Stewardship / Resistance Analysis for July 21, 2021

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Canadian One Health report tackles antimicrobial resistance

The Canadian Veterinary Medical Association (CVMA) and the National Antimicrobial Resistance Network (AMR) have released a new report focused on One Health that suggests improvements to a pan-Canadian AMR governance structure and optimal models for responding to RAM.

The report “Strengthening the Governance of the Response to Antimicrobial Resistance Across a Single Health Care in Canada” proposed two approaches, or models, for dealing with the AMR crisis. He says any approach must connect and foster knowledge sharing across One Health and across Canada, and it must increase the capacity to accelerate action and deliver meaningful solutions.

The first model, called the AMR Network, “is aimed at those who view the AMR ecosystem in Canada as complex, both in terms of the diversity of stakeholders involved and the range of actions needed to address the problem. problem in question, ”according to the report. It gives One Health experts control over priorities.

The second model, dubbed the AMR Center, takes a classic top-down approach and “allows a holistic approach to select priorities, choosing to have a significant impact in a number of priority areas”.

In a statement yesterday by the Public Health Agency of Canada (PHAC), Canadian Health Minister Patty Hajdu, MPA, said: “This report will help all parties take a One Health approach. tackle this universal problem. It will also serve as an important tool for discussions alongside the work the federal government is undertaking with provincial and territorial partners and with stakeholders to mitigate the potential impact of AMR and protect the health of Canadians.

PHAC funded the AMR network to explore governance models that unite various stakeholders.
CVMA report of July 19
PHAC statement of July 20

Study links prevalence of superbugs in emergency rooms to ambulance trips

A study by scientists at Duke University today finds that patients arriving to their emergency department (ER) by ambulance were almost four times more likely to have methicillin resistance Staphylococcus aureus (MRSA) or vancomycin resistant Enterococcus (VRE) colonization or infection than those who did not arrive by ambulance, although the number of both is low.

The single-center retrospective cohort study, published in Infection control and hospital epidemiology, involved 11,324 patients from 2016 to 2019. About a third (3,903) were in the ambulance group, the rest in the unexposed group.

Among them, 9 patients (0.08%) tested positive for MRSA and 3 (0.03%) for VRE. The 30-day prevalence of MRSA or VRE was higher in the ambulance group than in the unexposed group: 8 (0.20%) and 4 (0.05%), respectively. Patients arriving to the emergency room by ambulance were almost four times more likely to have MRSA or VRE within 30 days of encounter (relative risk, 3.72; 95% confidence interval, 1.09 to 12.71 ; P = .04).

The authors say that one of the strengths of their study is its strict inclusion criteria for assessing the prevalence of multidrug-resistant organisms (MDROs), but they also note that the study design did not consider all of them. confounding factors. They write: “To our knowledge, our study represents the first controlled and matched analysis to assess the impact of ambulance exposure on the development of MDROs.
July 21 Infect Control Hosp Epidemiol study


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