCERN ............................................................................................................... 13

2.3 SUPERBUGS ............................................................................................................................. 14

2.3.1 MICROBIAL INFECTION AND HOW IT SPREAD ......................................................................... 14

2.4 IMPACT OF THE SPREAD OF INFECTION IN THE HOSPITAL ON PATIENT CARE ............................... 15

3. ANTIBIOTIC RESISTANCE AND STATISTICAL EVIDENCE BASE ........................................................ 16

3.1 CENTRE FOR DISEASE CONTROL ASSESSMENT OF ANTIBACTERIAL RESISTANCE THREAT ..... 17

4. CURRENT PROBLEMS WITH CONTROL METHODS ............................................................................ 18

4.1 Healthcare ............................................................................................................................... 18

4.2 Community .................................................................................................................................. 20

CHAPTER TWO ...................................................................................................................................... 22

5.0 METHOD OF CONTROLLING THE SPREAD OF INFECTION ........................................................... 22

5.1 Hygiene ....................................................................................................................................... 22

5.2 Antimicrobial stewardship ...................................................................................................... 23

5.3 Laboratories, surveillance and screening.................................................................................... 23

5.4 Education ................................................................................................................................ 24

5.5 Research ...................................................................................................................................... 24

5.6 Managerial and political engagement ........................................................................................ 25

6. FIGHTING BACK AGAINST ANTIBIOTIC RESISTANCE...........

6.1 PREVENTING THE SPREAD OF RESISTANCE ..................................................................................... 25

CHAPTER THREE .................................................................................................................................... 27

7.0 RECOMMENDATION ................................................................................................................... 27

7.1 Healthcare ............................................................................................................................... 27

8. FUTURE DIRECTIONS FOR RESEARCH AND PRACTICE ....................................................................... 29

9. CONCLUSION ..................................................................................................................................... 31

10. REFERENCES .................................................................................................................................... 32