As the world continues its efforts against the Sars-CoV-2 virus, one cannot forget “superbugs,” that is, bacteria that resist the action of antibiotics. It is enough to mention that these caused the direct deaths of 1.27 million people in 2019 alone.

This number may not be particularly worrying, but if we think of the estimates that AIDS and malaria caused in 2019 – respectively 860,000 and 640,000 deaths – the perception changes, and not a little.

The confirmation came thanks to a report published in the scientific journal The Lancet: the careful and timely analysis, entitled “Global Research on Antimicrobial Resistance”, also calculated that antibiotic-resistant infections played an important role in almost 5 million of deaths. The scientists’ work covered 204 countries around the world and confirmed that antibiotic resistance (AMR) poses a real threat to the health of all, especially in low- and middle-income countries.

We at AMIL Care believe it is essential to reflect on this issue. For this reason, we decided to dedicate an article intended to assist the work of professionals such as purchasing managers in hospitals, medical equipment managers, clinical engineers (Aiic), safety and hygiene managers (HSE), and clinical risk managers (i.e., risk managers). 

Antibiotic resistance: a definition

When we talk about antibiotic resistance, we mean “the ability of a bacterium to resist the action of one or more antibiotic drugs” and to survive and multiply even in their presence. 

Antibiotic resistance, at least in part, is a phenomenon that can be natural – when the bacterium is naturally resistant to an antibiotic -, but also acquired – when the bacterium adapts to resist an antibiotic through modifications to its genetic heritage. 

Antibiotic resistance may therefore depend on (and increase) due to human actions. 

The Impact of antibiotic resistance in Italy 

In Italy, the surveillance of antibiotic resistance is coordinated by the Higher Institute of Health and is based on a network of hospital laboratories that send antibiotic sensitivity data for pathogens isolated from invasive infections. 

There are 8 pathogens under surveillance. 

Among Gram-positive bacteria: 

  • Staphylococcus aureus,
  • Streptococcus pneumonia,
  • Enterococcus faecalis and Enterococcus faecium.

Among the Gram-negative bacteria: 

  • Escherichia coli,
  • Klebsiella pneumoniae,
  • Pseudomonas aeruginosa,
  • Acinetobacter species.

 What causes antibiotic resistance?

There are many possible causes of antibiotic resistance. Let’s look at some of them briefly. 

  • The excessive or inappropriate prescription of antibiotic drugs, both in medicine and in veterinary medicine;
  • the inappropriate use and, in general, the excessive use of antibiotic drugs;
  • incorrect use of medicines by patients;
  • the use of antibiotics in zootechnics and agriculture;
  • the prevalence of hospital-acquired infections caused by antibiotic-resistant microorganisms, and the resulting limited control of these infections;
  • an increased diffusion of resistant strains, often due to an increase in international travel and migratory flows.

In particular, the continuous use of antibiotics favors the emergence, multiplication, and spread of resistant strains. Not only that: the presence of pathogens resistant to multiple antibiotics (in these cases, we speak of multidrug resistance) further reduces the possibility of an effective treatment. 

In addition, it should not be forgotten that this phenomenon largely concerns healthcare-related infections, which then arise and spread within hospitals and similar healthcare facilities. 

Antibiotic resistance: the consequences

The spread and multiplication of antibiotic-resistant bacteria in hospitals or healthcare facilities is a problem that should not be underestimated, as the infections caused by them can be not only serious but also difficult to cure. 

All over the world, antibiotic resistance increases the number of cases of illness and death and prolongs the duration of hospitalizations. In Italy, the percentage of bacteria resistant to antibiotics and causing infections can fluctuate between 30 and 60%. The greatest risk is that, over time, pan-resistant bacteria, i.e. resistant to all antibiotics, may develop. 

Without antibiotics, it is worth specifying that various treatments would no longer be possible, starting from organ transplants to chemotherapy, intensive care, and many other procedures. 

Since 2001, AR-ISS surveillance has been active in Italy, coordinated by the Higher Institute of Health, for the collection of data relating to the spread of antimicrobial resistance in healthcare facilities. Starting in 2017, a Plan to combat AMR was approved in Italy, which concerns, in addition to those antibiotics, also resistance to antifungal, antiprotozoal, and antiviral drugs. 

Antibiotic resistance: prevention and protection 

Many studies show that hundreds of thousands of deaths are caused by common and previously treatable infections, such as those of the respiratory tract or blood, because the bacteria that cause them have become resistant to treatments over time. 

There are several ways a country can tackle the phenomenon of antibiotic resistance: 

  • rapid and substantial investment in new treatments;
  • an improvement in the efficiency of infection control measures;
  • optimization of the use of antibiotics.

AMIL Care devices in response to antibiotic resistance 

How to prevent antibiotic resistance, and how to fight it?  

First of all, it is good to sanitize hospital environments correctly, using the right tools and relying on those who hold the most effective patents. 

It is now established that contamination of surfaces around the ward plays an important role in the transmission of microorganisms, starting with Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE), Clostridium difficile, Acinetobacter baumanii, Norovirus, and Klebsiella pneumonia. 

AMIL Care offers an effective, simple, and safe system, based on a patented and certified device. 

We are talking about the Medisystem system and in particular the Medibios Plus device, the latest generation micro-nebulizer of ready-to-use solutions. 

Medibios Plus is a practical, handy, and technological class I medical device CE marked, and is designed to be used in various hospital areas. It is positioned in the intermediate range of the Medibios range produced by AMIL Care and is covered by a European, American, and Mexican patent. 

Medibios Plus supplies liquid solutions such as class IIa medical devices, biocides, medical-surgical aids and supplies, and sanitizers. 

Each operator must scrupulously comply with the warnings and instructions provided in the manual, contained within each product.