A Global Perspective of Antimicrobial Resistance

Friday, 17 July 2009: 8:30 AM

Mary Wyckoff, PhD, MSN, ACNP, BC, APRN, BC, CCNS, CCRN
Surgical Intensive Care Unit, Jackson Health System/University of Miami, North Miami Beach, FL
Jeanne Siegel, PhD, ARNP, BC
Nursing, University of Miami School of Nursing and Health Studies, Coral Gables, FL

Learning Objective 1: describe the multiple factors that affect the choice of antimicrobials and how the cellular mechanisms facilitate the resistancy patterns.

Learning Objective 2: read an antibiogram and describe the benefits of choosing the most appropriate empiric therapy for clinically septic patients.

This session will provide an overview of the epidemiology of antimicrobial resistance on a global scale.  Multi-drug resistant organisms are prevalent in most countries.  These infections cause severe illness, especially hospital acquired infections (HAI) in acutely ill patient populations.  Choosing appropriate antimicrobial therapy has become increasingly complex as more  choices become available, even in developing nations.  Multiple factors affect the choice of agent, and resistance forces vary widely between clinical settings, patient populations, and geographic areas. Advanced practice nurses and other clinicians need to understand the cellular mechanisms through which bacteria become resistant to antimicrobial agents and how patient care practices affect resistance within individual patients and within the clinical environment. 
From 2000-2008 data was collected through culture results, speciation, and sensitivity.  Antibiograms were developed and analyzed to identify trends in antibiotic resistance. This important resource identified multidrug resistant strains and trends facilitating the decision for  prescribing empiric antibiotic therapy. Appropriate empiric therapy is essential to treat infections correctly and quickly to decrease mortality.
This session will provide participants with research-based recommendations on how to manage the use of antimicrobial agents, minimize HAI infections in acutely-ill patients, and responsibly care for patients in an age of widespread bacterial resistance to antimicrobial agents.  The primary focus will be on the most common sources of hospital acquired infection in acutely ill patient populations, which are pneumonia (both hospital and ventilator acquired), catheter-related or associated bloodstream infection, and urinary tract infection.  
 Key points in the early identification of these dangerous infections and appropriate diagnostic techniques will be discussed for each of the listed infections Recommendations will include description of evidence-based guidelines from professional societies, as well as provision of multiple resources both in print and online through which participants may gain knowledge of the state of the science of this important topic.