1. Antimicrobial Resistance and You Donna Riddle, BSMT (ASCP) Epidemiologist Executive Director, Nevadans for Antibiotic Awareness Clark County Health District (702) 383-1378

2. The Genesis of Resistance Nevadans for Antibiotic Awareness (NAA) Action Items for You –At Work –At Home –In Your Community

3. The Gram Stain Gram Positive Gram Negative

4. 1928: A Mold Changes Medicine Dr. Fleming’s discovery Penicillin inhibits bacterial enzymes necessary for cell wall production Mass production proves difficult

5. 1944 Military takes penicillin to the battlefield 1945 Scientists Isolate Resistance

6. The Next 50 Years 1950’s By prescription only 1960 Methicillin introduced 1961 Methicillin resistance 2001 62 % of S. aureus resistant 2000 Linezolid introduced 2001 Linezolid resistance

7. How is Sensitivity or Resistance Determined? Disc diffusion: Zones of no growth around antibiotic

8. Factors of Resistance Prevalence of resistance genes Extent of Antibiotic use

9. Staphylococcus aureus If S. aureus is resistant to methicillin, it is commonly resistant to cephalosporins and imipenem Antibiotic of choice: vancomycin VISA also known as GISA

10. Antibiotic Resistant Infections Cause: Prolonged hospital stays Fewer therapeutic options Greater costs

11. Nevadans for Antibiotic Awareness (NAA) NAA is a statewide task force of over 30 state and local public and private agencies and companies committed to reducing the spread of antibiotic resistance.

12. NAA Subcommittees Infection Control Public Awareness Provider Education Surveillance Forming a new subcommittee: Veterinary and Agriculture

13. Abbott Laboratories, Inc. Albertsons Bristol-Myers Squibb Carson-Tahoe Hospital Clark County Health District CR BARD Medical, Inc. GlaxoSmithKline Pharmaceuticals Health Plan of Nevada, Inc. Insurcorp Integrated Healthcare Services Magnus Translations Nevada State Board of Pharmacy Nevada State Health Division Orgill/Singer Insurance & Investments PacifiCare, Inc. Pfizer Inc. Pharmacia RITE AID Corporation Roche Laboratories Saint Mary’s Health Network Sav-on Sierra Community Healthcare Foundation Sierra Health Services, Inc. Southwest Medical Associates, Inc. Sunrise Hospital & Medical Center The Valley Health System and Owen Healthcare Virgen Advertising Walgreens Washoe Health System Wyeth-Ayerst

14. NAA Accomplishments Distributed healthcare guidelines Begun provider education Distributed materials to childcare centers Developed a statewide public education campaign Efforts/ contributions by members are voluntary.

15. Action Items for Work Provide home care sheet to patients with antibiotic resistant bacteria Always note antibiotic resistance on transfer forms

16. Action Items for Home Complete full course of antibiotics Don’t demand antibiotics for viral infections Wash your hands

17. Action Items for the Community Educate family and friends Support H.R. 1771: Antibiotic Resistance Prevention Act Buy antibiotic-free meat

18. The Genesis of Resistance Nevadans for Antibiotic Awareness (NAA) Action Items for You -At Work -At Home -In Your Community Questions?