Clinical oral microbiology: A view of the road ahead

2016 ◽  
Vol 7 (2) ◽  
pp. 82-85
Author(s):  
Deborah EA Lockhart ◽  
Caroline Pankhurst ◽  
Riina Richardson ◽  
Noha Seoudi ◽  
Andrew Smith ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Infection Prevention ◽  
The Road ◽  
Oral Microbiology

‘There’s none so blind as those that will not see.’ With almost daily headlines describing novel and re-emerging challenges in healthcare related to infection prevention and antimicrobial resistance, it is quite extraordinary that there are currently only four clinical oral microbiologists in UK consultant posts, and no trainees. Given the backdrop of increasing antimicrobial resistance, and a drive towards optimal diagnosis, surveillance and management of infection in all others areas of healthcare, how has this situation arisen? More importantly, can it be remedied? If so, how?

scholarly journals Where to from here? Identifying and prioritising future directions for addressing drug-resistant infection in Australia

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gregory Merlo ◽  
Minyon Avent ◽  
Trent Yarwood ◽  
Bonnie Smith ◽  
Mieke van Driel ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Infection Prevention ◽  
Implementation Strategies ◽  
Antibiotic Use ◽  
Future Directions ◽  
World Cafe ◽  
Resistant Infection ◽  
Using Data ◽  
Patient Stories

Abstract Background The Australian National Antimicrobial Resistance Strategy calls for a collaborative effort to change practices that have contributed to the development of drug-resistance and for implementation of new initiatives to reduce antibiotic use. Methods A facilitated workshop was undertaken at the 2019 National Australian Antimicrobial Resistance Forum to explore the complexity of antimicrobial stewardship (AMS) implementation in Australia and prioritise future action. Participants engaged in rotating rounds of discussion using a world café format addressing six topics relating to AMS implementation. Once all tables had discussed all themes the discussion concluded and notes were summarised. The documents were independently openly coded by two researchers to identify elements relating to the implementation of antimicrobial stewardship. Results There were 39 participants in the facilitated discussions, including pharmacists, infectious disease physicians, infection prevention nurses, and others. Participants discussed strategies they had found successful, including having a regular presence in clinical areas, adapting messaging and implementation strategies for different disciplines, maintaining positivity, and being patient-focused. Many of the recommendations for the next step involved being patient focussed and outcomesdriven. This involves linking data to practice, using patient stories, using data to celebrate wins and creating incentives. Discussion Recommendations from the workshop should be included in priority setting for the implementation of AMS initiatives across Australia.

scholarly journals A road-map for addressing antimicrobial resistance in low- and middle-income countries: lessons learnt from the public private participation and co-designed antimicrobial stewardship programme in the State of Kerala, India

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sanjeev Singh ◽  
Esmita Charani ◽  
Sarada Devi ◽  
Anuj Sharma ◽  
Fabia Edathadathil ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Infection Prevention ◽  
The State ◽  
Action Plans ◽  
Public And Private ◽  
Middle Income ◽  
Middle Income Countries ◽  
Public Health Threat

Abstract Background The global concern over antimicrobial resistance (AMR) is gathering pace. Low- and middle-income countries (LMICs) are at the epicentre of this growing public health threat and governmental and healthcare organizations are at different stages of implementing action plans to tackle AMR. The South Indian state of Kerala was one of the first in India to implement strategies and prioritize activities to address this public health threat. Strategies Through a committed and collaborative effort from all healthcare related disciplines and its professional societies from both public and private sector, the Kerala Public Private Partnership (PPP) has been able to deliver a state-wide strategy to tackle AMR A multilevel strategic leadership model and a multilevel implementation approach that included developing state-wide antibiotic clinical guidelines, a revision of post-graduate and undergraduate medical curriculum, and a training program covering all general practitioners within the state the PPP proved to be a successful model for ensuring state-wide implementation of an AMR action plan. Collaborative work of multi-professional groups ensured co-design and development of disease based clinical treatment guidelines and state-wide infection prevention policy. Knowledge exchange though international and national platforms in the form of workshops for sharing of best practices is critical to success. Capacity building at both public and private institutions included addressing practical and local solutions to the barriers e.g. good antibiotic prescription practices from primary to tertiary care facility and infection prevention at all levels. Conclusion Through 7 years of stakeholder engagement, lobbying with government, and driving change through co-development and implementation, the PPP successfully delivered an antimicrobial stewardship plan across the state. The roadmap for the implementation of the Kerala PPP strategic AMR plan can provide learning for other states and countries aiming to implement action plans for AMR.

scholarly journals European Union One Health Country Visits as Driver to Combat on Antimicrobial Resistance

2020 ◽  
Vol 41 (S1) ◽  
pp. s222-s222
Author(s):  
Pita Spruijt ◽  
Paul Bergervoet ◽  
Robbin Westerhof ◽  
Merel Langelaar ◽  
Marie-Cécile Ploy
Keyword(s):  
European Union ◽  
Antimicrobial Resistance ◽  
Peer Review ◽  
Infection Prevention ◽  
One Health ◽  
Competent Authority ◽  
Political Agenda ◽  
The European Union ◽  
Review System ◽  
Set Up

Background: In 2016, the European Union adopted unanimously Council Conclusions on the next steps to combat antimicrobial resistance under a One Health approach. To implement some of the provisions laid down in the Council Conclusions, a European Joint Action on Antimicrobial Resistance (AMR) and Healthcare-Associated Infections (HCAI) or EU-JAMRAI was set up, gathering 44 partners. Methods: As part of EU-JAMRAI, 13 participating European countries set up a country-to-country peer review system to evaluate each other’s national action plans (NAPs). This review system entailed a self-assessment, strengths–weaknesses–opportunities–threats (SWOT) analysis, and country visits. All steps were executed with representatives from both the human and the veterinary domains (One Health approach). Special attention was given to supervision and the way supervision can enhance the implementation of guidelines on AMR, both at the policy level and within healthcare institutions. Results: Despite differences in the stage of developing and implementing NAPs, all 13 countries are working on NAPs. In this process, country visits function as a moment to exchange best practices and to provide an outsider’s point of view. At the end of 2019, 13 country-to-country visits had taken place, resulting in tailor-made recommendations for each country. These recommendations were shared with the competent authority. An example is a country that used the recommendation to improve infection prevention as an immediate reason to get the topic on the agenda of the Ministry of Health. During the country visits, intersectoral participation was perceived as desirable, but in some cases it was challenging to arrange. For some highly relevant topics, it has been recognized that discussion should take place on a European level. Examples of such topics include supervision, infection prevention guidelines, funding, surveillance, and regular audits of antibiotic prescriptions for physicians including feedback loops. Conclusions: Peer review is a cooperative and friendly working method compared to common audits. The country visits function as an agenda setting tool to get or to keep AMR on the political agenda and presenting the most relevant topic(s) to address for each country.Funding: NoneDisclosures: None

scholarly journals Urgent, Comprehensive Federal Action Needed To Stem Mortality and Medicare Costs Associated With Antimicrobial Resistance

2021 ◽  
Author(s):  
Vance G Fowler ◽  
Amanda Jezek ◽  
Emily S Spivak ◽  
Kathy Talkington
Keyword(s):  
Antimicrobial Resistance ◽  
Infectious Diseases ◽  
Antibiotic Stewardship ◽  
Infection Prevention ◽  
Call To Action ◽  
Global Coordination ◽  
Medicare Costs ◽  
Stem Mortality

Abstract This paper is a call to action for the policies necessary to reduce the burden of antimicrobial resistance, including federal investments in antibiotic stewardship, antibiotic innovation, surveillance, research, diagnostics, infection prevention, the infectious diseases workforce, and global coordination.

scholarly journals Improving educator’s knowledge and confidence to teach infection prevention and antimicrobial resistance

2020 ◽  
pp. 001789692094959
Author(s):  
Catherine Hayes ◽  
Charlotte Eley ◽  
Carla Brown ◽  
Rowshonara Syeda ◽  
Neville Q Verlander ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Infection Prevention ◽  
Action Plan ◽  
Service Evaluation ◽  
Infection Prevention And Control ◽  
Post Intervention ◽  
Logistic Regression Models ◽  
Train The Trainer ◽  
The Uk

Objective: e-Bug is a teaching resource that addresses the UK 5-year National Action Plan on antimicrobial resistance (AMR) that pledges to work with educators and local authorities to ensure young people understand infection prevention and control (IPC) and AMR. This study aimed to evaluate the effectiveness and acceptability of the e-Bug face-to-face train-the-trainer intervention with school and community educators. Design: Service evaluation of an educational intervention via surveys. Setting: Workshops were organised by Public Health England (PHE) and collaborators in seven regions of the UK during 2018–2019. Method: Pre- and post-intervention surveys measured satisfaction with training, knowledge of IPC and AMR, and confidence to teach others. Statistical analyses included multilevel and ordinal logistic regression models to measure change in educator knowledge and confidence. Results: In all, 262 educators participated: primary (46%), secondary (17%), college (2%), healthcare (29%) and community (7%). Educators had high pre-intervention knowledge of topics, with significant improvement ( p < .05) in confidence to teach all topics and some significant IPC knowledge improvement, post-intervention. There was strong evidence for a difference in confidence change between educator types, with primary educators improving the most. Ninety-five percent of educators rated the train-the-trainer workshop positively, valued the interactive workshops and felt confident to use the resources. Conclusion: Confident and knowledgeable educators, achieved via e-Bug train-the-trainer workshops, will enhance education of IPC and AMR topics in schools and communities, and therefore support the UK 5-year AMR action plan. The intervention will be monitored with long-term follow-up surveys to explore how training has been disseminated and to evaluate long-term benefits.

scholarly journals CON: COVID-19 will not result in increased antimicrobial resistance prevalence

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Peter Collignon ◽  
John J Beggs
Keyword(s):  
Antimicrobial Resistance ◽  
Infection Prevention ◽  
Developed Countries ◽  
International Travel ◽  
Infection Prevention And Control ◽  
Resistant Bacteria ◽  
Healthcare Facilities ◽  
Factors Associated ◽  
Resistance Rates ◽  
And Control

Abstract Antimicrobial resistance (AMR) is affected by many factors, but too much of our focus has been on antimicrobial usage. The major factor that drives resistance rates globally is spread. The COVID-19 pandemic should lead to improved infection prevention and control practices, both in healthcare facilities and the community. COVID-19 will also have ongoing and profound effects on local, national and international travel. All these factors should lead to a decrease in the spread of resistant bacteria. So overall, COVID-19 should lead to a fall in resistance rates seen in many countries. For this debate we show why, overall, COVID-19 will not result in increased AMR prevalence. But globally, changes in AMR rates will not be uniform. In wealthier and developed countries, resistance rates will likely decrease, but in many other countries there are already too many factors associated with poor controls on the spread of bacteria and viruses (e.g. poor water and sanitation, poor public health, corrupt government, inadequate housing, etc.). In these countries, if economies and governance deteriorate further, we might see even more transmission of resistant bacteria.

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.

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