National Strategy preventing and limiting healthcare-associated infections and combating the phenomenon of antimicrobial resistance in Romania for the period 2023-2030.

The vision of the National Strategy preventing and limiting healthcare-associated infections and combating the phenomenon of antimicrobial resistance in Romania for the period 2023-2030 is to create sustainable premises for improving the health status of the Romanian population in the medium and long term, by preventing and limiting the occurrence of healthcare associated infections inserted in ICD (International classification of diseases), in particular Clostridioides infections, reducing the risk associated with AMR and encouraging the judicious use of antibiotics both in human medicine and in veterinary medicine. This Strategy was developed taking into account the legislative framework based on “One health approach”. Currently, Romania is distinguished by a leading position, at the level of the European Union, in the field of antimicrobial resistance and the consumption of antibiotics in human medicine.
The consumption of antibiotics is the main determinant of the selection of new microbial resistance mechanisms, including in the context of multiresistance, but also one of the triggering factors of healthcare-associated infections (HAIs), such as those caused by Clostridioides difficile. The available data indicate an extremely high level of bacterial resistance. For several pathogenic bacteria in human medicine, the level of antibiotic resistance in Romania is still one of the highest in Europe (e.g.: Pseudomonas aeruginosa, Acinetobacter spp., Klebsiella pneumoniae, MRSA).
This Strategy aims to promote the following general objectives: General Objective no. 1: Improving the legislative framework regarding the prevention, surveillance and limitation of healthcare associated infections inserted in ICD (International classification of diseases) and AMR. General Objective no. 2: Improving the knowledge and attitude of medical staff regarding healthcare associated infections inserted in ICD (International classification of diseases), AMR and the judicious use of antibiotics. General Objective no. 3: Ensuring a coherent framework for surveillance and reporting of healthcare associated infections inserted in ICD (International classification of diseases) and AMR and antibiotic data at national level, in line with strategic documents and EU and WHO indicators. General Objective no. 4: Communication of information to the public, in a transparent manner, as a way to combat healthcare associated infections inserted in ICD (International classification of diseases) and AMR. General Objective no. 5: Ensuring sufficient human resources numerically and as training and adequate technical resources for monitoring healthcare associated infections inserted in ICD (International classification of diseases) and AMR at national level. General Objective no. 6: Optimizing the use of antibiotics and vaccination in human and veterinary medicine, in the agricultural and environmental sectors. General Objective no. 7: Prevention and limitation of healthcare-associated infections by applying effective infection prevention measures.
Expected results. Through the implementation of this Strategy, the aim is to strengthen the national capacity to prevent, limit and control healthcare-associated infections (HAIs) and AMR and to implement the "One Health" concept, a better knowledge of the national context regarding HAI and AMR and an improvement in the implementation of the systems of surveillance of healthcare associated infections inserted in ICD (International classification of diseases) and AMR, better awareness of the risks that AMR poses to human health, animal health and environmental. All these measures that will result in increasing the quality of the medical aid, increasing patient safety, making the use of resources in the health system more efficient and increasing its performance. At the same time, the Strategy will have the effect of strengthening the capacity of all sectors involved in the implementation of the "One health" concept, improving cooperation between sectors, and in the medium and long term, the implementation of sustainable development objectives and the improvement of human and animal health will be ensured.