Our weekly wrap-up of antimicrobial stewardship & antimicrobial resistance scans
Saudi funding aims to boost national antimicrobial resistance plans
The World Health Organization (WHO) announced yesterday that it has received more than $21 million from Saudi Arabia to support implementation of national antimicrobial resistance (AMR) action plans in several low- and middle-income countries.
The WHO says it will use the $21.6 million voluntary contribution to provide technical support to seven countries—Egypt, Ethiopia, Jordan, Indonesia, Nigeria, Pakistan, and Sudan—to help them implement action plans based on their specific needs. The agency will focus on helping the countries build capacity for multisectoral governance, AMR awareness, surveillance, laboratory detection, antimicrobial stewardship, infection prevention and control, and monitoring and evaluation.
In addition, the support will enable the WHO to appoint a dedicated senior AMR technical advisor in each of the countries' WHO country office. Lessons learned from the seven countries will be used to update and scale the approach globally
"Having a bigger pool of flexible funds has allowed us to advance our work innovatively and provide the much-needed support to WHO country offices to ensure impact in low- and middle-income countries," WHO Assistant Director-General, Hanan Balkhy, MD, said in a press release. "This funding model allows WHO to be strategic and agile in efforts to address antimicrobial resistance—a threat to each of WHO's Triple Billion Targets—and to drive public health impact in countries."
Dec 9 WHO press release
Study finds high level of inappropriate testing for fungal disease
Originally published by CIDRAP News Dec 7
A study conducted at a large teaching hospital in Tokyo found that most tests used to diagnose invasive fungal disease were inappropriate, Japanese researchers reported yesterday in Open Forum Infectious Diseases.
The retrospective study, conducted at University of Tokyo Hospital, looked at data on patients who underwent testing with three different types of non–culture-based fungal assays (NCBFAs): beta-D glucan (BDG), galactomannan antigen (GMA), or cryptococcal antigen (CRAG). Testing was deemed appropriate if the clinical presentation was compatible with a fungal infection and there was a predisposing host factor at the time of ordering. The researchers also examined factors that increased risk of inappropriate NCBFA use.
A total of 1,159 patients underwent testing with either serum BDG, GMA, or CRAG tests during the study period. Among the 470 patients included in the analysis, roughly 80% of NCBFAs conducted were deemed inappropriate. Nearly 17% of patients underwent three separate unnecessary NCBFAs simultaneously.
Ordering by transplant medicine physicians, repetitions of the test, the absence of predisposing factors for fungal infections, and the absence of recommendations from infectious diseases (ID) consultants were associated with an increased risk of inappropriate NCBFA use.
The study authors say that while avoidable fungal testing doesn't get as much attention as inappropriate urine cultures or Clostridioides difficile testing, the results suggest fungal diagnostic stewardship is needed to prevent unnecessary cascades of care in patients at low risk of fungal infection.
"Our findings suggest that stewardship efforts engaging transplant physicians, clinical decision support tools to guide ordering practices, and involvement of ID physicians as stewards may be important strategies to improve fungal testing practices," they wrote.
Dec 6 Open Forum Infect Dis abstract