NORCA: Mapping survey, preliminary results

1. Nordic - Russian Cooperation on
Antimicrobial Resistance (AMR)
Containment, 2019-2020
Mapping survey, preliminary findings

2. To
• get an overview of existing structures and activities to
combat AMR in the regions in NW Russia and the partnering
Nordic countries.
• increase knowledge about
• AMR, antimicrobial resistance
• AMC, antimicrobial consumption
• ABU, antimicrobial use
• Infection control situation
• inform areas for interventions
• raise awareness in relevant fields
• Form a basis in support of implementation of the national
AMR-plans.
The purpose of the survey

3. Russian Regions Countries
Arkhangelsk (Denmark)
Murmansk Finland
Pskov Sweden
Republic of Karelia
St Petersburg
Responders as of June 05

4. B Preliminary findings microbiological services
• 5-15 laboratories per region and 20-25 laboratories in the countries
deliver microbiological services.
• There does not seem to be universal access to microbiological
services at the hospital level in all Russian regions
• There is a mixed use of Russian and European/Eucast AST
methodology. No-one seem to use CLSI
• Regional public laboratories offer reference functions with regard to
AST, but few regarding detection of resistance genes and
epidemiological typing
• Although quality systems generally seem to be in place, performance
was not assessed in this survey.

5. C Preliminary findings AMR surveillance
• All regions and countries have at least some data on the selected key
pathogens. Coverage appear to be fairly good in large or specialized
hospitals, while there seem to be a gap in data in smaller hospitals
• There also seem to be gaps in knowledge about AMR in pathogens
causing common infections in the community

6. D Preliminary findings surveillance of
antibiotic consumption
• Surveillance of ABU seem to be less developed than
surveillance of AMR
• Several regions do not participate in national/ international
surveillance
• There are gaps in compilations of antibiotic consumption
reports at different hospital levels
• Antibiotic consumption is not followed in general practice in
most places
• There seem to be a limitation in implementation of digital
prescription bot in hosptals and in general practice in the
regions which makes it hard to collect data on antibiotic
consumption.

7. E Preliminary findings antibiotic use
It seems to be gaps with regards to grug therapeutics committees
(DTCs) general somatic hospitals and in general practice in most Russian
regions
Point prevalence studies of antibiotic prescriptions have been conducted
in hospitals in some regions, but no corresponding diagnose-prescribing
surveys have been performed in general practice.
While stewardship teams are seen in larger hospitals they seem not to
be so common in smaller hospitals,

8. G Preliminary findings infection control
Most hospitals seem to have:
• An IPC program
• An IPC committe
• Access to an IPC nurse
• Access to an IPC physician
• IPC-training for all staff
There seem to be room for improvement regarding access to hand-
disinfectants at very bed

9. H Findings surveillance of HAI
Surveillance of:
• surgical site infections
• vascular catheter related infections
• VAP, ventilator associated pneumoniae, and
• CDI, clostridium difficile enterocolitis
Seem to be common although there are some uncertainities about
coverage

10. I/ Preliminary findings awareness-raising
• There seem to be room for more engagement in World Hand Hygiene
day and Antibiotic awareness week
• There also seem to be room for increased feed-back of surveillance
data to professionals and managements

11. J/ Preliminary findings training
• Health-care workers generally seem to be introduced to infection
control, but less to health-care associated infections and to AMR
• Employer seem to have greatest responsibility in all places

12. Surveillance of
• AMC, antimicrobial consumption
• ABU, antimicrobial use
• Compliance to treatment guidelines
• Improve access to hand-disinfectants
• Feed-back to managers and other stake-holders
• Raise awareness in relevant fields
Summary:
Some gaps to possibly address

13. Некоторые проблемные моменты на
основе предварительных
результатов исследования ситуации
• Надзор за использованием АМП
• Надзор за применением АМП
• Применение клинических рекомендаций
• Проблемы особенно характерны для амбулаторно-
поликлинического звена
• Информирование руководства/органов управления
здравоохранением и других заинтересованных сторон
• Повышение уровня знаний по отдельным вопросам
13.06.2019 Дмитрий Титков13