The following is a guest post from Jo of Head Nurse, who calls it "a simple guide to antibiotic resistance for the liberal arts major."

Are surgical masks effective enough to prevent those infected with the flu from transmitting it to others? Do the masks provide wearers with sufficient protection against infection?

As I’m sure many of you know, last night President Obama and ABC News hosted a discussion on the current state of health care in America. That reform is needed was universally supported. Debate, for the most part, centered on how much of a role government should play in delivery of care.

The current recession has been one of the worst economic slumps in recent memory, and hospitals have been not been immune from the slump. Like many businesses today, hospitals have been cutting fixed costs as deeply as they can, and one of the casualties of this cost cutting is infection control, says a recent study from the Association for Professionals in Infection Control and Epidemiology (APIC).

Here's another one to add to the tally of drawbacks of life-saving antibiotics: according to a recent article in the American Journal of Infection Control, the burden of Clostridium difficile (C. diff) in US health settings is significantly higher than previously estimated. "Thirteen in every 1,000 inpatients has C. diff -- 20 times more than previous estimates" (see attached image for variance in prevelence by state).

“In the Mexican port of Veracruz, a sculptor was putting the finishing touches on a bronze statue of a 5-year-old boy who is the country's earliest confirmed case of swine flu. The boy, Edgar Hernandez, recovered after being treated with antibiotics, and state officials said the statue will be a symbol of hope.” Associated Press, May 25, 2009.

How to best control resistance is a controversial matter. Existing recommendations do not always agree and some recommendations are conflicting. One clear example is the key components of the Swedish intervention mentioned in Maya's recent post—isolation and contact tracing. In this specific study, children were isolated from day-care, sometimes up to a year.

This impressive study by ETC researcher Patricia Geli and colleagues at the Swedish Institute for Infectious Disease Control provides a great illustration of cost versus benefit in public health. Researchers regularly screened all children in day care centers in two study areas for a resistant form of Penicillin-resistant Streptococcus pneumoniae, and sent children colonized with the bacteria home for over a month on average.

Would hospitals with relatively poor infection control practices benefit from knowing that their operations might be subject to inspection at any time? Washington state seems to think so and will begin conducting surprise inspections at Washington hospitals at least once every 18 months to check on compliance with infection control standards and other patient safety guidelines.

Will the swine flu epidemic emanating from Mexico be the next great pandemic that everyone fears? It is hard to say. The Mexican government seems to be doing all it can to limit the spread of the infection, and travel advisories attest that other governments are taking this seriously as well. The high number of deaths in Mexico is worrisome, but the low number of hospitalizations elsewhere is encouraging. With significant trade and travel, if this is the start of a new pandemic, it is likely that this virus will spread faster than any previous pandemic.