Vol. 1 No. 2 (2022): infermieristica journal: we never stop
Articles

Handling the challenge of antimicrobial resistant superbugs in the clinical setting: nursing staff as a pivotal player

PDF
  • Marco Coppi,
  • Ilaria Baccani,
  • Claudia Niccolai,
  • Alberto Antonelli,
  • Tommaso Giani,
  • Gian Maria Rossolini
Marco Coppi
Department of Experimental and Clinical Medicine, University of Florence, and Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
Ilaria Baccani
Department of Experimental and Clinical Medicine, University of Florence, and Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
Claudia Niccolai
Department of Experimental and Clinical Medicine, University of Florence, and Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
Alberto Antonelli
Department of Experimental and Clinical Medicine, University of Florence
Gian Maria Rossolini
Department of Experimental and Clinical Medicine, University of Florence, and Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
DOI: https://doi.org/10.36253/if-1906

Published 2022-12-17

Keywords

  • AMR,
  • MDR,
  • Infection Prevention and Control,
  • Antimicrobial Resistance,
  • Nursing Staff.
Copyright Notice

Abstract

Bacterial resistance to antibiotics (antimicrobial resistance, AMR) is spreading globally among major Gram-positive and Gram-negative bacterial pathogens (including staphylococci, enterococci, Enterobacterales, Pseudomonas aeruginosa and
Bacterial resistance to antibiotics (antimicrobial resistance, AMR) is rapidly spreading globally among major Gram-positive and Gram-negative bacterial pathogens (including staphylococci, enterococci, Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii); this phenomenon has a remarkable impact on morbidity, mortality and healthcare-associated costs. Evolution and dissemination of AMR can be counteracted with a combined strategy based on i) antimicrobial stewardship programs aimed at a prudent and appropriate use of antibiotics to improve clinical outcomes and reduce the selective pressure for resistance; and ii) infection prevention and control (IPC) practices, to limit the spread of resistant pathogens within the healthcare settings. In this scenario, the nursing staff plays a pivotal role, since these figures are involved in the enforcement and supervision of IPC bundles (e.g., contact precautions, hand, and environmental hygiene, active surveillance, patient isolation, or cohorting), which are essential to limit the spread of resistant pathogens among different patients. 

PDF

References

  1. Hutchings MI, Truman AW, Wilkinson B. Antibiotics: past, present and future. Curr Opin Microbiol. 2019
  2. Oct;51:72-80. doi: 10.1016/j.mib.2019.10.008. Epub 2019 Nov 13. PMID: 31733401.
  3. Tenover FC. Mechanisms of antimicrobial resistance in bacteria. Am J Infect Control 2006;34:S3–S10. doi:
  4. 1016/j.ajic.2006.05.219.
  5. Dadgostar P. Antimicrobial Resistance: Implications and Costs. Infect Drug Resist. 2019;12:3903-3910. doi:
  6. 2147/IDR.S234610.
  7. O’Neil J. Tackling drug-resistant infections globally: final report and recommendations. In: Ro A, ed.
  8. Resistance. London, United Kingdom; 2016; 1, 84. Available at: https://amr-review.org/sites/default/
  9. files/160518_Final%20paper_with%20cover.pdf.
  10. Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a
  11. systematic analysis. Lancet. 2022 Feb 12;399(10325):629-655. doi: 10.1016/S0140-6736(21)02724-0.
  12. Bassetti M, Garau J. Current and future perspectives in the treatment of multidrug-resistant Gram-negative
  13. infections. J Antimicrob Chemother. 2021;76(Suppl 4):iv23-iv37. doi: 10.1093/jac/dkab352.
  14. Koulenti D, Xu E, Mok IYS, Song A, Karageorgopoulos DE, Armaganidis A, Lipman J, Tsiodras S. Novel
  15. Antibiotics for Multidrug-Resistant Gram-Positive Microorganisms. Microorganisms. 2019;7(8):270. doi:
  16. 3390/microorganisms7080270.
  17. De Oliveira DMP, Forde BM, Kidd TJ, Harris PNA, Schembri MA, Beatson SA, Paterson DL, Walker MJ.
  18. Antimicrobial Resistance in ESKAPE Pathogens. Clin Microbiol Rev. 2020;33(3):e00181-19. doi: 10.1128/
  19. CMR.00181-19.
  20. WHO. Media Centre. News Release. WHO publishes list of bacteria for which new antibiotics are urgently
  21. needed. 2017. Available at: http://www.who.int/mediacentre/news/releases/2017/bacteria-antibioticsneeded/
  22. en/.
  23. Tacconelli E, Cataldo MA, Dancer SJ, De Angelis G, Falcone M, Frank U, Kahlmeter G, Pan A, Petrosillo N,
  24. Rodríguez-Baño J, Singh N, Venditti M, Yokoe DS, Cookson B; European Society of Clinical Microbiology.
  25. ESCMID guidelines for the management of the infection control measures to reduce transmission of
  26. multidrug-resistant Gram-negative bacteria in hospitalized patients. Clin Microbiol Infect. 2014;20 Suppl 1:1-
  27. doi: 10.1111/1469-0691.12427.
  28. European Centre for Disease Prevention and Control. Antimicrobial resistance in the EU/EEA (EARS-Net)
  29. -Annual Epidemiological Report 2020. Stockholm: ECDC. 2022. Available at: https://www.ecdc.europa.eu/en/
  30. publications-data/surveillance-antimicrobial-resistance-europe-2019.
  31. World Health Organization (WHO). Global action plan on antimicrobial resistance. 2015. Available at: https://
  32. apps.who.int/iris/bitstream/handle/10665/193736/9789241509763_eng.pdf?sequence=1.
  33. Arena F, Vannetti F, Di Pilato V, Fabbri L, Colavecchio OL, Giani T, Marraccini C, Pupillo R, Macchi C, Converti
  34. F, Rossolini GM. Diversity of the epidemiology of carbapenemase-producing Enterobacteriaceae in longterm
  35. acute care rehabilitation settings from an area of hyperendemicity, and evaluation of an intervention
  36. bundle. J Hosp Infect. 2018;100(1):29-34. doi: 10.1016/j.jhin.2018.05.025.
  37. Tomczyk S, Zanichelli V, Grayson ML, Twyman A, Abbas M, Pires D, Allegranzi B, Harbarth S. Control of
  38. Carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa in
  39. Healthcare Facilities: A Systematic Review and Reanalysis of Quasi-experimental Studies. Clin Infect Dis.
  40. ;68(5):873-884. doi: 10.1093/cid/ciy752.