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    Jan 16, 2021
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    Antibiotic resistance in conflict settings: lessons learned in the Middle East

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    Name:
    Kanapathipillai R et al - 2019 ...
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    Authors
    Kanapathipillai, R
    Malou, N
    Hopman, J
    Bowman, C
    Yousef, N
    Michel, J
    Hussein, N
    Herard, P
    Ousley, J
    Mills, C
    Seguin, C
    Saim, M
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    Issue Date
    2019-04-10
    Submitted date
    2019-05-10
    
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    Journal
    Journal of Antimicrobial Chemotherapy
    Abstract
    Me´decins Sans Frontie`res (MSF) has designed context-adapted antibiotic resistance (ABR) responses in countries across the Middle East. There, some health systems have been severely damaged by conflict resulting in delayed access to care, crowded facilities and supply shortages. Microbiological surveillance data are rarely available, but when MSF laboratories are installed we often find MDR bacteria at alarming levels.1 In MSF’s regional hospital in Jordan, where surgical patients have often had multiple surgeries in field hospitals before reaching definitive care (often four or more), MSF microbiological data analysis reveals that, among Enterobacteriaceae isolates, third-generation cephalosporin and carbapenem resistance is 86.2% and 4.3%, respectively; MRSA prevalence among Staphylococcus aureus is 60.5%; and resistance types and rates are similar in patients originating from Yemen, Syria and Iraq.1–3 These trends compel MSF to aggressively prevent and diagnose ABR in Jordan, providing ABR lessons that inform the antibiotic choices, microbiological diagnostics and anti-ABR strategies in other Middle Eastern MSF trauma projects (such as Yemen and Gaza). As a result, MSF has created a multifaceted, context-adapted, field experience-based, approach to ABR in hospitals in Middle Eastern conflict settings. We focus on three pillars: (1) infection prevention and control (IPC); (2) microbiology and surveillance; and (3) antibiotic stewardship.
    Publisher
    Oxford University Press
    URI
    http://hdl.handle.net/10144/619402
    Language
    en
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    Other Diseases

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