Wednesday 28 September 2016

Patients facing growing threat from potentially life-threatening antibiotic-resistant bugs

Published 19/07/2016 | 12:12

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Hospital patients are facing a growing threat from antibiotic-resistant bugs which are potentially life-threatening, a new report warned today.

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The patient safety watchdog HIQA issued the warning in an analysis of how hospitals are controlling the use of antibiotics.

It found that while superbugs like MRSA and Clostridium Difficile rates have fallen in Ireland, other bugs which can cause a number of different infection types including urinary tract and bloodstream infection, and which may be more difficult to treat,  are increasing.

Sean Egan HIQA’s acting head of Healthcare Regulation said: “A number of these Gram-negative bacteria are highly resistant, and are associated with serious infections, up to and including life-threatening sepsis.

“Unlike MRSA, patients who carry these bacteria cannot be treated to eradicate them from their bodies. Antimicrobial prescribing and infection control practices in hospitals, and equally in community health and social care settings, needs to be of a high standard to fully address this emerging problem.”

“Therefore, the nature of this change requires a different, nationally coordinated response by the HSE and in particular be extended beyond acute hospitals into other non-acute residential and community care settings.”

The report warned that while progress has been made in larger hospitals in implementing best practice in managing and using antibiotics, the level of progress identified varied across the country, with some smaller hospitals not having safe and sustainable measures in place to protect patients.

In addition, more effective national planning and coordination is required to ensure that the entire health system is as prepared as it can be for what is an increasing and serious challenge for health-care providers.

“Resistance to antibiotics continues to increase in Ireland and internationally. In some instances, the level of antimicrobial resistance now being detected leaves clinical staff with a very limited choice of medicines that they can use to try to treat people.

“Ensuring prudent antimicrobial usage, through antimicrobial stewardship, should be a priority across all health services to help to address this problem.’’

‘‘This review examined how well public acute hospitals implement antimicrobial stewardship best practice. We identified that a number of hospitals need urgent support from the national Health Service Executive (HSE) in this area, as they do not have an antimicrobial stewardship programme in place and lack specialized resources. This is a significant patient safety concern and should be reviewed as a matter of urgency by the HSE,” said Mr Egan.

The report said a  national plan to deal with these problems in Ireland has not been updated since 2001 and a new one is urgently needed.

“This review found much commendable progress by highly committed front-line staff in advancing antimicrobial stewardship, but this has been hampered by the lack of an up-to-date national plan in this area.

“There are pockets of excellence in some hospitals, yet others lag behind, and progress in non-acute settings such as nursing homes has been very limited. More needs to be done to ensure that good practice in this area becomes the routine norm.”

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