Why should antimicrobial resistance be a priority for the healthcare sector?

Dr Giancarlo Basaglia: Antimicrobial resistance is a significant clinical and public health issue, and a large part of the problem is resistance to antibiotics. People have been aware of this situation for a long time, and despite numerous useful initiatives, unless more effective action is carried out, the situation will deteriorate within the next few years.

“Among the many important areas involved, microbiology plays several specific roles.”

How does microbiology play a role in understanding and tackling antimicrobial resistance?

Among the many important areas involved, microbiology plays several specific roles. It is vital in the diagnosis of microorganisms causing infection and the subsequent testing of their sensitivity to numerous antimicrobials.

It enables us to then collect data on these microorganisms from an epidemiological standpoint. Microbiology also allows for the monitoring and prompt reporting of the most critical microorganisms in terms of aggressiveness and resistance to antimicrobials. This process and the data it produces helps significantly in consultation at all levels of healthcare, as well as the training of professionals and further research and study in the sector.

How does that initial diagnosis allow microbiology professionals to perform the subsequent stages?

Diagnosis is the daily work of microbiology professionals and it is also propaedeutic to the stages that follow. Diagnosis must be appropriate, within a time frame that meets clinical requirements and in line with the indications outlined in literature by various scientific associations and healthcare organisations.

Microbiological diagnosis is very important due to its clinical significance, but also because it is the basis for the majority of surveillance and epidemiology. The latter is important because it raises awareness about the situation and spread of microorganisms caused by infections and their resistance to antimicrobials on a local, national and international level.

How does collaboration play a part in tackling antimicrobial resistance?

Collaboration and surveillance networks are important when dealing with microorganisms and assessing their levels of resistance. Working together and benefiting from multiple forms of surveillance means we can analyse specific resistances to antibiotics and compare the results on a range of different levels. When it is possible to see the results of a particular antibiotic resistance from a number of regions, crucial steps can be taken in an effort to analyse potential causes and put forward improvement measures. This collaboration between regions and organisations is vital.

How has the Covid-19 pandemic affected the increase in antibiotic resistance microbes?

The Covid-19 pandemic is an example of how epidemiology can be used to assess new and urgent situations effectively. Studies have shown that those who suffer with Covid-19 also exhibit a considerable increase in resistance towards antibiotic treatment for infections such as methicillin-resistant Staphylococcus aureus (MRSA) and bacteria that produce extended spectrum beta-lactamases (ESBL) resistance to carbapenems (KPC) and quinolones. This represents a serious problem for these patients both when suffering from Covid-19 and in the post- Covid-19 phase, and also due to the potential spread of more aggressive microorganisms from these patients to others. While the emphasis is still very much on the Covid-19 pandemic, the pandemic of antimicrobial resistance demands that surveillance remains high and that more effective initiatives be established to support the continuing fight against it.

Research in collaboration with M Busetti, A Sartor, R De Rosa, M Gobbato, E Clagnan and L Arnoldo.