Clean Hospitals Can Reduce Antibiotic Resistance, Save Lives

Antibiotics have the capability to save lives and make much of modern medicine possible. However, bacteria can evolve resistance that does not allow them to be killed by antibiotics and pose a threat to those medical gains, especially when they spread through patients in healthcare settings. In patients taking antibiotics, the medicines can inhibit any drug-sensitive bacteria in the body. If the patient carries bacteria resistant to antibiotics, it creates an environment where they can thrive. It is well known that good hygiene is central to infection control in both health care and the community. However, it is less clear how hygiene (or other transmission control measures) impacts the evolution of antibiotic resistance. Now, a new study indicates that antibiotic resistance can be due to poor hygiene practices followed by hospitals or other medical facilities.

For the study, researchers at the Georgia Institute of Technology (Atlanta, GA, USA) examined whether hygiene can weaken the impact of antibiotic pressure on resistance evolution. The team started by developing a mathematical model of resistance in order to predict how good or poor hygiene could affect how rapidly resistant bacteria multiplies as a result of antibiotic treatment. The team tested their model against antibiotic resistance data from the European Centre for Disease Prevention and Control.

The data collected at 691 long-term care facilities across 19 European countries in 2013 indicated that this was the case. In countries where staff at such facilities made better use of alcohol-based hand rubs, there was less enrichment of antibiotic-resistant bacteria. This suggests that hospitals and other facilities such as nursing homes that use training and procedures for their cleaning staff can prevent patients from acquiring resistant bacteria from others, thus preventing the explosive acceleration in the spread of drug-resistant diseases.

“Health care hygiene is a cornerstone of good clinical practice”, said Kristofer Wollein Waldetoft from the Center for Microbial Dynamics and Infection at Georgia Institute of Technology. “It’s also key to the management of antibiotic resistance by protecting patients from the acquisition of resistant strains. The importance of hygiene, especially hand hygiene, is well appreciated by health care professionals, but compliance has nonetheless been shown to be poor. There is thus opportunity to improve on this important, yet simple, aspect of resistance management.”