Antimicrobial resistance: Key facts

Posted on 11 January 2018

Mediclinic is continually involved in the process of seeking solutions to the many daunting challenges faced by the healthcare industry, including infection prevention. Antimicrobial resistance and hospital-acquired infections are on the rise worldwide, and the prevention of these healthcare-associated infections (HAI) is a major challenge for both private and public healthcare systems.

As a reputable international healthcare organisation, Mediclinic promotes and adheres to stringent infection prevention and control programmes to identify, control and reduce the transmission of multidrug-resistant organisms (MDROs), and to improve patient safety within our hospitals.

In an environment where infection prevention and control is already highly regulated, Mediclinic, with the interests of its patients at heart, goes beyond mere compliance with regulations to prevent infections as far as possible.  Mediclinic’s prevention protocols and measures include conducting patient screenings, decolonising programmes where applicable, continuous monitoring of hand hygiene compliance and environmental cleaning, and employing dedicated Infection Prevention and Control (IPC) managers. As a result of this strong focus on infection prevention and control and the adoption of a multi-modal approach, Mediclinic has shown a reduction of 15% in the overall HAI rate as reported in 2016.

The reality is that South Africa is encountering the same threats of infections caused by MDROs, or bacteria that have become resistant to certain antibiotics, as the rest of the world.

Hospital patients are exposed to an increased risk of infection. Patients undergo various invasive procedures, many patients may have compromised immune systems, infections can be transmitted from patient to patient directly or through the hands of healthcare workers, or through direct contact with visitors. Infections can also be transmitted through contaminated equipment and can be environmentally acquired.

Adding to this challenge is the fact that our lifestyle also contributes to the development of these organisms. It is vital that everyone within the healthcare system, including doctors, nurses and patients, becomes involved in the process of managing and fighting the spread of MRDOs. Mediclinic believes that by teamwork in the different healthcare and community environments, the development and spread of MRDOs can be controlled.

Mediclinic remains unwavering in its commitment to quality healthcare for all South Africans and the current Mediclinic Public Private Initiatives roll out programme of pro bono surgical procedures for public sector patients bears testimony to this. Ongoing very positive independent patient satisfaction survey outcomes (undertaken by the international market leader in the field) testify to the positive patient experience in Mediclinic hospitals. Accurate patient records ensure thorough documentation of the entire patient journey, supporting the quality of care from initial admission all the way to post-stay care.

WHAT MEDICLINIC IS DOING TO IMPROVE PATIENT SAFETY

Mediclinic adheres to stringent, world-class infection prevention and control measures that include screening of patients who meet pre-defined criteria for the presence of multidrug resistant organisms.

Patients admitted to Mediclinic are requested to inform their healthcare worker if they have been recently admitted to another healthcare facility, had any procedures in hospitals or doctors’ rooms, travelled to other countries or were recently treated with an antibiotic for an infection. If we deem these patients at risk, they are then accommodated in special-isolation rooms to reduce the likelihood of transmission of organisms to other patients.

Patients who are about to undergo specific types of procedures are requested to shower with an antibacterial soap. This simple but important measure, implemented together with other interventions reduces the likelihood of developing an infection with a MDRO.

Our strategy also includes the continuous monitoring of hand hygiene compliance and environmental cleaning. Guidelines and training materials are based on scientific evidence and recommendations from the World Health Organisation (WHO), the Centre for Disease Control and Prevention (CDC) and the Canadian Institute for Healthcare Improvement (IHI).

An antimicrobial stewardship programme ensures that antibiotics are used appropriately and with consideration to reduce the development of MDROs. The majority of Mediclinic hospitals have dedicated Infection Prevention and Control (IPC) managers who are responsible for the implementation of our comprehensive IPC programmes. They work closely with the patient safety managers and ward pharmacists as a multi-disciplinary team, meeting regularly and continuously evaluating patient treatment plans and processes to improve patient safety.

MDROs OUTSIDE OF HEALTHCARE FACILITIES

As an added challenge, hospitals, clinics, old age homes/nursing homes, radiology, rehabilitation facilities, doctor consulting rooms and other healthcare facilities are no longer the only source of MDRO infection – personal hygiene factors and changes in diet also contribute to the development of these organisms.

For instance, where water is stored for long periods and/ or adequate hand hygiene is not performed due to the current Western Cape water shortages, additional opportunities for the transfer of MDRO infection arise.

Furthermore, inappropriate prescription and use of antibiotics in the community is also aggravating the problem and has a negative impact on the development of resistance.

MEASURES TO REDUCE PERSONAL RISK OF MDRO INFECTIONS

  • Ensure you follow your doctor’s instructions when taking prescribed antibiotics.
  • Avoid undercooked animal proteins.
  • Wash your hands with soap and water for at least 20 seconds, especially after visiting the gym or after contact sports.
  • Carry an alcohol hand rub with you and perform hand hygiene whenever necessary.
  • If you visit a patient in hospital or a nursing home, wash your hands or use an alcohol hand rub when you enter and before you leave the person’s room. In addition, wear disposable gloves if you expect to come in contact with body fluids.
  • Preventative vaccinations (such as the flu vaccine) also play a role in avoiding secondary infections.
  • Even practicing good hygiene in the preparation of food can reduce unnecessary illness due to diarrhoea that might require an antibiotic.
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