1.3 Resistance patterns in your workplace
Activity 4 Resistance patterns in your workplace [For clinicians]
Think about the organisms your laboratory identifies routinely. Referring to the GLASS and WHO priority R&D lists, what are the most important organism-resistance patterns that you see in your workplace? Are any combinations associated with outbreaks, for example in Critical Care? Do you see any patterns regularly which are not on the lists? If you routinely perform AST, would your laboratory currently be able to detect the resistance profiles of concern? Make notes and then compare with the example answer.
Discussion
It is likely that you encounter MRSA and ESBL-producers as these are very common, as well as carbapenemase producers if you live in a part of the world where these are established. If you have a Critical Care Unit in your hospital you are likely to have seen outbreaks with some of the MDR Gram negatives.
Activity 4 Resistance patterns in your workplace [For veterinarians]
Think about the organisms your laboratory identifies routinely. Have you had experience in detecting any of the organisms from the WHO R&D priority list in your laboratory? If you routinely perform AST, would your laboratory currently be able to detect the resistance profiles of concern? Make notes and then compare with the example answer.
Discussion
You are likely to be identifying the coliforms and enteric pathogens. Resistance is surprisingly common if you test for it, both in animals which have been treated with antimicrobials and in those which have not. The strains are readily transmissible and can be spread from other animals via the environment or from humans, hence the need to test for resistance.
Most of the GLASS and WHO priority R&D pathogens, including those of One Health importance, can be cultured easily; some have specific growth requirements (see the Isolating and identifying bacteria module). Some of the resistance patterns can be identified by routine AST; others, for instance ESBL production or VRE, may need additional testing to identify and confirm their presence. You will find out more about these methods later in the module.
1.2 WHO priority human pathogens for antimicrobial R&D
