By Carol A. Cates, MSN, MBA, RN
Chief Nursing Officer
Odessa Regional Medical Center
A few days ago, one of the nurses in the Emergency Department at the hospital told me that she was calling in a prescription for Augmentin, an antibiotic used for common bacterial infections, for one of her patients. She told me she had to call 12 pharmacies before she was able to find a pharmacy that was not sold out. I had never heard of such issues with Augmentin. Then today, I saw an article that many of the large pharmacy chains are starting to limit purchases of children’s pain reducing/fever reducing medications because they are starting to have difficulty keeping up with demand for those meds. Again, this is unprecedented in my nursing career. Those two things tell me we are having a great deal of illness here in the Basin and in the U.S., especially in our kids.
The illnesses we are seeing are being caused by one or more of four different germs. The first three are the viruses those of us in health care have been talking about for several weeks: Flu, RSV, and COVID. But there is another germ out there that is also causing a great deal of illness. That illness is strep. Strep is a group of infections caused by the streptococcus bacteria. Most strep infections occur in the upper respiratory system, which is why it’s often called “strep throat.” Most of the time, strep is quickly and easily treated by common oral antibiotics like Augmentin. But, strep, like the viruses we have been so worried about, can cause very serious illness in vulnerable populations. By vulnerable populations I mean people with weak or compromised immune systems. Examples of vulnerable populations would include but are not limited to the very young, the very old, people with chronic illnesses like heart disease, lung disease, or diabetes, and people on immunosuppressant medications.
That is bad enough, but so far this winter season, one strain of strep, strep A, has been especially problematic. That is because Strep A is becoming increasingly antibiotic resistant. Because of its resistance, Strep A can progress into serious illness, even in healthy people. The United Kingdom’s (UK) Health Services (their version of our Centers for Medicare and Medicaid Services) announced today that 15 children in the UK have died in recent days from Strep infections. Most of those deaths were related to antibiotic resistant Strep A.
Strep, like flu, RSV, and COVID is spread through respiratory droplets when people cough or sneeze. Most commonly those droplets end up contacting someone’s hands. That person then touches their face, especially the mouth, nose, or eyes, and they become infected. Just like with flu, RSV, and COVID, there are several ways to block that transmission process. First, stay away from others if you are sick. Second, wash your hands frequently using soap and water or a good quality hand sanitizer. Third, consider wearing a mask, especially when you are sick and cannot stay away from others. Finally, if there is vaccine, please consider taking it. They do make a huge impact in reducing both the number and severity of illnesses.
With bacterial infections, the other thing that is important is that you take the antibiotics as directed. Never save antibiotics for a later infection. The reason bacteria become resistant is because people take antibiotics when they are not appropriate, or when they don’t take as they should. For example, someone has strep, and they go to the doctor and get a prescription for a common antibiotic, like Augmentin. The person starts feeling better after a couple of days and they stop taking the antibiotics. What they don’t know is there are still some bacteria in their system that have survived the first few doses of the antibiotics.
When the drug stops, those bacteria can reproduce again, and in that reproduction, they are able to refine the parts of their system that allowed them to survive longer than other bacteria. That means after several generations, the bacteria now aren’t killed by that same antibiotic. This also happens when people take antibiotics when they have a viral infection, but this time the resistant happens with bacteria that are part of our normal biome and normally don’t cause infections. We have seen that for years with staph infections. Staph normally lives on everyone’s skin, but now there are drug resistant strains like MRSA, that can cause horrible illness when it gets into a wound or inside the body. Taking antibiotics as directed and only when prescribed by a health care provider eliminates the ability of bacteria to become resistant. Eliminating drug resistance benefits everyone, because then antibiotics work as they are supposed to.
Talking about illness is not really what I was hoping to talk about the day after Christmas, but as we continue to celebrate this week, I wanted to remind people to stay safe and infection free by taking precautions against transmitting illnesses like strep as we enjoy the holiday.
