Strategic measures for the control of surging antimicrobial resistance in Hong Kong and mainland of China

Cheng, Vincent CC; Wong, Sally CY; Ho, Pak-Leung; Yuen, Kwok-Yung

In summary, control of antimicrobial resistance in Hong Kong and mainland China depends on more intensive surveillance of farms, wastewater treatment plants, outpatient clinics and healthcare institutions. Parameters including antimicrobial consumptions, environmental contaminations, and antimicrobial resistance should be monitored with appropriate follow up action. Antimicrobial use animals must be banned, and biosecurity measures on farms should be strengthened. Sewage and wastewater treatment should be improved to prevent resistant bacteria from getting into the water, soil and fertilizers. Antimicrobial treatment in healthcare settings should only be given according to evidence-based guidelines, and regular auditing should be in place to reduce the inappropriate usage and duration of antibiotic treatment. Heightened public awareness about combating antimicrobial resistance and compliance with food and personal hygiene are important to decrease the acquisition of antimicrobial resistance, especially while taking antibiotics. Educational pamphlets should be handed to patients and relatives while awaiting hospital admission or drug prescriptions at the pharmacy. The combination of proactive 'added testing' for emerging MDROs, directly observed hand hygiene, and the 'entry and exit' control strategy are important additional measures to control and prevent new antimicrobial resistance in our hospitals. Interventions in healthcare setting should be regionally coordinated where patients, staff and visitors are often transferred between acute hospital service, convalescent hospital and elderly residential homes. Data of hand hygiene compliance, broad-spectrum antibiotic consumption, and incidence of newly diagnosed and hospital-acquired MDROs should be regularly released to public so that the performance of the individual hospitals are subject to auditing by the public from time to time.