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Healthcare Associated Infections, Antimicrobial Resistance and Health Economics

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A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 5847

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Special Issue Editor

Dr. Manuela Tamburro

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Guest Editor

Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
Interests: epidemiology; infectious diseases; antimicrobial resistance; antibiotics resistance determinants; healthcare infections; hygiene; infection prevention and control; surveillance; biostatistics; public health interventions

Special Issue Information

Dear Colleagues,

The increasing spread of antimicrobial resistance (AMR) represents a global public health threat and a serious concern for healthcare delivery. Significantly, it is projected to cause more deaths than all cancers combined by 2050. The misuse and overuse of antimicrobials are the main drivers in the development of drug-resistant pathogens, increasing the trend of multidrug resistance (MDR). According to estimates of from the Global Burden of Disease study in 2019, almost 5 million deaths were associated with bacterial AMR. Without effective antimicrobials, the success of modern medicine in treating infections—including during major surgery and cancer chemotherapy—would be utterly jeopardised. Moreover, the cost of AMR to the economy is also significant. In addition to death and disability, prolonged illness results in longer hospital stays, the need for more expensive medicines, and other financial challenges. According to the World Bank, the projected economic losses as a result AMR are comparable to those caused by the global financial crisis in 2008–2009, in terms of the annual reduction in global Gross Domestic Product. The majority of infections caused by MDR bacteria are of nosocomial origin, accounting for a burden comparable to that of the highest ranking non-communicable diseases in Europe. Preventing healthcare-associated infections (HAIs) is therefore an essential priority in strategies to curtail AMR emergence. Thankfully, 70% of HAIs are estimated to be avoidable with current evidence-based infection prevention and control (IPC) interventions.

The COVID-19 pandemic generated profound repercussions on hospital ecology, and has led to increased AMR rates; this is likely due to the disruption of antimicrobial stewardship (AMS) and IPC activities, the large use of broad-spectrum antimicrobials, and a rise in critical admissions in settings already highly endemic for MDR strains. Current procedures will likely become inadequate to protect vulnerable patients from severe MDR infections. Therefore, novel multisectoral approaches are urgently required—both for prevention and control—to fight the increasing challenge of AMR in healthcare systems worldwide.

We welcome articles focusing on, but by no means limited to:

(1) Epidemiology and prevention of HAIs;

(2) Multidrug-resistant microorganisms and therapeutic strategies;

(3) Antimicrobial consumption;

(4) The economic burden of HAIs and AMR.

Dr. Manuela Tamburro
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

antimicrobial resistance
antimicrobials consumption
antimicrobial stewardship
COVID-19 pandemic
health and economic burden
healthcare infections
multidrug resistance
treatment options

Published Papers (3 papers)

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Research

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13 pages, 961 KiB

Open AccessArticle

Healthcare System Distrust and Non-Prescription Antibiotic Use: A Cross-Sectional Survey of Adult Antibiotic Users

by Brooke A. Hawkes, Sana M. Khan, Melanie L. Bell, Jill Guernsey de Zapien, Kacey C. Ernst and Katherine D. Ellingson

Antibiotics 2023, 12(1), 79; https://doi.org/10.3390/antibiotics12010079 - 1 Jan 2023

Cited by 1 | Viewed by 1665

Abstract

Antibiotic resistance is a major public health concern driven by antibiotic overuse. Antibiotic stewardship programs are often limited to clinical settings and do little to address non-prescription antibiotic use in community settings. This study investigates the association between non-prescription antibiotic use and healthcare system distrust in the United States and Mexico. An online survey was deployed in the United States and Mexico with enhanced sampling through in-person recruiting in the border region. Non-prescription antibiotic use was defined as having bought or borrowed non-prescription oral or injectable antibiotics within the last 3 years. The survey included a previously validated 10-item scale to measure healthcare system distrust. Logistic regression was used to model the use of non-prescription antibiotics by the level of healthcare system distrust, adjusted for demographic characteristics and antibiotic knowledge. In total, 568 survey participants were included in the analysis, 48.6% of whom had used non-prescription oral or injectable antibiotics in the last 3 years. In the fully adjusted regression model, the odds of using non-prescription antibiotics were 3.2 (95% CI: 1.8, 6.1) times higher for those in the highest distrust quartile versus the lowest. These findings underscore the importance of community-based antibiotic stewardship and suggest that these programs are particularly critical for communities with high levels of healthcare system distrust. Full article

(This article belongs to the Special Issue Healthcare Associated Infections, Antimicrobial Resistance and Health Economics)

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8 pages, 268 KiB

Open AccessArticle

Impact of Infection Control on Prevalence of Surgical Site Infections in a Large Tertiary Care Hospital in Haiphong City

by Jérôme Ory, Quang Le Minh, Hung Phan Tien, Vinh Vu Hai, Elodie Careno, Tatiana Price, Alexandre Andrieux, Julien Crouzet, Catherine Dunyach-Rémy, Didier Laureillard, Jean-Philippe Lavigne and Albert Sotto

Antibiotics 2023, 12(1), 23; https://doi.org/10.3390/antibiotics12010023 - 23 Dec 2022

Viewed by 1528

Abstract

Few point prevalence surveys (PPS) have been conducted in Vietnam on Surgical Site Infections (SSI) or antimicrobial use in surgery. The objective of this study was to evaluate the PPSs of SSI before and after implementation of antibiotic stewardship programs (ASP) and infection control (IC) in a Vietnamese tertiary care hospital. ASP and IC practices were implemented in operating rooms and the orthopedic department, including antibiotic training, skin preparation, hand hygiene, gloves and sterile instruments, and SSIs risk factors. A PPS of SSIs and antimicrobial use was performed in January 2016 according to methods from the Centers for Disease Control and Prevention, before ASP and IC, and in December 2019. Information recorded included surgical data, antibiotic prophylaxis, microorganisms, and SSI risk factors. Skin preparation compliance assessed preoperative washing and antisepsis. SSI prevalence was 7.8% in 2016 versus 5.4% in 2019 (p = 0.7). The use of prophylactic antibiotics decreased from 2016 to 2019. A third-generation cephalosporin was prescribed more than 48 h after surgery for most patients. Skin preparation compliance increased from 54.4% to 70.5% between assessments. The decreased SSI, although non-statistically significant, warrants continuing this program. Vietnamese hospitals must provide comprehensive IC education to healthcare workers to address the prevention of SSI and establish IC policies. Full article

(This article belongs to the Special Issue Healthcare Associated Infections, Antimicrobial Resistance and Health Economics)

Review

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22 pages, 725 KiB

Open AccessReview

Educational Interventions to Reduce Prescription and Dispensing of Antibiotics in Primary Care: A Systematic Review of Economic Impact

by Vânia Rocha, Marta Estrela, Vanessa Neto, Fátima Roque, Adolfo Figueiras and Maria Teresa Herdeiro

Antibiotics 2022, 11(9), 1186; https://doi.org/10.3390/antibiotics11091186 - 2 Sep 2022

Cited by 8 | Viewed by 2252

Abstract

Antibiotic resistance remains a crucial global public health problem with excessive and inappropriate antibiotic use representing an important driver of this issue. Strategies to improve antibiotic prescription and dispensing are required in primary health care settings. The main purpose of this review is to identify and synthesize available evidence on the economic impact of educational interventions to reduce prescription and dispensing of antibiotics among primary health care professionals. Information about the clinical impact resulting from the implementation of interventions was also gathered. PubMed, Scopus, Web of Science and EMBASE were the scientific databases used to search and identify relevant studies. Of the thirty-three selected articles, most consisted of a simple intervention, such as a guideline implementation, while the others involved multifaceted interventions, and differed regarding study populations, designs and settings. Main findings were grouped either into clinical or cost outcomes. Twenty of the thirty-three articles included studies reporting a reduction in outcome costs, namely in antibiotic cost and associated prescription costs, in part due to an overall improvement in the appropriateness of antibiotic use. The findings of this study show that the implementation of educational interventions is a cost-effective strategy to reduce antibiotic prescription and dispensing among primary healthcare providers. Full article

(This article belongs to the Special Issue Healthcare Associated Infections, Antimicrobial Resistance and Health Economics)

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