Combating Superbugs: The Role of Community Education in Antimicrobial Resistance (AMR) Prevention

Objective The aim of the present study was to describe the process of establishment and coordination of the national Antimicrobial Use and Resistance in Australia (AURA) surveillance system. Methods Existing surveillance programs conducted by health organisations at state or multi-jurisdictional levels were reviewed, and gaps and opportunities identified for the development of a national system. In view of the time frame available as part of the Australian Government Department of Health funding agreement, the strategy used by the Australian Commission on Safety and Quality in Health Care was to commence work with existing surveillance programs, expanding and enhancing them and developing new systems where gaps were identified. Using the specifications of the AURA national system, the data from each of these elements were then analysed and reported. The system provides coverage for the acute and community sectors for antimicrobial use and antimicrobial resistance. Results The AURA surveillance system integrates eight streams of surveillance activities, including passive and targeted surveillance of antimicrobial use and resistance from hospitals (public and private) and the community (general practitioners and aged care homes). A gap was identified in timely surveillance of critical antimicrobial resistances (CARs), which resulted in the development of the national CARAlert system. The first comprehensive analyses of data across the surveillance programs was published in June 2016, providing baseline data for future reports to build on. Conclusion The AURA surveillance system has established the framework and foundation systems for an integrated and comprehensive picture of both antimicrobial use and resistance in Australia over time. National coordination and support will improve data collection, standardisation and analysis, and will facilitate collaboration across the states and territories, the Australian Government and the private sector. AURA publications will inform policy development and clinical decision making and improve consumer awareness of antimicrobial use and resistance. The system will continue to develop as a comprehensive system, with additional data over time, and appropriate clinical and epidemiological review. What is known about this topic? Surveillance of antimicrobial use and resistance is critical to inform effective policy development and public health responses to the growing problem of antimicrobial resistance. Until now, surveillance of antimicrobial use and resistance in Australia has been fragmented, with state and territory and professional group differences in data collection, analysis and reporting. What does this paper add? This paper profiles the development of the AURA surveillance system, the first nationally coordinated surveillance system for antimicrobial use and resistance, and its use of a partnership approach with contributing programs in order to promote participation and to obtain data to inform strategies to prevent and contain antimicrobial resistance. This paper highlights the establishment phase, noting that the system continues to be improved with growing participation from all sectors. What are the implications for practitioners? National surveillance data from the AURA surveillance system provides evidence for action to guide improvements in infection control, antimicrobial prescribing and the prevention and control of antimicrobial resistance across all healthcare sectors. It will also enable trends to be identified and reported on, and have the capability of determining the effect of interventions to improve and rationalise antimicrobial prescribing.

Estimating antimicrobial resistance burden in Europe—what are the next steps?

Spreading the word, not the infection: Reaching hospitalists about the prevention of antimicrobial resistance

Technology, particularly as it supports interactive learning communities, now plays a central role in community education. While technology affords access to information more efficiently than ever before, it also requires additional skills. For technology to play out its role effectively, community educators need to design instruction, curriculum, and programs that offer customizable learning and socially rich learning environments. Every effort needs to be made to make sure that learners have opportunities to access and learn with technology. Successful community efforts to incorporate technology tend to include these factors: local needs, local resources, local broad-based planning, partnerships among organizations, accessible and appropriate technologies, opportunities for community building and socializing, and locally meaningful content and outcomes. Two community education foci are examined in detail: women's empowerment and health literacy.

Technology, particularly as it supports interactive learning communities, now plays a central role in community education. While technology affords access to information more efficiently than ever before, it also requires additional skills. For technology to play out its role effectively, community educators need to design instruction, curriculum, and programs that offer customizable learning and socially rich learning environments. Every effort needs to be made to make sure that learners have opportunities to access and learn with technology. Successful community efforts to incorporate technology tend to include these factors: local needs, local resources, local broad-based planning, partnerships among organizations, accessible and appropriate technologies, opportunities for community building and socializing, and locally meaningful content and outcomes.

Evaluation of primary health care service participation in the National Tuberculosis Control Program in Menofya Governorate

The rapid spread of antimicrobial resistance (AMR) in the US hospitals poses serious quality and safety problems. Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices. To develop and validate a measurement scale for assessing hospitals' efforts to implement recommended AMR prevention and control measures. Surveys were mailed to infection control professionals in a national sample of 670 US hospitals stratified by geographic region, bedsize, teaching status, and VA affiliation. : Four hundred forty-eight infection control professionals participated (67% response rate). Survey items measured implementation of guideline recommendations, practices for AMR monitoring and feedback, AMR-related outcomes (methicillin-resistant Staphylococcus aureus prevalence and outbreaks [MRSA]), and organizational features. "Derivation" and "validation" samples were randomly selected. Exploratory factor analysis was performed to identify factors underlying AMR prevention and control efforts. Multiple methods were used for validation. We identified 4 empirically distinct factors in AMR prevention and control: (1) practices for antimicrobial prescription/use, (2) information/resources for AMR control, (3) practices for isolating infected patients, and (4) organizational support for infection control policies. The Prevention and Control of Antimicrobial Resistance scale was reliable and had content and construct validity. MRSA prevalence was significantly lower in hospitals with higher resource/information availability and broader organizational support. The Prevention and Control of Antimicrobial Resistance scale offers a simple yet discriminating assessment of AMR prevention and control efforts. Use should complement assessment methods based exclusively on AMR outcomes.

BackgroundCross-border healthcare may promote the spread of multidrug-resistant microorganisms (MDRO) and is challenging due to heterogeneous antimicrobial resistance (AMR) prevention measures (APM). The aim of this article is to compare healthcare workers (HCW) from Germany (DE) and The Netherlands (NL) on how they perceive and experience AMR and APM, which is important for safe patient exchange and effective cross-border APM cooperation.MethodsA survey was conducted amongst HCW (n = 574) in hospitals in DE (n = 305) and NL (n = 269), using an online self-administered survey between June 2017 and July 2018. Mann-Whitney U tests were used to analyse differences between answers of German and Dutch physicians (n = 177) and German and Dutch nurses (n = 397) on 5-point Likert Items and Scales.ResultsSimilarities between DE and NL were a high awareness about the AMR problem and the perception that the possibility to cope with AMR is limited (30% respondents perceive their contribution to limit AMR as insufficient). Especially Dutch nurses scored significantly lower than German nurses on their contribution to limit AMR (means 2.6 vs. 3.1, p ≤ 0.001). German HCW were more optimistic about their potential role in coping with AMR (p ≤ 0.001), and scored higher on feeling sufficiently equipped to perform APM (p ≤ 0.003), although the mean scores did not differ much between German and Dutch respondents.ConclusionsAlthough both German and Dutch HCW are aware of the AMR problem, they should be more empowered to contribute to limiting AMR through APM (i.e. screening diagnostics, infection diagnosis, treatment and infection control) in their daily working routines. The observed differences reflect differences in local, national and cross-border structures, and differences in needs of HCW, that need to be considered for safe patient exchange and effective cross-border APM.

Assessment of the participation of primary care services in national tuberculosis control program in Gharbia Governorate

Public attitude and knowledge of antibiotics are determinants of rational use of antibiotics and prevention of antimicrobial drug resistance. This study assessed perception and use of antimicrobials among staff members of a University in Southwestern Nigeria. Descriptive cross-sectional study among 450 staff members of Osun State University in Southwestern Nigeria using multistage sampling method was carried out. Semi-structured self-administered and pre-tested questionnaires were used in data collection. Data were analyzed using the SPSS software Version 17.0. Binary logistic regression models for the outcome variable of composite knowledge and attitude scores toward antimicrobials and their possible predictors were done and level of significance was set at p values ≤ .05 and confidence interval of 95% for all inferential analyses. Mean age of respondents was 26.8 (±11.1) years, and 331 (73.6%) had up to tertiary-level education. One hundred eighty-three (40.7%) and 267 (59.3%) had good and poor knowledge scores, respectively; 175 (38.9%) had positive attitude whereas 275 (61.1%) had negative attitude toward the use of antibiotics. About 279 (62.0%) were informed about judicious use of antibiotics, 398 (88.4%) had ever used antibiotics in the past 1 year with the Ampicillin and Cloxacillin combinations being the most commonly used. Eighty-eight (22.1%) used antibiotics for more than 10 days as at the last use. Predictors for having good knowledge and attitude include age, educational status, and ever having used antibiotics. Inadequate knowledge and attitude toward antibiotics were observed, and this necessitates sustained health education campaign to stakeholders on rational use of antibiotics, especially toward prevention of antimicrobial resistance.

People continue to socialize about the negative impacts of early marriage. However, early marriage still occurs a lot, especially in rural areas. This study aims to examine the factors causing early marriage, the impacts of early marriage, and the role of community education in preventing early marriage. This study uses a qualitative approach with the research location in Labakkang District, Pangkep Regency. Data collected through observation, interviews, and documentation were analyzed descriptively. The informants in this study numbered 5 people: a community leader, three early marriage couples, and an employee of the religious affairs office. The results of the study showed that early marriage was due to arranged marriages and considered a disgrace if they refused the proposal. The social health impacts of early marriage are dropping out of school, gender discrimination, divorce, mental health, pregnancy, childbirth, and postpartum problems. The role of community education in preventing early marriage is still very minimal because of the characteristics of a tough society that make it difficult to provide understanding. This research has implications for the importance of the government, community leaders, religious leaders, and traditional leaders working together to provide education regarding early marriage and its impact on society at large.

Antimicrobial resistance (AMR) represents a persistent and ascensive global threat influenced by antibiotic misuse and overuse. In the Romanian context, patterns of antibiotic consumption and resistance within the healthcare system are marked in the red scenario on the European map. General practitioners and pharmacists, among others, play a major role in stewardship towards AMR. To explore the practices, strategies, and challenges in antibiotic treatment and prevention of antimicrobial resistance from the perspectives of Romanian community pharmacists and general practitioners. Semi-structured interviews were conducted with six general practitioners and five community pharmacists in Romania from January to March 2024. An inductive, Goffman theory-inspired thematic analysis was conducted, inspired by Braun and Clarke's thematic analysis method, consisting of familiarization with the data, iterative coding guided by theoretically inspired questions, and identification and refinement of (sub)themes. Goffman's theory of social interaction, focusing on the concepts of front stage, backstage, and roles, guided the analytical questions. The results were presented in three overarching themes: 'Knowledge acquired backstage to support challenges and performance on front stage', 'Adapting roles and performances on the front stage: A mix of structured and twisted acts', and 'Interprofessional Collaboration: A latent part in the play's roles and performances'. Professionals prepared their understandings of AMR and antibiotics backstage, with an awareness of the challenges rooted in the Romanian context. The front stage scenario evolved from structured antibiotic performances led by AMR strategies with compliant actors to challenging performances influenced by actors which changed the course of performances and intended AMR strategies. The revealed competition between general practitioners and pharmacists further complicated antibiotic use and AMR-related performances. The Romanian socio-political system influenced the course of antibiotic treatment and the professionals' intended antibiotic related practices and AMR strategies. The study showed a theory-practice gap in health professionals' practices, leading to limited strategy integration towards AMR and increased antibiotic use. The study underscores the need for context-specific policies and interventions to minimize identified gaps.

BackgroundThe ability of microorganisms to resist antimicrobial medicines is called antimicrobial resistance (AMR). AMR awareness among the general public may be increased via a variety of approaches including the use of social media campaigns, traditional media, influencer outreach storytelling, community theatre, interactive games and quizzes and art and music. This analysis aims to evaluate YouTube videos to educate the general public about AMR.MethodsA content analysis was performed on the AMR educational videos that were retrieved from YouTube using the following keyword phrases: ‘what is antimicrobial resistance’, ‘causes of antimicrobial resistance’ and ‘prevention of antimicrobial resistance’.ResultsA total of 74 AMR educational videos were identified and analysed based on predefined selection criteria. Subsequently, three online videos that met the inclusion criteria were selected and analysed.ConclusionsThe analysed AMR educational videos were easily accessible and comprehensible, and serve as valuable resources for promoting AMR awareness and education among the general population.

Prevention of antimicrobial resistance in sub-Saharan Africa: What has worked? What still needs to be done?

Thailand Antimicrobial Resistance Containment and Prevention Program.