24-11-2023 (HONG KONG) The Hospital Authority in Hong Kong has issued a warning about the increasing prevalence of two superbugs among patients, prompting the launch of a pilot scheme that leverages artificial intelligence (AI) to tackle antibiotic overuse.
Dr Raymond Lai Wai-man, Chief Infection Control Officer of the authority, disclosed that cases of vancomycin-resistant enterococci (VRE) and Candida auris have risen in the first three quarters of 2023 compared to previous years. The surge is attributed to a shift in resources towards combating COVID-19, diverting attention from multidrug-resistant organisms.
The impact of COVID-19 on the allocation of isolation wards and the prescription of broad-spectrum antibiotics to address potential co-infections during hospitalizations contributed to the rise of these superbugs. With a decrease in coronavirus infections, the prevalence of common superbugs has returned to pre-pandemic levels, except for VRE and Candida auris.
Multidrug-resistant organisms, commonly known as superbugs, result from the overprescription and improper use of antimicrobials. Methicillin-resistant Staphylococcus aureus, a prevalent drug-resistant organism in the city, exhibited a 44.7% antibiotic resistance rate among samples collected in the first three quarters of the year. VRE showed an antibiotic resistance rate of 1.2%, compared to 0.22% in 2021 and 0.7% in 2022.
A worrying increase in VRE cases from fewer than 40 in 2021 to around 140 by late September 2023 has been noted. Patients carrying Candida auris rose from nearly 200 in 2020 to over 300 as of Oct 31, 2023, with a mortality rate ranging from 53 to 83.3%.
Emphasizing the importance of controlling these superbugs, Dr Lai highlighted the limitations in antibiotic choices and the potential for serious complications, even death, for patients with weakened immune systems.
To address the issue, a pilot scheme utilizing AI to analyze clinical data and assess the necessity of antibiotics will launch in January 2024 at Prince of Wales Hospital in Sha Tin and Princess Margaret Hospital in Kwai Chung. Initially focusing on one form of antibiotic, the program will expand to emergency rooms at 17 public hospitals from March, covering eight other types of medicine.
Currently, public hospitals rely on a team of doctors and pharmacists to assess the need for antibiotics. With the introduction of AI, notifications can be sent to doctors promptly, streamlining the decision-making process and saving valuable time.
Additionally, screenings for Candida auris among high-risk patients and residents of care homes, along with enhanced infection control measures, have been implemented to curb the spread of superbugs.
Dr Lai underscored the importance of personal hygiene in preventing transmission and advised the public to be vigilant about hand hygiene, avoid sharing personal items in public places, and strictly adhere to doctors’ instructions when taking antibiotics.
