AMR and Hygiene

In August 2020, a group of experts published a review setting out data which argues that promotion of hygiene behaviour change in the community could significantly reduce prescribing of antibiotics and prevent the spread of resistant bacteria. It shows that to maximize protection against infections in home and community settings a more focused approach to hygiene (Targeted Hygiene) is needed. The paper calls on health policy makers to recognise that curbing unnecessary antibiotic consumption cannot be achieved without also developing infection prevention strategies in community settings.

In this EMG podcastJonathan Sackier talks to Sally Bloomfield, Honorary Professor at the London School of Hygiene and Tropical Medicine, about the importance of antimicrobial resistance and hygiene. Together, they explore the relationship between AMR and infectious diseases, and the importance of Targeted Hygiene in homes and everyday life in tackling, not only AMR but also the COVID-19 pandemic. They discuss how myths about “germs” and lack of understating of how they spread, coupled with lack of understanding of hygiene – what it is and how it differs from cleanliness – is acting as a barrier to changing public hygiene behaviour. Implementation of behaviour change strategies which develop understanding of the “journey of the germ” and how to break it are essential to ensure that our hygiene practices are appropriate to the urgent public health issues we currently face.

Consumer use of antibacterial products is a contentious issue because of concerns that it may contribute to development of antibiotic resistance. A number of expert reports have been commissioned in the last 20 years. These agree that laboratory evidence “does indicate” that use of certain types of microbiocidal products could contribute to reduced susceptibility to antibiotics, but they also conclude that there is no evidence, as yet, that disinfectant/ antibacterial/ hand sanitizer use has contributed to antibiotic resistance in clinical practice”.

Swiss experts and consumers were interviewed about the risks of transmission of AMR. These were then qualitatively compared and the main gaps identified. The results revealed that Swiss consumers had several misconceptions regarding the sources and transmission of AMR. In particular underestimated the importance of poultry meat and pets as a potential source of AMR. Furthermore, high uncertainty was noted in experts regarding the prevalence of AMR in pets and the potential of transmission to their owners.