World Medical Association Statement on Resistance to Antimicrobial Drugs (2008):
“The global increase in resistance to antimicrobial drugs, including the emergence of bacterial strains resistant to all available antibacterial agents, has created a multi-faceted public health problem of crisis proportions. AMDR carries significant economic and human implications. The development of resistant microorganisms is a problem whenever antimicrobial agents are used. The increase in high-risk populations who frequently require antimicrobial therapy, including immunocompromised patients, those undergoing invasive medical interventions, those with implanted medical devices and patients with chronic debilitating diseases, has amplified the problem. The fact that certain infectious diseases have been linked to the development of chronic disease and cancer adds another dimension to the problem.”
Microorganisms exhibiting resistance to antibiotic drugs and disinfectants were prescreened for inclusion in this self-study material. Major microorganism strains responsible for increasing global mortality and morbidity were identified and are described in this syllabus. The following infective agents are not addressed, except as indicated in parentheses.
Viruses (influenza and HIV/AIDS, which increase the risk of
secondary microbial infections, are discussed)
Protozoa (malaria contributes to the morbidity and mortality
from other opportunistic infections in select countries and is
included in this activity)
Helminthes and fungi resistant to specific drug preparations
Use of consistent definitions of AMDR terms is required for improved communications among healthcare providers. Terminology used in this activity reflects, as much as possible, the International Classification of Diseases 9th Revision (ICD-9), and as applicable the ICD-10, which is to take effect in 2013. For example, the ICD-10 classification for Bacterial Agents Resistant to Antibiotics can be found in Codes U80 to U89.
The authors selected up-to-date AMDR clinical and other epidemiological data. As with any new educational material, some errors, omissions, and inconsistencies could have been inadvertently introduced. A critical review by subject matter experts was completed before the release of these materials. We intend to update the scientific and clinical information at least quarterly and the self-assessment questions as appropriate.
The proposed best practices and policies rely primarily on evidence-based information. Common sense and experience from clinical practice were used when sufficient scientific and/or research data were lacking.
Images of microorganisms cited in the syllabus are taken from the CDC Public Health Image Library (PHIL) http://phil.cdc.gov/.
A glossary of select terms used in the text are included after the Appendices.