Three to four billion years ago, microorganisms (bacteria) were first life on earth. They have existed millions of years longer than humans. Like humans, microbes have complex social and physical communities that are constantly evolving. These microbial communities are home to both beneficial bacteria and pathogens (bad bacteria).better understand Microbial Ecology—These intra-community and inter-community relationships are just the beginning of the journey of public health science.We are working to better understand what microbes and their surroundings can teach us to prevent infection, including resistant bacterial infection.
CDC knows that there are important links between microbial ecology and people’s health and well-being. Our skin and gut have our own microbial community, called the microbiome, that helps us keep our bodies healthy.we have a better chance Fighting infections when our microbiome is in balance— A mix of “good” beneficial bacteria to help control “bad” pathogens.
However, when we take antibiotics, antifungals, or other treatments, these drugs kill all bacteria—both harmful and beneficial. This disrupts our microbiome, allowing surviving pathogens that are often resistant to treatment to dominate our microbiome. This can lead to infection.
our The risk of infection increases when we are colonized, which means we have a threatening pathogen in our body but no symptoms of infection.Our risk of infection is higher when we were colonized and Microbiome is disrupted.
Using microbial ecology to promote and protect our health requires cross-cutting and dynamic efforts from diverse collaborators, including public health experts, academic researchers, private industry, and regulatory experts. Expanding our knowledge of microbial ecology at the intersection of public health will lead us to develop new strategies for preventing infection and combating antimicrobial resistance, especially in healthcare settings.
Protecting patients with microbial ecology
Although scientists know that microbial ecology plays an important role in maintaining human health, scientific questions remain. CDC Invest in microbial ecology research Study the interactions of microbes among people, animals, plants, food, and surfaces (such as countertops), all of which can serve as sources of microbes that lead to infection.
When a health care facility finds certain multidrug-resistant pathogens within its facilities, the CDC recommends colonization screening—the use of laboratory tests to identify colonized patients.When patients are colonized, a unique patient safety intervention called Pathogen reduction and decolonization Colonizing pathogens in the patient’s microbiome, such as the skin, nose, or gut, can be removed.
Healthcare providers are already using traditional therapeutic strategies to decolonize people, such as antiseptics, such as Chlorhexidine Gluconate. These strategies help avoid loss of beneficial bacteria and disruption of the microbiome because they can:
- Restrict application to a body part/individual microbiome or specific pathogens
- Reduced use of antibiotics and antifungals to treat infections, which can help slow down antimicrobial resistance
- Focus on colonized individuals or larger populations at increased risk of infection
However, more research is needed in the field of microbial ecology to expand and develop new therapeutic strategies to address colonization, Healthcare-Associated Infections (HAI) and antimicrobial resistance, while considering patient safety and impact on the patient microbiome. This innovative work helps us better understand how to develop and implement lifesaving tools.
To expand our patient safety toolbox, CDC needs public health experts, academic researchers, private industry, and regulatory experts to develop preventive products or strategies:
- Prevent colonization from recurring by doing more than “cleansing”, such as protecting and/or restoring the microbiome
- Reduction of pathogen burden (burden) and/or complete elimination of pathogens, especially in the case of targeted applications (eg, body parts, pathogens)
- Benefit individuals (individual patients or “sources”) and populations
As public health and scientific experts explore this unexplored area, we also need more conversations to continue to identify emerging challenges and forge new paths forward.
how you can help
When implementing antimicrobial stewardship practices, consider the impact of antibiotics, antifungals, and other therapies on the microbiome.
Incorporate pathogen reduction and decolonization into clinical practice when appropriate.
Learn about the importance of protecting your microbiome.
Reduce your and your patients’ risk of contracting HAI from facility water.
As leaders in public health and patient safety, the CDC and the Food and Drug Administration (FDA) are jointly sponsoring a Public Virtual Workshop August 30, 2022, on the development of therapeutics for HAI and the role that microbial ecology can play in this work.
This workshop is the first of its kind to focus on
- Current status of pathogen-directed products to prevent HAI
- Decolonization as a strategy to prevent HAI and its spread
- Targeting Antimicrobial Pathogens
- Challenges and Approaches to Developing Drugs and Registering Products to Prevent HAI
Can’t have a meeting? You can still help!
From policy, industry, academia, funding agencies and researchers, to healthcare workers, patients and advocacy groups – we can all contribute to incorporating microbial ecology into our prevention efforts. We look forward to working with you and having more conversations as we enter this new area together.
Melia Hale, Christopher Elkins, Cliff MacDonaldAlison Laufer Halpin and Mihnea Mangalea, Department of Healthcare Quality Promotion, and Lacey Avery, Department of Antimicrobial Resistance Coordination and Strategy, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC)
