New approaches for clinical management and prevention of resistant bacterial infections in high prevalence settings

Proposals should focus on the identification of best practices, and the development and validation of interventions, infection prevention and clinical management plans for dealing with resistant bacterial infections in high prevalence settings. The research needs to take into account the variety and capacities of local health care/nosocomial infrastructures, and the trends of resistance patterns on local, national and international level, as well as sex and/or gender differences, when relevant. Furthermore, research needs to lead to management plans that take into account commonalities as well as differences between different pathogens and resistance determinants.

The costs and benefits of the infection prevention and clinical management plans to be developed should be assessed as well as the feasibility of their implementation. Research into the practicalities and challenges to introduce such novel infection prevention and management plans is essential and their practical implementation, as pilot actions, in 2 or more European regions with high prevalence levels is strongly encouraged, while taking into account that the infection prevention and clinical management plans to be developed should be applicable for large geographical areas. The potential challenges in the uptake of interventions/management plans by national health systems should be researched and addressed and cooperation with the Joint action AMR and healthcare-associated infections (JAMRAI), ECDC and the EU Health Security Committee is recommended.

The Commission considers that proposals requesting a EU contribution of EUR 10-15 million would allow this specific challenge to be addressed appropriately. Nonetheless, this does not preclude submission and selection of proposals requesting other amounts.

Antimicrobial resistance represents a serious threat to public health in Europe and beyond. Within the last decades resistance has increased considerably in many clinically important pathogenic bacteria. Data collected by the European Centre for Disease Prevention and Control (ECDC)[[https://ecdc.europa.eu/en/antimicrobial-resistance]] shows that nowadays in several European countries prevalence levels of infections that can no longer be treated with last-line classes of antibiotics have reached levels where isolation measures may no longer be feasible. In addition to this, prevalence levels of resistant infections are likely to increase in countries where currently such levels are relatively low. This may lead to an increasing number of outbreaks of resistant infections in these countries. The challenge is to address this threat via a multi-disciplinary approach by developing suitable clinical management and infection prevention plans detailing how to deal with resistant bacterial infections in high prevalence settings. The spread of AMR across borders has been recognised globally and improving knowledge on clinical management and infection prevention in high prevalence settings might also benefit other countries around the globe, including low and middle income countries and thereby diminish the spread of resistant bacteria. This topic will contribute to the implementation of the EU One Health Action Plan against Antimicrobial Resistance[[https://ec.europa.eu/health/amr/sites/amr/files/amr_action_plan_2017_en.pdf]].

• Availability of tested cost effective models for prevention and treatment of bacterial infections in health care settings with high prevalence levels of resistant infections.
• Reduced spread of resistant hospital acquired infections in these settings.
• Knowledge that can be of use for other countries around the globe, including low and middle income countries, benefitting their local population and diminishing the global spread of resistant bacteria.