Mexico City, May 8, 2017 – Hands are the most powerful tools of health professionals. With them we feel our patients, identify their ailments and with them we provide support and hope. However, our hands can also be a source of danger for our patients because they are the main route of infection transmission. This was stated by Dr. Cecilia Acuña, Health Services and Systems Advisor on behalf of Dr. Gerry Eijkemans, PAHO / WHO Representative in Mexico, at the World Hand Hygiene Day memorial event, which in 2017 highlights the importance of this practice in the fight against antibiotic resistance.

Worldwide, millions of people are affected annually by at least one infection associated with health care. It is estimated that in developing countries 15% of patients admitted to hospitals and 34% of patients in intensive care units develop an infection associated with their health care.

This situation translates into significant financial losses for health systems, mainly due to the increase in days of hospital stay, and the fact that it is necessary to prescribe more expensive medications, but the most serious of the infections associated with health care. Health are its consequences on people, since they affect the most fragile patients, usually induce long-term disabilities and in many cases, they result in a significant increase in avoidable mortality.

The fact that infections are the most common adverse effect of health care in the world is very worrying and unacceptable, since most of these infections can be prevented through simple, low-cost interventions such as hand washing . Hands are the most powerful tools of health professionals. With them we feel our patients, identify their medical conditions and provide them with support and hope. However, our hands can also be a source of danger for our patients because they are the main route of infection transmission.

Hand hygiene at the right time saves lives and is an indicator of the quality and biosecurity of health services. Therefore, we must continue to strengthen their practice and ensure that hand washing is done with the correct technique at five key moments:
1. before touching the patient,
2. before performing a clean / aseptic task,
3. After being exposed to body fluids,
4. after touching the patient, and
5. After being in contact with the patient’s environment.

Today, handwashing is even more important as it is key to addressing one of the biggest challenges we face today that can put decades of progress in medicine and public health at risk. This great challenge is that of antimicrobial resistance.

The misuse and overuse of antimicrobials has increased the number of microorganisms resistant to treatments that historically helped save millions of lives. For example, although on a global scale the incidence of tuberculosis has been declining since 2000, this progress is threatened by the increase in cases of multi-drug resistant and extremely resistant tuberculosis. Likewise, the increasingly frequent occurrence of methicillin-resistant Staphylococcus golden infections is observed, with a probability of dying 64% higher than patients with non-resistant infections.

Recognizing the seriousness of this situation, in recent years the issue of antimicrobial resistance has acquired great relevance on the international agenda, with the adoption of Resolutions and action plans by PAHO Member States and WHO (WHA67 .25, WHA 68.7 of 2015, and CD54.R15). Moreover, the world leaders gathered at the General Assembly of the United Nations in 2016 pledged to adopt a comprehensive and coordinated strategy to address the root causes of antimicrobial resistance in multiple sectors, especially in human health, Animal health and agriculture.

On the other hand, on February 27, the WHO published its first list of antibiotic resistant priority pathogens. This list includes the 12 families of bacteria most dangerous to human health for having acquired resistance to a high number of antibiotics. This list seeks to promote and guide the research of new antibiotics and therefore these 12 families of bacteria are categorized according to the degree of urgency with which new antibiotics are needed. Bacteria have been classified in those with critical priority, high priority or medium priority. It is important to note that the critical priority group includes bacteria such as Klebsiella, E. Coli, Serratia, and Proteus, which are especially dangerous in contexts where health services are provided because they can cause serious and lethal infections, such as sepsis and pneumonia.

Recognizing that deficiencies in infection prevention and control favor the emergence of antimicrobial resistance, the Global Plan of Action on Antimicrobial Resistance, approved at the 68th World Health Assembly, calls for improved prevention and control of Infections both in the community and in healthcare centers, using proper hand hygiene as one of the main strategies.

We can all help promote proper hand hygiene at the right time. Our call to action is addressed:

To the health personnel to clean their hands at the right times and thus stop the spread of antibiotic resistance.
To the Directors, Managers and Administrators of the hospitals, to implement infection prevention and control programs designed to protect their patients from resistant infections.
To decision makers and policy makers, to make infection prevention and hand hygiene a national political priority.
To the leaders in infection prevention and control, so that they implant the essential components for the prevention and control of WHO infections, including hand hygiene, in the care establishments, in order to combat antimicrobial resistant infections.
Failure to take urgent and forceful actions to combat this global problem, the list of resistant pathogens can grow and endanger millions of lives. In this context, antimicrobial resistance represents a political and social challenge that we must address not only from the health sector, but from an intersectoral perspective.

Our colleagues in the agriculture, livestock, veterinary, economics and research and development promotion sectors must join this effort. We also need to add the population, sensitizing the general public about the danger it represents today and for future generations to lose the effectiveness of antimicrobials. The fight against antimicrobial resistance is in the hands of all of us.

Links of interest:

WHO publishes the list of bacteria for which new antibiotics are urgently needed
Campaign page “Save Lives: clean your hands”
PAHO page on antimicrobial resistance