nurse using a hand sanitizing station

The discovery of a U.S. patient with a new Escherichia coli strain resistant to colistin, the so-called antibiotic of last resort, has sparked a call for hospitals to intensify hand hygiene and environmental services efforts to prevent the bacteria’s spread.

In April, a woman treated for a urinary tract infection at a Pennsylvania clinic was found to have a new strain of E. coli with the gene MCR-1. Federal health officials reported on May 26 that the 49-year-old woman was the first U.S. patient discovered to have been infected with the new E. Coli strain.

The discovery reinforces the importance of maintaining effective environmental cleaning and disinfection and hand-hygiene practices in hospitals and health care facilities, says John Lynch, M.D., MPH, medical director of infection control, Harborview Medical Center, Seattle.

“Hand hygiene is one part to preventing the spread of the strain and the other part is excellent environmental cleaning,” Lynch says. He and other infectious disease specialists note that with the new strain, there is concern as to whether the genes will spread to other drug-resistant organisms and create a new superbug.

“The problem is that these genes in other types of bacteria move around. They can go into other bacteria in the same person or another person,” he says.

Materials for patient room cleaning are highly effective and “kill off 99 percent of all viruses, fungi and bacteria,” Lynch says. The problem is that hospitals are complicated environments that make cleaning all surfaces difficult.

“There are lots of surfaces,” he says. “It’s nearly impossible for a human being to reach all those surfaces even with the best tools and the right chemicals.”

Both he and Maria Ascano, an analyst with Decision Resources Group, Burlington, Mass., a health care research and consulting company, advocate the use of technology such as UV disinfection units to supplement rigorous cleaning.

Ascano also stressed that hand hygiene cannot be overemphasized. “Hand hygiene is a simple and highly effective way of reducing the spread of drug-resistant bacteria from one patient to another,”
she says.