- “The objective of the present study was to determine the additional total hospital
 cost and LOS attributable to health care-associated infections (HAIs) caused by
 antibiotic-resistant, gram-negative (GN) pathogens.”
McArthur, J. V., Tuckfield, R. C., Lindell, A. H. and Baker-Austin, C. (2011). When
rivers become reservoirs of antibiotic resistance: industrial effluents and gene nurseries.
Proceedings of the 2011 Georgia Water Resources Conference, held April 11-13, 2011
at the University of Georgia.
https://smartech.gatech.edu/bitstream/handle/1853/46105/4.5.1McArthur.pdf
- “Some water resources have become reservoirs af antibiotic resistance genes that
 can, under natural conditions, be transferred to water-borne pathogens.”
- “The current opinion in the scientific community is that the rapid and continuing
 increase in antibiotic resistance found in clinical settings is caused by the misuse
 and overuse of antibiotics in medicine and agriculture.”
- “Bacteria exposed to heavy metal pollution show elevated levels of antibiotic
 resistance (AR) and multiple antibiotic resistance (MAR) without ever being
 directly exposed to antibiotics.”
McBryde, E., Bradley, L., Whitby, M. and McElwain, D. (2004). An investigation of
contact transmission of methicillin-resistant Staphylococcus aureus. Journal of Hospital
Infection. 58(2). pg. 104-108. http://www.journalofhospitalinfection.com/article/S0195-
6701(04)00251-8/abstract
- “Hand hygiene is critical in the healthcare setting and it is believed that
 methicillin-resistant Staphylococcus aureus (MRSA), for example, is transmitted
 from patient to patient largely via the hands of health professionals. A study has
 been carried out at a large teaching hospital to estimate how often the gloves of a
 healthcare worker are contaminated with MRSA after contact with a colonized
 patient. The effectiveness of handwashing procedures to decontaminate the
 health professionals' hands was also investigated, together with how well
 different healthcare professional groups complied with handwashing procedures.
 The study showed that about 17% (9–25%) of contacts between a healthcare
 worker and a MRSA-colonized patient results in transmission of MRSA from a
 patient to the gloves of a healthcare worker. Different health professional groups
 have different rates of compliance with infection control procedures. Non-
 contact staff (cleaners, food services) had the shortest handwashing times. In this
 study, glove use compliance rates were 75% or above in all healthcare worker
 groups except doctors whose compliance was only 27%.”
