Over 3600 deaths due to infections from resistant to antibiotics germs and 166,000 days of hospitalization per year could be prevented in our country through a range of measures, from improved hand hygiene and infection control programs in hospitals to prudent use of antibiotics and related citizen information campaigns. If public health policies to combat antimicrobial resistance are not implemented immediately, in 2030, 43% of infections experienced by hospital patients in our country will be resistant to antibiotics and therefore much more difficult to treat. And it is worth noting that in Greece the prevalence of nosocomial infections is at least 10%.

“Tama” pleurisy

These OECD projections on the implications of the antimicrobial resistance problem in our country were presented by the Organization’s Health Policy Analyst, Ece Oselik, at a special event hosted yesterday by the Organization for Quality Assurance in Health Care (ODIPY) and the office of World Health Organization in Greece on occasion Global Antimicrobial Resistance Awareness Week 2022 (November 18-24). The event began with an experiential narration by Health Minister Thanos Pleuris, who had to be intubated in November 2016 — hitting rock bottom, doctors characteristically told his wife — due to a hospital infection. He emerged victorious from that battle and now, he says, has made a personal bet – he called it “tama” – to reduce hospital morbidity in the country.

Mr. Plyuris described nosocomial infections as a problem that is “hiding under the rug” because, in his words, “there is a responsibility. If someone has a stroke, the hospital can’t be held responsible, but if that person is on the ward and gets the germ and becomes infected, part of the responsibility lies with them.” He added: “We will never have places where there are no germs, but we can introduce rules to reduce the likelihood of infection from them.” In this context, the Minister touched upon the actions being taken towards solving the problem. He indicated that in his new contracts EOPYY with private health care providers, one of the mandatory quality indicators, on the basis of which the Agency will reimburse them, is a low level of nosocomial infections and their complications. He also focused on the problem of evaluating hospital departments and administrators based on their effectiveness in preventing nosocomial infections. According to Mr. Plevris, the ministry intends to post information on hospital infections per unit on the Internet with free access for patients and on a quarterly basis. “Everyone will know that in the next quarter, when new data will be released, the problem cannot be hidden under the carpet,” Mr. Plyuris said, adding: “Technically we are ready, we are looking for legislative tools to move forward.”

IPIG Program

The event featured the Panhellenic Infection Prevention and Control Program GRIPP, which is already being implemented in ten public hospitals in the country with financial support from the Stavros Niarchos Foundation. The goal of the program is to operate a unified national reporting system for surveillance of nosocomial infections and antimicrobial resistance – “so that everyone speaks the same language”, as commonly referred to – while at the same time implementing their control strategies. . Microbiome indicators are currently being recorded related to the central line (catheter in a large vein), the use of antibiotics per hospitalized patient, and the adherence of staff to hand hygiene at different stages of work with patients. Depending on the results obtained, the hospitals themselves are informed in order to improve these indicators.

“The Spy Came”

There is no shortage of challenges in this process. As mentioned by Giannis Kopsidas, Executive Director of CLEO (Center for Clinical Epidemiology and Outcomes of Diseases), which runs the program in collaboration with EODY and ODIPY, he heard expressions such as “Gestapo” from hospital workers during his visits as part of the program. ‘, ‘welcome spy’, ‘look how well I wash my little hands’. In other cases, workers question the results, “I don’t know how you do it, but the numbers can’t be right,” among those who have heard, despite entering the data themselves. Referring to the next steps for infection control in hospitals, EODY President Theoklis Zautis stressed that the surveillance system will be extended to the rest of the hospitals as well as the private sector, as well as other indicators of antimicrobial resistance. and consumption of antibiotics. In addition, this will form the basis for their integration into the surveillance system in other settings such as primary health care and rehabilitation centres.

“Strengthening PHY can help solve the problem,” said Evangelos Fragoulis, Secretary General of the Hellenic Academy of General/Family Medicine and PHY. The introduction of a personal physician can help through better communication between physician and citizen in informing citizens when they need to take antibiotics.

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