[This article has been jointly written by Jordi Vila, director of ISGlobal's Antibiotic Resistance Initiative and chief of the Clinical Microbiology Department at the Hospital Clínic of Barcelona, and by Elisabeth Guiral, researcher at ISGlobal]
While the title of this post may look like a figure of speech, it is not a metaphor. It is an actual fact that one of the keys to preventing bacterial diseases is to keep your hands clean. This simple everyday task is one of the main recommendations that the World Health Organisation will make during the first World Antibiotic Awareness Week to be held from 16 to 22 November 2015. The aim of the campaign is to increase global awareness about the problems affecting antibiotics today, namely that abuse and misuse of antibiotics are leading to the development of resistant bacteria that are difficult to eradicate. The problem is even more serious owing to the lack of new substances with antibiotic action in the pharmaceutical pipeline. Antibiotic resistance may soon become a critical global health problem.
Just by following these simple guidelines, which we can adapt to without difficulties, we can prevent the transmission of bacteria and, in turn, the development of infections and the need for antibiotics to combat them But what better way to avoid the problems associated with antibiotics than to avoid bacterial infections altogether? There are many simple everyday ways to avoid these diseases, which we are perhaps not all aware of; however, each one of us is personally responsible for taking the necessary steps. Just for a start, there is nothing so simple as washing your hands. Many public institutions have run campaigns to raise awareness about the importance of handwashing. Some, such as the initiative organised by the Hospital Clínic in Barcelona last year to mark World Hand Hygiene Day, have particularly targeted hospital staff. But be careful! There is no point washing your hands just any old way; there are specific guidelines, backed by scientific evidence, that explain how to wash your hands properly, issued by none other than the Center for Disease Control and Prevention of Diseases.
To prevent cross-contamination, after handling raw foods—meat, fish and eggs—you should always wash your hands before you touch foods that are eaten raw There are also key times when we should do this "arduous" task; for example, before eating, after handling garbage, and before, during and after preparing food. To prevent cross-contamination, after handling raw foods—meat, fish and eggs—you should always wash your hands before you touch foods that are eaten raw, such as fruit and vegetables. Handwashing is also strongly recommended in a number of other situations: before and after using the toilet, changing diapers or cleaning someone who has used the toilet; after coughing, sneezing or blowing your nose; before and after treating a cut or wound or caring for a sick person; and after touching an animal or handling animal feed or waste.
Other recommendations to prevent bacterial infections when preparing food include carefully washing vegetables that will be eaten raw Other recommendations to prevent bacterial infections when preparing food include carefully washing vegetables that will be eaten raw, such as lettuce. In fact, the guidelines even recommend adding bleach (one millilitre per litre) to the water used to wash vegetables. It is also important to cook food thoroughly to eliminate all possible bacteria; avoid partial cooking, especially in the case of minced meats, sausages and burgers. These foods must be heated through, ensuring that they reach a safe temperature. A temperature of at least 60 °C will kill most pathogenic bacteria.
Just by following these simple guidelines, which we can adapt to without difficulties, we can prevent the transmission of bacteria and, in turn, the development of infections and the need for antibiotics to combat them. At the same time, we are doing our bit to prevent the emergence of new resistance in pathogenic bacteria.
Since the early seventies no new families of antibiotics have reached the market, For some years now, the spread of antibiotic resistance has been a problem that we face with few weapons at our disposal. For this reason, public institutions and private companies have recently started to join forces to investigate how bacteria become resistant and to develop new and more effective antibiotics. If we can understand at the molecular level what makes a bacteria antibiotic resistant, we can develop new substances (called adjuvant molecules) to attack these targets and give our old friends the antibiotics back their power.
Moreover, since the early seventies no new families of antibiotics have reached the market, which means that some pathogenic bacteria have already developed resistance to all the antibiotics we use to treat them: these pathogens are called multidrug-resistant bacteria. With the emergence of these highly resistant strains, infections we were previously able to treat quickly and easily can now lead to complications compromising the patient's health. We should not be alarmist, but neither can we afford to delude ourselves: there is an urgent need to control the use of antibiotics and to synthesize new antibiotic agents.
And, we always have the option to do everything that lies in our own hands. It's not really that difficult!