A network to counter bacterial resistance – breaking latest news

Against super microbes, Maiday Infectivology was born, a network of Italian infectious disease centers for the management and consultancy of multi-resistant hospital infections, created by the Italian Society of Anti-infective Therapy (Sita) with the non-conditioning contribution of Shionogi. The initiative was presented on June 14 because the most aggressive bacteria pose a threat to patient safety, as are ships in the middle of an ocean storm. If then Italy certainly does not shine for the high incidence of those resistant to antibiotics, drugs in some cases used too much and improperly, it is understandable why it is necessary to invest energy and professionalism.

In recent years, the phenomenon has increased with a significant impact on public health – explained the Sita experts – with important implications both from a clinical and an economic point of view. The second report drawn up by the ECDC (European Center for Disease Prevention and Control) and the WHO, records high percentages of resistance to last line antibiotics in several European countries. So alarming that the phenomenon is defined as a threat to patient safety. In Italy in 2021 62,833 pathogens were isolated and the percentages of resistance to the main classes of antibiotics remain high, so much so that our country by incidence of resistant bacteria is positioned only after Greece
it’s Romania. It is estimated that in 2050 bacterial infections will cause 10 million deaths a year worldwide, exceeding deaths from cancer.

Various strategies have been put in place by scientific societies and government bodies to counter the phenomenon: the latest in chronological order is the alliance Maiday Infectivology, the first digital platform that allows you to receive direct advice on complex hospital cases from centers of national importance, who make their know-how available in the infectious disease field. The reason why Sita wanted to carry out this project – explains Matteo Bassetti, president of the Company and director of infectious diseases at the Policlinico San Martino Irccs hospital in Genoa and full professor at the University of Genoa – was to create a real among the Italian infectious disease centers to give help, support, where somehow there are fewer skills in the management of multi-resistant bacteria, or perhaps there is no structured infectious disease department at that time, with the possibility for these centers to receive a “second opinion” and also to share a continuous clinical update process, through weekly webinars. In the first phase, which will last around 4 months, the pilot project is launched with 3 hub centers and over 30 spoke centers belonging to the network. In the second phase, 3 other hub centers will join and the number of participating centers will be extended, reaching over 60 throughout the country. The Maiday platform will be active 24/7 with responses within 48 hours of second opinion requests and opportunities for specialists to continue professional development through weekly webinars.

The Maiday digital platform represents an opportunity to implement antimicrobial stewardship in hospitals (through the appropriate use of antibiotic therapies, the introduction of rigorous hygiene protocols in hospitals and the relaunch of vaccination practice) and to create a direct network between specialists engaged in the fight against antimicrobial resistance, with the fundamental objective of putting the specialists themselves in the best conditions to counteract multi-resistant infections, which are a real silent pandemic with important numbers and a significant impact especially in our country. The growing expansion of multi-resistant microorganisms has many explanations, but certainly the excess prescription of antibiotics represents a significant factor in the selection of resistant species – underlines Pierluigi Viale, Sita vice president, director of infectious diseases at the Sant’Orsola Malpighi Polyclinic in Bologna and professor ordinary at the University of Bologna – a sort of Darwinian mechanism whereby in an enormous microbial population, which colonizes our entire ecosystem, prolonged antibiotic therapy, with too broad a spectrum, repeated several times represents a stress factor that generates selection of resistant strains.

Antimicrobial stewardship based on a set of measures and interventions aimed at better managing antibiotic therapy, leaving only the doctor-patient contract but seeing each prescription from a system perspective – added Viale -. The Maiday platform was created to create a common language and culture among infectious disease specialists who deal with microbial resistance. In the last decade, just under ten new antibiotic molecules have been developed or are being developed, but the research and development of these drugs is difficult for several reasons, first of all because these superbugs are opportunists, which threaten life of fragile and compromised patients with various comorbidities and then why enrolling adequate numbers of vulnerable patients to have clinical trials with adequate evidence of efficacy is not simple.

Shionogi, a Japanese company with branches all over the world, including Italy, has consolidated experience in the field of antibiotics: We believe in doing things differently – says Andrea Pitrelli, market access & government affairs head of Shionogi Italia -. Healthcare systems are under pressure from all directions. In order to be able to meet and overcome the public health challenges of present and future generations, we are strongly oriented towards partnership, innovative and courageous ideas. Therefore, when Sita presented the opportunity to support this important initiative, it seemed to us that the project fits perfectly with our mission, which is to help develop greater knowledge and expertise in clinical practice in the use of new antibiotics – added Pitrelli – . We also believe that over time this initiative will help to collect a whole series of best practices to share with the wider scientific community, helping to increase knowledge on how to best use the new hospital antibiotics while preserving their effectiveness over time.