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Collaboration in infection control essential to meet future health crises
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The discovery of antibiotics, one of the greatest advancements in the history of medicine, was nonetheless a victim of the law of unexpected consequences: this miraculous life-saving tool gave rise to the unanticipated grave new danger of antibiotic resistance.
The growing realization that antibiotics are a shared global resource, where their misuse on one end of the world can have a devastating impact on their effectiveness on the other, demands that epidemiologists and all health professionals learn to collaborate more effectively than ever before — at the local, national and international levels.
Infection prevention and control teams within individual health systems are developing new tools and techniques to lead these efforts inside health care facilities. But the crucial worldwide prevention of serious infections and the promotion of appropriate antibiotic use requires a renewed commitment from public health professionals outside the hospital, from environmental services staff, from nursing and physician colleagues and from health care administration.
The fight against the deadly outbreak of Ebola virus disease was a vivid example of the value of health facilities collaborating with community partners to prevent, control and contain infectious diseases. In late 2014, amid increasing numbers of confirmed cases, WHO and its partners began coordinating a multicountry response to address the emergent care needs, interrupt transmission and contain the outbreak. This approach required building relationships and coordinating investments that crossed country, cultural and professional boundaries.
These relationships can come about through crises such as an Ebola outbreak, but efforts are already in place to create professional-to-professional level connections with multinational experts. Since 2009, the Society for Healthcare Epidemiology of America (SHEA) has built an international network of infection prevention and control experts to create relationships between the United States and international health care professionals with expertise in health care epidemiology and infection prevention. This program fosters networking opportunities and exposes these global leaders to educational opportunities that can promote the vital dissemination of knowledge and expertise. These leaders are afforded educational opportunities through SHEA’s journal and conferences.
This type of relationship-building before emergency situations is crucial. Within the U.S., public health and hospital partners have joined together to meet serious regional challenges in combatting communicable diseases, such as hepatitis A. In Kentucky, for example, the regional public health teams developed a vaccine strategy for containing a local hepatitis A outbreak. Understanding the limitations of their reach, they tapped relationships with the local children’s hospital to protect those aged 6 months or younger — who are ineligible for vaccine — by arranging adequate supplies and safe dosing of immune globulin. Together, public health and hospital teams were able to proactively prevent countless infections in the most vulnerable patients.
Although partnerships have been integral to the prevention and containment of infectious diseases, they have also had a significant impact on reducing inappropriate antibiotic use. In the U.S., we know that nearly one-third of all antibiotics are unnecessary or prescribed incorrectly. Together, community and hospital-based health professionals can build strategies for educating prescribers and overcoming sociobehavioral factors behind antibiotic prescribing to identify the nonclinical drivers of inappropriate prescribing that will help us design effective interventions.
During SHEA’s 2019 Spring Conference, from April 24 to 26 in Boston, attendees will recognize the importance of collaborating with external partners in infection prevention and antibiotic stewardship, as well as learn important strategies for building external partnerships to strengthen infection prevention efforts. To attend the meeting, or learn more about off-site continuing education opportunities, go to www.sheaspring.org.
- References:
- CDC. Antibiotic use in the United States, 2017: Progress and opportunities. https://www.cdc.gov/antibiotic-use/stewardship-report/pdf/stewardship-report.pdf. Accessed March 11, 2019.
- Fleming-Dutra KE, et al. JAMA. 2016;doi:10.1001/jama.2016.4151.
- WHO. Antimicrobial resistance global report on surveillance. https://apps.who.int/iris/bitstream/handle/10665/112642/9789241564748_eng.pdf;jsessionid=8FF33C2DF9FA1AF2909222345D84A4C2?sequence=1. Accessed March 11, 2019.
- For more information:
- Judith A. Guzman-Cottrill, DO, is chair of the SHEA Spring Conference and professor of pediatrics in the division of infectious diseases at the Oregon Health & Science University.
Disclosure: Guzman-Cottrill reports no relevant financial disclosures.