2. THE
ANTIBIOTIC
RESISTANCE
CRISIS

3. THE ANTIBIOTIC RESISTANCE CRISIS HISTORY OF BACTERIA
HISTORY OF ANTIBIOTICS
RESISTANCE
THE PROBLEM NOW
NEVADANS FOR ANTIBIOTIC AWARENESS

4. HISTORY OF BACTERIA BACTERIA HAVE BEEN AROUND LONGER
THAN ANY LIVING THING ON EARTH.
FOSSIL EVIDENCE DATES BACK 3.5 BILLION
YEARS.

5. HISTORY OF BACTERIA EARTH AS A DAY: 5:00 AM - BACTERIA APPEAR
10:00 PM DINOSAURS APPEAR
11:59 PM HUMANS APPEAR

6. HISTORY OF BACTERIA REPRODUCTION
BINARY FISSION CLONE OF ORIGINAL WITH SAME DNA
FAST PROCESS ONE BACTERIUM CAN PRODUCE ONE BILLION CLONES IN TEN HOURS

7. HISTORY OF BACTERIA REPRODUCTION
MUTATION A CHANGE, SO THAT THE “NEW” BACTERIA IS SLIGHTLY DIFFERENT THAN THE ORIGINAL

8. HISTORY OF BACTERIA REPRODUCTION
IF THE ENVIRONMENT IS RIGHT, THE “NEW” BACTERIA MAY SURVIVE BETTER AND REPRODUCE, PASSING ALONG THE MUTATION

9. HISTORY OF ANTIBIOTICS
1928 – DR. FLEMING DISCOVERS PENICILLIN FROM BREAD MOLD
1944 – U.S. MILITARY TAKES PENICILLIN TO THE BATTLEFIELD
1945 – BACTERIA WITH RESISTANCE TO PENICILLIN ISOLATED

10. HISTORY OF ANTIBIOTICS
RESISTANCE
1960s – METHICILLIN INTRODUCED
1991 – 29% OF STAPH AUREUS RESISTANT
2001 – 62% OF STAPH AUREUS RESISTANT

11. HISTORY OF ANTIBIOTICS
RESISTANCE
BACTERIA MUTATE TO PROTECT THEMSELVES FROM ANTIBIOTICS

12. HISTORY OF ANTIBIOTICS
RESISTANCE
THE MUTATED BACTERIA SURVIVE AFTER THE ANTIBIOTICS ARE GONE

13. HISTORY OF ANTIBIOTICS
RESISTANCE
EVENTUALLY THERE ARE MORE ANTIBIOTIC-RESISTANT BACTERIA THAN NON-RESISTIANT

14. HISTORY OF ANTIBIOTICS
RESISTANCE
THE MUTATED BACTERIA REPRODUCE, PASSING ALONG THE RESISTANCE TO THEIR OFFSPRING

15. HISTORY OF ANTIBIOTICS
RESISTANCE
BACTERIA CAN ALSO SWAP GENES, UNDER THE RIGHT CONDITIONS, SO DRUG-RESISTANT GERMS CAN SHARE THEIR RESISTANCE MECHANISMS

16. THE PROBLEM NOW

17. THE PROBLEM NOW

18. THE PROBLEM NOW
> 50% OF HOSPITAL ACQUIRED BLOODSTREAM INFECTIONS ARE CAUSED BY METHICILLIN-RESISTANT STAPH AUREUS (MRSA)
> 70% OF NURSING HOME STAPH INFECTIONS ARE CAUSED BY MRSA

19. THE PROBLEM NOW
“THERE ARE PATIENTS TODAY IN HOSPITALS FOR WHOM THERE ARE NO EFFECTIVE THERAPIES.”
Gary Doern
Director of Clinical Microbiology
University of Iowa

20. NEVADANS FOR ANTIBIOTIC AWARENESS WHAT WE HAVE DONE WHAT WE ARE DOING
WHO WE ARE
WHAT WE HAVE DONE
WHAT WE ARE DOING
RESULTS
HOW CAN YOU HELP

21. NEVADANS FOR ANTIBIOTIC AWARENESS WHO WE ARE
A STATEWIDE TASK FORCE THAT HAS BEEN IN EXISTENCE SINCE FEBRUARY 2001
3 SUBCOMMITTEES
PUBLIC AWARENESS
PROVIDER EDUCATION
INFECTION CONTROL AND SURVEILLANCE

22. NEVADANS FOR ANTIBIOTIC AWARENESS WHAT WE HAVE DONE PUBLIC AWARENESS
TV, RADIO SPOTS IN SPANISH AND ENGLISH AIRING TIMES PER MONTH
NEVADA LEGISLATURE PASSED A BILL SUPPORTING NAA
GOVERNOR GUINN ISSUED A PROCLAMATION SUPPORTING NAA

23. NEVADANS FOR ANTIBIOTIC AWARENESS WHAT WE HAVE DONE PUBLIC AWARENESS
EDUCATION PROGRAMS WERE COMPLETED FOR ALL CLARK AND WASHOE COUNTY SCHOOL NURSES AND THEIR AIDES
A 9TH AND 10TH GRADE SUPPLEMENTAL CURRICULUM BASED ON THE SURVIVOR SERIES IS BEING USED IN CLARK AND WASHOE COUNTIES

24. NEVADANS FOR ANTIBIOTIC AWARENESS WHAT WE HAVE DONE PUBLIC AWARENESS
> 10,000 BOOKMARKS HAVE BEEN DISTRIBUTED BY THE WASHOE COUNTY LIBRARY SYSTEM
MAJOR PHARMACY CHAINS HAVE DISTRIBUTED > 100,000 BOOKMARKS

25. NEVADANS FOR ANTIBIOTIC AWARENESS WHAT WE HAVE DONE PUBLIC AWARENESS
EMERGENCY ROOMS AND QUICK-CARE CENTERS ARE DISPLAYING OUR POSTERS AND BROCHURES (SPANISH & ENGLISH)
RECENT ANTIBIOTIC RESISTANCE INFORMATION HAS BEEN SENT TO ALL CLARK COUNTY CHILD CARE CENTERS

26. NEVADANS FOR ANTIBIOTIC AWARENESS WHAT WE HAVE DONE PROVIDER EDUCATION
PROVIDER PACKETS WERE SENT TO ALL PRIMARY CARE PHYSICIANS IN 2002 AND 2003
A CME PROGRAM WAS CONDUCTED FOR > 150 PHYSICIANS IN NORTHERN NEVADA
A HOSPITALIST EDUCATION PROGRAM HAS BEEN IMPLEMENTED IN CLARK COUNTY

27. NEVADANS FOR ANTIBIOTIC AWARENESS WHAT WE HAVE DONE PROVIDER EDUCATION
PRESENTATIONS TO UMC SECOND-YEAR RESIDENTS HAVE BEEN MADE
INDIVIDUAL PROVIDER OFFICE VISITS IN ELKO AND PAHRUMP HAVE BEEN COMPLETED
A PRESENTATION REGARDING NAA WAS MADE AT A CDC CONFERENCE

28. NEVADANS FOR ANTIBIOTIC AWARENESS WHAT WE ARE DOING
EXPANDING EFFORTS TO IMPROVE INFECTION CONTROL AND SURVEILLANCE WITH THE CDC 12-STEP PROGRAM
FINISHING DEVELOPMENT OF NAA WEB SITE
DEVELOPING AND IMPLEMENTING CHILD CARE PROFESSIONAL PROGRAM
INCREASING MEDICAL SCHOOL/RESIDENCY INVOLVEMENT

29. NEVADANS FOR ANTIBIOTIC AWARENESS WHAT WE ARE DOING
INCREASING PHARMACY SCHOOL INVOLVEMENT
EXPANDING EFFORTS TO IMPROVE INFECTION CONTROL IN LONG TERM CARE AND SKILLED NURSING FACILITIES
CONTINUING MEDIA CAMPAIGN AND ALL OTHER CURRENT EFFORTS TOWARD PUBLIC AND PROVIDER EDUCATION

30. NEVADANS FOR ANTIBIOTIC AWARENESS RESULTS
Number of Antibiotic Scripts Filled per Member per Month
HPN Consolidated (Commercial and Medicare)
2000 –2002

31. NEVADANS FOR ANTIBIOTIC AWARENESS HOW YOU CAN HELP
CONTINUE WORKING WITH THE INFECTION CONTROL/SURVEILLANCE COMMITTEE
INVITE US TO MAKE A PRESENTATION TO YOUR PHARMACY AND THERAPEUTIC COMMITTEE
WORK WITH HEALTHINSIGHT IN OUR SURGICAL INFECTION PREVENTION PROGRAM