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Tackling Antimicrobial Resistance: Strategies to Overcome Persistent Hospital Infections

In a major study presented at the ESCMID Global Congress, formerly known as ECCMID, in Barcelona, Spain, researchers reveal concerning findings regarding antimicrobial-resistant (AMR) hospital infections in the United States. Despite progress since the peak of the COVID-19 pandemic, hospital-acquired AMR infections remain significantly elevated, indicating a need for urgent action to address this ongoing public health challenge.

The study, led by Dr. Christina Yek from the US National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), examined data from 120 US hospitals before, during, and after the pandemic. The analysis focused on trends in AMR infections caused by various pathogens, including MRSA, VRE, ECR, CRE, CRAB, and CR-PA, among adults aged 18 years and older.

During the COVID-19 pandemic, hospital-acquired AMR infections surged by 32%, driving an overall increase in AMR prevalence of 6.3%. Notably, infections caused by gramme-negative pathogens, known for their resistance to multiple antibiotics, rose by almost 20%. The most significant increases were observed in infections resistant to carbapenems, considered the last resort for treating severe infections.

Dr. Yek emphasised that hospitals experiencing surges in severely ill COVID-19 patients had the largest increases in AMR infections. Factors such as heightened antibiotic use, challenges in infection prevention and control protocols, and shortages of personal protective equipment likely contributed to the spread of AMR infections in strained healthcare facilities.

While overall AMR incidence has nearly returned to pre-pandemic levels, hospital-acquired AMR infections remain 13% above pre-pandemic levels. In particular, infections caused by carbapenem-resistant organisms continue to pose a significant threat, with rates remaining substantially elevated compared to pre-pandemic levels.

Dr. Yek underscored the importance of addressing the persistence of high rates of hospital-acquired AMR infections, especially those caused by difficult-to-treat gramme-negative pathogens. More action is needed to protect patients and mitigate the impact of AMR on public health.

In response to these findings, experts recommend a multifaceted approach to tackle the challenge of antimicrobial resistance (AMR) in hospital settings. This includes implementing rigorous antibiotic stewardship programmes to optimize antibiotic use and curb the emergence of resistance. Strengthening infection prevention and control measures such as hand hygiene, environmental cleaning, and surveillance are also crucial to limit the spread of AMR pathogens within healthcare facilities. Additionally, there is a call for increased investment in research and development to develop new antibiotics and alternative treatment options for drug-resistant infections. Education and training for healthcare professionals on appropriate antibiotic use, infection prevention practices, and antimicrobial stewardship are deemed essential. Furthermore, fostering collaboration and coordination among healthcare facilities, public health agencies, and government organizations is highlighted as pivotal in addressing AMR on both regional and national levels.

By implementing these strategies and adopting a comprehensive approach to combating AMR, healthcare facilities can work towards reducing the burden of hospital-acquired infections and safeguarding patient health. Continued efforts and investment in AMR surveillance, research, and prevention are crucial to addressing this global health threat effectively.

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