Controlling antibiotic resistance in the community

Published on December 31, 2009 Reviewed on July 24, 2015   27 min

Other Talks in the Category: Pharmaceutical Sciences

0:00
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.
0:24
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.
1:25
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.
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Controlling antibiotic resistance in the community

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