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Bug off: Doctor Naomi Runnegar talks waging war on super-microbes

18 November 2020

Fighting killer bugs is a job we should all be adding to our resumes according to Infectious Diseases Physician and Clinical Microbiologist at Princess Alexandra Hospital, Dr Naomi Runnegar. The Co-chair of the newly established State-wide Infection Clinical Network says all Queenslanders have a responsibility to participate in the work of slowing down antimicrobial resistance (AMR) in the community so hospitals can continue to deliver complex care.

“AMR refers to cases involving bugs such as bacteria, viruses, fungi and parasites that no longer respond to medicines we would have used to kill them in the past. This makes the infections they cause in the body harder to treat,” Dr Runnegar said, explaining they can be deadly for vulnerable patients.

“Patients vulnerable to infection - immunocompromised patients, premature babies, people undergoing chemotherapy, organ transplant, and orthopaedic implant surgeries, for example – need functioning antibiotics for the best chance of successfully completing their care.”

She said bacteria tend to be good at evolving to become resistant to medicines because they can pick up DNA from other bacteria and the environment, and mutate to overcome any genetic disadvantage, which is why using medicines responsibly is the only way to preserve their effectiveness.

“To put it in perspective, bacteria can divide in as little as 20 seconds, so they have a much shorter reproductive cycle than do other living organisms. Because of this fact, we can never outrun AMR with new medicines.” 

Dr Runnegar said all consumers of medicines should take antibiotics only when necessary to assist with AMR management efforts.

“We are very lucky in Australia to be in a relatively safe position when it comes to AMR, and that is partly because at a broader level the prescription of antibiotics is fairly well regulated. My advice to consumers is if your GP tells you that you don’t need antibiotics, you should be comfortable taking that advice. The reality is, antibiotics don’t work against viruses. We should only be using them to treat bacterial infections.”

Dr Runnegar said in a hospital setting, infection prevention and control is key to managing the issue of AMR locally, and that proactive screening of patients who have come from overseas where AMR bugs are more common is part of the risk mitigation strategy at PA Hospital.

“Screening patients helps us prevent new introductions of superbugs like Candida auris, a fungus we thankfully haven’t yet encountered within the Metro South Health service that can cause bloodstream infections.

“Any high-risk patients who test positively for multi-resistant bugs like this are cared for in separate areas in their own rooms or under additional precautions to reduce the amount of spread in the hospital.”

Dr Runnegar said in the case of bugs like Vancomycin-resistant Enterococcus (VRE) that are particularly good at surviving in the environment, robust hygiene protocols come into play.

“Our cleaners are key to controlling these kinds of bugs and have specific products and methods to decontaminate surfaces that patients with VRE have been in contact with. Hand hygiene is also very important to prevent the spread of bugs such as Methicillin-resistant Staphylococcus aureus (MRSA) that live on the skin.”

She said antimicrobial stewardship also supports AMR management within the hospital.

“The problem is the more antibiotics people have or that are used in the hospital, the more likely it is that AMR bugs will emerge. But then there are also a lot of sick patients who need potent broad-spectrum antibiotics to survive,” she said.

“The Antibiotic Stewardship (AMS) Team develops prescribing guidelines and reviews patient prescriptions for restricted medicines to ensure we get the right balance between effective prescribing and over prescribing of these life-saving medicines.”

Dr Runnegar said widespread participation in the war against AMR will help to reduce the proliferation of killer bugs in the community. 

“AMR bugs are increasing in Australia but if we work together, we can slow down their spread,” she said.

“Two easy things we can all do to help out in this regard is taking antibiotics only when necessary and observing good hand hygiene.”

Last updated 18 November 2020
Last reviewed 18 November 2020

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