Role of infection control in combating antibiotic resistance

A C Whitelaw

Infection control has been identified as one of the key interventions in controlling the threat of antibiotic resistance. Reducing thetransmission of multidrug-resistant organisms (MDROs) reduces the need for broad-spectrum antibiotics in particular, while interventionsthat decrease the risk of infection have an impact on the use of any antibiotic. Hand hygiene remains the cornerstone of decreasing thetransmission of MDROs. Alcohol-based hand rubs are a cheap, effective and convenient means of performing hand hygiene. Patientscolonised or infected with MDROs should be placed on contact precautions, although implementation remains challenging in resourcelimitedenvironments. Screening for certain MDROs may play a role in curbing transmission of these organisms. If implemented, screeningmust be part of a comprehensive infection control strategy. In resource-limited settings, the costs and potential benefits of screeningprogrammes need to be carefully weighed up. Care bundles have been shown to reduce the incidence of common healthcare-associatedinfections, including catheter-associated urinary tract infection, ventilator-associated pneumonia, central line-associated bloodstreaminfection and surgical site infection. These bundles are relatively inexpensive, and can play an important role in reducing antibiotic use andimproving clinical outcomes.