Cost of Antimicrobial Resistance in Healthcare Settings: A Critical Review

2010 ◽  
pp. 102-119
Author(s):  
Liana R. Merz ◽  
Rebecca M. Guth ◽  
Victoria J. Fraser
Keyword(s):  
Antimicrobial Resistance ◽  
Critical Review ◽  
Healthcare Settings

scholarly journals Detection of ESKAPE pathogens and Clostridioides difficile in Simulated Skin Transmission Events with Metagenomic and Metatranscriptomic Sequencing

2021 ◽  
Author(s):  
Krista L. Ternus ◽  
Nicolette C. Keplinger ◽  
Anthony D. Kappell ◽  
Gene D. Godbold ◽  
Veena Palsikar ◽  
...  
Keyword(s):  
Microbial Community ◽  
Antimicrobial Resistance ◽  
Epidemiological Studies ◽  
Pathogen Transmission ◽  
Metagenomic Analysis ◽  
Indirect Transmission ◽  
Healthcare Settings ◽  
Clostridioides Difficile ◽  
Analysis Methods ◽  
Global Threat

1AbstractBackgroundAntimicrobial resistance is a significant global threat, posing major public health risks and economic costs to healthcare systems. Bacterial cultures are typically used to diagnose healthcare-acquired infections (HAI); however, culture-dependent methods provide limited presence/absence information and are not applicable to all pathogens. Next generation sequencing (NGS) has the capacity to detect a wide variety of pathogens, virulence elements, and antimicrobial resistance (AMR) signatures in healthcare settings without the need for culturing, but few research studies have explored how NGS could be used to detect viable human pathogen transmission events under different HAI-relevant scenarios.MethodsThe objective of this project was to assess the capability of NGS-based methods to detect the direct and indirect transmission of high priority healthcare-related pathogens. DNA was extracted and sequenced from a previously published study exploring pathogen transfer with simulated skin containing background microorganisms, which allowed for complementary culture and metagenomic analysis comparisons. RNA was also isolated from an additional set of samples to evaluate metatranscriptomic analysis methods at different concentrations.ResultsUsing various analysis methods and custom reference databases, both pathogenic and non-pathogenic members of the microbial community were taxonomically identified. Virulence and AMR genes known to reside within the community were also routinely detected. Ultimately, pathogen abundance within the overall microbial community played the largest role in successful taxonomic classification and gene identification.ConclusionsThese results illustrate the utility of metagenomic analysis in clinical settings or for epidemiological studies, but also highlight the limits associated with the detection and characterization of pathogens at low abundance in a microbial community.

scholarly journals Does Microbicide Use in Consumer Products Promote Antimicrobial Resistance? A Critical Review and Recommendations for a Cohesive Approach to Risk Assessment

2013 ◽  
Vol 19 (5) ◽  
pp. 344-354 ◽  
Author(s):  
Jean-Yves Maillard ◽  
Sally Bloomfield ◽  
Joana Rosado Coelho ◽  
Phillip Collier ◽  
Barry Cookson ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Antimicrobial Resistance ◽  
Critical Review ◽  
Consumer Products

scholarly journals Institutional governance and responsiveness to antimicrobial resistance: a qualitative study of Australian hospital executives

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055215
Author(s):  
Jennifer Broom ◽  
Alex Broom ◽  
Katherine Kenny ◽  
Jeffrey J. Post ◽  
Pamela Konecny
Keyword(s):  
Antimicrobial Resistance ◽  
Qualitative Interviews ◽  
Healthcare Providers ◽  
Department Head ◽  
Institutional Governance ◽  
Healthcare Settings ◽  
Hospital Executives ◽  
Framework Approach ◽  
Referral Hospitals ◽  
Australian Hospital

ObjectivesDespite escalating antimicrobial resistance (AMR), implementing effective antimicrobial optimisation within healthcare settings has been hampered by institutional impediments. This study sought to examine, from a hospital management and governance perspective, why healthcare providers may find it challenging to enact changes needed to address rising AMR.DesignSemistructured qualitative interviews around their experiences of antimicrobial stewardship (AMS) and responsiveness to the requirement for optimisation. Data were analysed using the framework approach.SettingTwo metropolitan tertiary-referral hospitals in Australia.ParticipantsTwenty hospital managers and executives from the organisational level of department head and above, spanning a range of professional backgrounds and in both clinical and non-clinical roles, and different professional streams were represented.ResultsThematic analysis demonstrated three key domains which managers and executives describe, and which might function to delimit institutional responsiveness to present and future AMR solutions. First, the primacy of ‘political’ priorities. AMR was perceived as a secondary priority, overshadowed by political priorities determined beyond the hospital by state health departments/ministries and election cycles. Second, the limits of accreditation as a mechanism for change. Hospital accreditation processes and regulatory structures were not sufficient to induce efficacious AMS. Third, a culture of acute problem ‘solving’ rather than future proofing. A culture of reactivity was described across government and healthcare institutions, precluding longer term objectives, like addressing the AMR crisis.ConclusionThere are dynamics between political and health service institutions, as well as enduring governance norms, that may significantly shape capacity to enact AMS and respond to AMR. Until these issues are addressed, and the field moves beyond individual behaviour modification models, antimicrobial misuse will likely continue, and stewardship is likely to have a limited impact.

scholarly journals Linking antimicrobial resistance surveillance to antibiotic policy in healthcare settings: the COMBACTE-Magnet EPI-Net COACH project

2020 ◽  
Vol 75 (Supplement_2) ◽  
pp. ii2-ii19
Author(s):  
Maria Diletta Pezzani ◽  
Fulvia Mazzaferri ◽  
Monica Compri ◽  
Liliana Galia ◽  
Nico T Mutters ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Long Term Care ◽  
Good Practice ◽  
Empirical Therapy ◽  
Surveillance Data ◽  
Term Care ◽  
Healthcare Settings ◽  
Hospital Units ◽  
Reporting Frequency

Abstract Objectives To systematically summarize the evidence on how to collect, analyse and report antimicrobial resistance (AMR) surveillance data to inform antimicrobial stewardship (AMS) teams providing guidance on empirical antibiotic treatment in healthcare settings. Methods The research group identified 10 key questions about the link between AMR surveillance and AMS using a checklist of 9 elements for good practice in health research priority settings and a modified 3D combined approach matrix, and conducted a systematic review of published original studies and guidelines on the link between AMR surveillance and AMS. Results The questions identified focused on AMS team composition; minimum infrastructure requirements for AMR surveillance; organisms, samples and susceptibility patterns to report; data stratification strategies; reporting frequency; resistance thresholds to drive empirical therapy; surveillance in high-risk hospital units, long-term care, outpatient and veterinary settings; and surveillance data from other countries. Twenty guidelines and seven original studies on the implementation of AMR surveillance as part of an AMS programme were included in the literature review. Conclusions The evidence summarized in this review provides a useful basis for a more integrated process of developing procedures to report AMR surveillance data to drive AMS interventions. These procedures should be extended to settings outside the acute-care institutions, such as long-term care, outpatient and veterinary. Without proper AMR surveillance, implementation of AMS policies cannot contribute effectively to the fight against MDR pathogens and may even worsen the burden of adverse events from such interventions.

Sign in / Sign up

Export Citation Format

Share Document