Regional cooperation to address antimicrobial resistance

Resistant bacteria spread through patients and healthcare professionals. This means they can be carried outside the walls of care facilities, from hospitals to homes or rehabilitation clinics, from homes to nursing homes and from nursing homes to hospitals. Because most patients tend to remain within a particular region, regional cooperation is essential for the national strategy. To achieve this, 10 regional care networks for antimicrobial resistance have been set up in the Netherlands.

What are regional AMR care networks?

In a regional care network, the various care facilities, Municipal Public Health Services (GGDs), professional associations and healthcare professionals from that region work together. This cooperation improves knowledge and skills in the field of infection prevention and antimicrobial resistance.

For each care network, the Minister of Health, Welfare and Sport has designated an academic or top clinical hospital that brings professionals from long-term, curative and public healthcare together into a steering committee. Under the leadership of this steering committee, a regional coordination team handles the performance and coordination of the activities within the network. This coordination team consists of a medical microbiologist, a public health physician, an infection prevention expert, an internist-infectiologist, an elderly care physician, a GP and an epidemiologist. Each region has a network coordinator who serves as the first point of contact for the care network.

The main objectives of the regional AMR care networks are:

• to gather support and promote cooperation between healthcare professionals and care facilities in order to limit the development and spread of resistance in the region;
• to provide insight into the epidemiology of highly resistant micro-organisms (HRMOs) in the region and to optimise the quality of the region’s infection prevention and antibiotics use policies;
• to coordinate and support care facilities in the region during HRMO outbreaks to prevent further spread.

What do the regional AMR care networks do?

First and foremost, the care networks stimulate cooperation in the region. They also improve knowledge and skills relating to infection prevention, antibiotics use and resistance. To this end, they carry out the following activities:

• Involving care facilities and healthcare professionals in the activities that are organised within the regional network, as well as encouraging participation in national surveillance of resistant micro-organisms, healthcare-associated infections and antibiotics use.
• Providing an up-to-date picture of AMR and infection prevention in the region by periodically adjusting the regional risk profile and management plan.
• Making transmural agreements about sharing information on outbreaks and carrier status of highly resistant micro-organisms (HRMOs) when transferring patients and clients to other care providers.
• Making data about resistance, healthcare-associated infections and antibiotics use available for use within the care network.
• Increasing expertise on infection prevention and AMR by organising refresher courses and further training.
• Improving infection prevention and reducing the number of healthcare-associated infections in the region by stimulating and facilitating insight into the quality of infection prevention in care facilities and healthcare organisation, e.g. through audits.
• Supporting and advising care facilities on the implementation of control measures during an HRMO outbreak.
• Promoting appropriate antibiotic prescription practices among care providers in the region, e.g. by encouraging the use of comparative information.

These are the 10 regional AMR care network 

AMR care networks

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Role of RIVM in regional AMR care networks

RIVM grants subsidies to the regional AMR care networks on behalf of the Ministry of Health, Welfare and Sport. To this end, RIVM supports the care networks in the subsidy procedure, reviews the subsidy applications and monitors the progress of the activities. RIVM is also responsible for coordination and knowledge exchange in the field of national and regional surveillance of antibiotics use, healthcare-associated infections and antimicrobial resistance.

For more information about the subsidies, see the policy on the subsidisation of regional AMR care networks.