One of the key strategies for tackling AR, alongside antibiotic stewardship and developing new antimicrobials, is greater emphasis on improving infection prevention and control practices to prevent spread of resistant strains. Strategy documents, however, show the emphasis is almost exclusively on preventing AR spread in healthcare settings. There is little mention of extending this to home and everydaylife – why not?
This situation is reflected in the 2 most recent (Sept 2014) strategy documents from the US and UK (see below)
Promoting hygiene at community level addresses the AR problem in 2 ways. Firstly it can reduce the incidence of infection and the numbers of patients seeking antibiotics from the doctor. Secondly it can reduce the silent spread of resistant strains within the healthy population. If it is correct that many or most healthcare associated infections are infections which source from the patients own body flora, then, as the carriage of resistant strains in the healthy community increases, so does the incidence of resistant healthcare infections. Simple measures, like ensuring that underclothing, socks, towels and bedlinen are laundered in a manner which ensures that they are made not just clean but hygienically clean can ensure that resistant skin and bowel strains are not spread amongst household members. Unlike handwashing, you don’t have to persuade people to launder their clothes!
Why is this community aspect being ignored?
An IFH review of the data on prevalence and spread of antibiotic resistant strains in the commuity can be found HERE .