The prevention and control of healthcare associated infections (HCAIs) and Antimicrobial Resistance (AMR) has been a significant patient safety and public health priority for my Department for numerous years.
A wide range of initiatives has been put in place in the Irish health system including:
- improved surveillance of infections and prescribing,
- infection prevention and control processes,
- antimicrobial stewardship initiatives,
- public and professional awareness raising and
- a significant emphasis on the education and training of healthcare professionals.
In October 2017, with Minister Creed, I published Ireland's first National Action Plan on Antimicrobial Resistance, 2017-2020 (iNAP) and since publication, my Department, the Department of Agriculture, Food & Marine and other organisations have been engaged in an intensive programme of work to implement the strategic objectives of the iNAP Plan.
Over the last eighteen months, a number of measures have also been put in place through the work of the National Public Health Emergency Team (NPHET), convened in October 2017 to address in particular the increase in the CPE 'superbug':
- The HSE has implemented strong governance arrangements for healthcare associated infections (HCAIs) and AMR.
- The HSE's Health Protection Surveillance Centre has also driven enhanced surveillance of HCAIs, including the production of monthly surveillance reports on CPE.
- My Department has provided additional funding for prioritised posts in both the acute and community sectors to build capacity for infection prevention and control and antimicrobial stewardship. These have included posts for the HSE's national antimicrobial resistance team, additional posts for laboratory/screening activities, and infection prevention and control teams.
- A suite of publicly available guidance documents has been developed by the CPE Expert Group. The Group provides expert advice across health care settings regarding actions that should be taken in relation to CPE screening and control of spread of CPE.
- A dedicated HSE communications campaign and website with focused information and education tools is in place.
While the number of newly diagnosed CPE patients has slightly increased, this is in the context of substantially increased screening activity over the past year.
Over two years, my Department has provided dedicated AMR funding, totalling €6.6 million in full year costs. The HSE has prioritised work programmes for this funding in line with HCAI/AMR risk. A number of posts are now in place and new developments are underway.
As part of iNAP, enhanced surveillance of AMR and antimicrobial usage patterns, both within and between sectors has commenced with the publication in January 2019 of Ireland’s first cross sectoral One Health Report on Antimicrobial Use and Antimicrobial Resistance. Work on a second report is underway.
Ireland is hosting a European Commission/European Centre for Disease Prevention and Control (ECDC) One Health AMR Country Visit from 7th - 11th October next. This type of visit to Member States by the Commission and ECDC is an established work programme providing support and advice to countries on their arrangements across the human health, animal health and environmental sectors, with an emphasis on antibiotic resistance and the ‘One Health' or whole of government approach. A programme including a full day of presentations and targeted site visits through the week is now confirmed. Ireland is very pleased to engage on this programme and notes its value to all participants.
The Department will continue to engage with the HSE and other stakeholders to ensure that AMR, HCAIs and CPE in particular remain a priority.