Infection control corner: five trends in fighting infections

December 28, 2016
By Thom Wellington

The end of the year is an excellent time to reflect upon accomplishments and set goals for the coming year. Reviewing the concerning health care-associated infection (HAl) rates, continuing emergence of multidrug-resistant organisms (MDROs) and innovative approaches to medicine provides an optimistic look into the near future. Innovation can be exciting for health care staff when it produces beneficial outcomes for the facility, and more importantly, the patients.

HAIs continue to have devastating effects on families as well as hospitals and long-term care facilities. With reported death rates from HAls hovering near 75,000, there is growing evidence that HAl deaths are misreported. Although causes of HAIs don’t change rapidly over time, the ways health care facilities fight them can. Here are five trends and developments in infection control that look promising for fighting the deadly HAI epidemic:



• Phage therapy: fighting infections with viruses
As concerns grow about antibiotic resistance, phage therapy reemerges. Phage therapy is the practice of treating infections with viruses called phages that attack bacterial cells, but leave human cells untouched. Phages were discovered to be antibacterial agents and were commonly used in Europe and the U.S. during the 1920s and ‘30s for treating bacterial infections. With the emergence of antibiotics, the use of phage therapy mostly disappeared in America. However, some countries in Europe continue to use this method of fighting MRSA and other infections.

Today, scientists are genetically engineering bacteriophages with specific parameters that provide hope in fighting MDROs. One of the main benefits of phage therapy is that phages are fairly narrow in their spectrum of activity. With phage treatment, it is possible to kill bacterial pathogens while avoiding the harming of normal flora bacteria. Because of this narrow spectrum of activity, superinfections are less likely and phages may be employed prophylactically with little fear of adversely affecting patients.

• Implantable antimicrobials
Implanting medical devices, including pacemakers, orthopedic prostheses and more, with a special biofilm coated with antimicrobial, antifungal and anti-inflammatory properties is gaining traction among many medical researchers. In a recent study, cardiac electronic devices enveloped inside an antimicrobial skin reduced the risk of surgical site infections (SSIs) by an eye-opening 80 percent.

Implantable antimicrobials are quickly gaining research investment due to early success in trials. Researchers are working to incorporate the technology in products used for cranial reconstruction, a common procedural area linked with significant infection rates of 15 percent. Some researchers are aiming to develop implantable antimicrobials geared toward prevention, rather than stopping post-surgical infections, by developing an antimicrobial implant that dispenses antiretroviral medication on a consistent basis.

• Gastrointestinal tract bacteria
Patients with burns and other traumatic injuries experience drastic changes in the bacterial populations of their gastrointestinal tracts. Different bacterial species that appear in gut flora have been shown to cause an imbalance in the microbiome, driving the immune system, specifically, in an anti-inflammatory response. Some gut flora can also regulate the production of antibodies, which can have effects in the lungs and other organ tissues. Probiotics could be a viable way to restore a healthy balance and reduce the risk of sepsis and other serious complications related to infections.

Some research reflects that the makeup of the gut bacteria plays a role in the likelihood of a patient developing a urinary tract infection or a C. diff infection. Developing genetically engineered bacteria that patrol the gut to detect inflammation, or make determinations about imbalances in gut bacteria populations, could leave people less susceptible to infections.

• Ultra-violet (UV) lighting
With the use of proper UV lighting technology, research has shown bacteria responsible for various infections, including bacteria known to be resistant to antibiotics, can be killed on surfaces in hospital rooms in less than 10 minutes. The technology has been outfitted in many platforms, including self-operated light fixtures capable of disinfecting wide ranges of surfaces, and mobile robots that clean and disinfect rooms. Research on the use of HAI-fighting robots has discovered fewer staff-contracted infections and loss of work time, resulting in a return on investment for health care facilities.

• Antibiotic overuse and resistance
Combating drug-resistant bacteria and enhancing good antibiotic stewardship can lead to overuse patterns and antibiotic resistance. In recent studies, 10 percent of physicians reported writing antibiotic prescriptions for 95 percent of patients with acute respiratory infections. The most current U.S. statistics attribute 23,000 deaths and more than 2 million illnesses to antibiotic-resistant bacterial infections. In an effort to curb antibiotic-resistant infections, the Centers for Disease Control and Prevention published new guidelines for encouraging clinical measures to address the problem. However, these focus on improving communication about drug-resistant treatments between facilities.

About the author: Thom Wellington is the CEO and a stockholder in Infection Control University, a company that provides staff training programs and control processes for infectious microorganisms in hospitals, clinics, long-term care facilities and other health care-related institutions.