AMR pandemic: rising to the challenge with medical technologies – EURACTIV
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By Miriam D’Ambrosio | MedTech Europe
18-11-2022
[MedTech Europe]
Medical technologies can help to reduce infection risks, contain outbreaks and support antimicrobial stewardship. It is time for a broader view with more emphasis on prevention.
Miriam D’Ambrosio is the External Affairs – Manager Communications.
What comes to mind when we think of the next pandemic and how prepared we are for it? Perhaps it is a new virus or bacterial infection suddenly spreading around the world ‒ followed by a rapid effort to develop treatments and vaccines.
But sometimes a crisis can develop slowly in plain sight. The antimicrobial resistance (AMR) pandemic coming over the horizon has emerged over several decades. AMR occurs when microorganisms, such as bacteria or viruses, change over time and no longer respond to medicines.
Despite the warnings of experts, we are ill-prepared for what would happen if, for example, antibiotics were no longer effective. This is not a problem for the distant future. The most common multidrug resistant bacteria are already responsible for an estimated 25,000 deaths per year in Europe.
Healthcare-associated infections (HAIs), which account for a significant portion of AMR-related illness, are associated with 37,000 deaths annually. The medical technology industry is committed to addressing HAIs and AMR as interconnected topics.
Political momentum
AMR is now on the political agenda like never before. The WHO has called AMR a ‘silent pandemic’; the issue has been discussed by the G7; and is among the priorities highlighted in the mission letter sent by European Commission President Ursula von der Leyen to the Commissioner responsible for health, Stella Kyriakides.
This is welcome ‒ but there is a problem. The conversation is often too narrowly focused on developing new antibiotics. While that is an important element of a holistic response to this crisis, we need to think bigger and broader. In particular, we need to see much greater emphasis on prevention.
It is vital that the human, animal and environmental sectors join forces to encourage the prudent use of antimicrobials, discover new antibiotics and embrace new and existing preventive measures. That is why it is heartening to see that prevention is the theme of this year’s World Antimicrobial Awareness Week (WAAW) which puts a One Health approach at the centre of its message.
Preventing, directing and monitoring
Prevention and management of HAIs contribute to the control of bacterial resistance by limiting the transmission of multidrug resistant organisms, and consequently lowering the need for antibiotic therapy ‒ offering less opportunity for bacteria to become resistant to the antibiotics designed to kill them. Here, medical technologies play a vital role: antibacterial sutures and implants, coated endoscopes and patient warming devices all contribute to a healthcare-wide prevention effort. Many of these tools are cost saving for healthcare systems.
For those who require in-hospital care, including surgery, the medical technology sector has been at the forefront of working with surgeons to develop and implement digital surgical checklists. Checklists and cognitive tools prevent infections and enhance patient safety by acting against the negative consequences of healthcare worker’s emotional stress, unproductive teamwork, and communication problems.
Diagnostic tests are key to reducing the misuse and overuse of antibiotics. For example, the early and appropriate use of tests to differentiate between bacterial and viral infections. As antibiotics do not work on viruses, diagnostic information provides healthcare professionals with the information they need to make sound prescribing decisions.
Knowing which kind of bacteria is causing a patient’s illness, as well as to which antibiotic it is susceptible, allows the right treatment to be chosen. This improves patients’ outcomes while saving time and resources that might otherwise be wasted. In parallel, diagnostics also support the prevention and management of HAIs, therefore protecting the whole patient community as well as healthcare professionals. This encompasses screening for pathogens, including multidrug-resistant organisms, at hospital admission, as well as monitoring hospital wards and patients, detecting outbreaks and informing their resolution.
Diagnostic technologies assist in the surveillance of AMR patterns, providing valuable data to inform antimicrobial policy from the level of the hospital ward up to national level. Innovative tools are also used to monitor the compliance of patients with treatment, while smart systems are already used in some hospitals to detect contact with infected individuals. This aids hospitals in isolating or separating those who are infected from those who are not.
Similarly, in the community, fast and accurate testing for sexually transmitted infections (STIs) can contain outbreaks by informing behaviour change among infected individuals.
Future priorities
Many of today’s tools can help to prevent tomorrow’s infections. Our large and diverse sector is investing in research and innovation in a wide variety of areas, and medical technology companies are actively participating in the EU Innovative Health Initiative (IHI).
Indeed, among their seven priorities for R&D, MedTech Europe members have committed to developing ‘tools and services that support infection control; diagnostics that guide antimicrobial treatment decisions; and tools that aid responses to emerging infectious diseases’.
The goal now must be to step up the collective efforts of all key players in the global fight against AMR. We also see opportunities for EU institutions and Member States to do more.
Stronger action to raise awareness of AMR and to implement national action plans is essential. The ECDC should be tasked with developing evidence-based guidance and behavioural tools on infection prevention and control to be applied in hospitals across Europe.
Member States should enhance the behavioural change of healthcare professionals by expanding antibiotic stewardship and infection control programmes in healthcare facilities, supported by electronic surveillance systems. Greater transparency on infection rates can also help to drive continuous improvement.
As the medical and economic value of innovative technologies that prevent and control AMR and HAIs must be understood more clearly, the European Commission and EU Member States should support the development of new funding, studies and business models favouring the adoption of such tools.
Let’s not underestimate the scale of the task ahead. However, with our collective effort and by using available technologies, we can rise to the challenge of the AMR pandemic together.
The future of healthcare depends on our success. Failure is not an option.