Multidrug-resistant organisms (MDROs) are a significant cause for concern among infection preventionists and healthcare professionals globally. While they may not be tangible threats to the everyday observer, according to the World Health Organization (WHO), they pose a severe global and local health risk. Differences in perspective on the magnitude of antimicrobial resistance’s (AMR) global effect imply a complex issue that requires a well-informed, multi-faceted approach. Antimicrobial resistance poses unique challenges that should be considered carefully by all infection preventionists (IPs) focused on implementing clinical evidence-based practices to aid in the treatment and prevention of hospital and community-acquired infections.
Among the WHO’s bacterial priority pathogens list, Mycobacterium tuberculosis (MDR-TB) is a major bacterial resistance concern, globally. However, the prioritization of other antimicrobial bacteria hinges on collaborative research and development. Determining the burden of pathogenicity requires an understanding of the setting, including factors like food safety, chemical hazards, and noncommunicable diseases. There currently lacks a consensus on the most effective practice to prioritize infectious diseases. It is crucial to be cognizant of changes in the incidence of antimicrobial resistance patterns, including disparities among populations affected by drug-susceptible TB, MDR-TB, and extensively drug-resistant TB (XDR TB), when prioritizing AMR efforts and collaboration across local, regional, and state levels.
The WHO has acknowledged the importance of preventing rapidly emerging fungal priority pathogens, such as Aspergillus fumigatus, Cryptococcus neoformans, and particularly the multidrug-resistant Candida auris. Antifungal resistance commonly leads to extended hospital stays, treatment, and can burden the health of the affected individuals, with access restrictions in low and middle-income countries due to cost. In tackling this threat, the CDC published the ‘Antibiotic Resistance Threats in the United States, 2019 Revision’ to highlight AMR-associated risks burdening the U.S., including antimicrobial stewardship (AS), diagnostics, resistance factors, and support efforts. However, despite significant strides, gaps continue to limit progress against AMR.
To mitigate the consequences of microbial resistance, the CDC recommends enhancing the focus on infection prevention efforts, by promoting education and awareness, and conducting retrospective reviews of electronic health data to reduce the AMR burden. The National Healthcare Safety Network (NHSN) is a key electronic system for IPs, offering a platform for routine reporting, tracking, and benchmarking of health care-associated infections (HAI). NHSN’s surveillance and reporting abilities stretch to various facilities, including psychiatric hospitals, ambulatory surgical centers, and long-term hospitals.
Alongside this, the Association for Professionals in Infection Control and Epidemiology supplies a competency model for IPs and Epidemiologists to systematically reduce the threat of MDROs and AMR. Leveraging surveillance technology, diagnostic testing data, and techniques to adhere to transmission-based and standard precautions can prevent possible infections in patients and staff. This meticulous approach ultimately supports global action plans to lessen AMR risk and impact precipitously.