Medical technologies are in a unique position to address several of the key challenges we face when thinking about antimicrobial resistance, as MedTech Europe explains.
Diagnostic tests and other medical technologies have an essential role to play in preventing the spread of antimicrobial resistance (AMR), which has been widely recognised as one of the most significant public health challenges of the 21st Century. Drug-resistant bacteria threaten to undo decades of hard-won progress in the fight against ill health and disease and return medicine to a pre-antibiotic era in which common, everyday infections become untreatable superbugs.
Here, trade association MedTech Europe tells Health Europa more about emerging medical technologies and their potential in the fight against antimicrobial resistance.
What role can medical technologies play in efforts to combat antimicrobial resistance?
Medical technologies (medical devices and in vitro diagnostics) play a part in preventing and controlling resistance in four distinct ways:
- Preventing and containing healthcare-associated infections (HAIs) and the development and spread of resistant bacteria in healthcare settings to manage antimicrobial resistance
- Detecting and identifying bacterial infections and their susceptibility to medication, therefore avoiding the misuse or overuse of antibiotics
- Monitoring and tracking resistance and enabling patient compliance to the appropriate use of antibiotics
- Outbreak management and surveillance to track, contain and prevent the spread of pathogens at local, hospital, regional, national and international level.
The problem of antimicrobial resistance has many different facets. Medical technologies are in a unique position to be able to address several of the key challenges we face to combat antimicrobial resistance:
- Preventing the spread and development of antimicrobial resistance: Specialised technologies used both in surgeries and in hospitals have been developed and designed specifically to prevent the spread of antibiotic-resistant bacteria within healthcare settings. This enables hospitals to minimise HAIs, which not only has an impact on the overall fight against antimicrobial resistance but also has a direct impact on patients as it helps them to avoid coming back from hospital with an infection.
- Guiding the optimal use of antibiotics: Ensuring that antibiotics are used as and when needed is essential to prevent the emergence and spread of AMR pathogens. Diagnostic technologies can help to rapidly identify which patients are suffering from a bacterial infection and, if that is the case, even identify the resistances so as to select the right antibiotic to be used in each patient.
- Enabling healthcare systems to combat antimicrobial resistance effectively: Healthcare systems bear the brunt of managing patients who suffer from antimicrobial-resistant infections – and the difficulty in dealing with those infections places a substantial burden on healthcare systems. When treatments are ineffective, infections spread within hospitals or patients are misdiagnosed, not only do patients suffer but the entire health system needs to dedicate more of its limited resources to managing the consequences. Medical technologies are essential in limiting the impact of antimicrobial resistance and ensuring that patients get the right therapy as soon as needed.
- Focusing patient care for better outcomes: It is essential to remember why the fight against antimicrobial resistance is so important. Managing the use of antibiotics, strengthening healthcare systems, preventing the spread of infections and ensuring that care is available when needed all serve a single purpose which must not be forgotten: to ensure that the care patients receive when battling an infection is going to deliver the best possible outcome. if you look at the statistics and predictions you will see that millions of patients could potentially perish due to the spread of AMR pathogens, but combatting antimicrobial resistance is something that is not only done in a systemic way but is done millions of times around the world every year for the health of every individual patient who battles an infection. When used together medical technologies are there to make a difference for each patient who struggles to overcome an infection.
The majority of human consumption of antibiotics occurs in the community setting – what especial role can medical technologies play here?
In the community setting, medical technologies on the diagnostics side provide a role in the appropriate use and appropriate prescription of antibiotics. Through technologies such as rapid testing, it is easier to diagnose and identify if a person has a bacterial or a viral infection and therefore provide the right prescription and recommend if the person will need antibiotics or not.
There are also a few tests that provide a specific diagnosis for a health condition. For example, there are specific diagnostic tools that can detect influenza A and B viruses, which can give a more accurate idea of a treatment, further preventing unnecessary prescription of antibiotics.
Another way that medical technologies help in a community setting is to understand the susceptibility of bacteria to a medication. This means that if you have a bacterial infection, the doctor can send a sample to the lab and they can provide information on which antibiotic the specific bacteria will respond to. The advantage of it is that you will have the right antibiotic to use. This can prevent the use of a broad-spectrum antibiotic, which is cited as one of the reasons why there is a lot of resistance growing in a community setting.
There are also wound care solutions for home after a hospital stay (after a person is discharged) which help prevent HAIs and therefore reduce the need for antibiotics.
What medical technology solutions are emerging in response to the antimicrobial resistance challenge?
Solutions are useful when they address a real problem – ten years ago one of the big challenges in antimicrobial resistance was the crying baby.
Imagine the situation: a crying baby comes into hospital with a fever. What is the best course of treatment? Is there an active infection? Would such an infection respond to antibiotics? How can such a situation be effectively managed?
In response to this challenge rapid assays were developed which allowed physicians to distinguish within minutes a bacterial infection which could be treated with antibiotics from a viral infection which would not respond to the same treatment.
This was a great step forward, but it also illustrates one of the main challenges when combatting antimicrobial resistance – how the answer to one problem actually uncovers a different problem.
It turns out that these new assays – effective though they are – can still be confounded by parasitic infections. While these are rare in babies within the Western world, in many parts of the world these parasites – in particular malaria, which infects over 200 million per year – are endemic. There is therefore now a race to develop assays which will give the ability to physicians in the field to rapidly determine if a crying baby with a fever has a bacterial, viral or parasitic infection, thus guiding the most effective treatment.
One of the key aspects of medical technology is that it seeks to combine advances in technologies across the board and adapt them to medicine. This is no different in the case of antimicrobial resistance, and many cutting-edge technologies are being adapted into the fight, for instance:
- Artificial Intelligence systems – to both monitor and predict the spread of AMR pathogens across the globe, but also to help diagnose individual patients and rapidly identify the nature of individual infections
- Advanced 3D printing materials and systems which enable the production of implants with antimicrobial properties to prevent infections at the implant sites
- New materials that provide antimicrobial coatings to prevent the transmission of
How is MedTech Europe contributing to attempts to prevent and control resistance?
As the trade association for the medical technologies, MedTech Europe has been active in advocating and raising awareness about the issue of antibiotic resistance with key stakeholders at the European level such as the European Commission, European Parliament, Member States and patient associations.
Many of our members are also part of research initiatives that find new solutions to the challenges of antimicrobial resistance through partnering with different institutions, including other industry stakeholders.
We are also part of a global health coalition with other research institutes, NGOs etc. that raise awareness on a G20 level of the importance of co-ordinating efforts to combat antimicrobial resistance on a global level.1
This article will appear in issue 7 of Health Europa Quarterly, which will be published in November 2018.