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AMR: effective infection prevention and control measures

02 August 2019
Volume 30 · Issue 8

Abstract

Antimicrobial resistance is on the rise. As more infections are becoming resistant to antibiotic treatment, it would benefit practice nurses to be aware of the effective measures they can use to prevent the spread of infection, explains Naomi Fleming

When micro-organisms are exposed to an antimicrobial, more susceptible organisms succumb, leaving behind those resistant to the antimicrobial. They can then pass on resistance to their offspring. The use and misuse of antimicrobials has increased the number and types of resistant organisms. As a result, standard treatments become ineffective and infections persist and may spread. Infection prevention and control (IPC) is key to reducing demand for antimicrobial use and reducing the acquisition of antimicrobial resistance. Poor IPC can increase the spread of drug-resistant infections. Interventions such as effective hand hygiene and vaccination have significant potential to limit opportunities for drug-resistant strains to emerge. Effective leadership is vital and nurses are central to promoting IPC, leading on IPC compliance and ensuring uptake of vaccination in primary care.

The World Health Organization (WHO) defines antimicrobial resistance (AMR) as the ability of a micro-organism (such as bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics, antivirals and antimalarials) from working against it.

Drug resistance is a natural evolutionary phenomenon. When micro-organisms are exposed to an antimicrobial, the more susceptible organisms succumb, leaving behind those resistant to the antimicrobial. They can then pass on their resistance to their offspring. Over the past years, the use and misuse of antimicrobials has increased the number and types of resistant organisms. Consequently, many infectious diseases may one day become uncontrollable. With the growth of global trade and travel, resistant micro-organisms can spread promptly to any part of the world (WHO, 2017).

As a result of AMR, standard treatments become ineffective and infections persist and may spread to others. The O'Neill (2016a) report estimated that by 2050, 10 million lives a year and a cumulative $100 trillion of economic output will be at risk due to the rise of drug-resistant infections if we do not find proactive solutions to slow down drug resistance. Approximately 700 000 people die of resistant infections every year (O'Neill, 2016a). Antibiotics are a special category of antimicrobial drugs that underpin modern medicine as we know it. If they lose their effectiveness, key medical procedures (such as gut surgery, caesarean sections, joint replacements, and treatments that depress the immune system like chemotherapy) could become too dangerous to perform (O'Neill, 2016a).

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