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Hcainetwork.org

Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection February 2009 Volume 1, Number 2
In This Issue

 European Union
antibiotics among the public, health care professions and societies and the conference was ‘myth-busting’ in relation to antibiotic resistance and the The schools poster competition winner James
A teaching resource
Fawcett standing in front of his poster with the
for hygiene,
Minister Ann Keen and Dom Wood
microbes and
were participating in this initiative as a infections aimed at
team. The Minister also highlighted the role of educating children and raising awareness about the prudent and responsible use of antibiotics in the younger generation. primary and
secondary schools.
To further help raise awareness a schools poster competition called ‘Antibiotic Resistance Challenge’ was organised. Schools from across England participated in this competition with the winner attending the conference in London to receive his prize from Ann Keen and the television presenter Dom Wood. A dedicated website has been created for podcasts of the presentations and Click on the link
above to find out
more about ARHAI
and its members or
to access
presentations and
notes of previous
ARHAI meetings.


http://ecdc.europa.eu/

The European
Centre for Disease
Prevention and
Control (ECDC) is
an EU agency which

aims to strengthen
The runner up posters from left to right: Chloe Mead, Amy Sanders and Colette Baker,
Europe's defenses
Dan Mitten
against infectious
Access full information about the schools poster competition winner and diseases.
The results of the quarterly mandatory MRSA Bacteraemia for July to September 2008 have shown an encouraging reduction in the number of cases. There has now been a http://www.nhs.uk/ARC
continuous downward trend in MRSA bacteraemia with a 13% decrease in the number Official website of
of reported cases received in July to September 2008 compared with the previous the ARHAI and DH
quarter (April to June 2008) and a 33% reduction compared with the corresponding quarter of 2007 (July to September). schools poster
competition.
There was a 30% decrease in the number of reported MRSA bacteraemias received in 2007/08 compared with 2006/07, with a decrease in the rate from 1.67 to 1.19 cases per 10,000 bed days. Contact Us
ARHAINewsletter@hpa.org.uk
 The updated Health Protection Agency (HPA) guidance on the “Diagnosis and management of PVL-associated Staphylococcus aureus infections (PVL-SA) in the UK” can be found on  The Department of Health and the HPA have produced guidance on Clostridium difficile Infection, Prevention and Management. This guidance provides advice for health care professionals on all aspects of the surveillance, prevention, diagnosis, treatment and management of  The HPA has launched an educational DVD which provides an introduction to infection control for care homes. This DVD will be distributed free of charge to all care homes, HPUs and other relevant stakeholders. It features a series of seven short films focusing on the following areas: - Prevention of Exposure to Blood and Body Fluids Following reports last year that circulating H1N1 viruses had been identified with a mutation causing oseltamivir resistance, UK surveillance for the winter 2008 has demonstrated a continuing spread of these viruses. The majority of H1N1 viruses are resistant to oseltamivir, but susceptible to zanamivir and amantadine. Most of these isolates are from the southwest of England. Nevertheless, around 90% of currently circulating influenza is the H3N2 virus, susceptible to both neuraminidase inhibitors. The HPA should be alerted to any strain of the virus showing resistance to either of the neuraminidase inhibitors. Neisseria gonorrhoeae – cefixime susceptibility Following the spread of ciprofloxacin resistant strains, cefixime has become the standard therapy for gonorrhoea. Currently it is given as a single 400mg oral dose. Recently there have been reports of MICs of 1-2mg/L (borderline susceptibility) in Japan; there has also been a rise in the MICs in UK isolates. This is of particular concern as there are no other oral antibiotic alternatives currently available and laboratories are advised to report any cefixime-resistant isolates to the HPA. Carbapenem resistance – novel therapies Carbapenem resistance is becoming an ever-increasing problem in both hospital and community acquired infections in the UK and many other countries. The most common organisms involved are Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli and Enterobacter species. Plasmid-encoded carbapenemases are capable of causing severe infections in patients in hospitals and care homes. Moreover, these organisms are not easily detected in routine microbiology investigations. The therapeutic options for infections caused by these gram-negative organisms are very limited and there is a pressing demand for novel therapies. An overview of the pipeline for novel agents returns very few hits for new antimicrobials targeted for treatment of drug-resistant gram-negative pathogens. There are a few agents exhibiting promising results but these are in the very early stages of development. One agent is the carbapenem Doripenem, which has recently been approved by the FDA and is under review in Europe. This has shown increased in-vitro activity against Pseudomonas aeruginosa and similar activity to meropenem against extended-spectrum beta-lactamase producing pathogens. However, whether this activity will be reflected in clinical practice remains to be seen. The University Hospital of South Manchester NHS Foundation Trust in collaboration with ARHAI and the senior Anti-infective Pharmacists of the United Kingdom Clinical Pharmacists Association (UKCPA) has developed a self-assessment toolkit to help direct NHS Trusts in their antimicrobial management and strategy. This electronic tool-kit will be launched shortly and its aim is to assist Trusts in their antimicrobial management strategies by providing focus and direction especially in preparation for the impending Care Quality Commission inspections. 4 March 2009 ARHAI meeting, London
17 June 2009 ARHAI meeting, London
30 September 2009 ARHAI meeting, London
If you would like further information about any of the above please contact the ARHAI secretariat. Call 020 8327 6627 or email

Source: http://www.hcainetwork.org/ARHAINewsletter%20February2009.pdf

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THE JOURNEY TO COMPASSIONATE CARE In 1991, I helped create one of the fi rst woman-centred, harm-reduction programs for women from the Downtown Eastside of Vancouver.1 The grassroots program was named Drug and Alcohol Meeting Support for Women (DAMS) by women who met weekly. DAMS emerged as a response to concerns about harms associated with drug use, poverty, isolation, HIV/AIDS, and parenting.

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