The People's Perspective on Medicine

Show 948: Superbugs, Stethoscopes and New Technologies to Prevent the Spread of Infection

Antibiotic-resistant superbugs may spread from patient to patient on stethoscopes and other medical equipment. What can we do to stop them?
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Superbugs, Stethoscopes and New Technologies to Prevent the Spread of Infection

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Do you take antibiotics for granted? Many of us do. After all, these drugs have been saving lives for decades, serving as magic bullets against deadly infections such as pneumonia, gangrene or blood poisoning since the middle of the 20th century.

Superbugs Sneer at Antibiotics:

Unfortunately, the bacteria that cause infections have been evolving and many have developed resistance to common antibiotics. Some have even become resistant to our strongest drugs. Are these superbugs about to reverse the achievements of modern medicine?

What Can We Do to Prevent the Spread of Superbugs on Stethoscopes?

A number of experts tell you about the threat and how it can be countered. We hear about the danger of multi-drug resistant infections in hospitals, and learn that stethoscopes become just as contaminated as doctors’ hands in the course of an examination. But while hands are usually washed, stethoscopes are rarely disinfected between patients. A simple technology can make that much easier, while a room-sterilizing robot (Tru-D) can help prevent the spread of infections from one patient to the next.

This Week’s Guests:

Vance Fowler, MD, is Professor of Medicine in the Department of Medicine and Professor of Molecular Genetics and Microbiology in the Division of Infectious Diseases at Duke University School of Medicine.

Didier Pittet, MD, MS, is Director of the Infection Control Programme at the University of Geneva Hospitals and Faculty of Medicine. He directs the World Health Organization Collaborating Centre on Patient Safety and is external programme lead of the WHO First Global Patient Safety Challenge: Clean Care Is Safer Care.

Tuan Dam is CEO and founder of Cleanint Technologies, a company that makes devices to disinfect pens, stethoscopes and remote control devices.

Mario Soares is Director of the Environmental Health and Safety Department and the Infection Prevention and Control Department at The Methodist Hospital System in Houston.

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site. CDs may be purchased at any time after broadcast for $9.99. To download the free mp3, select mp3 from the pulldown menu above “Add to Cart.”

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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A timely show since I was the victim of a serious infection from medical procedures. I may purchase a copy of this program for the hospital.

I was a little disappointed in the story on overuse/misuse of antibiotics in the medical field and the resultant development of super bugs that require multiple and prolonged administration of antibiotics.
The development of superbugs/antibiotic resistant bacteria is not just an issue for the medical community. Over 80% of the antibiotics used today are used in agriculture/raising of meat animals.
A majority of these antibiotics are used not to cure animal diseases, but to make the animals gain weight faster. They are also used to prevent illness in young animals that are confined in overcrowded and stressful environments that make them more susceptible to diseases. Better animal husbandry practices that reduce the stress and overcrowding would reduce the need for antibiotics.
Antibiotics excreted in the waste of these animals are finding their way into the water and our drinking water supplies. So we get our exposure through the water, through our food, and medical community.

The handwriting IS on the wall. The post-antibiotic era is quickly approaching. The question is: What are we going to do about it. The two most likely options are: 1) Concentrate on measures which strengthen the immune system, such as sun exposure which provides vitamin D and sulphated cholesterol, omega 3s, vitamin C, vitamin A, zinc, ect; and 2) Embrace Nature’s own antibacterials: bacteriophage.
Being good harbingers, The Poeple’s Pharmacy has already done an excellent show on bacteriophage. Here is the description for show 689 Bacteriophage vs Antibiotic Resistance:
“The problem of antibiotic resistance is increasing. Superbugs like MRSA (methicillin-resistant staph aureus) are becoming harder and harder to treat as they evolve resistance to the most powerful antibiotics used against them.
Back before the development of antibiotics, scientists were working on a different way to fight bacterial infections. They enlisted viruses that attack only those particular bacteria. Should we go back to this old bacteriophage technology for the future of fighting infection?
Guests: David Weber, MD, MPH, professor of medicine, pediatrics and epidemiology at the University of North Carolina at Chapel Hill Schools of Medicine and Public Health. He’s also associate chief of staff and medical director of infection control at UNC Health Care.
Elizabeth Kutter, PhD, Professor of Biophysics at the Evergreen State College in Olympia, Washington. She heads the Laboratory of Phage Biology there.”
Maintaining each show in its own silo keeps things simple. Unfortunately, there is just not enough time for all the questions one would like answered to be asked. In spite of that, I wish the question of bacteriophage could have been, at least momentarily, raised. As it stands, the appearance is given that there are no viable alternatives to antibiotics, which may tend to mislead those who are unaware that there are, indeed, alternatives. Sincerely, Russ

Every time I have a Dental procedure, I am required to take four 150 MG Caps, oral CLIDAMYCIN, because I had Knee Replacement Surgery. All Dentists I have seen, require this, even though my Knee Surgery was over 10 years ago. I really object to having to take this antibiotic!! If I do not take this drug, I can’t get my Dental needs taken care of. I am now 84 years old and take Warfarin, plus some other drugs.
Will I have to take this antibiotic forever, even for teeth cleaning? I truly object to this practice!

Thank you for today’s interesting program. Apart from the obvious, I am interested in learning more about the antibacterial pen (holder) that was mentioned during the program. Can you offer the brand name and where I can buy one?
Again thank you for your program and your continued efforts to offer us a more healthy world.
People’s Pharmacy response: The company is called Cleanint, and the device is called CleanPen.

Sugar and white flour don’t raise insulin levels excessively in normal people. Of course there are few normal people left in this country to study. (minor quibble with Terry’s comment on the white bread/obesity story)
The next piece of medical equipment to study is the computer keyboard in the exam/hospital room or the laptop carried through the rooms of all the sickest patients. One of my old bosses just sent compressed air to blow out the laptop – I would not want to be in that room when the bad bugs all went airborne. St. Luke’s Hospital in St. Louis has a computer in each room which has a cleanable plastic cover for the keyboard so fingertip microbes and exhaled bugs don’t get down inside where they can’t be cleaned.
With these keyboard devices, docs and nurses need to wash their hands before examining the patient, between the patient and the computer, between the computer and the patient and after cleaning their stethoscopes – so in seeing 40 patients, wash your hands 250 times a day but when the skin gets damaged you will need to take some time off to heal because broken skin can harbor worse bugs. Doctors spending half their days typing doesn’t make sense anyway – so time to retool.

Very disappointing with the general attitude of the medical community towards patients trying to stay better informed about the multi-drug resistant infections in hospitals and superbugs being generated by crop farming practices. These problems have been with us for a while now and are increasingly getting worse.Unfortunately we the common patients are usually looked down on when we question the procedures in a medical facility regarding cross contamination of possible infectious diseases.
Your article was right to the point at looking at dealing with cross contamination in hospitals and medical facilities. I mentioned superbugs being generated by farming practices and cattle and chicken yards as they too generate organisms from the use of antibiotics, hormones and steroids that mutate into superbugs. All these organisms must be dealt with at our medical facilities and the medical society is running out of options on what to use in this fight.
To fight a organism we must first and foremost stop spreading it. Human beings staff hospitals and we all know we don’t always do what we are suppose to. My girlfriend contracted MRSA in our local hospital. While she was being treated in a isolation room I watched the nurse come in and walk by the scrub changing station and go directly to my girlfriend and change the bandages in the infected area, with her stethoscope hanging over her shoulder. She then took off the examination gloves, threw them away and left the room to move on to her next patient. Her scrubs were never changed and she didn’t wash her hands when she entered the room.
In taking off her examination gloves the second glove was touched on the outside by her hand which was about to touch every door knob she is about to walk thru… We have a lot of work to do here folks! Do not under estimate the severity of this problem.

I liked the show. It was about protecting the vulnerable population from transfer of illness in a hospital environment where the worst bug meets the weakest host. As suggested by other comments there are other areas for discussion. It is up to each individual, first of all, to be vigilant as to her own stamina and resistance. Each of us is host to millions of bacteria and this fact makes it appear obvious that bacteria, and the continual dance bacteria do in and around us, are part of the life of a healthy individual. But when it is time for surgery or chemotherapy, the patient needs protection, hence the need to control the microorganisms in a hospital or in close quarters between the sick and the vulnerable. I loved hearing about the robot, and I’ve recently seen the ‘clean remote’ in motels. The companies doing those things should be commended. They are doing what current science tells us is the best we can do.

I don’t understand. On the one hand, we are reducing our use of antibacterial soaps so we can avoid killing off bacteria that would be competitors of superbugs. (We don’t want to make the world safe for “superbugs.”) Then on the other hand, we are wanting to kill bugs right and left on stethoscopes and wherever.
If we want to keep competitors of superbugs around, why would we want to make hospitals places where superbugs would flourish?

Calling Dr. Welby? The medical times they are a-changin’.
Today’s show had four doctors or medical professionals. Only one it seemed was the typical white doc with a middle-American speech pattern. Dr. Welby or Dr. Kiley. I wonder if there’s a show in this.
Example: you might go to a medical facility of any kind and encounter a female doc, or a black person, or an Asian, etc. These days, you might even be counseled by an Achondroplastic Dwarf. Dr. Welby ain’t nowheres to be found. So be it. Gotta learn to deal with it.
Patients will encounter new ethnicities, and as your show today demonstrated, different accents. Some may be put off (which is improper but part of the human condition). Some may lose confidence. Should there changes be ignored?
I think there may be a subject here for an exploration by Joe and Terry.
And then there’s an ongoing question in the interstices: Which is better–young doctor (stereotypically in tune with the newest technology and ideas) or old doctor (stereotypically seen it all / can deal with it all)?
Maybe we need to educate patients, not just doctors, nurses, PAs and NPs and pharmacists etc. — Just thinking out loud.

A disappointing show. At first it sounded like fear-mongering, making people afraid of doctors and things like stethoscopes. The “estimate” of 100,000 people dying each year from hospital acquired infections is lousy reporting. Mixing diseases with surface germs. Then you talked with the CEO of a company that makes disinfectants. Shilling? At any rate, please keep this usually valuable show from becoming a haven for hypochondriacs.

Years ago my niece did a junior high science project studying the presence of harmful bacteria on the arms of wheelchairs in inventory at the local hospital. The judges and the hospital administration were astounded. They had not figured that this would be a platform for the transfer of illness – the old “hiding in plain sight” trick. Protocols have changed all over since then. But disinfecting everything can’t be the end of the story, partly because it is impossible – an arm’s race. I’ll be interested to hear what else can be done to protect the vulnerable from the consequences of exposure to so-called super bugs.

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