World AMR Congress 2019 !

I hold the honor of being they Keynote speaker on day 2 of the World AMR Congress in Washington D.C. on November 7 & 8.

Launched during the release of key reports such as the AMR Review and A Scientific Roadmap for
Antibiotic Discovery, the World AMR Congress has brought attention to the threats of this emerging crisis to
the global healthcare system.
The conference gathers global leaders in infectious diseases to meet, brainstorm and discuss the
challenges and opportunities on seven topic areas:
• Antibiotic R&D: advancing the development of antibiotic and non-traditional therapies and improving
commercialization strategies
• Diagnostics: innovating the development and deployment of rapid diagnostics tests, while ensuring an
effective integration into hospitals’ workflow and reimbursement
• Antimicrobial stewardship: using technology to improve antibiotic prescription, monitoring and
surveillance while advancing stewardship-based purchasing guidelines
• Pitch & Partner: joining funding and partnerships with antibiotics and diagnostics innovation
• Infection Control: advancing policies to improve infection prevention, control and compliance in
healthcare facilities
• Manufacturing: overcoming challenges for a sustainable and controlled antibiotic manufacturing and
supply chain
• Vaccines: discussing the clinical and economic value of vaccines to combat AMR
This November 7-8, 2019, 600 attendees from over 40 countries will be gathered at the Renaissance
Washington, D.C. Downtown Hotel for the largest AMR conference ever.

I will also be holding a round table session later in the afternoon on prevention for hospitals and what patients can do. Below is a link to the schedule as well as featured speakers. If you are in the industry, please consider attending….

World AMR Congress Brochure & Information

Pfizer

Thank you Pfizer Pharmaceuticals for allowing me to share my patient story at the Latin American sales conference in Miami! A fun team for sure and the great news is they just developed a new antibiotic geared specifically towards Pseudomonas. It received FDA clearance the day before my speech!

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( My conference techies!)

Thank you for having me out and keep up the good fight in the antibiotic spectrum!

This talk led to a great WEB EX speech to Pfizer in Dubai for their Eastern sales conference. They have never heard a patient story and had dozens of great questions.

Hello Locus Bioscience!

Had a great response as I shared my patient story at Locus Bioscience in RTP North Carolina.

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Locus is a young research company that has been developing CRISPR genomics to aid in the application of Bacteriophage therapy by directing it to specific genes in the bacterium it is attacking. This novel therapy is on the cutting edge of eliminating bacteria infections form patients. They are working closely with the new FDA division of Novel Therapeutics.

Thank you team!

GenMark San Diego!

Was very honored to be invited to share my story at the GenMark Diagnostics global meeting in San Diego this January.

GenMark

GenMark has recently won FDA approval for its new E-Plex system for raid diagnostics on for Bacterial infections.The ePlex BCID Panels aid clinicians in the identification of bacterial and fungal organisms as well as antibiotic resistance genes within approximately 1.5 hours of blood bottle positivity, allowing treatment decisions to occur days earlier than with conventional methods.

The talk was well received y all with great follow up questions and concern over what patients suffer from infections including the pain of sepsis.

 

Thank you all!!

World AMR Congress 2018!

Last week in Washington D.C. I had the honor of being on a keynote panel to share my patient story. The congress was attended by people from around the world who could offer solutions to the antibiotic resistance problem  other than simply new antibiotics which are drying up. Also in attendance were representatives form the FDA, DHHS, as well as an address from Dr. Tedros of the World Health Organization.

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I was on a panel with Dr. Neil Clancy M.D., an Infectious Diseases specialist from the University of Pittsburgh and Tom Lowery, Chief Scientific Officer of T2 Biosystems sharing my story to bring awareness to sepsis and antimicrobial resistance and what it can do to a patient.

 

Part of one day also included a video shoot of my story complete with makeup and hair!

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Myself, Dr. Neil Clancy, Tom Lowery CSO, and Sandy Estrada of T2

Thank you to T2 Biosystems for being my sponsor!

 

Let’s Connect the Silos in the War on HAI’s

The power of a common goal

 

I have seen a lot of conversations on social media and in print in the last year or so from experts in fields of cleaning supplies, architects, and researchers stating that their way is the best way to stop hospital infections. Even the centers for Medicare and Medicaid have stated they have the solution by stopping reimbursement to hospitals for any infections that they caused. Environmental disinfectant developers state they have the only answer; and clinical researchers state they hold the key. When I hear from the World Health Organization that we declared war on antimicrobial resistant pathogens years ago and not much has been accomplished it is disheartening, as I live with one of these pathogens.

Fighting hospital acquired infection is a collaborative endeavor and when it comes to the healthcare industry, all of the following are worthy of consideration:

Surface Materials

Materials to build hospital surfaces have come a long way. We know wood is porous and should not be accepted and we know sharp corners are impossible to disinfect. Along with being durable and easy to clean, surface materials should also be airtight and resistance to cracks and dents. Yet I have visited many health care facilities and notice many defects in surfaces used. Hospitals and clinics seem loath to take the initiative to replace old and worn surfaces. Plus the fact that there is no federal regulation on what surfaces a healthcare facility must use whether it be in hard surfaces, textiles, or medical devices.

Recent findings on contamination of healthcare surfaces include:

MRSA survives for 11 days on a plastic patient chart, more than 12 days on a laminated countertop, and nine days on a cloth curtain. Pseudomonas lives on hard dry surfaces for up to seven days.

In an investigation of contaminated room door handles in a university hospital setting, 27% of door handles were contaminated by MRSA or methicillin-sensitive Staphylococcus aureus (MSSA). In a hospital culture survey, 42% of hospital privacy curtains were contaminated with Vancomycin-Resistant Enterococcus (VRE) and 22% with MRSA

Environmental Services Staff

Unfortunately, cleaning and disinfection is often sub-par with many studies showing that EVS are cleaning and disinfecting only about 30 to 50 % of the surfaces that they should be. These include toilet handholds, light switches, doorknobs, bedside rails, nurse call buttons, TV remotes, and patient telephones.

Ongoing education, training and monitoring is important to ensure compliance and we need to ensure EVS staff is especially trained and knowledgeable about infections and that they help fight them. EVS should be certified after each training and training should involve uniform care, gloving, and the ability to communicate to healthcare personnel that they have a concern when warranted. EVS play a key front-line role in infection prevention and control.

Lab Personnel

Lab workers are a part of the puzzle also:

Proper Specimen Collection

Accurate Identification and Susceptibility Testing

Laboratory Information Systems for comprehensive information /ordering

Rapid Diagnostic Testing

Rapid reporting of Laboratory Data

Outbreak Recognition and Investigations – Molecular Typing

Maintaining Organism Storage

Maintaining Cultures of Specimens from Hospital Personnel and the Environment

The services that the infection control program can offer to the laboratory include functioning as a liaison to the clinical services to improve the quality of specimens sent to the laboratory and promoting appropriate use of cultures and other laboratory tests. It can also assist the laboratory with its system for monitoring antimicrobial agent susceptibilities by identifying the pathogens that are of nosocomial origin.

Researchers

Research for new methods of tacking ARM’s and new antibiotics is a large part of the puzzle. Some of the latest research has been done on the following and most show promise for conquering some of these pathogens.

CRISPR (pronounced “crisper”) stands for Clustered Regularly Interspaced Short Palindromic Repeats, which are the hallmark of a bacterial defense system that forms the basis for CRISPR-Cas9 genome editing technology. In the field of genome engineering, the term “CRISPR” or “CRISPR-Cas9” is often used loosely to refer to the various CRISPR-Cas9 and -CPF1, (and other) systems that can be programmed to target specific stretches of genetic code and to edit DNA at precise locations, as well as for other purposes, such as for new diagnostic tools. With these systems, researchers can permanently modify genes in living cells and organisms and, in the future, may make it possible to correct mutations at precise locations in the human genome in order to treat genetic causes of disease.

Quorum Sensing

The discovery that bacteria are able to communicate with each other changed our general perception of many single, simple organisms inhabiting our world. Instead of language, bacteria use signaling molecules which are released into the environment. As well as releasing the signaling molecules, bacteria are also able to measure the number (concentration) of the molecules within a population. Nowadays we use the term ‘Quorum Sensing’ (QS) to describe the phenomenon whereby the accumulation of signaling molecules enable a single cell to sense the number of bacteria (cell density). In the natural environment, there are many different bacteria living together which use various classes of molecules, as they employ different languages they cannot necessarily talk to all other bacteria.

Bacteriophage Therapy

A bacteriophage is a type of virus that infects bacteria. In fact, the word “bacteriophage” literally means “bacteria eater,” because bacteriophages destroy their host cells. All bacteriophages are composed of a nucleic acid molecule that is surrounded by a protein structure. A bacteriophage attaches itself to a susceptible bacterium and infects the host cell. Following infection, the bacteriophage hijacks the bacterium’s cellular machinery to prevent it from producing bacterial components and instead forces the cell to produce viral components. Eventually, new bacteriophages assemble and burst out of the bacterium in a process called lysis. Bacteriophages occasionally remove a portion of their host cells’ bacterial DNA during the infection process and then transfer this DNA into the genome of new host cells. This process is known as transduction.

 

Developers of Environmental Cleaning Agents

Cleaning is essential in the health care industry for environmental surface management and infection prevention and control. The Centers for Disease Control and Prevention (CDC) and Healthcare Infection Control Practices Advisory Committee recommend that all health care settings, regardless of the level of care provided, make infection prevention a priority and those standard precautions, including environmental cleaning, be used as a means to reduce infection transmission.

Every day there are new products created and we need this research and development to continue especially hand in hand with surface developers as they complement one another in efficiency and effectiveness. Products in hand washing, instrument disinfecting and surface disinfecting along and others are an integral key to the infection battle.

 

Hospital Designers

Hospital designers and architects play an important role by designing a space that has all the aspects of keeping dangerous pathogens out. Newer design models incorporate the patient’s perspective and are based on medical-outcome evidence, patient satisfaction, and patient safety. One of the most important shifts in hospital design in the past few years has been to design patient-care spaces for infection control.

  • How HVAC is implemented
  • Patient flow
  • Room design
  • OR and procedure room design
  • Floor design
  • Green space implementation

Patients

Patients, care givers, and family also play a role in the transmission of infections. You must be your own advocate and if you are unable to communicate it is important doe family to do so.

Some things patients can do consist of asking friends and family to not bring flowers or plants. They are great vectors for pathogens. Ask your doctor or anyone that uses a stethoscope on you to wipe them down as well as asking all to wash hands. Do not lay your eating utensils on your bed. Linens and bed covers hold and can transmit C-Diff and other bacteria.

Have your family bring wipes to cover surfaces that they see EVS miss and ask if the antibiotic you are getting is necessary. Overuse and needless use of antibiotics contributes to the strength and resistance superbugs maintain.

We all need to collaborate and communicate to make sure we win this war. No one solution is the answer and this requires teamwork to defeat a killer that will take out 10 million people by 2050 per CDC estimates.

 

 

Mary Millard M. Ed is a public speaker on HAI’s and is an advocate for patients as well as research and funding on ARM’s. She is also a Board Member for the Healthcare Surfaces Summit.

 

References

American Journal of Infection Control

Volume 43, Issue 5, 1 May 2015, Pages 424-434

 

Centers for Disease Control and Prevention

 

Centers for Medicare & Medicaid Services

 

Calfee DP, et al. Supplement Article: SHEA/IDSA Practice Recommendation Strategies to Prevent Transmission of Methicillin-Resistant Staphylococcus aureus in Acute Care Hospitals. Infection Control and Hospital Epidemiology 2008; 29:S62-S80.

Facilities Guidelines Institute and the AIA Academy of Architecture for Health, with assistance from the U.S. Department of Health and Human Services. Guidelines for Design and Construction of Hospitals and Health Care Facilities, 2001 edition

Hosokawa S, Ole I, Kamiya A. Contamination of room door handles by methicillin-sensitive/methicillin-resistant Staphylococcus aureus. Journal of Hospital Infection, Volume 51, Issue 2, June 2002. Pages 140-143.

Ju Hun Lee, Christopher M Warne, Heung-Wuk Lee

Nature Protocols 12, 1999–2013

2018 Healthcare Surfaces Summit !

The 2018 Summit was a resounding success, and our keynote speaker Steve Tomasino of the EPA stayed for the entire event!

Companies joining this year were PDI, Eastman Chemical, Microban, and Contec. They all joined in our round-table discussions as well as offered their expertise in the breakout groups for education, research, and more.

It was an honor to officially be voted in as a Board Member.

I look forward to next year as we solve the issue of surface transmission of infections!

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Steve Tomasino of the EPA

 

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Breakout sessions                       gathering                                     

 

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Linda Lybert talks surface testing