CROSS-PILLAR CASE STUDY 1 CROSS-COUNTRY LAB STRENGTHENING AND CAPACITY BUILDING

One of our first projects which began implementation in Autumn 2021, aims to optimise the use of antibiotics for Surgical Antibiotic Prophylaxis (SAP) in 10 Georgian hospitals, by implementing an antimicrobial stewardship programme. After working with the Georgian Association of Surgeons to adapt the WHO SAP guidelines, and later rolling it out in hospitals, in 2022 we worked with the British Society for Antimicrobial Chemotherapy (BSAC) to develop a MOOC to compliment the project, the first module of which is now available on Future Learn.

Since the start of this project, several complimentary supporting activities have been developed to strengthen lab capacity in the country, for both human and animal diagnostics. One such activity proposes to establish timely and accurate identification of organisms using a MALDI-TOF platform. By improving the quality and timeliness of organism identification and introducing rapid antimicrobial susceptibility testing (RAST), the project aims to optimise antimicrobial use in health care settings. Aside from introducing the platform, another activity is investigating the feasibility of using MALDI-TOF and RAST as part of an antimicrobial stewardship programme. A deeper knowledge of the costs and benefits will inform wider scale-up of the complimentary activities in Georgia and the region.

As discussed in the reflections under pillar 1, procurement processes have posed some challenges, which has unfortunately delayed the arrival of the MALDI-TOF platform. While some aspects of the project have therefore been delayed, much cross-country learning has continued regardless.

In June 2022, project teams from the National Centre for Disease Control (NCDC) lab in Georgia, and the International Livestock Research Institute (ILRI) in Kenya attended training at the European Committee on Antimicrobial Susceptibility Testing (EUCAST) Laboratory in Växjö, Sweden. The course, co-funded by ICARS, provided a valuable opportunity to bring people together to exchange knowledge and skills on antimicrobial Susceptibility Training (AST), and to build the capacity of attendees to later deliver the training within their own country settings. Since the training in Sweden, the team from NCDC has provided training for staff from the State Laboratory of Agriculture (SLA) to support the Georgian poultry project and a group of Kyrgyz microbiologists to support the human health project in Kyrgyzstan. This training was later followed by a workshop held at ILRI in November 2022 for 24 participants, including three ICARS project participants engaged in other ICARS supported projects.

Strengthening lab capacity in Georgia is not only limited to human health. To support the project aiming to reduce the use of antibiotic growth promoters in Georgian poultry farms, staff from SLA came to Denmark to learn about residue testing.