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Antimicrobial Resistance

A growing global concern to public health

Background on Antimicrobial Resistance (AMR)

AMR occurs when bacteria or fungi obtain the ability to overcome the antimicrobials that have been developed to destroy them. Without any drugs stopping these pathogens, they continue growing, making them difficult or impossible to treat.1

Antimicrobial Resistance is a growing global concern, especially in the wake of the COVID-19 pandemic. According to a study published in The Lancet2, there were 1.27 million global deaths related to antimicrobial resistance in 2019. 73% of those deaths were caused by just six pathogens. Resistant bacteria pathogens can lead to sepsis, and compared to susceptible strains, they are more costly, contribute to longer length of stays, and are associated with higher mortality rates. For example, resistant strains of E.coli, A. baumannii, K. pneumoniae, and S. aureus are at least 2x as deadly3 as their susceptible counterparts, and antimicrobial resistance could cost healthcare systems worldwide $300 billion to more than $1 trillion annually by 2050.4

How AMR Spreads in a Healthcare Setting

Any time antibiotics are used, they can contribute to the development of antibiotic resistance. Pathogens survive in plumbing (e.g., sink drains, toilets) and can splash back onto people. Without proper Infection Control, bacteria can spread to people from other people on surfaces like bedrails or the hands of healthcare workers.

Procedures and medical devices (e.g., catheters) can be pathways for bacteria to enter the body, and bacteria can move with patients when they are transferred from one facility to another or even when they are discharged. Resistant infections can also cause infections in the community when they are not stopped in a healthcare setting.5

Diagnostics for AMR

Current methods for genotypic and phenotypic susceptibility testing rely on positive growth from blood culture, which can take several days. The World Health Organization (WHO) has outlined “better diagnostics” as an essential priority area for fighting back against the spread of AMR, while the CDC states that Antimicrobial Stewardship is one of our best prevention tools against AMR. Culture-independent diagnostics are one way to address the limitations of current diagnostic standards. The T2Bacteria, T2Candida, and T2Resistance Panels provide identification of the most prevalent bacterial and fungal pathogens and genetic markers of resistance within 3 to 5 hours of the first patient blood draw and are independent of blood culture. Results from the panels provide clinicians with critical data needed to influence treatment decisions sooner, often before the second dose of broad-spectrum antimicrobials is administered.

Antimicrobial Stewardship

Antimicrobial stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing and use is critical to effectively treat infections, protect patients from harm caused by unnecessary antibiotic use, and combat antibiotic resistance. Stewardship committees are essential to stopping the spread of AMR in healthcare settings.

Initiatives that may be considered by Stewardship Committees:

T2Resistance Panel

Addressing the unmet need for faster detection of antimicrobial resistance

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  1. https://www.cdc.gov/drugresistance/about.html
  2. Murray, C., et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet. 2022
  3. Burden of Antibiotic Resistance. ReAct Group. 2012 – https://www.reactgroup.org/wp-content/uploads/2018/03/1.7-ReAct.-Burden-of-antibiotic-resistance.pdf
  4. Dadgostar, P., Antimicrobial Resistance: Implications and Costs. Infect Drug Resist. 2019
  5. Antibiotic Resistance Threats in the United States, 2019 Centers for Disease Control and Prevention

T2RESISTANCE PANEL

Gram-negative marker
KPC
OXA-48 Group
NDM /VIM/IMP
CTX-M 14/15 AmpC(CMY/DHA)

Gram-positive marker
vanA/B
mecA/C