Infections caused by multidrug-resistant bacteria (MRB) and emerging highly resistant bacteria (eHRB) represent a major risk that can lead to therapeutic stalemate. Preventing healthcare-associated infections (HAIs) caused by these bacteria in healthcare facilities is therefore a major priority. Discover how using the process developed by Oxy’Pharm combining Sanivap and Nocotech can help healthcare facilities prevent the build-up and spread of MRB and eHRB infections.
MRB and eHRB Pose a Risk of Therapeutic Stalemate
Infections caused by multidrug-resistant bacteria (MRB) and emerging highly resistant bacteria (eHRB) are growing at an alarming rate: +35% in 2023 within the AP-HP hospital system. In France, 12,500 people die each year from antibiotic-resistant infections.
“Hospitals have seen massive antibiotic use over many years. Bacteria have developed strategies to evade and defend themselves against these antibiotics,” says Mathieu Agnet, Scientific Director at Oxy’Pharm.
This situation is particularly worrying as infected patients become increasingly difficult to treat as a result, especially as certain bacterial strains are developing resistance to increasing numbers of antibiotics. In some cases, this can even lead to therapeutic stalemate, leaving the patient with no other effective treatment options.
MRB and eHRB: A Major Issue in Burn Units
THE MOST FEARED MULTIDRUG-RESISTANT AND HIGHLY RESISTANT BACTERIA IN BURN CARE UNITS
Emerging Highly Resistant Bacteria (eHRB) are commensal bacteria of the digestive tract and are resistant to many antibiotics. Within this category, Vancomycin-resistant Enterococci (VRE) and Carbapenemase-producing Enterobacteriaceae (CPE) are the most feared bacteria in burn care units.
Multidrug-Resistant Bacteria (MRB) are bacteria that have multiple resistance mechanisms against several families of antibiotics. Methicillin-resistant Staphylococcus aureus (MRSA) and Imipenem-resistant Acinetobacter baumannii (ABRI) pose significant problems, particularly in burn units. ABRI, a particularly dangerous bacterium for immunocompromised individuals, is frequently found in burn units.
BURN PATIENTS ARE PARTICULARLY VULNERABLE
Burn patients are at increased risk of colonization and infection by MRB and eHRB for two reasons. Firstly, burn patients’ skin no longer acts as a protective barrier, facilitating bacterial entry into the body. Secondly, these patients are immunocompromised; their weakened immune system therefore provides a favorable environment for the rapid development of these bacteria
MODES OF TRANSMISSION AND SPREAD OF PROBLEMATIC PATHOGENS
eHRB often live in sink and shower drains. Meanwhile, ABRI thrives on inert surfaces. Since the bacterial reservoir is usually human, ABRI is brought in either by the patient themselves or by the healthcare team. Transmission occurs directly from patient to caregiver or caregiver to patient, and indirectly through contaminated hands, equipment, furniture, and medical devices. The twofold problem posed by ABRI is its ability to survive on inert surfaces and its extreme resistance to many types of antibiotics. “It is therefore very difficult to eradicate, especially as it is difficult to identify the infectious source maintaining the infection on the ward or in the patient’s room,” says Mathieu Agnet.
Measures to Control the Spread of MRB and eHRB
Preventing bacterial infections relies on respecting hospital hygiene rules. There are three levels of precautions:
- Standard precautions, including hand hygiene, apply at all times for all patients and in all rooms.
- Additional precautions are implemented in the case of MRB and aim to significantly enhance hand hygiene and environmental cleaning.
- Specific precautions for eHRB involve isolating the patient and their room to prevent the spread of eHRB. These cases constitute a third level of precautions. Routine cleaning is not entirely effective as it does not always eliminate the ABRI source.
Routine cleaning is not entirely effective as it does not always eliminate the ABRI source.Other disinfection methods must therefore be implemented.
Firstly, it is beneficial to use airborne disinfection, a method that ensures contact with all surfaces in a room (including the patient’s room and operating rooms).
In fact, the SF2H (the French Society for Healthcare Hygiene) has issued recommendations regarding the management of eHRB epidemics. According to these recommendations, when an eHRB epidemic is no longer under control, airborne disinfection is a particularly effective solution for eradicating environmental contamination.
Secondly, steam is highly effective at eliminating all bacteria, including MRB and eHRB. “The disinfectant properties of steam, on a broad and homogeneous spectrum, prevent the contamination and the dissemination of MRB in the environment,” says Mathieu Agnet.
Oxy’Pharm’s Comprehensive Solution: The Sanivap and Nocotech Combo
Sources of contamination are numerous and environmental contamination is massive, as indicated by a study led by Jean Winoc Decousser entitled “Defining MRB/eHRB: Nothing Works!” and presented to the SF2H. The only solution is to work upstream to prevent patient contamination in the first place.
Oxy’Pharm has developed a proven and effective hygiene solution based on the Sanivap and Nocotech product range:
- Sanivap is a medical device for bio-cleaning and surface disinfection using steam.
- Nocotech is an airborne surface bio-disinfection solution that draws on the combined action of a treatment device and a disinfectant product.
“The combination of steam and airborne disinfection of surfaces is particularly effective and quickly tackles the issue in any epidemic situation involving MRB or eHRB, particularly in burn units,” says Mathieu Agnet. “What’s more, this combined initiative is an ideal tool in the fight against resistant bacteria: steam is used in standard precautions, while the combined steam and airborne surface disinfection solution is used as part of additional and specific eHRB precautions.”
In dealing with this type of issue, it is essential to use strategies tailored to the problem and its scope; employing effective solutions and acting quickly and with a broad approach when contamination has already spread through a hospital ward. The steam and airborne disinfection combination created by Oxy’Pharm – the Sanivap and Nocotech combo – has repeatedly proven its potential in cases of ABRI in burn units, for example.
In conclusion, the Sanivap and Nocotech combined solution from Oxy’Pharm offers a comprehensive, effective solution for combating MRB and eHRB in burn units:
- Sanivap ensures efficient steam bio-cleaning, effectively eliminating resistant bacteria.
- Nocotech provides airborne disinfection, reaching even hard-to-access surfaces.
This dual approach meets the different levels of precautions recommended by SF2H. To find out more, please contact your regional sales representative.