Prevention, anyone?

Thanks to Eli’s recommendation, I watched the Frontline documentary on antimicrobial resistance last night. The culprits (MRSA, pan-resistant Stenotrophomonas, NDM- and KPC-producers) are fearsome, and the stories are riveting. The most haunting line is exactly ten minutes in, when Will Lyman (the somber voice of Frontline) intones that “Addy and her mother had entered the post-antibiotic era”. The statement is both shocking and true, and one we’ve covered before. Overall, this is perhaps the best lay media treatment of this issue that I’ve seen, and features many of our eloquent friends and colleagues. In particular, pay attention to Dr. John Quinn, an expert in gram negative resistance who died earlier this month after a battle with cancer. He will be sorely missed. You can watch the documentary in full here. 

One minor criticism: too much emphasis on drug development and new technology (e.g. whole genome sequencing, “robot” cleaning), not enough discussion of the hard work of basic infection prevention (hand hygiene, contact precautions, environmental cleaning). I know from discussion with those involved that these topics were discussed during interviews, but probably not deemed compelling enough to survive the editing process. New drugs buy some time and can be life-saving, but only until bacteria catch up…..and genome sequencing didn’t halt the NIH outbreak, strict enforcement of basic prevention measures did. I hear a lot of general nihilism about hand hygiene (adherence rates will never exceed 60%, high rates can never be sustained, etc., etc.). The truth is that we have much more work to do to better understand and solve the hand hygiene problem. 

Frontline plans a second show in the spring of 2014 that covers the role of antimicrobial use in driving resistance, which I look forward to seeing. Might I suggest they begin planning a third installment, dedicated exclusively to the problem of hand hygiene in healthcare settings?

Photo of Ignaz Semmelweis from Wikipedia Commons