Nurses ‘important link’ in preventing antimicrobial resistance

NURSES are “the most important link” in the healthcare delivery process and they play a pivotal role in preventing antimicrobial resistance (AMR), said an infectious diseases specialist.

“It is at vulnerable moments like these when a nurse [assumes the role of] reassuring the patient and networking between the patient’s needs and all other departments within a hospital,” said Dr. Arthur Dessi E. Roman, a fellow of the Philippine Society for Microbiology and Infectious Diseases and a training officer at the Research Institute for Tropical Medicine, at an Aug. 24 event organized by UP Med Webinars.

AMR, which refers to the ability of microorganisms such as bacteria and viruses to defeat the drugs designed to kill them, is caused by missteps by healthcare providers, such as when they fail to wash hands in between patient encounters; the healthcare industry, such as when drugs are stored poorly, thus making them lose their potency; and the patients themselves, such as when they don’t adhere to the prescribed course of treatment.

The World Health Organization estimates that some 4.5 million people from the Asia-Pacific will die due to AMR by 2050.

In the Philippines, AMR threats include extended-spectrum beta-lactamase (ESBLs), which are enzymes that break down commonly used antibiotics such as penicillin; as well as methicillin resistant Staphylococcus aureus (MRSA).

If ESBL rates are allowed to rise, the antibiotics used to treat urinary tract infections caused by E. coli are “bound to fail because they are resistant,” said Dr. Roman. “That’s how bad ESBLs can be,” he added.

According to 2021 data from the Antimicrobial Resistance Surveillance Program of the Department of Health, about 50% of E. coli isolates are already resistant to drugs like Cefuroxime.

MRSAs, meanwhile, can be transmitted from in-dwelling devices such as urinary catheters, which nurses monitor. Five of the 10 S. aureus isolates in the Philippines are MRSA, down from 65% in the past five years.

“Admittedly, nurses see patients more frequently than doctors. They can recognize opportunities for the removal of devices such as urinary catheters,” he said in the vernacular, adding that nurses are instrumental in administering antibiotics in a timely fashion.

“Nurses are not just there to follow doctors’ orders. They are partners in patient care,” said Dr. Roman. — Patricia B. Mirasol