Surutilisation des antimicrobiens, résistance bactérienne et infections nosocomiales aux soins intensifs: comprendre, innover et intervenir pour réduire

 

Patricia Fontela

Institut de recherche du Centre universitaire de santé McGill

 

Domaine : santé de la mère, des enfants et des adolescents

Programme Chercheurs-boursiers cliniciens - Junior 2

Concours 2019-2020

Bacterial resistance is an important problem worldwide. It is strongly associated with antibiotic overuse. In hospitals, antibiotic overuse is caused by unnecessary prescription of antibiotics for viral infections and by prolonging antibiotic treatment duration for bacterial infections beyond patients' needs. This leads to the selection of bacteria that are resistant to antibiotics. Resistant bacteria, for example Clostridium difficile, may infect hospitalized patients and cause their death. This happens because the currently available antibiotics may not be effective to treat infections caused by resistant bacteria. Intensive care units (ICUs), including pediatric ICUs (PICUs), have the highest rates within hospitals of bacterial resistance, of antibiotic use, and of hospital-acquired infections. Importantly, their resistant bacteria spread to other hospital wards and then out to the community. In PICUs, around 70% of patients receive at least 1 antibiotic during their stay, and, in up to 33% of cases, such treatment is unnecessary.

To reduce bacterial resistance in PICUs, I propose a research program targeting its three pillars: prolonged antibiotic treatments, unnecessary antibiotic prescription, and hospital-acquired infections. I will develop tools to be used by medical teams to personalize antibiotic treatment duration based on individual patient needs and to improve the differential diagnosis between viral and bacterial lung infections in young children. I will also study if transfusing freshly donated blood increases the risk for hospital-acquired infections in ICU patients.

Reducing bacterial resistance is essential from a medical and public health viewpoint. My research program will generate results that will significantly decrease antibiotic overuse and bacterial resistance in PICUs with the final goal of improving the health of critically ill children.