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18 Ogos 2010

Aku dan Superbug

SUPERBUG ALERT

PATIENTS in Bahrain who underwent operations in India or Pakistan in the last six months could be at risk from a deadly superbug, which appears to be going global.NDM-1 has already spread from India to the UK, partly due to medical tourism.

Similar infections have been seen in the US, Canada, Australia and the Netherlands, with infections being passed from patient to patient in UK hospitals, according to the BBC.

Health Ministry officials in Bahrain said no cases of the superbug, which is resistant to the strongest antibiotics, had been reported here.

However, they are identifying high risk groups - especially patients who underwent surgical procedures in India or Pakistan in the last six months.

"We are aware of the problem and we are practising the international guidelines for controlling the spread of such kind of micro-organisms," Health Ministry infection control steering committee head and infectious disease consultant Dr Jameela Al Salman told the GDN yesterday.

"We are worried about this bug because it's resistant to all strong antibiotics - we have one antibiotic that might help but it might not, so there is a risk the patient could die."

NDM-1 is the abbreviated name of the newly-identified enzyme New Delhi Metallo-beta-lactamase, which makes bacteria resistant to a broad range of antibiotics.

This includes antibiotics of the carbapenem family that were a mainstay for the treatment of other antibiotic-resistant bacteria.

Bacteria that carry such genes are often referred to as "suberbugs", since infections are very hard to treat.

"There are no specific symptoms of the new superbug because they are related to where the infection is, for example if it is in urine, the patient will have symptoms of a urinary infection," said Dr Al Salman.

"Superbugs are mainly seen in hospitals, but more cases are being found in the community because of the abuse of antibiotics.

"They can be easily transmitted by just being in contact with a person who has the bug."

Dr Al Salman said the main way to control the spread of the superbug was through proper infection control measures.

"This requires us to identify the suspected cases as soon as possible and isolate them, practise good hand hygiene and the best cleaning standards inside the health facility - in addition to the proper use of personal protective equipment," she said.

"Healthcare workers and patients have a major role in decreasing the impact of this problem by being informed and practising the best infection control measures and hand hygiene, in addition to the proper use of antibiotics."

Dr Al Salman said superbugs had increased over the past 10 years mainly due to the abuse and misuse of antibiotics, as well as patients not taking the proper dose or duration of antibiotics.

The Health Ministry plans to tackle the problem by launching a campaign later this year to raise awareness about the dangers of misusing antibiotics, including lectures and other activities.

"Many patients have viral diseases, but they still take antibiotics which are not needed," said Dr Al Salman.

"It shouldn't be like this, they should go to their physician and get a prescription if needed.

"Here people buy medicines over the counter, but in the US and UK you can't get antibiotics so easily.

"More superbugs are coming so we must be very careful."

NDM-1 was first identified in December 2009 in a patient who was admitted to a hospital in New Delhi. It has since been detected in bacteria in India, Pakistan, the UK and US.

Kemunculan superbug2 yang semakin kebal dan gagah adalah disebabkan oleh penyalahgunaan antibiotik yang berleluasa dan juga penggunaannya yang tidak mengikut peraturan. Saban hari aku berjumpa dengan pesakit dan ibubapa pesakit yang minta antibiotik supaya sakit mereka cepat sembuh. Keperluan pemberian antibiotik adalah mengikut jenis penyakit dan bukannya semua orang sakit perlu makan antibiotik untuk sembuh.

  1. Demam, batuk dan selsema yang 'biasa' yang kurang daripada 3 hari, 90% daripadanya disebabkan oleh virus sahaja. Rehat yang cukup dan minum banyak air dah cukup untuk menyembuhkannya. Memakan antibiotik kadang2 boleh memburukkan keadaan.
  2. Sekiranya doktor memberikan antibiotik, ianya perlu dimakan ikut jadual dan dihabiskan sekurang2nya untuk 3 hari. Anda tidak boleh makan ikut keperluan dan jika perlu sahaja kerana fungsi dan kegunaannya pasti akan berubah.
  3. Ada pesakit yang minta kat doktor antibiotik yang 'kuat sikit' untuk cepat sembuh katanya. Disebabkan malas nak berbahas dengan pesakit, sesetengah doktor mengikut sahaja kehendak pesakit.
  4. Ada sesetengah doktor yang terus gunakan antibiotik yang kuat2 kat pesakit kerana boleh charge lebih kat pesakit. Ini salah dari segi etika.
  5. Biasanya bila pesakit dirujuk ke klinik2 pakar di hospital2 swasta, antibiotik yang kuat dan canggih diberi kat pesakit. Selepas itu jangan haraplah antibiotik kat klinik2 biasa boleh melawan kuman2 yang ada dibadan mereka. Sebab itu aku jarang merujuk pesakit kanak2 ke klinik pakar swasta.
  6. Syarikat2 ubat biasanya cuba menjual pelbagai jenis antibiotik terutamanya yang kuat dan canggih ke klinik seperti klinik aku. Pada aku, aku tak perlu antibiotik2 tersebut untuk merawat penyakit demam selsema yang biasa. Lainlah kalau klinik aku ada buat kes2 pembedahan besar2.
  7. Walaupun dinasihatkan beberapa kali, pesakit2 jarang makan antibiotik ikut aturan. Biasanya mereka berhenti memakannya bila dia dah rasa sihat. Diri sendiri sebagai contoh. Aku jarang makan antibiotik ikut aturan. Confirmed lupa punya.
  8. Aku jarang beri anak2 aku makan antibiotik. Begitu juga dengan pesakit2 kanak2 aku. Kalau aku rasa tak perlu makan antibiotik, aku tak beri. Emak bapaknya nak ikut cara aku ke tidak, itu terpulanglah. Kalau mereka nak ke klinik lain sebab tak dapat antibiotik dariku pun terpulanglah.
  9. Aku tak simpan banyak jenis antibiotik kat klinik aku. Yang biasa2 aje seperti Cloxacillin, Cephalexin, Amoxycillin, Erythromycin, Bactrim dan paling kuat pun cuma ada Augmentin dan Cefaclor. Itupun asyik expired aje sebab jarang guna.
  10. Kalau pesakit2 kencing manis, aku selalu beri antibiotik yang agak kuat dan lebih panjang masanya kerana aku tahu, sistem antibodi badan mereka tak kuat. Masalahnya tetap sama iaitu mereka makan ubat ikut sukahati dia sahaja

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