Epidemiologists, clinicians and healthcare facility managers discuss one of the most pressing threats to modern medicine – antimicrobial resistance (AMR).

Participants had the opportunity to hear about the experience of Sweden, a country that has been developing a systematic approach to curbing resistance for many years through a combination of infection control, rational use of antibiotics and strategic planning at the national level.

One of the main speakers was Birgitta Luts, an epidemiologist and associate professor at Karolinska Institutet, who revealed the critical link between infection prevention and control (IPC) and antimicrobial resistance. She emphasised that most healthcare-associated infections are caused by resistant bacteria. This means that every new case of nosocomial infection automatically increases the need for antibiotics and puts more pressure on the system. Lutsi reminded that in Europe, the burden of infections caused by resistant bacteria is already equal to the combined impact of influenza, tuberculosis and HIV/AIDS – more than 670,000 infections and more than 33,000 deaths each year.

Based on a real case from Sweden, she demonstrated how failure to comply with basic IPC rules can lead to a large-scale crisis. The case involved an outbreak of ESBL-producing Klebsiella pneumoniae at Uppsala University Hospital in 2005–2008. Over four years, 320 infected patients were identified there, and the hospital was forced to spend at least €3 million in a single year to control the outbreak. Analysis showed that the cause of the spread was not the environment, equipment or external sources, but rather a lack of hand hygiene, no dress code, excessive use of antibiotics and chronic overcrowding of the medical facility.

To stop the outbreak, Swedish experts implemented a set of measures: from mandatory hand hygiene and the ban on gowns and jewellery to training for all categories of staff, including cleaners, students and even patients. Since then, the situation has changed dramatically, and Sweden has become an example of how discipline, management and standards can completely stop the spread of resistant bacteria.

The second speaker was Thomas Tengden, Senior Consultant in Infectious Diseases and President of the Swedish national programme Strama. He presented a broad and in-depth view of the problem of AMR from a clinical and systemic perspective. Through the demonstration of a real clinical case – a 12-year-old boy from Ukraine who, after a severe burn injury, was infected with several multi-resistant bacteria at once – Thomas Tengden showed how complex and dangerous infections become when there are almost no effective drugs left to treat them.

He emphasised that treating resistant infections requires complete personalisation: precise selection of drugs, dosage adjustment depending on the patient's condition, regular monitoring of antibiotic concentrations, use of rapid diagnostics and intelligent decision-making algorithms. In a world where new antibiotics are rarely developed and old ones are losing their effectiveness, optimising the use of already available drugs is becoming critically important.

Thomas Tengden discussed in detail the Swedish Strama programme, which is an example of a successful national strategy to combat AMR. Strama develops clinical guidelines, analyses data on antibiotic prescriptions, trains doctors, ensures cross-sector coordination, and helps institutions develop local guidelines based on real-world data on resistance. Strama's work is one of the reasons why Sweden has remained among the countries with the lowest levels of antibiotic prescribing in Europe for many years.

The third master class is planned as part of the ZDOROVI and ReAct series of events.

On 9 December, from 2:00 p.m. to 4:30 p.m., there will be a training session entitled «The role of nurses and nursing assistants in antibiotic resistance: from theory to practice» (4 CPD points, synchronous translation), dedicated to practical IPC tools and work in clinical situations. Registration:

https://forms.gle/xbgAJRVAu9piiSV97.

ReAct is one of the most renowned global networks working on the issue of antibiotic resistance since 2005. The network is present on four continents and combines scientific, educational and political activities. ReAct participates in the formation of global policies, cooperates with the WHO, governments and leading universities around the world, and dominates in the field of promoting innovative solutions for the rational use of antibiotics and the fight against resistant infections.

For several years, ZDOROVI has been strengthening the direction of continuous medical development and infection control. Over 26,000 CPD certificates and the participation of over 2,200 doctors in support programmes demonstrate the systematic nature and scale of the organisation's work. The joint webinar with ReAct is part of a broader series of educational events designed to expand the knowledge of Ukrainian medical professionals, strengthen their ability to respond to challenges, and integrate best global practices into Ukrainian medicine.