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Antimicrobial resistance (AMR) is a growing global problem and because the management of COVID-19 is increasingly becoming dependent on pharmacological interventions, there is greater risk for accelerating the evolution and spread of antimicrobial resistance. According to the WHO, AMR is the largest global health threat in the 21st century that requires urgent measures. Common infections are becoming untreatable due to the emergence of AMR.
AMR occurs when bacteria, viruses, fungi, and parasites alter over time and stop responding to medicines. This makes infections harder to treat and in turn increases the risk of disease spread, severe illness, and death. Antibiotics are one of the best tools to help save millions of lives. However, the rise of antibiotic-resistant bacteria is diminishing the efficacy of antibiotics and endangering the feasibility of most modern medical procedures. As a result, addressing AMR requires a holistic and multisectoral approach.
Antimicrobial stewardship in the COVID-era As hospitals faced being overwhelmed by SARS-CoV-2 patients, priorities, understandably, changed. Access to antibiotic susceptibility testing (AST), a key tenet of robust antimicrobial stewardship, was limited by time constraints and infection control measures. As a result, the use of broad-spectrum antibiotics in hospitalized COVID patients in the absence of bacterial screening became almost routine in the early days of the pandemic, prompting many to warn of the impact on AMR. Overtreating people with antibiotics can put them at risk of unnecessary side effects. Furthermore, it is at odds with the medical community’s efforts to limit AMR by preserving antibiotics for those who really need them. Confirming the presence, identity, and resistance profile of a causative agent in sepsis is essential to good antimicrobial stewardship – or making sure the right patient gets the right treatment at the right time.
Amit Chopra Managing Director India and South Asia Thermo Fisher Scientific
Various randomized controlled trials have demonstrated the value of the biomarker procalcitonin (PCT) in helping to differentiate between viral and bacterial infections and informing treatment de-escalation strategies. A precursor of the hormone calcitonin, PCT is detected at very low levels in healthy individuals but is upregulated by the cytokines released in response to bacterial infections. It has been shown to lead to more adequate diagnosis and appropriate treatment – the cornerstone of antibiotic stewardship. Rapid antibiotic susceptibility testing (AST) also has a role to play. Traditional methods of AST, which can define pathogens and guide first-time treatment plans, can take up to 72 hours due to the requirement for overnight cultures. But new ways of doing things are emerging. There is an unmet need for rapid and decentralized diagnostics in outpatient clinics to reduce the misuse of antibiotics. AST minimizes the unnecessary use of antibiotics and helps curb the spread of antibiotic resistance. There is a committed effort by the scientific community to ensure that antibiotic use remains informed and measured to protect future healthcare. Thermo Fisher Scientific is contributing significantly as a partner in these efforts. We understand the role AST plays, and we have a robust product line to support AST efforts. The Thermo Scientific™ Sensititre™ System for ASTis a complete portfolio of solutions that provides modular, customizable antibiotic susceptibility testing to meet the unique demands of each laboratory, regardless of size and volume. Utilizing diagnostics and biomarkers to reduce the overuse of antibiotics is key to tackling AMR and spread of antibiotic-resistant infections. In short, correct first-time clinical decisions not only help protect the global population, but they also protect at an individual and healthcare system level. And by adding biomarkers, such as PCT, and advanced methods like rapid AST to the diagnostic jigsaw, we can start to balance the twin threats of sepsis and AMR.