Like many others, I am keeping a close eye on the UK Government’s commissioned ‘Review on AMR’. The Review team have been tremendously productive over the last few years, already releasing detailed reports on:
- Vaccines and antimicrobial sparing approaches to therapy
- Reduing antimicrobial use in agriculture and the environment
- Assuring a safe, secure, and controlled supply chain for antimicrobials
- Developing and embracing rapid diagnostics
- Developing new antimicrobials
- Overview of intial steps
- The impact of AMR
The Review recently published a summary of their reports to date, which I found extremely useful and thought I’d share.
The next report to be released with be on infection prevention and control. I’ve felt for some time that all the good work that is going into using existing antimicrobials sparingly, developing new antimicrobials, alternative therapeutic approaches, and improving diagnostics is really only delaying the inevitable. In this game of cat and mouse, microbes will find a way to circumvent whatever approach we take to treating them once an infection has been established. So it seems to me that ‘prevention is better than cure’ and so I antipate eagerly the findings of the Review’s report on infection prevention and control!
Image: amr-review.org.
Reflections on Infection Prevention and Control 
Jon .. I am in agreement with your concern. It is my rudimentary understanding of microbiology that over time it is inevitable that microbes will eventually adapt to varying degrees to chemistry based efforts to eliminate them. I mention this because in a Post Antibiotic Era cleaning is going to be ever more critical as a front line of defense in terms of Public Health.
Given we have been cleaning with the same core chemistry for a couple of thousand years, albeit in increasing strengths, it is understandable that pathogen bacteria have mutated to the point of being increasingly resilient / resistant against many of the cleaning products and protocols that are currently used.
The expansion of the breadth of the detected presence / outbreaks of Super Bugs such as MRSA into areas such as schools, prisons, gyms and other public places suggests that these Super Bugs are developing a level of resistance to current cleaning chemistry and associated protocols that is not dissimilar to what is being experienced with Antibiotics.
When it comes to cleaning products, we are collectively witnessing an increase in the level of chemical sensitivity that seems to correlate with both increased usage and product concentrations / strength. This is therefore limiting the ability to further increase the concentrations of such products.
As such there is a dire need to re-examine both the products we clean with, and the associated protocols.
An alternative to current approaches the use of probiotic cleaners, which introduce a biological component to the cleaning process to address the biological issue of pathogen bacteria and the biofilms they ceate that shelter and protect them.
The introduction of the probiotic bacteria into the cleaning process delivers a competitive group of healthy, safe bacteria that out consumes the available food source and so the pathogens starve to death. This is a natural process that eliminates the risk of mutation; bacteria like any other living entity cannot mutate to survive starvation.
What is also different about this approach is that a protective layer of self regulating probiotics are left on the surface which inhibits the re-colonization of pathogens and the reformation of the pathogen biofilm.
Such an approach to cleaning is as applicable to commercial cleaning of facilities as it is to cleaning medical equipment (thinking here of the CRE issues with endoscopic equipment such as the outbreak at UCLA Medical Center which garnered so much media attention last year).
Whilst there is no “silver bullet” / single solution to these emerging challenges, the potential contribution to Public Health of probiotic cleaners in an environment where antibiotics are increasingly less reliable and the importance of cleaning becomes ever more critical to hygiene and public health / safety should be given serious consideration.
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We’ll its also because of the fact that people are unaware of how these organisms are mutating because of drug abuse. Any disease right now, people are blindly taking antibiotic that they have used earlier. Recent studies and experiments showed how we can treat TB without the use of drugs by reducing the cholesterol content in host. Such experiments and results proves that pathogenic microorganisms can be controlled not only by treating these bacteria but also by treating host and altering few conditions that is favorable for their growth.
Coming to Probiotics, they have played a major role in maintaining the immune response. Again the problem is with the various research projects that have lacked encouragement and the best results and strains ended up within four walls. Researchers should be given a chance to put their product into commercial use or at least common people should be aware of what has been done so that they take further decision.
Mutant strains are due to excessive usage of drugs but given a chance we also need to find better alternative to fight against them by boosting our immune response instead of antibiotics or this problem would be never ending.
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