Project 126: Student Project – Honours Project – Multi resistant gram – negative bacteria in the Northern Tasmania Area Health Service, prevalence and associated risk factors.

02 Jan 2014

The inaugural Bachelor of Nursing Honours Scholarship was awarded to Thomas Heazelewood.

This research project (scholarship) looked at the current prevalence of a specific class of bacteria known as ‘gram negative’ strains in the Northern Area Health Service. In particular it aimed to investigate bacteria that have demonstrated resistance to multiple antibiotics, which had been dubbed in the media as “super bugs”.

A retrospective audit was conducted in the Northern Tasmania area health service to identify the prevalence of a class of bacteria, known as “gram-negative”, that are resistant to multiple antibiotics (MRGN bacteria). These bacteria are often referred to as super-bugs and pose a significant threat to health due to the difficulty treating infections caused by them (due to their resistance to many antibiotics) and the increasing numbers in both the hospital setting and the community.

All new reports of MRGN bacteria in the health service throughout 2013 (n=74) were identified and information such as the sample type (eg. urine, blood) and the number of antibiotics to which they were resistant was collected. The medical records of more than half (n=44) of the patients that the samples came from were audited to try and identify who may be at more risk of this type of infection. The most common MRGN bacteria identified was a resistant form of E. coli, a bacteria commonly found in the human gut. The majority of samples were urine samples, mainly from females. Urinary tract infections are common in women, but this study highlights the growing presence of resistant bacteria in urinary tract infections which may make them more difficult to treat in the future. The use of urinary catheters was also identified as a potential risk factor.  The majority of the samples were from people aged over 65yrs , indicating that the risk of having a MRGN bacterial infection may increase with age.

All the MRGN bacteria were susceptible to (still able to be treated by) at least one antibiotic. Bacteria have been identified in most other states in Australia that are resistant to all current antibiotics, but this was not found in the Tasmanian sample.

Further investigation into MRGN bacteria in Tasmania is recommended. The high prevalence of urinary catheter use, and particularly the management of urinary catheters in patients with additional complications such as dementia, warrants further research that investigates the best ways to provide care for these patients to try and prevent MRGN bacterial infections.