Impact of COVID-19 on Health Care-Associated Infections and Antimicrobial Resistance in Mexico

Impact of COVID-19 on Health Care-Associated Infections and Antimicrobial Resistance in Mexico

Covid-19 and the Surge of Healthcare-Associated Infections

Ah, the Covid-19 pandemic. Just when you thought the only thing we’d have to worry about was whether to leave the house in pants or pajamas, it brings us a whole new set of health headaches. And let’s be honest, it’s like an episode of *Hospital*—you think you’re the star of the show until you realize you’re just a side character in an evolving plot of Healthcare-Associated Infections (HAI) and antimicrobial resistance. You know, the stuff that makes you question whether your hospital stay will give you more than just a bill!

The stats are in, and they read like the bad news section of a comedy show: if you go to the hospital, there’s a serious chance you’ll walk out with a little gift called a resistant infection. That puts you at a whopping 64 out of 100,000 chance of kicking the bucket. So, how can you trust your doctor when the only thing on their prescription pad is “survival of the fittest”?

And Dr. Alfredo Ponce de León, head of Infectology at the National Institute of Nutrition (or as I like to call him, “the germ whisperer”), has some stern advice on this. He says we not just need to stomp on antimicrobial resistance, but we need to do it with both feet and perhaps a microphone in hand to educate everyone involved—starting with the medics themselves! Let’s be clear, folks: antibiotics are not your go-to for viral infections! Can’t stress that enough. If you give kids antibiotics like candy, what do you think will happen? They’ll grow up thinking “I can’t take a cold without a side of penicillin!”

This dilemma was highlighted recently at a panel called “Impact of the Covid Pandemic on HAIs.” It sounds impressive, doesn’t it? Like a meeting of the minds where you expect grand solutions, but instead, it’s just a bunch of experts scratching their heads about how to manage monkeypox, syphilis, and the oncoming apocalypse. They spoke about the pervasive burden of cross infections during the pandemic—like an unwanted party guest who walks in with Covid and leaves you with a fungal infection, like a true overachiever.

And just when you thought you could safely return to a hospital, the conversation around the rational use of antibiotics becomes real. Doctors used to prescribe them for an entire 21 days (which is apparently too much time to make your gut flora consider a career change). Now we’re down to three—and soon it might be less than a day. Who knows? Perhaps by next week, they’ll just slip it into your water like a secret ingredient to survival.

Our very own Dr. Boris Martínez also managed to slip in a cheeky comment on the need for better data management in times of crisis—a bit like trying to unravel a ball of yarn while blindfolded! Thanks to the poor handling of Covid data, we might miss the next big pandemic entirely or, worse, rely on the offices of Instagram influencers for real-time updates!

And then there’s the IV Forum on In-hospital Infections happening soon. Because what could be more thrilling than a weekend spent with specialists delving into regulatory angles about antimicrobial use? I mean, grab the popcorn! Who needs action movies when you have specialists discussing the costs of HAIs? My heart can barely take all this excitement!

Across the Atlantic, on a different stage in Geneva, global representatives are debating a Pandemic Agreement. It’s like a group project where every student’s a slacker, but they still have to get together and agree on who does the work. This time, we’re hoping they might just take a note or two to ensure that the next pandemic doesn’t go down smoother than a shot of tequila at a bar! Will they prioritize lives or simply prolong a model that keeps poorer countries dependent? We all know the answer: it’ll likely depend on who has the best lobbyists!

Lastly, we’ve got the Mexican Hospital Consortium (CMH) entering the scene. Founded by the late Javier Potes, it was meant to be the private sector’s shining star, but now they seem to be settling into more of a ‘lost sitcom plot’ vibe. Without their brilliant leader, they’re left asking whether they can hold it all together. Can they maintain the dynamics as they go through a midlife crisis? Because that’s all we need—a consortium with an identity crisis!

In conclusion, folks, the aftermath of Covid has gifted us more than we bargained for. And as we navigate through HAIs, antibiotic use, and global health negotiations, let’s hope we step out of the pandemic not just with our vaccinations in order but with a newfound respect for the health professionals juggling far too many hat changes. Cheers to surviving the chaos, and remember—there’s no punchline to this story, just a reminder to keep your health in check.

One pressing consequence of the Covid-19 pandemic has been the alarming rise in Health Care-Associated Infections (HAI), a situation that compounds the already serious issue of antimicrobial resistance, which poses a considerable challenge to public health on a global scale. In Mexico, this issue is further exacerbated, often going unnoticed and unmeasured, making it all the more critical to bring it to the forefront of public awareness.

Patients who enter hospitals are now facing increased risks, particularly when they contract infections, which can severely complicate their clinical conditions. The situation worsens dramatically when these infections are caused by resistant bacteria, leading to a staggering increase in mortality risk, with rates reaching as high as 64 deaths per 100,000 patients infected.

Dr. Alfredo Ponce de León, head of Infectology at the National Institute of Nutrition (INNCMSZ), emphasizes the urgent need for a clear understanding of antimicrobial resistance, particularly among healthcare professionals. During the pandemic, many patients experienced cross infections, where patients admitted for Covid-19 often left intensive care with additional complications, such as fungal or bacterial infections like candidiasis. These secondary infections significantly contributed to mortality rates, highlighting the critical need for better infection control practices.

In response to the escalating crisis, there is now a pressing obligation to carefully manage and regulate antibiotic use. Previously, antibiotics were prescribed for an average of 21 days, a duration that has continually decreased to 10 days, then to just 3, with ongoing discussions that suggest it may drop to as little as one day in the future. Dr. Ponce de León stresses that this is not about eliminating the use of anti-infectives but rather ensuring their rational and appropriate application, especially concerning the fact that antibiotics do not treat viral infections and may be unnecessary in pediatric cases. The overarching problem remains a lack of awareness and understanding about proper antibiotic use among both clinicians and the public.

The significant issues of HAIs were further explored during a panel titled “Impact of the Covid Pandemic on Healthcare-Associated Infections (IAAS),” organized by the Infection-Free Hospitals initiative. This panel was part of a broader discourse on medical and public health topics at the Medical Expo, which commenced on October 29 at the WTC in Mexico City.

Irma Aguilar Delfín, a biomedical researcher and immunologist, moderated the panel, which also covered the monkeypox outbreak among HIV patients. Dr. Jezer Lezama from the Condesa Clinic reported a concerning statistic: 80% of mpox tests in HIV-positive individuals returned positive, indicating a persistently high incidence of infection despite a slight decrease recently. He added that during the pandemic, the rates of positivity in HIV testing had fallen, attributed to delayed diagnoses, but those numbers are now stabilizing. Of the over 8,000 patients at the clinic, half are receiving preventive treatment with antiretrovirals (PREP) to mitigate their risk of HIV infection. However, issues such as substance abuse present significant barriers to treatment adherence, exacerbating challenges like increased syphilis cases within this vulnerable population.

Dr. Boris Martínez, known for creating the Covid-19 open data dashboard, shared insights into the lessons learned from the Covid-19 crisis that the nation must heed during future health emergencies. He criticized the inadequate management of pandemic data, which could have served as a critical resource for informed decision-making. For instance, he pointed out that early warning systems could have been established, while timely reporting of lethality figures was delayed, undermining public urgency and trust. Medical units also ceased reporting cases, evidenced by a drop in submissions from 1,000 to 660 to the Severe Acute Respiratory Infection (SARI) network. Additionally, there were alarming lapses, such as inadequate testing at many locations and an unethical emphasis on intubating patients—a practice shown to amplify mortality rates.

Forum on In-hospital Infections at the UIA

Looking ahead, the IV Forum titled “The Challenge of In-hospital Infections” will take place at the Universidad Iberoamericana (UIA) from November 6 to 7. At this event, specialists will discuss regulatory measures concerning antimicrobial rational use, implications in pediatric healthcare, advancements in diagnostic methods, the importance of animal health under the One Health framework, and the substantial impact of HAIs on health financing. The forum will also explore the potential opportunities that artificial intelligence introduces in addressing this critical public health dilemma.

Pandemic Agreement: The future is debated in Geneva

In Geneva, from November 4 to 15, representatives of over 100 countries will converge for the Intergovernmental Negotiating Body (INB12) meeting following nearly three years of negotiations. This pivotal gathering will play a crucial role in determining whether millions will survive or perish during future pandemics, especially for nations in the global south. As negotiations reach their climax, there remains an opportunity to forge a more equitable agreement regarding access to vaccines and essential health supplies in future health crises, a dire necessity that was severely lacking during the Covid-19 pandemic. Dr. Jorge Saavedra, executive director of the AHF Institute for Global Public Health, contends that the decisions made in Geneva will either prioritize the lives of millions or continue a health model that leaves impoverished nations reliant on the benevolence of wealthier countries during crises.

CMH turns the page

The Mexican Hospital Consortium (CMH), which was established by the prominent health leader Javier Potes, who tragically passed away in June, has built a robust network of over 50 hospitals across key cities in Mexico. Under Potes’s guidance, this consortium maintained operational independence while fostering valuable partnerships with suppliers and institutional allies to prioritize patient-centered care. His key role in the hospital alliance formed with the public sector during the pandemic was pivotal in averting the collapse of the healthcare system amid overwhelming challenges.

Now, under the leadership of Javier Valdez, the CMH appears to be charting a new course, as Potes’s former team has begun to disband. The future of the CMH hinges on its ability to uphold the leadership and vision necessary to address the ongoing challenges in the healthcare sector, a feat that will test its resilience and commitment to patient care without the foundational framework established by its late founder.

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