Healthcare Experts Unite to Combat Antimicrobial Resistance At Landmark Symposium

Left to right: Dr Mark Miller (Chief Medical Officer of bioMérieux), His Excellency Axel Cruau (Ambassador of France to Malaysia), YB Dato’ Lukanisman bin Awang Sauni (Deputy Minister of Health Malaysia) and En Mohd Hareeff Muhammed (CEO of Premier Integrated Labs and Chairman of Organising Committee of Center of Excellence) officiating the event.  

Kuala Lumpur, 23 November 2023 – Healthcare leaders and experts from public, private and global healthcare organisations came together yesterday for the landmark Antimicrobial Stewardship (AMS) Center of Excellence (COE) Day Symposium, jointly organised by bioMérieux, IHH Healthcare Malaysia, and Premier Integrated Labs. The symposium facilitated knowledge exchange and interconnectivity between AMS teams from different specialities, to address the threats of Antimicrobial Resistance (AMR). AMR is a major global health concern that hampers our ability to treat common infectious diseases, resulting in prolonged illness, higher healthcare costs, and increased mortality.

They shared insights into the challenges posed by AMR and the role of AMS as a solution. The symposium also highlighted the importance of diagnostics in AMR control, the link between antimicrobial resistance and judicious use of antibiotics, and initiatives in the public and private healthcare sector for controlling AMR.

Dr Mark Miller, Chief Medical Officer at bioMérieux and an expert on AMR and AMS, addressed how latest diagnostic tests can help physicians in adopting AMS principles while providing appropriate treatment for infectious diseases. Meanwhile, the National Institute of Health (NIH) presented their insights on national antimicrobial resistance data, which is integral in directing national efforts against this public health threat.

The symposium marked the first anniversary of the establishment of the AMS Center of Excellence (COE) partnership between bioMérieux, IHH Healthcare Malaysia and Premier Integrated Labs. The latter two healthcare providers join healthcare institutions in China and India to be designated as AMS COEs in Asia Pacific. Since its establishment, the Malaysia COE has marked several milestones in the fight against AMR. Notably, they have established an antibiotic resistance reporting framework, and organised nine AMS education programmes for front line healthcare professionals to advance their skills in AMS.

The presence of Deputy Minister of Health, YB Dato’ Lukanisman bin Awang Sauni, underscored the national importance of the symposium. YB Dato’ Lukanisman, in his speech said, “I am extremely pleased to see a partnership with the private sector committed to combating AMR. The effort to overcome this global threat requires collaboration from multiple different sectors. I would also like to congratulate bioMérieux, IHH Healthcare Malaysia and Premier Integrated Labs for being the first AMS COE in the region, and for organising a successful event today.”

Left to right: Dr. Rahela Ambaras Khan, Head of Pharmacotherapy Services, Pharmacy Department, Hospital Kuala Lumpur; Mr Tan Yew Aik, Head of Pharmacy Services IHH Healthcare Malaysia; En Mohd Hareeff Muhammed, CEO of Premier Integrated Labs and Chairman of Organising Committee of Center of Excellence; YB Dato’ Lukanisman bin Awang Sauni, Deputy Minister of Health Malaysia; His Excellency Axel Cruau, Ambassador of France to Malaysia; and Jacob Morton, AMS Global Programme Director bioMérieux at the symposium.

Mr Jean-François Naa, CEO of IHH Healthcare Malaysia, added, “At IHH Healthcare Malaysia, we are fully committed to combating AMR. It is integrated into our global sustainability goals, and we have set up an active AMS committee in Malaysia to strategically spearhead initiatives. In this battle against AMR, knowledge remains our strongest ally. The exchange of insights and experiences between global experts, local healthcare leaders and private healthcare providers is crucial, as we navigate these uncharted waters. Moving forward, it is crucial that we work together strategically to combat resistance, instead of in silos.”

The symposium was a significant step towards addressing the global health concern of AMR. It not only facilitated knowledge exchange and collaboration but also highlighted the importance of strategic partnerships in combating AMR

ABOUT ANTIMICROBIAL RESISTANCE 

Antimicrobial resistance (AMR) is a global health crisis caused by the natural mutation of bacteria, fungi, viruses, and parasites, leading to their resistance to antimicrobials. This means that standard antimicrobial treatments become ineffective, and infections persist, increasing the risk of severe consequences to the patient. AMR is directly responsible for 1.27 million deaths annually and is associated with 4.95 million deaths worldwide due to drug-resistant infections.

Combating AMR is critical to safeguard the efficacy of antibiotics for future generations. The appropriate use of diagnostics can guide responsible antimicrobial use, preserving their lifesaving potential.
ABOUT THE CENTER OF EXCELLENCE PARTNERSHIP

bioMérieux adopts a proactive, partnership-driven approach to combat AMR. Through diagnostic and data-driven solutions, bioMérieux strives to enhance AMS efforts. The AMS Centers of Excellence (COE) designation is awarded to leading hospitals globally that commit to best AMS practices. Currently, bioMérieux is partnered with thirteen sites across multiple continents. IHH Healthcare Malaysia and Premier Integrated Labs have achieved the distinction of becoming the first healthcare providers in ASEAN to be awarded the COE.

This partnership aims to promote data-driven best practices as well as to advance medical education in the field of AMS. It also focuses on generating real-world medical and economic data, emphasising the value of combining diagnostics, medical education, lab consultancy services, and information technology solutions. This partnership symbolises a significant step toward a world free from the threat of AMR.

By inspiring other health institutions, the COE can contribute to increasing the quality of care and improving the level of healthcare systems in Malaysia.

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Are You Aware of Your Child’s Handwashing Habits? Here’s Why You Should Be

WORDS LIM TECK CHOON

FEATURED EXPERT
PROFESSOR EMERITA DR ELIZABETH SCOTT
Chair of the Global Hygiene Council
FIRST, THE BIG CONCERN
  • Infectious diseases are the leading cause of death all over the world.
  • Every year, there are about 525,000 children under 5 that perish from diarrhoea-related diseases.
  • A single emerging infectious disease can cost the global economy anything from USD30–50 billion.
  • There is also the rise of drug-resistant infections to worry about.
WHAT DO OUR CHILDREN HAVE TO DO WITH THIS?

Professor Dr Elizabeth Scott reveals that about 1.8 million children under the age of 5 die each year from diarrhea-related diseases and pneumonia.

However, it does not have to be this way. Professor Dr Scott shares that:

  • Simple handwashing could protect 1 in 3 children from diarrhoea.
  • Likewise, handwashing can shield 1 in 5 children from pneumonia.

“Access to handwashing essentials such as soap and water, and hand washing education in schools not only fosters good hygiene habits but can help to improve attendance,” she goes on to explain.

She adds: “Furthermore, early hygiene habits potentially enhance child development in some settings.”

Are you washing your hands correctly? Click for a larger, clearer image.
OUR KIDS AREN’T WASHING THEIR HANDS ENOUGH OR CORRECTLY, THOUGH!

Results of the Global Hygiene Council’s survey on nearly 5,000 parents, primary school teachers
and children aged between 5 and 10 found that:

  • 40% of primary school children are not always using soap when washing their
    hands at school.
  • 27% of primary school children did not learn how to wash their hands at school.
  • Only 37% of parents and teachers know that hands can still contain germs when they are visibly clean.
  • 47% of primary school children believe that if their hands are visibly clean, they will not get sick.
  • 65% of primary school children say they have seen people in their school not wash their hands after going to the toilet.
  • 50% of parents and teachers believe that children’s handwashing habits have little effect on whether they get ill.
OH DEAR, IS THERE ANYTHING THAT CAN BE DONE ABOUT THIS?

The Global Hygiene Council offers the following recommendations, which they call the ‘four pillars of change’:

Pillar 1: Build on lessons learned from the COVID-19 pandemic.

Link lessons learned from the implementation of hygiene practices in previous pandemics (such as handwashing, mask wearing, and surface disinfection) to provide policy guidance for future public health campaigns and infection, prevention and control policies.

Pillar 2: Mainstream AMR-sensitive infection prevention and control tools.

Direct more focus on infection prevention and investment in new antimicrobials, vaccinations, and antimicrobial stewardship. National action plans on antimicrobial resistance should be adapted to include hygiene and Water, Sanitation, and Hygiene (WASH) recommendations for home and community settings.

Pillar 3: Quantify the economic benefits of hygiene.

Consider hygiene education and access to appropriate hygiene facilities as a critical and cost-effective solution for facilitating hygiene behaviour change and protecting against the spread of infectious diseases in schools, at workplaces, and throughout communities.

Pillar 4: Establish strong hygiene habits.

Make public communications campaigns easy to understand and built on evidence-based approaches. Highlight the personal impact that changing hygiene behaviour has on the health of families and communities with respect to reducing the risk of infection.

PROTECTING FUTURE GENERATIONS AGAINST PANDEMICS

To protect against future pandemics, including the threat of antimicrobial resistance, there is a need for greater public awareness of the role of targeted hygiene practices in preventing infections within home and community settings.

Future public health campaigns and infection prevention and control policies should include clear and practical information on evidence-based practices, as well as ensuring adequate access to clean water and hygiene resources to help prevent the spread of infections, including those that are drug resistant.

References:

  1. World Health Organization. (2021, March 10). Diarrhoea. https://www.who.int/health-topics/diarrhoea
  2. McArthur D. B. (2019). Emerging infectious diseases. The nursing clinics of North America, 54(2), 297–311. https://doi.org/10.1016/j.cnur.2019.02.006
  3. Liu, L., Johnson, H. L., Cousens, S., Perin, J., Scott, S., Lawn, J. E., Rudan, I., Campbell, H., Cibulskis, R., Li, M., Mathers, C., Black, R. E., & Child Health Epidemiology Reference Group of WHO and UNICEF (2012). Global, regional, and national causes of child mortality: An updated systematic analysis for 2010 with time trends since 2000. Lancet (London, England), 379(9832), 2151–2161. https://doi.org/10.1016/S0140-6736(12)60560-1
  4. Ejemot, R. I., Ehiri, J. E., Meremikwu, M. M., & Critchley, J. A. (2008). Hand washing for preventing diarrhoea. The Cochrane database of systematic reviews, (1), CD004265. https://doi.org/10.1002/14651858.CD004265.pub2
  5. Aiello, A. E., Coulborn, R. M., Perez, V., & Larson, E. L. (2008). Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. American journal of public health, 98(8), 1372–1381. https://doi.org/10.2105/AJPH.2007.124610

Is Antimicrobial Resistance the Next Global Threat After COVID-19? Let’s Find Out

WORDS PROFESSOR DR SASHEELA SRI LA SRI PONNAMPALAVANAR

FEATURED EXPERT
PROFESSOR DR SASHEELA SRI LA SRI PONNAMPALAVANAR
Infectious Disease Professor
University Malaya Medical Centre (UMMC)

As Malaysia and most of the world transitioned to the endemic phase of COVID-19, it’s easy to forget that just two years ago, the pandemic had led to millions of lives lost, rise in unemployment rates, and the near-collapse of healthcare systems due to the tsunami of cases. Today, thanks to the quick development of medical innovations such as COVID-19 vaccines, we are now able to continue living our lives in the new normal, resuming productivity, and building towards economic recovery and growth.

Now that we have seen the long-lasting and devastating impact that a pandemic can leave, it is vital that we draw our attention to tackling another urgent public health crisis—antimicrobial resistance, which continues to rise to alarming levels across the world.

A SILENT PANDEMIC

Over the years, antimicrobial resistance has become an urgent health challenge on a global scale. This is because microbes such as bacteria, fungi, and viruses no longer respond to commonly used medicines, resulting in infections becoming harder to treat.

How antibiotic resistance happens. Click the image above for a larger, clearer version.

Antimicrobial treatment no longer serves their desired effect, which in turn will increase the risk of poor outcomes in patients with an infection caused by antimicrobial resistance.

During the COVID-19 pandemic, there was a significant increase in antibiotic prescriptions despite a relatively low bacterial co-infection rate.

The misuse of antibiotics in these patients can result in increased selective pressure for antimicrobial resistance leading to a lasting consequence of the COVID-19 pandemic .

Apart from overprescribing of antibiotics unnecessarily, the increased risk of antimicrobial resistance is compounded by the lack of awareness of appropriate antibiotic use and a poor understanding on the consequences of misusing antibiotics among the public .

It is estimated that drug resistance claims 700,000 lives every year, and this toll is projected to increase exponentially to 10 million a year by 2050 without immediate action.

CONCERNING IMPACTS OF ANTIMICROBIAL RESISTANCE

Development of new antibiotics may not be fast enough to replace those that have become less effective due to antimicrobial resistance

The discovery of antibiotics was a turning point in human history, revolutionizing medicine and increasing the survival rates of infected patients over time.

However, the growing burden of antimicrobial resistance threatens the return to a world with a scarcity of effective treatments for even common bacterial infections such as urinary tract infection, pneumonia, skin infection, and surgical site infections.

As the effects of antimicrobial resistance continue to increase today, the discovery and development of new antimicrobials is not able to keep up against the emergence of AMR.

There is an urgent need for new antibacterial drugs in the market, but with this, comes the importance of ensuring that these antibiotics are used wisely.

Patients should be prescribed antibiotics only when needed, at the right dose, frequency, and duration. Otherwise the new antibiotics will also suffer the same fate as its predecessors and eventually lose effectiveness .

Antimicrobial resistance can also result in productivity loss caused by sickness and premature death, as well as rise of healthcare cost that stems from prolonged hospital stays and care

Without effective tools for the prevention and adequate treatment of drug-resistant infections, treatment may fail for an increasing number of patients. There will also be an increased risk in major medical procedures such as surgery, chemotherapy, and organ transplants .

WHAT CAN WE DO TO REDUCE & PREVENT ANTIMICROBIAL RESISTANCE?
  1. We should only take antibiotics when prescribed by a doctor and correctly follow the prescription directions.
  2. Don’t demand for antibiotics and buy medication without a prescription, or share or take leftover antibiotics.
  3. Maintain strict infection prevention measures such as hand hygiene to reduce the spread of antimicrobial resistance organisms.
  4. There is now increasing evidence that certain vaccines currently available for infectious diseases can decrease the risks of AMR by preventing bacterial and viral infections. Keeping up to date on vaccination schedules. particularly for children and elderlies, may be able to reduce the use of antibiotics, and thus prevent antibiotic-resistant infections.
A CALL TO STAKEHOLDERS TO RISE UP & REDUCE THE SPREAD OF ANTIMICROBIAL RESISTANCE

Besides creating awareness among consumers and healthcare professionals, combatting antimicrobial resistance also requires action from governments, policymakers, and industry players to really address the crux of the issue.

Investment is required in antibiotic research and development, both as a tool to control novel disease outbreaks, and to treat known pathogens developing resistance to currently available treatments.

We must learn from the COVID-19 pandemic to address the next global and public health threat. We have seen that it is indeed possible for all parties to work together to reduce the spread of COVID-19—from citizens adhering to new SOPs, pharmaceutical companies driving innovations that led to the creation of vaccines and COVID-19 treatment, and governments who put in place and enforced guidelines for the people, while also supporting the R&D of these innovations.

The same urgency is needed so that we can prevent the next public health crisis.