I hope you caught a glimpse of our interview with Betsy Hirsch on Tuesday on the impact of antibiotic resistant bacteria on national health. Bottom line: resistance is no good. Infectious microbes that evolve to essentially spit out the drugs we try to kill them with are powerful bugs, even if they are microscopic. In fact, according to a new report put out last month by the CDC, they are responsible for more than 20 thousand deaths each year.
Hirsch is an assistant professor in the Department of Pharmacy Practice where she is researching how combinations of drugs might do a better job of killing these bacteria than a single drug alone. The approach brings to mind a comic book scenario in which Batman and Superman join forces. Kryptonite might get Superman eventually, but not before he’s had a go at the bad guys. And once he’s dead, sad though it may be, Batman can pick up the slack. Likewise, Superman is capable of some pretty powerful things that Batman, regular guy that he is, could never come close to achieving.
But while developing new antibiotics and combinations thereof are critical as we attempt to navigate a future ever more wrought by resistant bacteria, perhaps the most important super powers we have for protecting ourselves are foresight and behavior. Hirsch points out in the interview that over- and inappropriate use of antibiotics are perhaps the two main culprits that have gotten us where we are today in this horror story of antibiotic resistance. Going forward, our greatest defenses will be infection control and prevention, she says. And the first step in control and prevention is, undoubtedly, knowledge.
On Wednesday at IDWeek, the combined annual meeting of the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the HIV Medicine Association, and the Pediatric Infectious Diseases Society, Hirsch and her team presented findings on how our ubiquitous devices can serve as fomites for infection, in particular resistant bacteria.
In a collaborative project with assistant professor Steve Leonard and associate clinical professor Jason Lancaster, Hirsch and her team swabbed the sleek surfaces of 30 pharmacy practice faculty members’ iPads for three types of bacteria: methicillin-resistant Staphylococcus aureus (aka MRSA), vancomycin-resistant Enterococcus, and Pseudomonas aeruginosa. The team was expecting to see some differences in the level of bacterial colonization on iPads that regularly visit the clinic (about half of the group also have clinical appointments) than on those that stick around the university more often. No such luck, though.
It turns out both groups had significant levels of bacteria living on them, providing fertile ground for transferring infection from one person to another. For those iPads that do see the hospital, the results show yet another surface for clinicians to be wary of when interacting with patients, especially immunocompromised patients, like people with cancer or HIV, and even pregnant women.
A few months ago I asked Kim Lewis, another Northeastern faculty member whose research topic of choice happens to be hearty microbes like antibiotic resistant bacteria, what kinds of precautions we should take when protecting ourselves from the multitudes of bad bacteria among us (because, please don’t forget that there are plenty of good bugs out there that we rely on for our good health as well). He told me that our best bet is rubbing alcohol, rather than the antibacterial soaps you see on the market containing the antiseptic triclosan. The few bacteria that survive triclosan onslaught have something called a multidrug resistant pump embedded at various points around their cell membrane. If these are the only bugs left to survive, then when they reproduce, their babies will also have MDRs as the pumps are called for short. A slew of bacteria with MDRs amounts to a antibiotic-resistant infection.
So, if you want to keep your iPad clean, I guess the best bet is simply an alcohol wipe. On the other hand, Apple is apparently toying with the idea of developing devices with antibacterial surfaces built right in. This might work something like Tom Webster’s antibacterial paper towels, which are coated with selenium nanopoarticles, creating a rough surface upon which bacteria have a rather difficult time growing. If Apple ever does come out with such a design, it would be great to see how they’d hold up to Hirsch’s experimental protocol.