Clinical laboratories could play a key role in helping users collect their samples correctly, interpret results, and transfer flu test data to their health records
Clinical laboratories may have another opportunity to provide service to their clients and the physicians who treat them. With the success of at-home COVID-19 testing, consumer demand for self-tests is changing and advances in diagnostic technology now make it feasible to make more influenza (flu) tests available for consumers to buy and use at home.
At-home tests for SARS-CoV-2 can be found at pharmacies all across America. But that’s not the case with tests for influenza.
Should self-test flu kits eventually become available and common, clinical laboratories could offer the service of helping consumers understand:
that the test was conducted correctly (specimen collection and analysis),
“Home flu testing would ensure that those who do need and receive antiviral medication for influenza are the ones who need it the most,” and that “we are making our treatment decisions based on data,” infectious disease specialist Christina Yen, MD (above), University of Texas Southwestern Medical Center, told STAT News. At-home flu self-tests could also bring opportunities for clinical laboratories to provide service to healthcare consumers and the physicians who treat them. (Photo copyright: UT Southwestern Medical Center.)
Pros and Cons of Consumers Doing At-home Influenza Testing
According to the federal Centers for Disease Control and Prevention (CDC), COVID-19 and influenza are both upper respiratory illnesses with similar symptoms. So, why don’t we have more at-home flu tests available? Partly because at-home testing is a relatively new phenomenon in modern healthcare.
“It’s really rare, and it’s really new that people are allowed to know about what’s happening inside their body without a physician in the middle,” Harvard epidemiologist Michael Mina, MD, PhD, told STAT News. The article uses the example of at-home pregnancy tests. Despite a prototype for an at-home pregnancy test being created in 1967, it took another decade before an over-the-counter pregnancy test became available to the public.
“The general thinking was, ‘How could a woman possibly know what to do if she found out she was pregnant on her own without a doctor in the room?’ That is a ridiculous concern because women have been doing that for millions of years,” Mina added.
So, why be cautious when it comes to giving patients the option of at-home flu testing?
There are some cons to at-home influenza tests. Average citizens are not clinical laboratory professionals. They might obtain too little sample for an accurate reading or read the results incorrectly. Then, there is the possibility for false-negatives or false-positives.
An at-home test user is not likely to consider the possibility of a false result, however clinicians look at the situation with more nuance. If the patient was still symptomatic or in a high-risk community, the provider could administer a more sensitive medical laboratory test to confirm the previous test results.
“In a Facebook post from mid-November with hundreds of responses, concertgoers compared symptoms and positive test results, many of those from tests taken at home. But those data weren’t added to state public health tallies of COVID’s spread,” STAT News noted.
The larger concern is that samples obtained by at-home self-test users are not submitted for genomic sequencing. This could lead to incomplete data and delay identifying new variants of the coronavirus in communities.
Another barrier to at-home flu testing is that rapid influenza diagnostic testing can be unreliable. In 2009, the rapid influenza tests could only detect the H1N1 influenza virus in a mere 11% of samples, STAT News reported. Because of this, the FDA now requires manufacturers to test their rapid tests against eight different strains that change every year depending upon which strains are prevalent. This could present a problem if individuals use leftover tests from the previous flu season.
Do Pros of At-home Testing Outweigh the Cons?
At-home testing is convenient and makes testing more accessible to patients who may not be able to get to a clinic. Being able to test at home also encourages individuals to take precautions necessary to stop the spread of whichever illness they may have. Given the similarities in symptoms between influenza and COVID-19, people could benefit from having tools at home that correctly identify their illness.
At-home COVID-19 tests are here to stay, and at-home influenza tests may be on the way soon. Clinical laboratories could play an important role in educating the public on the correct handling of these tests.
Program launched by a Rochester-area technical center is intended to provide early study for students interested in a career in clinical laboratory medicine
Acute shortages of clinical laboratory staff across all types of skills is one of the big stories of this new year. It is also triggering unconventional approaches to reach students in high school and interest them in careers as medical technologists (MTs). One such example is a high school in New York that now offers a top-level medical laboratory program designed to create interest—then train—high school students for a career in laboratory medicine.
“With the acute shortage of medical technologists, this effort by one high school to reach students early and encourage them to pursue a career in clinical laboratory medicine should be of interest to all laboratory professionals,” said Robert Michel, Editor-in-Chief of Dark Daily and its sister publication The Dark Report.
“Our juniors and seniors in high school will learn about 60 employable laboratory skills,” said Jim Payne (above), a Medical Laboratory Assisting and Phlebotomy program instructor at WEMOCO. “They learn not only medical laboratory skills, but [the skills] are transferable to biotechnology, to chemical labs, food labs, environmental labs, research, forensics, and so on. The goal is each individual student comes out skilled in all 60 skills.” Clinical laboratories may want to explore creating similar programs with high schools in their own areas. (Photo copyright: Twitter.)
Dynamic Curriculum of Clinical Laboratory Skills
During the first year of the WEMOCO program, students learn skills that Jim Payne, a Medical Laboratory Assisting and Phlebotomy program instructor at WEMOCO, stated he learned in college. These include:
The students also learn the theories and techniques behind phlebotomy and how to perform blood draws (venipuncture).
Students spend 40 hours drawing blood samples from real patients in local medical laboratories and can earn a certification as a Phlebotomy Technician after completing the necessary coursework.
During the second year of the program, students learn college-level:
They also receive their certifications in American Red Cross CPR/AED and First Aid and spend 80 hours actually working in local clinical laboratories. Upon completion of the second year of coursework, students can earn a certification as a Certified Medical Laboratory Assistant.
“In both cases, they can get jobs straight out of the program,” said Payne in the CLP podcast. “But a lot of our grads go on to college for medical laboratory careers.”
Overcoming Vocational School Stigma
Recruiting students into the program was initially challenging as some of the negative stigma surrounding non-traditional coursework had to be overcome. Vocational education is now referred to as career and technical education and the WEMOCO program is more academically focused than previous vocational studies. Students can obtain some college credits when completing the two-year program.
“With my students, when we are teaching them how to do the math around making laboratory solutions, for example, that requires algebra,” Payne explained. “And they have to actually make something with the algebra and suddenly it starts to make a lot more sense than the way that they were taught in a traditional high school.”
In addition, some students interested in the program struggled in a typical high school environment due to lack of direction, according to Payne. However, when those same students found their focus, discovered a passion, and were motivated and challenged, they flourished.
Originally, Payne gave a talk to potential enrollees. But he found there was more interest if students were given a hands-on experience at their first exposure to the program. He also lets current students interact with interested students and allows them to answer any questions in a student-friendly manner.
“Students who are interested in the program come in, they get lab coats on, they get gloves on, and they are then told a story about a case and have to perform a few experiments to try to determine what is wrong with a patient. They actually do things,” Payne explained.
Multiple Career Paths in Clinical Laboratories upon Graduation
One advantage to completing the two-year WEMOCO program is that students can explore all the different careers in clinical laboratory medicine and are offered opportunities to work in medical laboratory situations. Phlebotomy students perform 40 hours of work in a blood lab with a goal of performing 50 successful sticks, although many students perform more than that.
“I have students who are under the age of 18 drawing blood on real patients with real samples with these companies’ trainers. It’s like they have been hired,” Payne said. The medical laboratory assistant work is broken up into increments of two hours a day over the course of several months.
Another benefit to the WEMOCO program is that students are prepared for a job right out of high school, which pleases both the students and the parents. Many graduates of the program go on to college to study different fields within the clinical laboratory profession.
Attracting Young Students to the Clinical Laboratory Profession
Payne believes it is important to get young kids interested in the medical laboratory profession in the lower grade levels. His suggestions for stoking that level of interest include:
Developing programs that are age-appropriate but contain medical laboratory concepts.
Outreach programs where clinicians talk to students in the lower grades to spark interest.
Outreach programs where kids can perform simple experiments like staining onions and seeing results.
Telling stories and explaining the roles labs play in helping patients.
Holding field trips where students visit local clinical laboratories and observe medical laboratory professionals.
Opportunities for students to shadow medical laboratory technicians so the kids can imagine themselves in the profession.
Participating in local activity day/career day events.
He also believes that clinical laboratory professionals should promote their field at every opportunity.
“The biggest thing is actively advocating for the profession. Any chance I get, I’m going out and trying to talk to anyone about the clinical laboratory. Try to have some statistics in your back pocket or other things that can be a good talking point and make a powerful statement to people,” Payne suggested.
Determining unique ways to garner interest in the medical laboratory profession is a crucial step in mitigating staffing shortages. Clinical laboratory leaders may want to participate in community outreach programs and serve as advocates for their profession.
As clinical laboratory self-testing expands, sharing of test results with healthcare providers becomes even more essential to optimize health outcomes
Survey data collected by the University of Michigan’s Institute for Healthcare Policy and Innovation (IHPI) indicates that consumer interest in direct-to-consumer (DTC) medical self-testing is growing. In fact, DTC testing appears to be more popular ever, even among older adults who were asked how they feel about performing clinical laboratory self-testing and specimen collecting for certain illnesses.
According Michigan Medicine’s MHealth Lab, “82% of older adults say that in the future, they would be somewhat or very interested in taking a medical test at home.”
Dark Daily has written regularly about this trend and how leaders need a strategy to serve this class of consumer. That strategy could include collecting the self-test results from consumers and keeping a complete record of consumers’ clinical laboratory test results from inpatient, outpatient, and self-test settings.
“As more companies bring these direct-to-consumer [medical] tests to market and buy ads promoting them, it’s important for healthcare providers and policymakers to understand what patients might be purchasing, what they’re doing with the results, and how that fits into the broader clinical and regulatory picture,” said research scientist Jeffrey Kullgren, MD (above), Associate Professor of Internal Medicine and Health Management and Policy at the University of Michigan in a press release. Clinical laboratories may find opportunities to support patients’ self-testing in tandem with the physicians who treat them. (Photo copyright: University of Michigan.)
Importance of Sharing Clinical Laboratory Self-Test Results
Individuals responding to the poll were asked only about medical laboratory self-tests they had purchased themselves either online or at a retail store. Tests provided to respondents by a healthcare provider or given to them for free were not part of the survey.
The researchers discovered that 48% of respondents had purchased at least one variety of at-home health tests in the past. The types of tests bought included:
Tests for infections other than COVID-19, such as urinary tract infections or HIV (4%), and
Other types of at-home tests, including those for allergies and food sensitivities (10%).
Approximately 82% of the respondents said they would be somewhat or very interested in taking at-home medical tests and nine out of 10 believed the test results should be shared with their doctors. But only 55% of respondents who had taken an at-home medical test and received positive results for infection other than COVID-19 had shared those results with their primary care physician.
However, 90% of respondents who had purchased a self-test for cancer screening did provide their doctors with the results.
“As we have seen in COVID-19, it’s important to share results from a home test with a provider so that it can be used to guide your care and be counted in official statistics,” said Jeffrey Kullgren, MD, Associate Professor of Internal Medicine and Health Management and Policy at the University of Michigan in an IHPI press release. Kullgren, a primary care physician and healthcare researcher at Michigan Medicine and the VA Ann Arbor Healthcare System, directed the IHPI poll.
Not All Medical Self-Tests Are Regulated by the FDA
The most prominent reason for wanting to use at-home tests was convenience and 59% of those surveyed felt that the results could be trusted.
The poll also found that 53% of older adults believe at-home medical tests are regulated by the federal government, which isn’t always the case. Many at-home medical tests are reviewed by the federal US Food and Drug Administration (FDA), but not all such tests receive full FDA review.
The FDA, however, offers an online, searchable database consumers can use to determine if a certain over-the-counter test is regulated by the FDA.
“Home tests can be a convenient way for older adults to check if they have an illness, such as COVID-19” stated Indira Venkat, Senior Vice President, AARP Research in the press release. “But consumers should make sure they know whether the test they are taking is FDA-approved, and how their health or genetic information might be shared.”
Other interesting outcomes of the research include:
The purchasing of at-home COVID-19 tests was highest among those between the ages of 50 and 64 when compared to the 65 to 80 age group, but there were no age differences for other types of at-home tests.
Respondents who are married or have who more education and/or higher household incomes were more likely to have purchased at-home tests.
Blacks were less likely to buy at-home medical tests than Whites or Hispanics.
Interest for at-home tests was higher among women than men.
Advertising swayed 44% of purchasing respondents to buy a DNA test and 11% to buy a cancer screening test.
Are DTC Home Tests as Accurate as Clinical Laboratory Testing?
At-home medical self-testing and sample collection is becoming accepted and established with consumers and the medical community, which is drawing attention to the accuracy of these tests and how clinical laboratories are being affected by the trend.
The findings of this recent survey of older consumers is just the latest evidence that at-home self-testing for everything from COVID to cancer is here to stay. Clinical laboratories should be looking for ways to serve this patient population and the physicians who treat them.
Clinical laboratories continue to test sample delivery by drone as a viable alternative to ground transport
In Switzerland, another clinical laboratory drone delivery service recently launched and it has several unique capabilities. This new pilot project to test the delivery of medical laboratory samples by UAV (unmanned aerial vehicle, aka drone) is being conducted by the Dr. Risch laboratory group and start-up drone company Jedsy.
What makes the Risch/Jedsy drone delivery service unique when compared to other drone delivery services is their drone’s capability to deliver directly to windows, regardless of where that window is. This, according to a Jedsy news release, “makes the transport of samples faster and more environmentally friendly.”
Dr. Risch group has 14 clinical laboratories and eight sample collection locations throughout Switzerland. The Swiss Federal Office of Civil Aviation (FOCA) approved Dr. Risch’s first flight between its lab in Vaduz, the capital of Liechtenstein, to its lab in Buchs St. Gallen, sUAS News reported. Risch began transporting lab samples between those locations on an experimental basis in December of 2022.
The Jedsy glider, as the drone is called, has a distinctive vertical takeoff, hover, and landing capability. Once it achieves a safe altitude, it transitions to forward flight and can travel at speeds up to 150 kilometers per hour or about 93 miles per hour.
All systems on the Jedsy drone are redundant and developed to be fail-safe. A human drone operator follows the flight visually via a livestream connection. Once the drone approaches a building for landing, with the exception of the docking station the entire surrounding area is blurred to ensure the privacy of nearby individuals.
The Jedsy Glider (above) is quieter than other multicopters, according to Jedsy, and is able to dock outside a window or balcony. This enables the convenient loading and unloading of clinical laboratory specimens in any type of weather. The docking station also serves as a charger for the drone’s battery to ensure the craft is available for use at any time. Similar medical laboratory sample drone delivery services have been tested in Switzerland but none with Dr. Risch Labs’ unique window delivery option. (Photo copyright: Jedsy.)
Why Transport Clinical Laboratory Samples by Drone?
“The last two years during the COVID-19 pandemic have shown convincingly how important this service is for the healthcare sector,” explained the medical laboratory group’s founder and CEO, Martin Risch, MD, in the Jedsy press release.
Risch envisions a need for drones in certain medical situations. Dr. Risch currently employs about 50 courier drivers who transport by ground medical samples to regional medical laboratories throughout Switzerland every day.
“If, however, the courier vehicles are stuck in traffic or if they are driving during rush hour, the planned daily routine regarding the analysis and the medical diagnosis is delayed. We hope that this will allow us to offer an even better service, which will ultimately benefit the patients,” Risch stated.
Jedsy has already utilized its glider drone successfully in Africa to deliver laboratory specimens and medicines to remote locations and looks forward to its continued benefits.
“With the new drone, we have already gained important flying experience in Malawi, where over 5,000 flights have been performed as part of the UNICEF drone corridor,” said aerospace engineer Herbert Weirather, founder and CEO of Jedsy, in the press release. “Health centers have already been supplied with critical medicines by Jedsy and the service is being expanded continuously,” he added.
Use of Drones to Deliver Clinical Laboratory Samples Growing Worldwide
Utilizing drones to deliver medical supplies and laboratory specimens is not a new concept and has been tested several times in the past. Dark Daily has previously reported on some of the projects that have been attempted.
The use of drones to deliver clinical laboratory specimens is a rising trend that could be extremely beneficial for healthcare systems, medical professionals, and patients. A number of clinical laboratories in the US and around the world have initiated drone pilot programs, however, there has been little follow-up press coverage about either the success of these efforts or whether they continue to operate.
Nevertheless, faster delivery of laboratory specimens can lead to more timely diagnoses which can potentially lead to better patient outcomes. In the future, it’s likely more clinical laboratories will receive specimens via drones.
It’s not only medical laboratory technicians, healthcare workers across the board continue to deal with extreme pressures that preceded the pandemic
Burnout in healthcare is a constant problem, especially in overstressed clinical laboratories and anatomic pathology groups. To raise awareness about the plight of medical laboratory technicians (MLTs) and other frontline workers in the healthcare industry, a former lab tech recounted her experience during the COVID-19 pandemic that led to burnout and her departure from the lab profession during 2020-2021.
Suzanna Bator was formerly a laboratory technician with the Cleveland Clinic and with MetroHealth System in Cleveland, Ohio. Her essay in Daily Nurse, titled, “The Hidden Healthcare Heroes: A Lab Techs Journey Through the Pandemic,” is a personalized, human look at the strain clinical laboratory technicians were put under during the pandemic. Her story presents the quandary of how to keep these critical frontline healthcare workers from experiencing burnout and leaving the field.
“We techs were left unsupported and unmentored throughout the pandemic. No one cared if we were learning or growing in our job, and there was little encouragement for us to enter training or residency programs. We were just expendable foot soldiers: this is not a policy that leads to long-term job retention,” she wrote.
Clinical laboratory leaders and pathology group managers may find valuable insights in Bator’s essay that they can use when developing worker support programs for their own clinical laboratories and practices.
“The pressure never let up. No matter how mind-numbing and repetitive the work could get, we had to work with constant vigilance, as there was absolutely no room for error,” Suzanna Bator wrote in Daily Nurse. Burnout in clinical laboratories is an ongoing problem that increased during the COVID-19 pandemic. (Photo copyright: Daily Nurse.)
Hopeful Beginnings and Eager to Help
During the early days of the COVID-19 pandemic, folks in every industry stepped up. Fashion designers tasked their haute couture seamstresses with making personal protective equipment (PPE), neighbors brought food and supplies to their immunosuppressed or elderly neighbors, and healthcare workers took on enormous workloads outside of their own departments and traditional responsibilities, The New York Times reported.
When Bator joined the Cleveland Clinic’s COVID-19 team she had no clinical lab tech accreditations. Nevertheless, she and 12 other non-accredited hires were quickly put onto the second and third shifts to keep up with SARS-CoV-2 test demands.
“In the beginning, I was so happy to be helping and working during the pandemic. I felt proud to be on the front lines, honing my skills and discovering what it was like to work under intense pressure. My work was good even when the work was hard. There was no room for error and no time to waste.”
At the Cleveland Clinic, Bator and her colleagues did not experience the equipment and supply shortages other clinics faced, at least not in the beginning of the pandemic. That began to change in late 2020.
Unrelenting Pace and Supply Shortages as Pandemic Grew
Despite their state-of-the-art equipment at the Cleveland Clinic, problems began to arise as the pandemic wore on.
“The machines we worked on were never meant to be run at this intensity and would frequently break down during the second shift. Those of us on the third shift were then left to deal with these problems despite our lack of technical training. Even worse, there were no supervisors on staff to help us problem-solve or troubleshoot, which only added to the pressure,” Bator noted.
And the high demand for testing left little room for new lab techs to hone any other skills.
“The pressure never let up. No matter how mind-numbing and repetitive the work could get, we had to work with constant vigilance, as there was absolutely no room for error,” she added.
Eventually, Bator left the Cleveland Clinic for a county hospital to “get off the graveyard shift and begin working on more than just COVID testing,” she wrote. However, soon after her move the Omicron variant hit, and she was once again running COVID tests.
Six months later she had had enough. She burned out and “dropped out of the industry after only a few years,” she wrote. And she was not the only one.
“The [Cleveland] Clinic began to hemorrhage techs who left for better opportunities at different hospitals or in different fields. Of my original 15-or-so-member team two years ago, only four remain in the same department, and only about half remain in the clinical lab field at all,” Bator wrote.
Burnout in Clinical Laboratories
Worker burnout is a state of mental and/or physical exhaustion caused by a heavy workload. Those experiencing burnout may feel emotionally overwhelmed, anxious, and depressed. Burnout can manifest in physical, mental, and emotional symptoms.
Burnout in the wake of the COVID-19 pandemic is an issue affecting all facets of healthcare. According to Forbes, a 2022 report by Elsevier Health found that 47% of US healthcare workers plan to leave their current role in the next two to three years, in some measure due to the enormous pressures healthcare workers face.
And workers are not the only ones paying attention to burnout. On May 23, 2022, the United States Surgeon General, Vice Admiral Vivek Murthy, MD, issued a Surgeon General’s Advisory highlighting the need to address worker burnout.
“COVID-19 has been a uniquely traumatic experience for the health workforce and for their families, pushing them past their breaking point,” Murthy noted. “Now, we owe them a debt of gratitude and action. And if we fail to act, we will place our nation’s health at risk. This Surgeon General’s Advisory outlines how we can all help heal those who have sacrificed so much to help us heal.”
Healthcare workers were facing high levels of burnout before 2020, the COVID-19 pandemic only made the issue worse. The National Academies of Medicine (NAM) reported in 2019 that worker burnout had reached a “crisis level,” and that during the pandemic, half of all healthcare workers reported symptoms of at least one mental health condition.
Training Programs Needed to Offset Worker Shortages and Retain Staff
As Bator reported in Daily Nurse, “The American Society of Clinical Pathology (ASCP)—the largest association for [medical] laboratory professionals—has stressed the importance of promoting MLS/MLT programs to produce certified, well-trained lab professionals, to fill major staffing shortages. However, filling the positions is only one piece of the puzzle.”
Bator points out that there wasn’t space nor time for guidance or advancement with the sheer volume of SARS-CoV-2 testing they had to complete.
“Late last year, during the worst of the Omicron variant surge, the only people I could commiserate with were the nurses who thanked us for running their pediatric ICU tests first,” she said. “They understood what we meant when we said we were drowning and stopped calling the lab to pester us for results because they knew that the positivity rate in Cuyahoga County was the third highest in the country and that the entire system was overwhelmed.”
Suzanna Bator is just one early-career worker among many healthcare professionals who have experienced this type of burnout due to the COVID-19 pandemic. As made evident by her piece, the pathology and clinical laboratory professions are losing workers who otherwise might have entered training programs to further their careers in those fields.
The issue of worker burnout is not just a temporary stressor on the clinical laboratory industry. Both worker burnout and staffing shortages in labs preceded the pandemic and will have continuing long-term effects unless steps are taken to reverse it.
Clinical laboratory data was key in identifying antibiotic-resistant bacteria responsible for surge in BSIs in hospitals and other healthcare facilities in 2020 and 2021
Clinical laboratory data compiled by the European Antimicrobial Resistance Surveillance Network (EARS-Net) shows that a massive increase in bloodstream infections (BSIs) occurred among EU nations during the first two years of the COVID-19 pandemic. The study found that BSIs caused by certain antimicrobial-resistant (AMR) pathogens, known as superbugs, more than doubled in EU hospitals and healthcare facilities in 2020 and 2021.
Microbiologists and clinical laboratory managers in the US may find it valuable to examine this peer-reviewed study into AMR involved in blood stream infections. It could contain useful insights for diagnosing patients suspected of BSIs in US hospitals where sepsis prevention and antibiotic stewardship programs are major priorities.
“Antimicrobial resistance undermines modern medicine and puts millions of lives at risk,” said Tedros Adhanom Ghebreyesus, PhD, Director-General, World Health Organization, in a WHO press release. “To truly understand the extent of the global threat and mount an effective public health response to [antimicrobial resistance], we must scale up microbiology testing and provide quality-assured data across all countries, not just wealthier ones.” Clinical laboratories in the US may be called upon to submit data on bloodstream infections in this country. (Photo copyright: WHO.)
Clinical Laboratories in EU Report Huge Increase in Carbapenem Resistance
To perform their study, researchers measured the increase in Acinetobacter BSIs between 2020 and 2021, the first two years of the COVID-19 pandemic. Their data originated from qualitative regular antimicrobial susceptibility testing (AST) from blood samples collected by local clinical laboratories in the European Union/European economic area (EU/EEA) nations.
The researchers limited their dataset to Acinetobacter BSI information from the European medical laboratories that documented results of carbapenem susceptibility testing for the bacterial species.
Carbapenems are a class of very powerful antibiotics that are typically used to treat severe bacterial infections. A total of 255 EU/EEA clinical laboratories reported their data for the study. The scientists found that the percentages of Acinetobacter resistance varied considerably between EU/EEA nations, so they separated the countries into three different groups:
Nations in Group One—The Netherlands, Belgium, Austria, Estonia, Denmark, Germany, Iceland, Finland, Luxembourg, Ireland, Norway, Sweden, and Malta—experienced less than 10% resistance to carbapenems.
Nations in Group Two—Slovenia, Czech Republic, and Portugal—had carbapenem resistance between 10% and 50%.
Nations in Group Three—Croatia, Bulgaria, Greece, Cyprus, Italy, Hungary, Lithuania, Latvia, Romania, Poland, Spain, and Slovakia—demonstrated carbapenem resistance equal or greater than 50%.
The study also found that Acinetobacter BSIs rose by 57% and case counts increased by 114% in 2020 and 2021 when compared to 2018 and 2019. The percentage of resistance to carbapenems rose to 66% in 2020 and 2021, up from 48% in 2018 and 2019.
Antimicrobial Resistance Especially High in Hospital Settings
The researchers further arranged the data into three hospital ward types: intensive care unit (ICU), non-ICU, and unknown. The increase in BSIs caused by Acinetobacter species resistant to carbapenems was greater in ICU-admitted individuals (144%) than non-ICU-admitted individuals (41%).
There are more than 50 species of Acinetobacter bacteria and various strains are often resistant to many types of commonly-used antibiotics. Symptoms of an Acinetobacter infection usually appear within 12 days after a person comes into contact with the bacteria. These symptoms may include:
Blood infections,
Urinary tract infections,
Pneumonia, and
Wound infections.
Healthy people have a low risk of contracting an Acinetobacter infection with the highest number of these infections occurring in hospitals and other healthcare settings. Acinetobacter bacteria can survive for a long time on surfaces and equipment, and those working in healthcare or receiving treatment are in the highest risk category.
The prevalence of this type of bacteria increases in relation to the use of medical equipment, such as ventilators and catheters, as well as antibiotic treatments.
WHO Report Validates EARS-Net Research
In December of 2022, the World Health Organization (WHO) issued a Global Antimicrobial Resistance and Use Surveillance System (GLASS) report that revealed the presence of an increasing resistance to antibiotics in some bacterial infections. That report showed high levels (above 50%) of resistance in bacteria that frequently caused bloodstream infections in hospitals, such as Klebsiella pneumonia and Acinetobacter.
The WHO report examined data collected during 2020 from 87 different countries and found that common bacterial infections are becoming increasingly resistant to treatments. Both Klebsiella pneumoniae and Acinetobacter can be life threatening and often require treatment with strong antibiotics, such as carbapenems.
More research is needed to determine the reasons behind increases in Acinetobacter infections as reported in European hospitals and other healthcare settings, and to ascertain the extent to which they are related to hospitalizations and the upsurge in antimicrobial resistance during the COVID-19 pandemic.
Microbiologists and clinical laboratory managers in the US may want to learn more about the fIndings of this European study involving AMR and use those insights to plan accordingly for any future increase in bloodstream infections in this country.
