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Antimicrobial Stewardship, Prevention of Infection and Resistance in Africa

Project description

Fighting drug-resistant infections in African hospitals

Across the African continent, hospitals are dealing with the challenge of multidrug-resistant bacterial infections, while infection control and antimicrobial stewardship remain uncoordinated. With this in mind, the EU-funded ASPIRE project aims to improve cleanliness in four hospitals in Ethiopia and Ghana with special emphasis on handwashing, visitor hand hygiene, and cleaning of surfaces. ASPIRE seeks to reduce healthcare-associated infections by 15 %, as well as enhance treatment outcomes by implementing personalised antibiotic therapy using therapeutic drug monitoring and pharmacodynamic modelling. By integrating these approaches into an eHealth system, ASPIRE fosters a sustainable and cost-efficient strategy to effectively counter antibiotic resistance.

Objective

African hospitals are increasingly providing microbiological diagnostics, hygiene and antimicrobial stewardship (AMS) procedures in response to multidrug-resistant (MDR) bacterial diseases. However implementation within integrated, multidisciplinary hospital services is often poorly established. We first aim to assess the impact of an enhanced hospital hygiene intervention on the incidence of healthcare-associated infections (HAI) in hospitalized patients, using a stepped-wedge cluster randomised trial (SW-CRT) design. Clusters (surgical, medical wards, ICUs) in four tertiary level hospitals in Ethiopia and Ghana will be transitioned to interventions focusing on hand and instrument hygiene procedures, hygiene procedures for visitors and standardized room surface cleaning. Microbiological assessments and AMR of patients and hospital environments will be conducted, with an expected 10-15% reduction in HAI incidence. Nested within the SW-CRT, we further focus on therapeutic drug monitoring (TDM) and predicted pharmacodynamic target attainment (PTA) to optimize beta-lactam antibiotic regimens as part of AMS procedures. Patients (N=400) with severe bacterial infections (e.g. sepsis) will receive standard versus standard plus TDM/PTA based AMS assessment, with dose optimization expected in up to 50% of cases. By integrating TDM/PTA into an AMS eHealth system, we aim to generate generalizable population-based PTA support, linked with cost-effectiveness analysis to promote sustainability within routine care procedures. By shifting antibiotic treatment from an empirical to a more individualized patient management strategy, we aim to introduce optimized and affordable AMS interventions, expecting an impact on improved clinical response and reduction of AMR within hospitals. Our study consortium is built on multidisciplinary expertise. Partners have been linked for years through African-European hospital partnerships implementing high quality microbiological diagnostics.

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Programme(s)

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Topic(s)

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HORIZON-JU-RIA - HORIZON JU Research and Innovation Actions

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Call for proposal

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(opens in new window) HORIZON-JU-GH-EDCTP3-2024-01-two-stage

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Coordinator

LUDWIG-MAXIMILIANS-UNIVERSITAET MUENCHEN
Net EU contribution

Net EU financial contribution. The sum of money that the participant receives, deducted by the EU contribution to its linked third party. It considers the distribution of the EU financial contribution between direct beneficiaries of the project and other types of participants, like third-party participants.

€ 0,00
Address
GESCHWISTER SCHOLL PLATZ 1
80539 MUNCHEN
Germany

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Region
Bayern Oberbayern München, Kreisfreie Stadt
Activity type
Higher or Secondary Education Establishments
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Total cost

The total costs incurred by this organisation to participate in the project, including direct and indirect costs. This amount is a subset of the overall project budget.

€ 923 165,00

Participants (7)

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