Emory is preparing to launch a center devoted to antibiotic resistance. On Wednesday, Arjun Srinivasan, one of the CDCâ€™s point people for antibiotic use and hospital acquired infections, kicked off the preparations with a talk on the multifaceted nature of this problem.
Without attempting to cover everything related to antibiotic resistance (that would take a bookÂ — or several), I willÂ note in an upcoming post how Emory and partners such asÂ Childrenâ€™s Healthcare of Atlanta already haveÂ begun assembling many of the necessary tools.
Tackling antibiotic resistance has to take into account the habits of physicians, the expectations of patient, improved surveillance and antibiotic overuse in agriculture, as well as research on new antibiotics and detecting dangerous bacteria. In short, itâ€™s both a science and policy issue — captured well by the documentary Resistance.
At the end of his talk, Srinivasan made a remark that brought this home for me, saying â€œWe just have to push all the boulders up the hill at the same timeâ€ in response to a question about balancing effort on science vs policy. Allusions to Sisyphus!
Yet he provided some hope too, highlighting a recent CDC studyÂ that models how a coordinated response to antibiotic resistance in health care facilities could substantially cut infections.
One of the best examples of a coordinated response to one particularly nasty form of antibiotic-resistant bacteria (carbapenem-resistant enterobacteria) comes from Israel, admittedly a small country where a coordinated response may be easier to implement, Srinivasan said. He also mentionedÂ the “Extensively drug resistant organism” (XDRO) registry from Chicago. Coordinated in this situation means health-care facilities exchanging information, hospital talking to nursing home, about what patients may be taking with them.