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HICprevent

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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Superbug basics: Remain calm and remind your doctor to wash his hands

January 12th, 2015

Frontline, one of the most respected sources for public affairs reporting, recently asked three infectious disease experts some common sense questions about the threat of "superbugs" resistant to many antibiotics. The physicians doing this off-the-cuff consult were Sean Elliott, MD, medical director of infection prevention at the University of Arizona Health Network; Brad Spellberg, MD, an infectious diseases specialist at Harbor-UCLA Medical Center in LA; and Wendy Stead, an infectious diseases specialist at Beth Israel Deaconess Medical Center in Boston. Here are a few of the basic points.

Don’t Panic

Everyone may be at risk, but the chances of catching a drug-resistant bug outside of the hospital are small for most. “For the average healthy person walking down the street? Those organisms are not much of a threat,” Stead says.

“The first principle is to try to live a healthy lifestyle to reduce the need to be in the hospital” where you are more likely to encounter these bugs, Spellberg says. Keep your home and work space clean. Be aware of the food you eat: Wash fruits and vegetables carefully and cook other food properly to reduce your chance of coming into contact with harmful bacteria."

How do you know if you have a superbug?

“You don’t. And your doctor won’t either, at least at first,” Spellberg said. “The infections caused by antibiotic-resistant bacteria do not cause different symptoms than infections caused by antibiotic-susceptible infections.”

While it’s impossible to give broad advice about so many different kinds of bacteria — and if you’re concerned, you should call your doctor first — there are some signs that an illness might be more serious. “In general, fevers, if they’re accompanied by shaking chills, if they’re getting worse instead of better, that would suggest there’s a bacterial process,” Elliott said.

With community-acquired MRSA, many people first notice a skin infection or boil that becomes larger and more painful, Stead says.

But if you do suspect such an infection, don’t rush to the emergency room, where you might be exposed to other bugs or infect others. Call your primary-care doctor first for advice.

Wash Your Hands with Soap and Water. Really Wash Them.

Doctors say they cannot recommend this enough.

“Wash your hands regularly and religiously in the normal times that you would think you should wash them,” Stead says. “Give it a good amount of time” — about 15 seconds — “scrubbing hands thoroughly, not just in and out of the water.”

Turn off the faucet using a paper towel.

Alcohol-based hand-sanitizers are handy too, but remember that one bug, C. Diff, is resistant to that as well. But it does respond to soap and water. So Wash. Your. Hands.

Ask Your Doctors to Wash Their Hands

“It is every patient’s right to have every health-care provider entering the room have clean hands,” Elliott says. “We’re supposed to do it, we mandate 100% hand- hygiene compliance, but the reality is that doesn’t happen,” he says.

Some hospitals even make health-care providers wear buttons encouraging patients to ask them if they’ve washed their hands. Even if they’re buttonless, you should feel free to ask your providers about it.

“Really — we are not offended by that,” Stead says.

Ask Whether You Need that Antibiotic

Doctors sometimes feel pressured by patients or their families to prescribe an antibiotic, even if it’s not necessary. Don’t assume you need one — antibiotics don’t work on viral infections like colds or the flu. If your doctor does recommend one, ask whether you really need it.

“Using antibiotics does kill off non-resistant bacteria in your body and makes you likely to acquire antibiotic-resistant bacteria in their place,” Spellberg says. “If your doctor says that they think your infection is probably caused by bacteria and that you do need an antibiotic, ask, ‘Do I need a broadly active antibiotic, or can I take a narrower antibiotic?’ The broader the antibiotic, the more damage to your normal bacteria can be caused. We want physicians to try to prescribe antibiotics that are as narrow as possible for a given infection.”