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ICU Patients Need More Protection from Superbugs

Patients in intensive care units are at greater risk of acquiring antimicrobial-resistant infections, and now, a group of international infectious disease experts ar calling for better protection for these high-risk patients.

An international coalition of intensive care and infectious disease experts have released a statement calling for more awareness and action among health care professionals to reduce the development of antimicrobial resistance (AMR) in patients in intensive care units (ICUs).

Although AMR broadly refers to the bacterial, viral, and fungal pathogens that have developed resistance to antibiotics, antivirals, and antifungals, tackling increasing resistance in bacteria has become a public health imperative around the world. Infections from drug-resistant bacteria threaten to undo years of global health advances, with the World Health Organization (WHO) noting that 480,000 people worldwide develop multidrug-resistant tuberculosis each year, affecting the fight against HIV and malaria. Patients with antibiotic-resistant infections experience longer hospital stays, higher medical costs, and increased risk of mortality.

Highlighting the problem of antibiotic resistance, in September 2017, the WHO released a report warning that the world is running out of antibiotics because of growing bacterial resistance and the lack of new antibiotics being developed.

“In addition to multidrug-resistant tuberculosis, WHO has identified 12 classes of priority pathogens—some of them causing common infections such as pneumonia or urinary tract infections—that are increasingly resistant to existing antibiotics and urgently in need of new treatments,” said a statement from WHO on the report.

Though antibiotic resistance is a threat advancing on many fronts, hospital patients in ICUs can be at particular risk of acquiring infections from drug-resistant superbugs. In a new statement recently published in Intensive Care Medicine, the official journal of the European Society of Intensive Care Medicine and the European Society of Paediatric and Neonatal Intensive Care, an international group of 20 authors from these and other organizations wrote that AMR infections are a clear and present danger to these high-risk patients. The authors are part of the Antimicrobial Resistance in Critical Care (ANTARTICA) coalition, which formed in November 2017 to address the problem of AMR in ICU patients.

The coalition notes that at least 25,000 patients die each year because of AMR infections in the hospital, many of them in the ICU, and the number of patients in Europe acquiring and dying from these infections is expected to continue to rise significantly. They estimate that by 2050, about 390,000 patients in European countries will die from AMR infections. Increased awareness and action from health care professionals can help prevent and improve treatment of these infections in ICUs, says the new statement.

“Close collaboration with other specialties, and combining these and other interventions in antibiotic stewardship programs should be a priority in every ICU,” write the authors.

“Considerate antibiotic use and adopting strict infection control practices to halt AMR remains a responsibility shared by all health care workers, from physicians to maintenance personnel, from nurses to physiotherapists, from consultants to medical students. Together, we can reduce AMR in our ICUs and continue to treat our patients effectively.”