Antimicrobial resistant bacteria

About antimicrobial resistance

Antibiotic medications are used to treat infections and diseases caused by bacteria. They have made a major contribution to improving human health and life expectancy. Many diseases that once killed people can now be treated effectively with antibiotics. However, some strains of bacteria have become resistant to antibiotics. This is called antimicrobial resistance, also known as antibiotic resistance.

Antimicrobial resistant bacteria are bacteria that are not controlled or killed by antibiotics. They are able to survive and even multiply in the presence of an antibiotic. Most infection-causing bacteria can become resistant to at least some antibiotics. Bacteria that are resistant to many antibiotics are known as multi-resistant organisms (MRO).

Some bacteria are also naturally resistant to certain antibiotics. For example, benzylpenicillin has very little effect on most bacteria found in the human digestive system (gut).

Antimicrobial resistance is a serious public health problem. The development of antibiotic resistance can be prevented by minimising unnecessary prescribing and overprescribing of antibiotics, the correct use of prescribed antibiotics, and good hygiene and infection control practices.

Bacteria resistant to antibiotics

Some bacteria have developed resistance to antibiotics that were once commonly used to treat them. For example, Staphylococcus aureus (‘golden staph’) and Neisseria gonorrhoeae (the cause of gonorrhoea) are now almost always resistant to benzyl penicillin. In the past, these infections were usually controlled by penicillin. Rates of antimicrobial resistance are increasing across the world.

Antimicrobial resistance is a major public health problem. The most serious concern is that some bacteria have become resistant to almost all of the readily available antibiotics. This can make infections and diseases more serious and challenging and costly to treat. These bacteria can also spread from person-to-person.

Important examples of antimicrobial resistance strains of bacteria are:

• methicillin-resistant Staphylococcus aureus (MRSA)
• vancomycin-resistant Enterococcus (VRE)
• multi-drug-resistant Mycobacterium tuberculosis (MDR-TB)
• carbapenemase-producing Enterobacterales (CPE).

Ways to prevent antimicrobial resistance

The most important ways to prevent antimicrobial resistance are to:

• Use antibiotics appropriately. It is important to reduce unnecessary and over-prescribing of antibiotics. For example, when antibiotics are prescribed for conditions that do not require them such as viral illness (antibiotics do not work against viruses).
• Complete the entire course of any prescribed antibiotic so that it can be fully effective and not breed resistance.
• Practise good hygiene such as handwashing and use appropriate infection control procedures.

Transmission of antimicrobial resistant bacteria in hospitals

The common ways in which bacteria can be passed from person to person include:

• contact with contaminated hands of hospital staff
• contact with contaminated surfaces such as door handles, over-bed tables and call bells
• contact with contaminated equipment, such as stethoscopes and blood pressure cuffs.

Infection prevention and control in hospitals

Standard precautions in hospitals are work practices that provide a basic level of infection prevention and control for the care of all people, regardless of their diagnosis or presumed infection status.

These precautions should be followed in all hospitals and healthcare facilities and include:

• performing hand hygiene before and after all patient contact
• the use of personal protective equipment such as gloves, gowns, masks or eye protection when contact with blood or body fluids is anticipated
• appropriate handling and disposal of sharps (for example, needles)
• waste management
• aseptic techniques, for example, when changing wound dressings or performing invasive procedures
• routine cleaning of the environment
• appropriate reprocessing of reusable medical equipment and instruments
• respiratory hygiene and cough etiquette
• appropriate handling of linen.
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Implementing standard precautions minimises the risk of transmission of infection from person to person, even in high-risk situations.

Additional precautions with antimicrobial resistant bacteria

Additional precautions (also known as transmission-based precautions) are used when caring for people who are known or suspected to be infected or colonised with highly infectious pathogens (micro-organisms that cause disease).

Micro-organisms may be classed as ‘high risk’ if:

• their transmission route (that is how they are spread) makes them more easily transferred to other people
• they are caused by antibiotic resistant bacteria.

Additional precautions are tailored to the particular pathogen and route of transmission. Additional precautions may include:

• use of a single room with ensuite facilities or a dedicated toilet
• dedicated care equipment for that person
• restricted movement of the person
• healthcare workers wearing certain personal protective equipment for all interactions with that person.

Transmission of antimicrobial resistant bacteria in the community

Antimicrobial resistant bacteria can also be passed from person to person within the community. This is becoming more common.

Ways to prevent transmission of organisms, including antibiotic resistant bacteria, are:

• Wash hands before and after food handling, after going to the toilet and changing nappies.
• Cover your nose and mouth when coughing and sneezing.
• Use tissues to blow or wipe your nose.
• Dispose of tissues properly into the rubbish. Wash your hands after disposing of your used tissues.
• Do not spit.
• Stay at home if you are unwell.
• Do not send children to child care, kindergarten or school if they are unwell.
• If you are prescribed antibiotics, take the entire course – do not stop because you are feeling better.
• If you continue to feel unwell, go back to the doctor.
• Avoid use of products that advertise they contain antibiotics, or are antibacterial or antimicrobial, unless advised to do so by your health professional.

Where to get help

• Your GP (doctor)
• Your Local Public Health Unit
• Pharmacist
• Community health centre