The A-Z of Patient Care - R is for Resistance

We have all heard about ‘antibiotic resistance’ or ‘antimicrobial resistance’ in recent news, but what is really happening? Antibiotics can save lives, but improper use is quickly leading to a global crisis.

In 1945 Sir Alexander Fleming was awarded the Nobel Prize in Medicine for his discovery of Penicillin1. During his acceptance speech, he shared a cautionary tale regarding the responsible usage of antibiotics and warned “it is not difficult to make microbes resistant to penicillin”1. Of course, we now know his warnings were correct; antimicrobial resistance has become one of the biggest threats facing global health2

Antimicrobial resistance (AMR) is defined by the World Health Organization (WHO) as the ability of microorganisms to stop an antimicrobial (such as antibiotics) from working against it2.  AMR happens naturally overtime, however, overuse in recent years is quickly accelerating the process4. Without the discovery of new antibiotics, microbes are gradually becoming untreatable, threatening many of the most important medical advances we have made in recent years3.

• It will be increasingly difficult to treat common diseases such as MRSA and C.difficile, that we have previously taken for granted.

• Dangerous diseases that have recently been controlled such as HIV and malaria, will once again spiral out of control.

• Medical procedures such as surgery, organ transplantation and cancer chemotherapy will become extremely high risk.

• Life expectancy could fall back to where it was in the early 1900’s.

A Future Threat?

Antimicrobial resistance is not just threatening the future of global health, reports have shown that resistance is already everywhere, causing prolonged illness, extended hospital stays, increased medical costs and in the most severe cases, death.

Urgent Response

The urgency of this crisis has been acknowledged by many world leaders and health institutions. The UK Health Secretary Matt Hancock stated, “antimicrobial resistance is as big a danger to humanity as climate change”7 whilst WHO Director-General Dr Tedros Adhanom Ghebreyesus warned “antimicrobial resistance is one of the most urgent health risks of our time”8.  To address this crisis, a global action plan was put in place at the World Health Assembly, with a goal of ensuring continuity of successful treatment and prevention of infectious diseases3.

Research and Development

The plan emphasises the importance of developing new antimicrobials and optimising existing antimicrobial agents. Supporting research is also required to gain a better understanding of how resistance develops and spreads. When presenting their plan, the World Health Assembly emphasised the importance of a ‘one-health’ approach, whereby all countries and sectors collaborate to achieve the best outcomes for everyone. To guide research and development of new antibiotics, the World Health Organisation has issued a priority pathogen list focussed on global health priorities10. Leveraging these actions together will hopefully help in the race to tackle antibiotic resistance.

Prevention

The action plan also discusses how we can reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures3. Some of the key proposals include better immunisation so individuals develop protection from diseases that may otherwise need antimicrobial treatment; improving the awareness of AMR amongst health professionals and the wider public to promote behavioural changes towards more responsible usage and good sanitation and hygiene in all settings to restrict the spread of infection3.

"Every Infection Prevented Is One That Needs No Treatment"

Preventing infection reduces the need for antimicrobial treatment and the associated costs. At Vernacare, we are experts when it comes to infection prevention. 50 years ago we invented the disposable toileting system, designed to replace the need for reusable plastic bedpans which carry increased risk of transmitting bacteria such as CRE, VRE and C. Difficile that have developed resistance to some antibiotics.

Despite research demonstrating that bedpan washing does not eliminate all infection and bacterial spores, a large proportion of hospitals worldwide are still using reusable bedpans and bedpan washers. We are passionate about helping health care facilities SWITCH to our full system solution which includes a range of pulp containers and hospital macerators that ensure safe and hygienic disposal of waste and a range of patient hygiene solutions, such as our Oasis® waterless bathing range, that reduces the risk of infection that traditional bed bathing with water poses.

Infection prevention is a crucial factor in managing antimicrobial resistance. By reducing the need for and use of antimicrobials, we lessen the potential for development of resistance. To find out more about how our system can help you limit infection and the related need for antimicrobial treatment click here.