Bridging the gap: Linking for -profit organizations to the public health initiative of combating antimicrobial resistance

As the prevalence of antimicrobial resistance continues to rise around the world, the need to implement effective public health strategies grows more intense. These strategies include establishing local, national, and international surveillance networks to track known resistance patterns and detect new ones, to educate health care professionals, and to support basic and clinical research. This paper concentrates on the challenges and practical obstacles for dealing with this, essentially environmental, problem which results from the peculiar nature of the market in health care. I developed a survey to focus on, these three strategy areas: antimicrobial resistance surveillance, antimicrobial resistance education and antimicrobial resistance research. I distributed over 1,000 surveys to American Hospital Association, AHA, affiliated hospitals, collected and analyzed the data and developed a viable policy response based on the analysis. The collected data supported current literature in that it identified many communication "gaps" within the private sector, which negatively contribute to the emerging threat of antimicrobial resistance. The study further identified communication "gaps" between the public and private sector and shows that "bridging these (communication) gaps," specifically, linking for-profit organizations to the public health initiative of combating antimicrobial resistance, would offer the best policy response. As a result of the survey analysis, I developed a policy solution to managing antimicrobial resistance on a global basis. An antimicrobial surveillance system was the most sought after solution by survey participants, therefore, an electronic surveillance system, currently funded by a for-profit organization, was investigated as a case in point. The system developed merges information technology (IT) with microbiological expertise to collect and standardize antimicrobial susceptibility data produced by clinical laboratories across the USA. By February 2002, the electronic database, modified as a result of this study, contained more than 40 million susceptibility test results from 259 institutions for 103 drugs, 2,985,789 strains of bacteria, 547 species and 1,979,959 patients. Using an IT approach, as a strategy for managing the resistance problem, it is possible to collect large volumes of reliable data on a daily basis so that patterns of interest are discovered in real time. If "linked," to current public health initiatives, this electronic surveillance system has been shown through this pilot study to represent the solution to understanding and managing antimicrobial resistance on a global basis.