"It's a really scary situation at the moment!" was Matt Barnard's opening gambit as he spoke at the BVNA Congress on the subject of antimicrobial resistance (AMR).
He highlighted that AMR is present in every country in the world and he gave some dramatic examples – for example, carbapenem is no longer effective against Klebsiella pneumonia in hospitals and resistant strains of TB are increasing at an exponential rate worldwide.
Pharmaceutical companies do not have any real incentive to develop novel antibiotics because of the time that it takes to research, develop and licence them; the short time during which they are licensed exclusively before generic versions emerge; and the relatively small market globally for this class of medicine. Governments are particularly poor at providing realistic funding for antimicrobial products too, apparently preferring to fund high-profile, vote-catching projects.
"As nurses," Matt said, "we have to be aware of the dynamic exchange of resistant strains of bacteria that occurs in veterinary practice – from patient to patient, from the environment to the patient, and, importantly, between nurses and the patients." Research has shown that veterinary nurses have a much higher level of infection from methicillin-resistant strains of bacteria than the general UK population. It is now an occupational hazard.
Barrier nursing is, therefore, essential. It may be time consuming but it is critical and must be given top priority and the time that it needs. "Don't let the vets rush you," said Matt as he spent time with the audience going through all the items in practice that harbour infection and are agents for its spread.
In summary, Matt explained that veterinary nurses have a duty to:
• improve client awareness and understanding of the problems associated with AMR
• strengthen their knowledge (and that of their clients) and adopt an evidence-based approach to practice
• reduce the incidence of cross-infection in practice through effective sanitation and barrier nursing
• optimise the use of antibiotics.