1、THE ANTIBIOTIC RESISTANCE CRISISTHE ANTIBIOTIC RESISTANCE CRISIS HISTORY OF BACTERIA HISTORY OF ANTIBIOTICS RESISTANCE THE PROBLEM NOW NEVADANS FOR ANTIBIOTIC AWARENESSHISTORY OF BACTERIAREPRODUCTIONBINARY FISSION CLONE OF ORIGINAL WITH SAME DNAFAST PROCESS ONE BACTERIUM CAN PRODUCE ONE BILLION CLON
2、ES IN TEN HOURSHISTORY OF BACTERIAREPRODUCTIONMUTATION A CHANGE,SO THAT THE“NEW”BACTERIA IS SLIGHTLY DIFFERENT THAN THE ORIGINALHISTORY OF BACTERIAREPRODUCTIONIF THE ENVIRONMENT IS RIGHT,THE“NEW”BACTERIA MAY SURVIVE BETTER AND REPRODUCE,PASSING ALONG THE MUTATIONHISTORY OF ANTIBIOTICS1928 DR.FLEMING
3、 DISCOVERS PENICILLIN FROM BREAD MOLD1944 U.S.MILITARY TAKES PENICILLIN TO THE BATTLEFIELD1945 BACTERIA WITH RESISTANCE TO PENICILLIN ISOLATEDHISTORY OF ANTIBIOTICS1960s METHICILLIN INTRODUCED1991 29%OF STAPH AUREUS RESISTANT2001 62%OF STAPH AUREUS RESISTANTRESISTANCEHISTORY OF ANTIBIOTICSRESISTANCE
4、 BACTERIA MUTATE TO PROTECT THEMSELVES FROM ANTIBIOTICSHISTORY OF ANTIBIOTICSRESISTANCE THE MUTATED BACTERIA SURVIVE AFTER THE ANTIBIOTICS ARE GONEHISTORY OF ANTIBIOTICSRESISTANCE EVENTUALLY THERE ARE MORE ANTIBIOTIC-RESISTANT BACTERIA THAN NON-RESISTIANTHISTORY OF ANTIBIOTICSRESISTANCE THE MUTATED
5、BACTERIA REPRODUCE,PASSING ALONG THE RESISTANCE TO THEIR OFFSPRINGHISTORY OF ANTIBIOTICSRESISTANCE BACTERIA CAN ALSO SWAP GENES,UNDER THE RIGHT CONDITIONS,SO DRUG-RESISTANT GERMS CAN SHARE THEIR RESISTANCE MECHANISMSTHE PROBLEM NOWPSEUDOMAS AEROGINOSA13141618.516232628CEFTAZIDIME IMIPENEM%RESISTANCE
6、 1991 1999 2000 2001 1991 1999 2000 2001THE PROBLEM NOWSTREPTOCOCCUS PNEUMONIA32422229PENICILLIN CEFOTAXIME%RESISTANCE 2000 2001 2000 2001THE PROBLEM NOW 50%OF HOSPITAL ACQUIRED BLOODSTREAM INFECTIONS ARE CAUSED BY METHICILLIN-RESISTANT STAPH AUREUS(MRSA)70%OF NURSING HOME STAPH INFECTIONS ARE CAUSE
7、D BY MRSATHE PROBLEM NOW “THERE ARE PATIENTS TODAY IN HOSPITALS FOR WHOM THERE ARE NO EFFECTIVE THERAPIES.”Gary DoernDirector of Clinical MicrobiologyUniversity of IowaNEVADANS FOR ANTIBIOTIC AWARENESS WHO WE ARE WHAT WE HAVE DONE WHAT WE ARE DOING RESULTS HOW CAN YOU HELPNEVADANS FOR ANTIBIOTIC AWA
8、RENESSWHO WE AREA STATEWIDE TASK FORCE THAT HAS BEEN IN EXISTENCE SINCE FEBRUARY 20013 SUBCOMMITTEES PUBLIC AWARENESS PROVIDER EDUCATION INFECTION CONTROL AND SURVEILLANCENEVADANS FOR ANTIBIOTIC AWARENESSWHAT WE HAVE DONEPUBLIC AWARENESS TV,RADIO SPOTS IN SPANISH AND ENGLISH AIRING 400-500 TIMES PER
9、 MONTH NEVADA LEGISLATURE PASSED A BILL SUPPORTING NAA GOVERNOR GUINN ISSUED A PROCLAMATION SUPPORTING NAANEVADANS FOR ANTIBIOTIC AWARENESSWHAT WE HAVE DONEPUBLIC AWARENESS EDUCATION PROGRAMS WERE COMPLETED FOR ALL CLARK AND WASHOE COUNTY SCHOOL NURSES AND THEIR AIDES A 9TH AND 10TH GRADE SUPPLEMENT
10、AL CURRICULUM BASED ON THE SURVIVOR SERIES IS BEING USED IN CLARK AND WASHOE COUNTIESNEVADANS FOR ANTIBIOTIC AWARENESSWHAT WE HAVE DONEPUBLIC AWARENESS 10,000 BOOKMARKS HAVE BEEN DISTRIBUTED BY THE WASHOE COUNTY LIBRARY SYSTEM MAJOR PHARMACY CHAINS HAVE DISTRIBUTED 100,000 BOOKMARKSNEVADANS FOR ANTI
11、BIOTIC AWARENESSWHAT WE HAVE DONEPUBLIC AWARENESS EMERGENCY ROOMS AND QUICK-CARE CENTERS ARE DISPLAYING OUR POSTERS AND BROCHURES(SPANISH&ENGLISH)RECENT ANTIBIOTIC RESISTANCE INFORMATION HAS BEEN SENT TO ALL CLARK COUNTY CHILD CARE CENTERSNEVADANS FOR ANTIBIOTIC AWARENESSWHAT WE HAVE DONEPROVIDER ED
12、UCATION PROVIDER PACKETS WERE SENT TO ALL PRIMARY CARE PHYSICIANS IN 2002 AND 2003 A CME PROGRAM WAS CONDUCTED FOR 150 PHYSICIANS IN NORTHERN NEVADA A HOSPITALIST EDUCATION PROGRAM HAS BEEN IMPLEMENTED IN CLARK COUNTYNEVADANS FOR ANTIBIOTIC AWARENESSWHAT WE HAVE DONEPROVIDER EDUCATION PRESENTATIONS
13、TO UMC SECOND-YEAR RESIDENTS HAVE BEEN MADE INDIVIDUAL PROVIDER OFFICE VISITS IN ELKO AND PAHRUMP HAVE BEEN COMPLETED A PRESENTATION REGARDING NAA WAS MADE AT A CDC CONFERENCENEVADANS FOR ANTIBIOTIC AWARENESSWHAT WE ARE DOING EXPANDING EFFORTS TO IMPROVE INFECTION CONTROL AND SURVEILLANCE WITH THE C
14、DC 12-STEP PROGRAM FINISHING DEVELOPMENT OF NAA WEB SITE DEVELOPING AND IMPLEMENTING CHILD CARE PROFESSIONAL PROGRAM INCREASING MEDICAL SCHOOL/RESIDENCY INVOLVEMENT NEVADANS FOR ANTIBIOTIC AWARENESSWHAT WE ARE DOING INCREASING PHARMACY SCHOOL INVOLVEMENT EXPANDING EFFORTS TO IMPROVE INFECTION CONTRO
15、L IN LONG TERM CARE AND SKILLED NURSING FACILITIES CONTINUING MEDIA CAMPAIGN AND ALL OTHER CURRENT EFFORTS TOWARD PUBLIC AND PROVIDER EDUCATIONNEVADANS FOR ANTIBIOTIC AWARENESSRESULTS0.0810.0820.0800.0600.0630.0580.0560.0530.0510.0710.0660.0640.0000.0100.0200.0300.0400.0500.0600.0700.0800.090Quarter
16、 1Quarter 2Quarter 3Quarter 4200020012002Number of Antibiotic Scripts Filled per Member per MonthHPN Consolidated(Commercial and Medicare)2000 2002NEVADANS FOR ANTIBIOTIC AWARENESS CONTINUE WORKING WITH THE INFECTION CONTROL/SURVEILLANCE COMMITTEE INVITE US TO MAKE A PRESENTATION TO YOUR PHARMACY AND THERAPEUTIC COMMITTEE WORK WITH HEALTHINSIGHT IN OUR SURGICAL INFECTION PREVENTION PROGRAMHOW YOU CAN HELP
