Linking infection control to clinical management of infections to overcome antimicrobial resistance

A questionnaire-based study was conducted among final-year Thai medical students. The problem of antimicrobial resistance is well recognized, but their knowledge of antimicrobial resistance, appropriate antimicrobial use, and infection control was substantially limited. Only half of these students recognized existence of an antimicrobial stewardship program or infection control unit in their hospitals.Infect Control Hosp Epidemiol 2016;37:603–605

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One Health—Its Importance in Helping to Better Control Antimicrobial Resistance

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed4010022 ◽

2019 ◽

Vol 4 (1) ◽

pp. 22 ◽

Cited By ~ 27

Author(s):

Peter Collignon ◽

Scott McEwen

Keyword(s):

Antimicrobial Resistance ◽

Infection Control ◽

One Health ◽

Growth Promotion ◽

Animal Husbandry ◽

Resistant Bacteria ◽

Antimicrobial Use ◽

Inappropriate Use ◽

International Agencies ◽

Better Regulation

Approaching any issue from a One Health perspective necessitates looking at the interactions of people, domestic animals, wildlife, plants, and our environment. For antimicrobial resistance this includes antimicrobial use (and abuse) in the human, animal and environmental sectors. More importantly, the spread of resistant bacteria and resistance determinants within and between these sectors and globally must be addressed. Better managing this problem includes taking steps to preserve the continued effectiveness of existing antimicrobials such as trying to eliminate their inappropriate use, particularly where they are used in high volumes. Examples are the mass medication of animals with critically important antimicrobials for humans, such as third generation cephalosporins and fluoroquinolones, and the long term, in-feed use of antimicrobials, such colistin, tetracyclines and macrolides, for growth promotion. In people it is essential to better prevent infections, reduce over-prescribing and over-use of antimicrobials and stop resistant bacteria from spreading by improving hygiene and infection control, drinking water and sanitation. Pollution from inadequate treatment of industrial, residential and farm waste is expanding the resistome in the environment. Numerous countries and several international agencies have now included a One Health Approach within their action plans to address antimicrobial resistance. Necessary actions include improvements in antimicrobial use, better regulation and policy, as well as improved surveillance, stewardship, infection control, sanitation, animal husbandry, and finding alternatives to antimicrobials.

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Ukrainian Strategy and Action Plan for the Prevention of Healthcare Association Infections (HAIs) and Antimicrobial Resistance

International Journal of Antibiotics and Probiotics ◽

10.31405/ijap.2-3.18.01 ◽

2018 ◽

Vol 2 (2-3) ◽

pp. 6-23

Author(s):

A.G. Salmanov

Keyword(s):

Antimicrobial Resistance ◽

Infection Control ◽

Medical Care ◽

Action Plan ◽

Medical Personnel ◽

Laboratory Diagnosis ◽

Training System ◽

Hospital Environment ◽

Effective Control ◽

Control And Prevention

The Ukrainian Strategy and Action Plan for the Prevention of Healthcare Association Infections (HAIs) and An- timicrobial Resistance defines the purpose, principles and main directions of the improvement of the National system for control and prevention of HAI and AMR pathogens of these infections, mechanisms of its functioning, as well as expected socio-economic impact. Action plan underscores the need for an effective «One Health» approach involving coordination among numer- ous international sectors and actors, including human and veterinary medicine, agriculture, environment, and well-informed consumers. The Action Plan recognizes and addresses both the variable resources nations have to combat antimicrobial resistance. The main objectives of the Ukrainian Action Plan is to improve the regulatory, legal and methodological support system of prevention of Healthcare-associated Infections (HAI), laboratory diagnosis and monitoring of AMR pathogens infections, training system for medical personnel in these fields. We are talking about the introduction of modern approaches and optimization of controls and prevention of HAI, preventing of transmission of multi re- sistance pathogens in healthcare institutions, improving the effectiveness of disinfection and sterilization measures. It is planned to create a unified system of laws and regulations that will ensure effective control and prevention of HAI and AMR, and investigation of outbreaks when they occur and ensuring of adequate compensation to victims; to prepare a standard on infection control with the compliance of mandatory requirements aimed at preventing HAI and AMR in healthcare institutions based on their profile; to create in healthcare institutions the methods of epidemiological diagnostic, based on standard criteria for determining of nosocomial infection cases by anatomic localization of infection. In addition, it is necessary to optimize the list of indications for microbiological and clinical research material and objects of hospital environment, rules of sampling and shipping of samples of biological material in the laboratory. And to develop target prevention programs for HAI and AMR at the national (country), regional and municipal levels. To implement modern technologies on infection control and monitoring of AMR in health care institutions. As a result of the Ukrainian Action Plan is expected to reduce the number of infections caused by resistant strains of microorganism’s mortality, disability and complications from infections associated with medical care, increase the employment potential of the nation by reducing temporary and permanent loss of working ability as a result of population diseases. Also, it is necessary to increase safety of patients and staff while providing medical care.

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Relationship of Antimicrobial Control Policies and Hospital and Infection Control Characteristics to Antimicrobial Resistance Rates

American Journal of Critical Care ◽

10.4037/ajcc2007.16.2.110 ◽

2007 ◽

Vol 16 (2) ◽

pp. 110-120 ◽

Cited By ~ 20

Author(s):

Elaine L. Larson ◽

Dave Quiros ◽

Tara Giblin ◽

Susan Lin

Keyword(s):

Logistic Regression ◽

Antimicrobial Resistance ◽

Hand Hygiene ◽

Infection Control ◽

Practice Guidelines ◽

The United States ◽

Staff Attitudes ◽

Provider Attitudes ◽

Control Policies ◽

Resistance Rates

• Background Antibiotic misuse and noncompliance with infection control precautions have contributed to increasing levels of antimicrobial resistance in hospitals. • Objectives To assess the extent to which resistance is monitored in infection control programs and to correlate resistance rates with characteristics of antimicrobial control policies, provider attitudes and practices, and systems-level indicators of implementation of the hand hygiene guideline of the Centers for Disease Control and Prevention. • MethodsAn on-site survey of intensive care unit staff and infection control directors of 33 hospitals in the United States was conducted. The following data were collected: antimicrobial control policies; rates during the previous 12 months of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and ceftazidime-resistant Klebsiella pneumoniae; an implementation score of systems-level efforts to implement the guideline; staff attitudes toward practice guidelines; and observations of staff hand hygiene. Variables associated with resistance rates were examined for independent effects by using logistic regression. • ResultsResistance rates for S aureus, enterococci, and K pneumoniae were 52.5%, 18.2%, and 16.0%, respectively. Ten (30.3%) hospitals had an antibiotic control policy. No statistically significant correlation was observed between staff attitudes toward practice guidelines, observed hand hygiene behavior, or having an antibiotic use policy and resistance rates. In logistic regression analysis, higher scores on measures of systems-level efforts to implement the guideline were associated with lower rates of resistant S aureus and enterococci (P=.046). • Conclusions Organizational-level factors independent of the practices of individual clinicians may be associated with rates of antimicrobial resistance.

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Infection control and antimicrobial resistance

Germs and governance ◽

10.7765/9781526140791.00025 ◽

2021 ◽

Keyword(s):

Antimicrobial Resistance ◽

Infection Control

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1306. Antimicrobial Resistance Knowledge, Attitudes, and Perceptions Among Medical Students in Southern India

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.1139 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S399-S399

Author(s):

Olivia Menden ◽

Sumathi Prabhu ◽

Veena Shetty ◽

Chaithra Pandith ◽

Shobha Giri ◽

...

Keyword(s):

Multivariate Analysis ◽

Medical Students ◽

Antimicrobial Resistance ◽

Infection Control ◽

Antimicrobial Stewardship ◽

World Health ◽

Attitude Score ◽

Major Public Health Problem ◽

Antimicrobial Prescribing ◽

The Mean

Abstract Background Antimicrobial resistance (AMR) is a major public health problem in India. The World Health Organization recognizes that the education of medical students on antimicrobial stewardship plays a critical role in the efforts to combat AMR, but data related to knowledge, attitudes and practices (KAP) regarding AMR is limited in India. Methods This cross-sectional study was conducted in July-August 2017. Medical students at K.S. Hegde Medical Academy in Mangalore, India were surveyed with an anonymous questionnaire using a convenience sampling method involving second year, third year, fourth year, and intern students (n = 347). Data about demographics, sources of information, and antimicrobial training were collected. In addition, AMR knowledge and attitude scores were calculated. A Mann–Whitney U test was used to determine factors that were associated with significant differences in knowledge scores and attitude scores. The primary outcome measure of this study was to determine positive predictors of increased confidence in prescribing antimicrobials in the future using multivariate analysis. Results A total of 347 surveys were analyzed (response rate of 98.9%). The mean total knowledge score was 11.47 out to 31 with a standard deviation (SD) of 3.39, and the mean attitude score was 5.99 out of 16 (SD = 4.207). While 13.2% of students were “very familiar” or “familiar” with the term “Antimicrobial Stewardship,” and 88.2% of students said they would like more antimicrobial education in medical school. On multivariate analysis, female gender (OR 2.51, 95% CI (1.51, 4.18)), clinical vignette antimicrobial knowledge scores (OR 1.26, 95% CI (1.05, 1.51)), positive attitude scores (OR 0.94, 95% CI (0.88, 0.995)), awareness of Infection Control Policy (OR 1.87, 95% CI (1.09, 3.22)), and > 3 years of antimicrobial prescribing clinical training (OR 2.48, 95% CI (1.29, 4.75)) were predictors of confidence in antimicrobial prescribing. Conclusion This study identifies several possible interventions for improving confidence such as increased clinical knowledge through clinical experience, increased awareness of infection control policies and antimicrobial guidelines, and empowering students to be antimicrobial stewards to combat AMR. Disclosures All authors: No reported disclosures.

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COVID-19 and the potential long-term impact on antimicrobial resistance

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkaa194 ◽

2020 ◽

Vol 75 (7) ◽

pp. 1681-1684 ◽

Cited By ~ 36

Author(s):

Timothy M Rawson ◽

Luke S P Moore ◽

Enrique Castro-Sanchez ◽

Esmita Charani ◽

Frances Davies ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Severe Acute Respiratory Syndrome ◽

Hand Hygiene ◽

Infection Control ◽

Negative Impact ◽

Unintended Consequences ◽

Emerging Infections ◽

Long Term Impact ◽

Global Threat

Abstract The emergence of the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has required an unprecedented response to control the spread of the infection and protect the most vulnerable within society. Whilst the pandemic has focused society on the threat of emerging infections and hand hygiene, certain infection control and antimicrobial stewardship policies may have to be relaxed. It is unclear whether the unintended consequences of these changes will have a net-positive or -negative impact on rates of antimicrobial resistance. Whilst the urgent focus must be on controlling this pandemic, sustained efforts to address the longer-term global threat of antimicrobial resistance should not be overlooked.

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