This talk is titled Controlling Antibiotic Resistance in the Hospital Environment.
My name is Dr. Ian Eltringham,
and I'm a Medical Microbiologist and Infection Control doctor,
working at a large teaching hospital in London.
In this talk, I will aim to describe
the problem of antibiotic resistance in a healthcare setting,
and explore ways of controlling it.
Brief references are provided to encourage students
to access some source data where appropriate.
Surveys of antibiotic resistance have shown
wide temporal and geographic variation in antibiotic-resistant organism rates.
For instance, MRSA was first described in the UK in 1961,
but the first clinical isolates in the United States were not seen until 1968.
Typically, rates vary between healthcare institutions,
clinical specialties, and even between individual wards within a given hospital.
The highest rates are usually seen in critical care facilities,
and among immunocompromised patients,
but much depends on the age of the population being studied.
For instance, point prevalence studies conducted by
the United States Pediatric Prevention Network in
2002 showed MRSA colonization in less than 4% of pediatric ICU patients,
whereas 10 to 24% carried ceftazidime
or aminoglycoside resistant gram-negative bacilli.
This contrasts sharply with a 2003 National Nosocomial Infections Surveillance data,
which shows 60% of Staph aureus isolate from adult ICU patients to be MRSA.
In the same study, the percentage of enterococcal isolates from ICUs that were
resistant to vancomycin was 28.5%.