Issue link: https://beckershealthcare.uberflip.com/i/653703
38 ANTIBIOTIC RESISTANCE & STEWARDSHIP Serving Antibiotic-Free Meat Proves Difficult for Some Hospitals By Heather Punke W ith antibiotic resistance in the spotlight, scientists have urged hospitals to drop meat from their menus that comes from animals given antibiot- ics. Hospitals across the nation have responded, but it hasn't always been smooth sailing. For instance, Hackensack (N.J.) University Medical Center is making antibiotic-free meat a priority, but has run into resistance, especially from its distributer, which told the hospital it didn't have the necessary supply, ac- cording to an NPR report. Aer working with the distributer and a group purchasing organization, HackensackUMC was able to phase out meat treated with antibiotics. However, the hospital pays 30 percent more for the antibiotic-free chicken and is now working on getting more antibiotic-free beef and pork. Across the country at Overlake Medical Center in Bellevue, Wash., 79 percent of meat purchases are now anti- biotic-free. is hospital ran into budget issues in making the switch, according to NPR. Overcoming budget and supply issues is one thing, but other hospitals may encounter even greater challenges due to contracts with food service man- agement companies, according to NPR. e companies have a limited supply of antibiotic-free meat, and hospitals "don't have flexibility in changing vendors or supply," Hillary Bisnett with Practice Greenhealth and Health Care Without Harm told NPR. However, the push is worth it for some hospital officials. "It took a lot of work to make this happen and a lot of pushing, but hospitals should be inclined to push the industry to make a change," Kyle Tafuri, Hackensack- UMC's senior sustainability adviser, told NPR. n Research Highlights How Antibiotics Enable C. diff Infections By Max Green G rowth of Clostridium difficile, the harmful bac- teria responsible for many hospital-acquired infections, is normally inhibited by bile acids altered by healthy microbes in the gut. However, when patients are administered antibiotics that kill off those healthy microbes, they can lay the groundwork for an environment hospitable to C. diff infections, according to a study from mSphere. Researchers from the University of Michigan in Ann Arbor and North Carolina State University at Raleigh found primary bile acids in the small intestine allowed harmful bacteria to grow regardless of antibiotic treat- ments. But when those same spores reached the large intestine, home to secondary bile acids, the bacteria were stopped in their tracks. After antibiotic treatment, which eliminated the intestinal bacteria that bolster secondary acids, C. diff was able to grow quickly. "[T]argeting growth of C. diff will prove most important for future therapeutics and that antibiot- ic-related changes are organ specific," the authors conclude. "Understanding how the gut microbiota regulates bile acids throughout the intestine will aid the development of future therapies for C. diff infec- tion and other metabolically relevant disorders such as obesity and diabetes." n Antiseptic Baths in ICUs Shown to Not Increase Drug Resistance in MRSA By Max Green C hlorhexidine, an antiseptic used to bathe patients in in- tensive care units to prevent infection, has been shown not to increase drug resistance in pathogens responsi- ble for hospital-acquired infections, according to an Infection Control & Hospital Epidemiology study. "There has been concern in the healthcare community about the impact of routine, daily chlorhexidine bathing on fostering the spread of bacteria resistant to this agent," David Warren, MD, lead author of the study and associate professor of Medicine in the Division of Infectious Diseases at Washing- ton University School of Medicine and hospital epidemiologist at Barnes-Jewish Hospital in St. Louis, said in a news release. "We did not see sustained increase in [methicillin-resis- tant Staphylococcus aureus] resistant to chlorhexidine." Barnes-Jewish Hospital researchers reviewed ICU data from 2005 through 2012, comparing the level of chlorhexi- dine resistance in 500 randomly selected MRSA samples. They found the level of resistance to chlorhexidine fell from 6.2 percent to zero, before rising back up to 1.5 percent between 2006 and 2009, then spiked to 16.9 in 2009 before falling again to 4.6 percent in 2011 and 7.7 percent in 2012. The authors concluded the spikes in MRSA resistance can likely be attributed to patients entering the ICU who were already colonized with drug-resistant MRSA. n