Since the discovery of penicillin in 1928 by Alexander Fleming, antibiotics and other antimicrobial drugs have revolutionized treatment of infectious diseases. However, even at the time of discovery, Fleming himself cautioned that resistance was a formidable and likely threat we might encounter if these drugs were not used judiciously. 89 years later, his concerns have proved warranted.

The most recent data from the Centers for Disease Control and Prevention (CDC) show that each year in the U.S., over 2 million people become infected with bacteria resistant to antibiotics, leading to an estimated 23,000 deaths annually. It is clear we are in the throes of this threat and now is a critical time to respond in order to reduce the spread and impact. Resistance, however, poses a moving target, with new resistant microbes appearing and spreading across geographic boundaries more and more often.

In recognition of the need for urgent response and the power of sharing information, the Association for Professionals in Infection Control and Epidemiology (APIC) is dedicating this year’s International Infection Prevention Week (IIPW), October 15-21, 2017, to raising awareness around antibiotic resistance (AR) and the roles of healthcare providers, public health professionals, and patients in combatting AR.

Stories from the Field: Fighting Antibiotic Resistance at the Local Level
Local health departments (LHDs) can play an important role in the response to AR. Identifying the need for healthcare facilities to address this issue together, rather than individually within their respective facilities, the Centers for Disease Control and Prevention (CDC) encourages a coordinated approach to reduce antibiotic-resistant infections. LHDs are in an ideal position to facilitate this coordination.

LHDs can support their local healthcare partners by providing education and increasing awareness, assisting with the planning and implementation of stewardship programs, and encouraging inter-facility communication. A common strategy for increasing regional communication is by developing and participating in local collaboratives or coalitions. LHD staff at the Flathead City-County Health Department in Montana and the Kanawha-Charleston Health Department in West Virginia have successfully leveraged coalitions for infection prevention and fighting AR.

Flathead City-County Health Department: Collaborating to Advance Community Outreach
By: Lisa Dennison, RN, BSN the Infectious Disease Prevention & Control Coordinator at Flathead City-County Health Department in Montana on their work with the Kalispell Regional Hospital’s Antibiotic Stewardship Committee

The Flathead City-County Health Department is fortunate to participate in the Kalispell Regional Hospital’s Antibiotic Stewardship Committee. As a member of this committee, the health department has the opportunity to partner with the hospital on activities for AR prevention. While the hospital focuses on internal provider education and processes related to AR prevention, the health department has the capability to conduct community outreach regarding what the public can do to prevent AR. This outreach includes educating the public on when antibiotics are not necessary (i.e. viral infections) and how to use antibiotics wisely. Our goal is to decrease the demand for antibiotics by patients, decrease sharing of antibiotics, and increase the adherence to prescribed antibiotics. In addition to public education, the health department has a unique opportunity to be the hospital’s liaison to other providers that are not associated with the hospital’s network. For example, AR education can be provided by the Health Department to assisted living facilities, independent providers, and the local federally qualified health center. The Flathead City-County Health Department is still in the beginning stages of this campaign; however, we are confident that by collaborating with the hospital, we will be able to move forward in curbing the spread of antibiotic resistance!

Kanawha-Charleston Health Department: Partnering to Provide Training & Education
By: Janet Briscoe, RN, BSN, MBA, CIC, Director, Epidemiology and Threat Preparedness at the Kanawha-Charleston Health Department in West Virginia reflects on their work with the West Virginia chapter of APIC

The Kanawha-Charleston Health Department (KCHD) Division of Epidemiology has been associated with the West Virginia chapter of APIC (APIC–WV) for several years. The members of APIC–WV are dedicated to directing, supporting, and improving the practice and management of infection prevention. The organization is very active throughout the state and a strong supporter of public health initiatives. Through the APIC-WV network, the health department has collaborated with infection preventionists on outbreak investigations, emergency preparedness exercises, Ebola and other emerging infectious diseases, and antibiotic stewardship campaigns. APIC–WV has supported public health in a myriad of ways and in 2016 the health department had a unique opportunity to enter into a collaborative agreement with them to develop a pilot program offering training for outpatient healthcare facilities that did not have access to staff with expertise in infection control. APIC members took the lead in developing the curriculum and providing presenters for the training while KCHD facilitated the training and provided logistical support. By sharing resources and combining the core strengths and expertise of our organizations we were able to offer training on the basics of infection control to outpatient clinic sites. In the near future, we plan to reenergize this project and join with the West Virginia Healthcare-Associated Infections Multidisciplinary Advisory Group to evaluate the feasibility of duplicating this training across the state. As Director of Epidemiology and Threat Preparedness, I am appreciative for the support of the West Virginia chapter of APIC.

Get Involved!
These and other collaborative efforts have enhanced regional awareness around the importance of antimicrobial stewardship in preventing infections and keeping patients safe. You can participate in IIPW and engage your LHD in the fight to curb AR by:

• Sharing messages from the promotional toolkit about antibiotic resistance and IIPW in your newsletters and via social media.
• Downloading the infographic posters, logos, and web buttons.
• Check out NACCHO’s AMR factsheet and email [email protected] to share the work your organization is doing to fight AR in your community.
• If you have an idea about an IIPW activity or resource, email Julie Blechman, [email protected].