Antimicrobial resistance
Tackling MRSA as an example In the early 2000s, bacteria resistant to antibiotics were widespread in UK hospitals, with MRSA posing a major threat to public health.10
This led to nationwide infection control
programmes in the mid-2000s, with a rapid decline in infections.10 Rapid and accurate information enables infection control measures to be implemented faster which can positively impact patient management. For MRSA, industry played a key role in in training programmes, investing in high quality resources and technologies towards the prevention of HCAIs. Industry and companies like BD also invested in improving diagnostics, with advances in rapid test molecular assays helping deliver faster identification and antibiotic susceptibility testing and reporting to enable targeted treatment and control measures, such as isolation, to be implemented. While antibiotic resistant organisms remain a significant public health threat, there are key learnings we can utilise to inform an effective AMR strategy. Practice and culture change is essential to infection prevention and effective antibiotic stewardship. Tackling this needs resources, and funding with collaboration between all stakeholders. This includes the need for patient involvement and education within stewardship processes across integrated care systems.
The ongoing fight against sepsis Ron Daniels, Sepsis Trust UK, says that: “Sepsis affects around 245,000 people each year in the UK, claiming at least 48,000 lives.11,12
As a
condition in which the body mounts a damaging response to infection, sepsis is a medical emergency. For every hour in which we delay administering appropriate antibiotics and controlling the source of infection, the chance of survival reduces.”13,14 The Sepsis Six is the name given to a bundle of medical therapies designed to reduce mortality
in patients with sepsis. Drawn from international guidelines that emerged from the Surviving Sepsis Campaign, the Sepsis Six was developed by The UK Sepsis Trust in 2006 as a practical tool to help healthcare professionals deliver the basics of care rapidly and reliably.15
The
Sepsis Six consists of three diagnostic and three therapeutic steps – all to be delivered within one hour of the initial diagnosis of sepsis.16 Blood cultures remain the gold standard in the microbiological diagnosis of sepsis.17
Therefore,
optimising the blood culture pathway is essential for ensuring the best outcomes for patients with sepsis and providing the most effective antimicrobial stewardship programme.9
This,
in turn, supports the reduction of morbidity and mortality rates, improves patient care and reduces healthcare costs.18 The key to improving outcomes lies not only in ensuring people have access to healthcare at the right time and empowering health professionals to act, but also in more effective integration of diagnostics into clinical systems and pathways to reduce the turnaround time, at each stage of the blood culture pathway18
– be it better sample
collection techniques to ensure accurate blood volumes are obtained, or decreased time to results by placing relevant technologies closer to the patient.9,18 These steps are examples of how an efficient diagnostic pathway can support clinicians to respond rapidly and accurately, not only saving individual patient lives, but also educating populations, the next generation, and slowing the spread of sepsis.19 The Infection Management Coalition (IMC)
was convened in January 2021 to drive change in support of holistic management and pandemic preparedness in response to the devastating impact the COVID-19 pandemic has had on
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societies and economies globally.20 As the IMC suggests, placing a truly integrated
ecosystem of diagnostics into an effective, highly trained resilient clinical system, which is easy for patients to access, has the potential to save lives.20 It is essential that a collaboration of
stakeholders including policymakers, industry and key opinion leaders work with healthcare organisations and statutory bodies to capitalise on the significant opportunities for improvement available.
Learning from COVID-19 The COVID-19 pandemic has further exacerbated concerns about AMR, raising questions about the global health system’s preparedness and its ability to respond to pandemics, but also how to keep patients healthy and safe in a world where antibiotics are losing their effectiveness. During the COVID-19 pandemic, 91 per cent
of patients admitted to intensive care units around the world received some form of antibiotic treatment.21
During the early stages
of the pandemic there were so many COVID-19- related concerns and unknowns. Difficulty in the rapid exclusion of bacterial infections and a lack of treatment guidelines pushed healthcare professionals to err on the side of treating with antibiotics.22
On a positive note, in the fight against
COVID-19, the UK raced to expand its diagnostics capacity, with the HM Treasury budgeting £13.5bn in 2021-22 for testing across England,23 alongside the introduction of the new ‘Lighthouse Labs’24
to increase capacity.
Better use of on-the-spot tests, which allow clinicians to distinguish between bacterial and viral infections, helped to tackle unnecessary prescribing of antibiotics as a default option by doctors unaware of the
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