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The Biohazard worker and NDM-1

Tuesday, April 17, 2018   (0 Comments)
Posted by: Thomas Licker
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The Biohazard worker and NDM-1

Thomas Licker, CEICR, CBRM

I happened to be lucky enough to be one of the Keynote speakers at the the World Congress on Infectious Diseases this year and it opened my eyes to the future risks that my workers could be exposed to when responding to BiohazardTrauma or Crime Scenes. We are in a new world of antibiotic resistance and it is not going to get any better. I often talk about the arms race against microbes from the disinfection side of things but talking to infectious disease professionals and learning what they are up against was quite sobering. There are a whole lot of articles on healthcare acquired infections (HAI) out there. But what happens when a patient is discharged and sent home on a long regiment of antibiotics that may be ineffective to the microorganism?

Being an American BioReovery Association(ABRA) member contractor we receive calls for all sorts of potentially infectious materials and emergency projects. But when you are dealing with a potentially infectious material in unknown conditions, the variables risks for cross-contamination can be overwhelming. Newer healthcare facilities that are properly designed have realitively easy to clean hard surfaces but residential properties have all sorts of porous and soft contents that can harbor contaminants. This can become a source for reoccurring infections and hospital re-admittance in which health care systems are now financially responsible for. We get this with a lot with C.Diff, VRE and MRSA. But what about NDM-1 strains of pathogens that are an absolute killer.

Copied from Wikipedia

New Delhi Metallo-beta-lactamase-1 (NDM-1)[1] is an enzyme that makes bacteria resistant to a broad range of beta-lactam antibiotics. These include the antibiotics of the carbapenem family, which are a mainstay for the treatment of antibiotic-resistant bacterial infections. 

NDM-1 was first detected in a Klebsiella pneumoniae isolate from a Swedish patient of Indian origin in 2008. It was later detected in bacteria in India, Pakistan, the United Kingdom, the United States,[3] Canada,[4] and Japan.[5] The most common bacteria that make this enzyme are Gram-negative such as Escherichia coli and Klebsiella pneumoniae, but the gene for NDM-1 can spread from one strain of bacteria to another by horizontal gene transfer.[6]

Other potential candidates that are shown to exhibit NDM-1 resistance include Acinetobacter baumannii and the emergence of resistant Pseudomonas Aeruginosa.

Due to emerging antibiotic resistance and other threats such as resistant Mycobacterium tuberculosis (XDR-TB) strains and viruses of environmental significance, I hope that you look and consider the required training, education and independent third party certification of environmental professionals and technicians dealing with Trauma and Crime Scene Cleanup, Infestation Issues, Facility Hygiene, Sewage Cleanup and Biohazard response. Our industry is constantly evolving and it takes constant continuing education of our employees to keep up with it. Not all restoration companies have invested to have this capability, certification or expertise in house. Many try and get away with having the minimum OSHA Blood Borne Pathogen training requirement and minimum insurance as a janitorial contractor or say they have their own in house training programs. This is why it is important to vett contractors independent Third Party Credentials that hold them to training standards and a code of ethics.

With over a million people in the air at any given time and the amount of people traveling internationally we are only a flight away from facing extremely dangerous condition.

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ABRA’s objective is “to achieve and maintain the highest levels of competence among members in the performance of their profession. To teach, instill and require the highest technical, ethical and educational standards.” ABRA certified firms are required to maintain proper insurance, OSHA compliance, Bloodborne Pathogen training records, respirator fit testing, proper handling of biohazardous waste and other laws or requirements in order to maintain good standing with the American Bio-Recovery Association aka ABRA.