Bacteria Becoming Resistant To Hospital Disinfectants, Warn Scientists (theguardian.com)

Hospitals will need to use new strategies to tackle bacteria experts have warned, after finding a type of hospital superbug is becoming increasingly tolerant of alcohol -- the key component of current disinfectant hand rubs. From a report: Handwashes based on alcohols such as isopropanol have become commonplace as a method of infection control. But while the move has been linked to benefits, including a fall in rates of hospital infections of methicillin-resistant Staphylococcus aureus (MRSA), new research suggests it might also have had unexpected consequences. Scientists say they have discovered that superbugs known as vancomycin-resistant enterococci, or VRE, appear to be becoming more tolerant to alcohol.

Comments

Fair warning

[KeensMustard]

"Bacteria Becoming Resistant To Hospital Disinfectants, Warn Scientists" - I don't like the fact they are becoming resistant, but at least they had the decency to warn us about it.

Re:Fair warning

[K. S. Kyosuke]

Coccy buggers?

Use bacteriophage

[Gravis Zero]

What we need to do is find a suitable bacteriophage variant that can obliterate MRSA. It's not a permanent fix but it will buy us more time to figure out how to engineer bacteriophages.

Bacteriophages and eventually engineered bacteriophages seem like the likely future for fighting bacterial infection. It also seems like machine learning would be a good fit for developing bacteriophage variants when resistant mutations are found.

Re:Use bacteriophage

[Anonymous Coward]

Turns out that bacteria that evolve resistance to antibiotics tend to be weak against bacteriophages, and vice versa (wish I could find a citation, sorry!). But phages tend to be narrow spectrum. Also storage of phages is already a bit tricky, so you complicate it further by needing to store a huge library of phages to address targeted bacteria.

Phage therapy is impractical on a large scale as it triggers an immune system response, and is quickly wiped from a healthy person's system. But for someone already immune compromised it could be a very useful therapy.

For topical treatment most phages don't survive in open air and either oxidize or revert to a dormant state.

(P.S. - almost all the phage research from the Soviet Union is crap. poorly designed studies, missing double-blind studies. conclusions determined before the outcome, political consensus building rather than honest peer review)

Re:Use bacteriophage

[sexconker]

Wrong.

[On a plague of bird-eating lizards that ate all of Springfield's pigeons]
Skinner: Well, I was wrong. The lizards are a godsend.
Lisa: But isn't that a bit short-sighted? What happens when we're overrun by lizards?
Skinner: No problem. We simply unleash wave after wave of Chinese needle snakes. They'll wipe out the lizards.
Lisa: But aren't the snakes even worse?
Skinner: Yes, but we're prepared for that. We've lined up a fabulous type of gorilla that thrives on snake meat.
Lisa: But then we're stuck with gorillas!
Skinner: No, that's the beautiful part. When wintertime rolls around, the gorillas simply freeze to death.

Re:Use bacteriophage

[HiThere]

But phages evolve too, so when their food starts becoming elusive, they start becoming better hunters....or, of course, change their food preferences. You could talk to the Australians about some of the downsides.

Nothing new

[RandCraw]

An isopropyl alcohol bath is resoundingly insufficient to sterilize surgical instruments. This has been known for decades. Likewise, nobody in their right mind assumes a quick wipe with an alcohol pad will make your skin sterile either. Thus this news story adds nothing really new, except that some MRSA bugs may have become somewhat more resistant to a halfhearted swat of alcohol. Stop the presses...

Re:Nothing new

[bobbied]

> An isopropyl alcohol bath is resoundingly insufficient to sterilize surgical instruments If this has been known for decades could you please post a link to some reliable paper showing this. Because I don't believe you.

Medical sterilization of instruments has not been done in an alcohol bath for ages except as a last resort. It's marginally better than nothing, but not by much.

Current sterilization processes involve high heat in autoclaves (Basically pressure cookers) for items that can take the heat. There are some ozone processes that don't use pressure and heat that's effective and many one-time use items are sterilized using radiation after sealed in their packaging. Using alcohol or just boiling in water even would be considered gross malpractice at this point and would only be used as a last resort.

Re:Nothing new

[HiThere]

There are things for which boiling water is their normal environment. Most of them don't specialize in infecting humans, but this doesn't mean they can't pass around their plasmids to those that do.

That said, boiling water is generally a good way to throughly wash something. Exceptions are when something is really baked on. Unfortunately, a very small exception can carry a simply huge number of bacteria. When I was an assistant in a biochem lab I sometimes washed glassware. The drill was, first you wash and dry it. Then you submerge it in concentrated Nitric Acid. Then you submerge it in anhydrous alcoholic solution of Potassium Hydroxide. Then you rise it in distilled water. This isn't always a practical approach, and I wasn't even worried about bacteria. Just contamination.

Doctor House says...

[Impy the Impiuos Imp]

Whatever's not done already:

1. Find out how various disinfectants work at the cellular level.
2. Select 3 or 4 different ones that are otherwise fairly safe, but that operate in very different ways.
3. Mix them into a new product.
4. Use it.

See, simultaneous adaptation across multiple (say, four) different sterilization vectors (this would work for internal antibiotics too) is like throwing down four poles onto an adaptation space and hope they all form an octopus x on the same point.

Invent a new, use until it doesn't work, repeat, is a failure mode. You are literally doing the best optimal way to make germ killers be useless as fast as possible.

Re:Maybe they should use real disinfectants?

[blindseer]

This is the same BS that happened with penicillin etc.
Yeah, if you give every single farm animal half a dose per day, everything is going to grow resistant.

What a bunch of bullshit.

Farmers aren't as stupid as you think. They know bacteria can get resistance to antibiotics if they are overused. I grew up on a farm and we used antibiotics fairly regularly, but far from daily. Pigs would get a shot of antibiotics when they were brought off the truck into the confinement building. They wouldn't get another shot unless one got sick, and only that one pig would be separate from the rest and get a shot. If the pig improved then it would be returned to the pen with the rest of the pigs. If it didn't improve then it got another shot... from a revolver. The carcass would then be fed to the dogs.

The cattle, like the pigs, typically got one shot of antibiotics in their life. This would happen when they got big enough to dehorn. They'd be run one by one into a dehorn chute where one guy would cut of the horns and another would give a shot of antibiotics. If a cow got sick then it might get a shot of antibiotics, and if it was producing milk at the time the milk would be discarded. If the cow got better then it would be returned to producing milk. If it didn't then it would be sent to the rendering plant for leather and bone meal, the meat would be discarded.

All meat and milk is tested for antibiotics randomly and when there is suspicion of contamination. I'm not aware of any fines imposed but a dairy farmer seeing 1000 gallons of grade A milk get dumped down the drain, and not getting paid for that shipment, is punishment enough.

Re:not just hospitals

[Puls4r]

That's true about bleach not being appropriate. Unsurprisingly, you'll find there are already bugs out there that can tolerate bleach, at least in the levels you'll find in your non-commercial cleaners and clothes washing bleach. We're dealing with that right now while taking care of an ailing family member at home who is prone to infection. The hospital has confirmed the strain of infection our family member has will be unaffected by low levels of bleach.

This is why we need more science education

[rsilvergun]

in this country. I've been hearing about this for years and nobody's doing much of anything about it. Certainly not enough. Meanwhile in the United States we've got a resurgence of things like Faith Healers and the like (plus numbskulls pushing Homeopathy and "Essential Oils"). It doesn't help that we don't have universal healthcare so I know a ton of people turned away from science because they just plain can't afford medical care. Faith Healers & Homeopathy are still cheaper than a doctor visit over here. And don't get me started on the number of folks I knew who saved antibiotics for the next time they got sick because it costs $200 bucks to have a doctor write the script...

No shit

[Chewbacon]

Infection control in about every hospital I've set foot in in the last 14 years will tell you hand sanitizer doesn't do shit for VRE - wash your hands.

Deadly Romanian scandal

[socheres]

This reminds me of a big scandal in Romania involving a firm called Hexi Pharma who was the major distributor of dissinfectants to all .ro hospitals.

They were found to dillute the cleaning substances so they sell more to the hospitals in the last 10 years or so.

This of course coincides in time with the situation described in TFA. ...

Re:Steam vapor cleaners

[steveha]

If I'm understanding the abstract correctly, this study showed that three seconds of hot steam was 99.95% effective at killing biofilm. "Compared with chemical disinfection, steam treatment for <1 second a similar level of biofilm disinfection as provided by incubation with 10-ppm sodium hypochlorite (bleach) for 10-20 minutes of contact time."

https://www.ncbi.nlm.nih.gov/pubmed/22418602/

The above study tested a particular brand of commercial steam vapor cleaner ("Ladybug") with a feature called "TANCS". I'd be interested to know how well other brands of steam cleaners would work. Is "TANCS" key to this or was it simply the high-temperature steam?

From the Ladybug web site here's an article that discusses the results of another study, also showing that the Ladybug is effective:

https://www.ladybugsteamvapor.com/study-validates-ladybug-dry-steam-vapor/

Re:Steam vapor cleaners

[Mashiki]

Hospitals in most cases have long since moved to "one-time-use" tools for surgery and that's the end of it. The used stuff is bagged and shipped for destruction and new medical tools made. That means even if you have clean tools, someone fucking up during their wash can transfer it to a patient. Even day-to-day items are pretty much use once-throw away, simply because the transmission possibility is way too high. The problem with MRSA is that it can thrive on surfaces, hands, and so on. It can thrive through wash cycles of bedding and so on too. This is where the real problem comes from.

This is what happened to my uncle about a decade ago when he had to get his kneed replaced. It went well, then he started to complain of pain. Then he got sick hard, and fast. His knee swelled up, and they hit him with a heavy dose of antibiotics to kill it. Problem was it was already immune to everything they had available at the time. He had to go back in for surgery, they pulled the knee joint, then found out it had spread into the bone and was eating it. They gave him two options if that was the case, remove the leg above the infection site or try cutting back the bone as far as they could and trying again. He took option 2, and he got lucky.

Old days in the hospital it was always washing down surfaces with a mix of iodine and usually a secondary. It was the push for cheaper options that led to the wide-spread use of rubbing alcohol usually 70% instead of 99%. For instruments back in the day it was always baking at 350F for 20 minutes, then wrapping in sterile white linen. That's what nurses were also taught back in the 50's and 60's as well for tool cleanup. Again that heavily changed in the 70's and 80's.