CM/Spotlight: Infection Control Images courtesy of bluebearry/iStock/ThinkStock Frankensteinian Pathogens And Disinfecting Resistance As bacteria becomes resistant to disinfectants, it can also become resistant to the antibiotics typically used to treat people infected by the pathogen. By: Robert Kravitz O Robert Kravitz is a fre-quent writer for the profes-sional cleaning and build-ing industries. for more info Visit www.cmmonline.com and type in search keyword: Infection control . For more information on related products, visit www.cmmonline.com , select BUYERS’ GUIDE from the main navigation bar, and enter keyword: Education . On January 6, 2014, the U.S. Centers for Disease Control and Prevention (CDC) discovered 44 cases of a strain of bacteria called carbapenem-resistant enterobacteriaceae , or CRE, in northeast Illinois. Thirty-eight confirmed cases involved patients treated at a Park Ridge, Illinois, hospital who had un-dergone an endoscopic procedure of the pancreas or bile ducts in 2013. This bacterium was first reported in 2009; since then, there have only been 96 outbreaks reported in the entire country, making this high number of new cases quite significant. “It’s the largest outbreak that we’ve seen in the U.S. of this bacteria ever,” said Alex Kallen, a doctor of infectious diseases who served as the supervisor of the CDC investigation. The infection that results from this bacterium is highly resistant to most antibiotics, and patients who contract the infection have, at most, a 50 per-cent chance of survival. To be clear, this bacterium is not transferred by touching a contaminated surface or other common sources of cross-contamination. Rather, it is contracted by coming into contact with a medical instrument or scope used to view the stomach and intestines for medical issues such as pancreatic cancer and gallstones. But what is of concern to the CDC, as well as medical facilities and cleaning professionals every-where, is that the hospital was using accepted and recommended methods to clean the scopes. Could this bacterium have become resistant to traditional methods of cleaning and disinfecting? Unsure of what is causing this serious issue, the hospital has “moved to gas sterilization for these particular scopes, which exceeds the manufactur-er’s recommended cleaning and disinfectant guide-lines,” said Kallen. outbreak has become resistant we do know that many types of bacteria are becoming resistant. This means that many hospital administrators and cleaning professionals now believe they need to use ever-more-powerful disinfectants in greater quantity to kill germs and bacteria. A study published in the January 2009 issue of the journal Microbiology described this phenomenon in more detail. The study was based on a test performed by re-searchers at the National University of Ireland, who slowly introduced higher levels of disinfectants to kill lab cultures of the bacteria Pseudomonas ae-runginosa . This pathogen is rarely harmful to healthy people but can cause serious illness and death in people with compromised immune systems. After gradually increasing the pathogen’s ex-posure to the disinfectant benzalkonium chloride, which is used in a variety of products, including hand sanitizers, some floor cleaners and spray dis-infectants, researchers found that they had what is termed a “Frankensteinian pathogen” on their hands that showed a 12-fold resistance to the disinfectant. To make matters worse, as the bacteria becomes resistant to disinfectants, it can also become resis-tant to the antibiotics typically used to treat people infected by the pathogen. This means that such diseases can eventually become immune to treatment — a very worrisome trend that has already been observed in medical fa-cilities around the world. According to Dr. Gerard Fleming, one of the key researchers behind the Irish study mentioned ear-lier, when this happens, “We’ve lost the first line of defense [disinfectants], as well as the second line of defense [antibiotics].” Losing The Battle Against Bacterium While we are not sure if the bacterium causing this What Cleaning Professionals Should Know “The message, for heaven’s sake, is to use disin-30 CM/Cleaning & Maintenance Management ® • February 2014
CMM – Archives February 2014: 30
