This is Doctor P Wilson Consultant Microbiologist at University College London Hospitals.
I'm going to talk about Controlling Antibiotic Resistance in the community.
I've around 20 years experience looking after
the Camden and Islington Primary Care Trusts
with regards to both antibiotics and infection control.
Bacterial resistance is a worldwide problem although mutation itself is quite rare.
Most of this increasing difficulty is due to an increased use of antibiotics.
The more we use, the more infection becomes resistant.
Suboptimal dosing usually due to
poor compliance in a part of the patient is also a real problem.
And a further contributor is the use of growth promoting antibiotics in animals.
For example, Ava Paulsen has been used for many years at least until
the last couple of years to make the weight of chickens greater.
Surveillance is useful because it can tell us
how much bacteria resistance there is in a local community.
And we can feedback to the clinicians
what their appropriate use of antibiotics in the community should be.
And thereby, giving some measure of control over bacterial resistance.
The targets for control are
Methicillin-resistant Staphylococcus aureus with which we're all familiar.
The extended spectrum beta-lactamase producers,
which are gram negative rods present in the gut
but a common cause of complicated Urinary Tract Infection.
Multidrug resistant tuberculosis, which is prevalent in a low level
in the community and is a problem both for the staff as well as the patients.
Vancomycin resistant enterococci, they are present in the gut floor of
the normal population but are a particular issue with treatment of leukemic patients.
Pneumococci are showing more and more resistance
to penicillin particularly those strains coming in from Spain.
And Neisseria gonorrhoeae increasing levels of
Ciprofloxacin resistance particularly when those strains are imported from the far East.
Finally, Acinetobacter Baumannii has been a major problem in hospitals
already and is starting to be seen in the community.