scholarly journals Antimicrobial Resistance: An Update from the Canadian Committee on Antibiotic Resistance

2005 ◽  
Vol 16 (5) ◽  
pp. 309-311
Author(s):  
Canadian Committee on Antibiotic Resistance
Keyword(s):  
British Columbia ◽  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Present Article ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Antibiotic Use ◽  
Infection Prevention And Control ◽  
Professional Communities ◽  
And Control

The present article is one of a series prepared by the Canadian Committee on Antibiotic Resistance (CCAR). These articles are designed to update readers on current activities intended to limit the development and transmission of antibiotic resistance in Canada. Headquartered in Vancouver, British Columbia, the CCAR provides outreach to public and professional communities through activities focused on infection prevention and control, resistance surveillance and optimal antibiotic use.

AMR: effective infection prevention and control measures

2019 ◽  
Vol 30 (8) ◽  
pp. 390-395
Author(s):  
Naomi Fleming
Keyword(s):  
Antimicrobial Resistance ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Drug Resistant ◽  
Practice Nurses ◽  
Prevention And Control Measures ◽  
Spread Of Infection ◽  
And Control

Antimicrobial resistance is on the rise. As more infections are becoming resistant to antibiotic treatment, it would benefit practice nurses to be aware of the effective measures they can use to prevent the spread of infection, explains Naomi Fleming When micro-organisms are exposed to an antimicrobial, more susceptible organisms succumb, leaving behind those resistant to the antimicrobial. They can then pass on resistance to their offspring. The use and misuse of antimicrobials has increased the number and types of resistant organisms. As a result, standard treatments become ineffective and infections persist and may spread. Infection prevention and control (IPC) is key to reducing demand for antimicrobial use and reducing the acquisition of antimicrobial resistance. Poor IPC can increase the spread of drug-resistant infections. Interventions such as effective hand hygiene and vaccination have significant potential to limit opportunities for drug-resistant strains to emerge. Effective leadership is vital and nurses are central to promoting IPC, leading on IPC compliance and ensuring uptake of vaccination in primary care.

scholarly journals Antibiotic Use in Low and Middle-Income Countries and the Challenges of Antimicrobial Resistance in Surgery

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 497
Author(s):  
Massimo Sartelli ◽  
Timothy C. Hardcastle ◽  
Fausto Catena ◽  
Alain Chichom-Mefire ◽  
Federico Coccolini ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Control ◽  
Low And Middle Income

Antimicrobial resistance (AMR) is a phenomenon resulting from the natural evolution of microbes. Nonetheless, human activities accelerate the pace at which microorganisms develop and spread resistance. AMR is a complex and multidimensional problem, threatening not only human and animal health, but also regional, national, and global security, and the economy. Inappropriate use of antibiotics, and poor infection prevention and control strategies are contributing to the emergence and dissemination of AMR. All healthcare providers play an important role in preventing the occurrence and spread of AMR. The organization of healthcare systems, availability of diagnostic testing and appropriate antibiotics, infection prevention and control practices, along with prescribing practices (such as over-the-counter availability of antibiotics) differs markedly between high-income countries and low and middle-income countries (LMICs). These differences may affect the implementation of antibiotic prescribing practices in these settings. The strategy to reduce the global burden of AMR includes, among other aspects, an in-depth modification of the use of existing and future antibiotics in all aspects of medical practice. The Global Alliance for Infections in Surgery has instituted an interdisciplinary working group including healthcare professionals from different countries with different backgrounds to assess the need for implementing education and increasing awareness about correct antibiotic prescribing practices across the surgical pathways. This article discusses aspects specific to LMICs, where pre-existing factors make surgeons’ compliance with best practices even more important.

scholarly journals Implementing a Combined Infection Prevention and Control with Antimicrobial Stewardship Joint Program to Prevent Caesarean Section Surgical Site Infections and Antimicrobial Resistance: a Tanzanian Tertiary Hospital Experience

2020 ◽  
Author(s):  
Elisa Gentilotti ◽  
Pasquale De Nardo ◽  
Boniface Nguhuni ◽  
Alessandro Piscini ◽  
Caroline Damian ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Caesarean Section ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Surgical Site Infections ◽  
Tertiary Hospital ◽  
Infection Prevention And Control ◽  
Post Intervention ◽  
Combined Infection ◽  
And Control

Abstract Background. Surgical site infections are a leading cause of morbidity and mortality after caesarean section, especially in Low and Middle Income Countries. We hypothesized that a combined infection prevention and control with antimicrobial stewardship joint program would decrease the rate of post- caesarean section surgical site infections at the Obstetrics & Gynaecology Department of a Tanzanian tertiary hospital. Methods. The intervention included: 1. formal and on-job trainings on infection prevention and control; 2. evidence-based education on antimicrobial resistance and good antimicrobial prescribing practice. A second survey was performed to determine the impact of the intervention. The primary outcome of the study was post-caesarean section surgical site infections prevalence and secondary outcome the determinant factors of surgical site infections before/after the intervention and overall. The microbiological characteristics and patterns of antimicrobial resistance were ascertained.Results. Total 464 and 573 women were surveyed before and after the intervention, respectively. After the intervention, the antibiotic prophylaxis was administered to a significantly higher number of patients (98% vs 2%, p<0.001), caesarean sections were performed by more qualified operators (40% vs 28%, p=0.001), with higher rates of Pfannenstiel skin incisions (29% vs 18%, p<0.001) and of absorbable continuous intradermic sutures (30% vs 19%, p<0.001). The total number of post-caesarean section surgical site infections was 225 (48%) in the pre-intervention and 95 (17%) in the post intervention group (p<0.001). A low prevalence of gram-positive isolates and of methicillin-resistant Staphylococus aureus was detected in the post-intervention survey. Conclusions. Further researches are needed to better understand the potential of a hospital-based multidisciplinary approach to surgical site infections and antimicrobial resistance prevention in resource-constrained settings.

scholarly journals Perspective: Conventional Infection Prevention and Control Practices in Post-Antibiotic Era

2018 ◽  
Author(s):  
Samer Singh
Keyword(s):  
Antimicrobial Resistance ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Local Environment ◽  
Infection Prevention And Control ◽  
Potential Threat ◽  
Agriculture Sector ◽  
Contributory Factors ◽  
Current Article ◽  
And Control

The antibiotic or antimicrobial resistance is rapidly spreading in microbes relevant to human health. Two visible major contributory factors have been the indiscriminate overuse of antimicrobials for preventing diseases in human and to enhance the productivity in agriculture sector. To mitigate the potential threat posed by post-antibiotic era, the global health stakeholders have been making extra efforts at a war footing to formulate and implement global and national plans of action. In the current article, an endeavour is made to provide a perspective to look beyond the current focus on just use of the antimicrobials. Attention has been drawn towards various obvious and not-so-obvious self-preservation infection-prevention practices in vogue from the pre-antibiotic era whose usage has been on decline in the antibiotic era for various reasons. Particularly, the practices with a clear potential to effectively decrease the spread of pathogens through contact, curtail the evolution and dissemination of the antimicrobial resistance in local environment and its introduction into the global community, should be Identified and strengthened to make them part of comprehensive hygiene and quarantine practices. Broadly, the suggestions pertaining to the personal and community hygiene including bereavement practices, isolation and quarantine of suspected pathogen carriers, and water and environment security have been made to invoke a constructive debate and discussion among various stakeholders for their evaluation and implementation to effectively delay the development of antimicrobial resistance wherever possible and disrupt its spread to pathogens.

scholarly journals When do big problems far away become smaller than the problems closer to home: Lessons for antimicrobial resistance from Father Ted

2019 ◽  
Author(s):  
Tjibbe Donker ◽  
Katie L. Hopkins ◽  
Susan Hopkins ◽  
Berit Muller-Pebody ◽  
Tim E.A. Peto ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Control Strategy ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Control Strategies ◽  
Absolute Number ◽  
Infection Prevention And Control ◽  
Admission Screening ◽  
Imported Cases ◽  
And Control

AbstractInfection prevention and control strategies aimed at reducing the occurrence of Carbapenemase-Producing Enterobacteriaceae (CPE) and other antimicrobial-resistant organisms often include advice about screening patients coming from hospitals with a known resistance problem, to prevent introductions into new hospitals by shared patients. We argue that, despite being an efficient method of identifying cases, admission screening for introduction prevention is only effective if the absolute number of imported cases from other hospitals outnumbers the cases coming from the hospital’s own patient population, and therefore is only a feasible control strategy during the start of an epidemic. When determining whether import screening is still advisable, we therefore need to be continuously reminded of how Father Ted so eloquently summarised the principles of perspective: “These are small, but the ones out there are far away”.

scholarly journals Hospital Infection Prevention and Control (IPC) and Antimicrobial Stewardship (AMS): Dual Strategies to Reduce Antibiotic Resistance (ABR) in Hospitals

2020 ◽  
pp. 89-108
Author(s):  
Gwendolyn L. Gilbert ◽  
Ian Kerridge
Keyword(s):  
Nineteenth Century ◽  
Antibiotic Resistance ◽  
Antimicrobial Stewardship ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Hospital Infection ◽  
Infection Prevention And Control ◽  
Drug Resistant ◽  
Preventable Harm ◽  
And Control

Abstract In this chapter we review the development of hospital infection prevention and control (IPC) since the nineteenth century and its increasingly important role in reducing the spread of antibiotic resistance (ABR). Excessive rates of hospital-acquired infection (HAI) fell dramatically, towards the end of the nineteenth century, because of improved hygiene and surgical antisepsis, but treatment remained rudimentary until effective antibiotics became widely available in the mid-twentieth century. While antibiotics had profound clinical benefits, their widespread appropriate and inappropriate use in humans and animals inevitably led to the emergence of antibiotic resistance (ABR). Within 50 years, this could no longer be offset by a reliable supply of new drugs, which slowed to a trickle in the 1980s. In hospitals, particularly, high rates of (often unnecessary) antibiotic use and ABR are exacerbated by person-to-person transmission of multi-drug resistant organisms (MDRO), which have, so far, largely resisted the introduction of antimicrobial stewardship (AMS) programs and repeated campaigns to improve infection prevention and control (IPC). Despite clear evidence of efficacy in research settings, both AMS and IPC programs are often ineffective, in practice, because of, inter alia, insufficient resourcing, poor implementation, lack of ongoing evaluation and failure to consult frontline staff. In this chapter we review reasons for the relatively low priority given to preventive programs despite the ethical obligation of healthcare organisations to protect current and future patients from preventable harm. The imminent threat of untreatable infections may provide an impetus for a shared organisational and professional commitment to promoting the cultural and behavioural changes needed to successfully reduce the burdens of ABR and drug-resistant HAIs.

scholarly journals Point-Prevalence Surveys of Antibiotic Use at Three Large Public Hospitals in Kenya

2020 ◽  
Vol 41 (S1) ◽  
pp. s353-s354
Author(s):  
Sylvia Omulo ◽  
Margaret Oluka ◽  
Loice Ombajo ◽  
Eric Osoro ◽  
Rosaline Kinuthia ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Medical Officer ◽  
Antibiotic Use ◽  
Public Hospitals ◽  
Point Prevalence ◽  
Infection Prevention And Control ◽  
Older Individuals ◽  
And Control

Background: Antibiotics are the most prescribed medicines worldwide, accounting for 20%–30% of total drug expenditures in most settings. Antimicrobial stewardship activities can provide guidance for the most appropriate antibiotic use. Objective: In an effort to generate baseline data to guide antimicrobial stewardship recommendations, we conducted point-prevalence surveys at 3 hospitals in Kenya. Methods: Sites included referral hospitals located in Nairobi (2,000 beds), Eldoret (900 beds) and Mombasa (700 beds). [Results are presented in this order.] Hospital administrators, heads of infection prevention and control units, and laboratory department heads were interviewed about ongoing antimicrobial stewardship activities, existing infection prevention and control programs, and microbiology diagnostic capacities. Patient-level data were collected by a clinical or medical officer and a pharmacist. A subset of randomly selected, consenting hospital patients was enrolled, and data were abstracted from their medical records, treatment sheets, and nursing notes using a modified WHO point-prevalence survey form. Results: Overall, 1,071 consenting patients were surveyed from the 3 hospitals (n = 579, n = 263, and n = 229, respectively) of whom >60% were aged >18 years and 53% were female. Overall, 489 of 1,071 of patients (46%) received ≥1 antibiotic, of whom 254 of 489 (52%) received 1 antibiotic, 201 of 489 (41%) received 2 antibiotics, 31 of 489 (6%) received 3 antibiotics, and 3 of 489 (1%) received 4 antibiotics. Antibiotic use was higher among those aged <5 years: 150 of 244 (62%) compared with older individuals (337 of 822, 41%). Amoxicillin/clavulanate was the most commonly used antibiotic (66 of 387, 17%) at the largest hospital (in Nairobi) whereas ceftriaxone was the most common at the other 2 facilities: 57 of 184 (31%) in Eldoret and 55 of 190 (29%) in Mombasa. Metronidazole was the next most commonly prescribed antibiotic (15%–19%). Meropenem was the only carbapenem reported: 22 of 387 patients (6%) in Nairobi, 2 of 190 patients (1%) in Eldoret, and 8 of 184 patients (4%) in Mombasa. Stop dates or review dates were not indicated for 106 of 390 patients (27%) in Nairobi, 75 of 190 patients (40%) in Eldoret, and 113 of 184 patients (72%) in Mombasa receiving antibiotics. Of 761 antibiotic prescriptions, 45% had a least 1 missed dose. Culture and antibiotic susceptibility tests were limited to 50 of 246 patients (20%) in Nairobi, 17 of 124 patients (14%) in Eldoret, and 23 of 119 patients (19%) in Mombasa who received antibiotics. The largest hospital had an administratively recognized antimicrobial stewardship committee. Conclusions: The prevalence of antibiotic use found by our study was 46%, generally lower than the rates reported in 3 similar studies from other African countries, which ranged from 56% to 65%. However, these survey findings indicate that ample opportunities exist for improving antimicrobial stewardship efforts in Kenya considering the high usage of empiric therapy and low microbiologic diagnostic utilization.Funding: NoneDisclosures: None

Implementing a Combined Infection Prevention and Control with Antimicrobial Stewardship Joint Programme to Prevent Caesarean Section Surgical Site Infections and Antimicrobial Resistance: a Tanzanian Tertiary Hospital Experience

2020 ◽  
Author(s):  
Elisa Gentilotti ◽  
Pasquale De Nardo ◽  
Boniface Nguhuni ◽  
Alessandro Piscini ◽  
Caroline Damian ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Caesarean Section ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Intervention Group ◽  
Surgical Site Infections ◽  
Tertiary Hospital ◽  
Infection Prevention And Control ◽  
Post Intervention ◽  
And Control

Abstract Background Surgical site infections after caesarean section are a leading cause of morbidity and mortality, especially in Low and Middle Income Countries. We hypothesized that combining infection prevention and control with an antimicrobial stewardship programme would decrease the rate of post- caesarean section surgical site infections at the Obstetrics & Gynaecology Department of a Tanzanian tertiary hospital. Methods A first survey was conducted to assess the burden of post-CS SSI. Thereafter, an intervention was introduced including: 1. formal on-the-job training on infection prevention and control; 2. evidence-based education on antimicrobial resistance and good antimicrobial prescribing practice. A second survey was performed to determine the impact of the intervention. The primary outcome of the study was information on the prevalence of post-caesarean section surgical site infections whereas the secondary outcome was the identification of the determinant factors of surgical site infections before/after the intervention and overall. The microbiological characteristics and patterns of antimicrobial resistance were also established. Results A total of 464 and 573 women were surveyed before and after the intervention, respectively. After the intervention, the antibiotic prophylaxis was administered to a significantly higher number of patients (98% vs 2%, p <0.001), caesarean sections were performed by more qualified operators (40% vs 28%, p =0.001), with higher rates of Pfannenstiel skin incisions (29% vs 18%, p <0.001) and of absorbable continuous intradermic sutures (30% vs 19%, p <0.001). The total number of post-caesarean section surgical site infections was 225 (48%) in the pre-intervention group and 95 (17%) in the post intervention group ( p <0.001). A low prevalence of gram-positive isolates and of methicillin-resistant Staphylococus aureus was detected in the post-intervention survey. Conclusions Further research is needed to better understand the potential of a hospital-based multidisciplinary approach to surgical site infections and antimicrobial resistance prevention in resource-constrained settings.

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