{"id":17232,"date":"2023-11-13T09:22:21","date_gmt":"2023-11-13T09:22:21","guid":{"rendered":"https:\/\/www.global-pps.com\/?p=17232"},"modified":"2023-11-13T10:27:32","modified_gmt":"2023-11-13T10:27:32","slug":"entretien-avec-le-dr-jose-artur-paiva-drive-ams-lead-in-portugal","status":"publish","type":"post","link":"https:\/\/www.global-pps.com\/fr\/interview-with-dr-jose-artur-paiva-drive-ams-lead-in-portugal\/","title":{"rendered":"Entretien avec le Dr Paiva, responsable du programme drive-AMS au Portugal"},"content":{"rendered":"
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Pour commencer, pourriez-vous vous pr\u00e9senter et donner quelques informations sur votre expertise professionnelle ?<\/strong><\/h3>

Je suis m\u00e9decin, form\u00e9 en m\u00e9decine interne et en m\u00e9decine intensive, avec un int\u00e9r\u00eat particulier pour les maladies infectieuses. Toutefois, depuis 1991-1992, je travaille principalement dans le domaine des soins intensifs. Je travaille dans un grand h\u00f4pital du nord du Portugal, en tant que directeur du service de m\u00e9decine intensive. En outre, je suis professeur agr\u00e9g\u00e9 invit\u00e9 de m\u00e9decine \u00e0 l'universit\u00e9 de Porto, o\u00f9 j'enseigne des sujets li\u00e9s aux soins intensifs, \u00e0 la transplantation et \u00e0 la r\u00e9sistance aux antimicrobiens. Au niveau national, je dirige le programme de sant\u00e9 prioritaire, abr\u00e9g\u00e9 en PPCIRA, qui traite des infections associ\u00e9es aux soins de sant\u00e9 et de la r\u00e9sistance aux antimicrobiens. Il s'agit en fait des deux faces d'une m\u00eame pi\u00e8ce, car l'objectif principal n'est pas de r\u00e9duire la r\u00e9sistance aux antimicrobiens, mais plut\u00f4t de r\u00e9duire les infections caus\u00e9es par ces bact\u00e9ries r\u00e9sistantes aux antimicrobiens. Depuis 2013, le Portugal dispose d'un programme national de priorit\u00e9s en mati\u00e8re de sant\u00e9. Dans le cadre de ce programme, tous les \u00e9tablissements de soins de sant\u00e9 sont l\u00e9galement tenus de mettre en place une \u00e9quipe de gestion des antimicrobiens. Le programme vise \u00e0 minimiser l'utilisation inutile d'antibiotiques sp\u00e9cifiques, tels que les quinolones et les carbap\u00e9n\u00e8mes.<\/p>

Pourquoi le projet drive-AMS et la lutte contre la r\u00e9sistance aux antimicrobiens vous paraissent-ils importants ?<\/strong><\/h3>

L'\u00e9mergence de la r\u00e9sistance aux antimicrobiens est principalement influenc\u00e9e par l'exposition aux antimicrobiens, qu'il s'agisse d'antibact\u00e9riens, d'antifongiques ou d'antiviraux. Notre objectif premier est d'\u00e9liminer l'utilisation inutile d'antibiotiques afin de r\u00e9duire l'\u00e9mergence d'antimicrobiens r\u00e9sistants. L'\u00e9ducation seule n'est pas suffisante pour atteindre cet objectif, il est crucial de susciter des changements de comportement chez les professionnels de la sant\u00e9 afin de r\u00e9duire les prescriptions inutiles d'antibiotiques. Le projet drive-AMS comble le foss\u00e9 entre les strat\u00e9gies \u00e9ducatives et comportementales, donnant ainsi une impulsion suppl\u00e9mentaire \u00e0 nos initiatives. Il est important de noter que l'AMS ne consiste pas \u00e0 modifier les prescriptions d'antibiotiques, mais \u00e0 changer les prescripteurs, \u00e0 modifier les perspectives des praticiens m\u00e9dicaux et la culture des services cliniques.<\/strong><\/span><\/p>

Un autre aspect crucial de drive-AMS est sa nature collaborative impliquant six pays, dont quatre sont confront\u00e9s \u00e0 des d\u00e9fis importants en mati\u00e8re de r\u00e9sistance aux antimicrobiens. Cette collaboration, sous la direction de l'Universit\u00e9 d'Anvers et de Radboudumc \u00e0 Nim\u00e8gue, permet de partager des solutions, des id\u00e9es et des mises en \u0153uvre entre les pays participants, renfor\u00e7ant ainsi notre lutte collective contre la r\u00e9sistance aux antimicrobiens.<\/p>

Pourriez-vous nous faire part de vos exp\u00e9riences professionnelles concernant l'impact de la r\u00e9sistance aux antimicrobiens sur les patients ?<\/strong><\/h3>

Travaillant aux soins intensifs, j'ai rencontr\u00e9 un grand nombre de patients gravement malades affect\u00e9s par des micro-organismes multir\u00e9sistants. En 2016, mon h\u00f4pital a \u00e9t\u00e9 confront\u00e9 \u00e0 une grave \u00e9pid\u00e9mie d'infections par des Klebsiella pneumoniae<\/em>, Les bact\u00e9ries r\u00e9sistantes aux antibiotiques sont particuli\u00e8rement r\u00e9pandues dans les services de chirurgie. R\u00e9agissant rapidement, nous avons mis en place un syst\u00e8me de triage pour les patients admis pr\u00e9sentant des facteurs de risque pour ces organismes r\u00e9sistants. En effectuant une surveillance d\u00e8s l'admission, nous avons efficacement endigu\u00e9 la transmission intra-hospitali\u00e8re et minimis\u00e9 d'autres \u00e9pid\u00e9mies. Cette exp\u00e9rience nous a appris que les institutions doivent s'adapter aux nouveaux d\u00e9fis de la r\u00e9sistance aux antimicrobiens en mettant en \u0153uvre des mesures proactives pour pr\u00e9venir les \u00e9pid\u00e9mies. Apr\u00e8s tout, il ne faut pas oublier que la r\u00e9sistance aux antimicrobiens est un probl\u00e8me de sant\u00e9 publique, il vaut mieux pr\u00e9venir que r\u00e9agir<\/strong><\/span>.<\/p>

Comment avez-vous int\u00e9gr\u00e9 le projet drive-AMS aux programmes existants et avez-vous rencontr\u00e9 des difficult\u00e9s ou des surprises positives ?<\/strong><\/h3>

Nous avons lanc\u00e9 le projet drive-AMS au Portugal avec trois institutions pilotes, \u00e0 savoir ma propre institution et deux autres institutions g\u00e9ographiquement proches de nous dans le nord du Portugal : un h\u00f4pital g\u00e9n\u00e9ral et un h\u00f4pital oncologique. Les deux \u00e9tablissements g\u00e9n\u00e9raux se concentrent sur l'utilisation des antibiotiques dans les infections respiratoires, \u00e0 la fois la bronchite trach\u00e9ale et la pneumonie, tandis que l'institut oncologique se concentre sur les patients neutrop\u00e9niques qui d\u00e9veloppent une infection. Nous avons formalis\u00e9 la liaison entre la politique nationale - le programme national PPCIRA - et drive-AMS, en recevant l'aval de la direction g\u00e9n\u00e9rale de la sant\u00e9, ce qui conf\u00e8re une plus grande respectabilit\u00e9 \u00e0 nos efforts. Nous pr\u00e9voyons d'\u00e9tendre le projet \u00e0 cinq autres institutions et d'organiser des sessions de formation pour un r\u00e9seau \u00e9tendu d'h\u00f4pitaux : un cours PPS de l'Universit\u00e9 d'Anvers et un cours partenaire organis\u00e9 par nous avec la coop\u00e9ration du Radboudumc en janvier 2024.<\/p>

Si l'int\u00e9gration du projet drive-AMS a suscit\u00e9 de l'enthousiasme en raison des \u00e9quipes AMS pr\u00e9existantes, des difficult\u00e9s, telles que le manque de temps d\u00e9di\u00e9 et l'importance insuffisante accord\u00e9e par les administrations hospitali\u00e8res, ont \u00e9t\u00e9 r\u00e9solues par une nouvelle loi, publi\u00e9e en septembre 2022. Les h\u00f4pitaux sont tenus d'allouer un temps sp\u00e9cifique aux programmes de lutte contre la r\u00e9sistance aux antimicrobiens. En outre, la pand\u00e9mie de COVID-19 a mis en lumi\u00e8re le r\u00f4le crucial des \u00e9quipes de contr\u00f4le des infections et de gestion des antimicrobiens dans les h\u00f4pitaux.<\/p>

Y a-t-il d'autres enseignements importants que vous aimeriez partager ?<\/strong><\/h3>

Il ne faut pas oublier le COVID-19. Le SARS-CoV-2 est toujours l\u00e0 et il \u00e9volue constamment. Pour le reste, la pand\u00e9mie nous a certainement enseign\u00e9 plusieurs le\u00e7ons qui vont au-del\u00e0 de la r\u00e9sistance aux antimicrobiens. La premi\u00e8re est que l'approche on\/off des plans d'urgence - avec l'\u00e9tat normal et l'\u00e9tat d'activation - est erron\u00e9e. Au lieu de cela, nous avons besoin d'une adaptation constante, et les institutions devraient \u00eatre en mesure de s'adapter en permanence \u00e0 ce qui est n\u00e9cessaire. Deuxi\u00e8mement, nous devons g\u00e9rer les id\u00e9es \u00e9mergentes en temps de crise, lorsque la participation de tous ceux qui ont des id\u00e9es est cruciale<\/strong><\/span>. Enfin, l'importance de la collaboration et de l'interaction comme rem\u00e8de \u00e0 la mentalit\u00e9 de silo ne peut \u00eatre n\u00e9glig\u00e9e. L'application de ces le\u00e7ons \u00e0 la r\u00e9sistance aux antimicrobiens permettra une am\u00e9lioration continue, une approche participative et l'identification des lacunes en mati\u00e8re de qualit\u00e9 afin de renforcer la lutte contre la r\u00e9sistance aux antimicrobiens.<\/p>

Quels sont vos projets pour le r\u00e9seau drive-AMS au Portugal ?<\/strong><\/h3>

Je suis sinc\u00e8rement enthousiaste quant au potentiel du projet drive-AMS \u00e0 modifier la prescription d'antimicrobiens en transformant les prescripteurs. En effet, le projet, gr\u00e2ce \u00e0 la collaboration et aux strat\u00e9gies comportementales, peut contribuer \u00e0 acc\u00e9l\u00e9rer la gestion des antimicrobiens au Portugal. J'ai vraiment h\u00e2te de voir les r\u00e9sultats de ces efforts au cours des trois prochaines ann\u00e9es.<\/p>

\"\"<\/p>

\u00c0 propos du Dr Paiva<\/strong><\/h3>

Jos\u00e9-Artur Paiva est le directeur du service de m\u00e9decine intensive \u00e0 l'Institut de recherche sur les maladies infectieuses (IRM) de l'Universit\u00e9 de Californie du Sud. Centre hospitalier universitaire de S\u00e3o Jo\u00e3o<\/a>, Il est \u00e9galement directeur du programme national de pr\u00e9vention des infections et de la r\u00e9sistance aux antimicrobiens \u00e0 la direction g\u00e9n\u00e9rale de la sant\u00e9. Il est \u00e9galement directeur du programme national de pr\u00e9vention des infections et de la r\u00e9sistance aux antimicrobiens \u00e0 la direction g\u00e9n\u00e9rale de la sant\u00e9. Il est sp\u00e9cialiste en m\u00e9decine des soins intensifs et en m\u00e9decine interne et poss\u00e8de des comp\u00e9tences certifi\u00e9es en m\u00e9decine d'urgence et en gestion des syst\u00e8mes de sant\u00e9. Il est actuellement un membre actif de l'\u00e9quipe de chercheurs du R\u00e9seau europ\u00e9en de recherche et de pr\u00e9paration aux pand\u00e9mies et aux maladies infectieuses \u00e9mergentes (EU-RESPONSE), financ\u00e9 par le programme de recherche et d'innovation Horizon 2020 de l'UE, ainsi qu'un membre du projet drive-AMS, \u00e9galement financ\u00e9 par l'UE, qui vise \u00e0 promouvoir et \u00e0 maximiser la gestion des antimicrobiens en Europe.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"

Dr. Jos\u00e9-Artur Paiva is director of the Intensive Care Medicine Department at the Centro Hospitalar Universit\u00e1rio Sao Joao in Portugal. In this interview, he covers critical insights into the fight against antimicrobial resistance and the instrumental role of the drive-AMS project. Dr. Paiva’s experiences and future plans underscore the importance of collaborative efforts and proactive strategies in combating this global health challenge.<\/p>","protected":false},"author":7,"featured_media":17243,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ocean_post_layout":"","ocean_both_sidebars_style":"","ocean_both_sidebars_content_width":0,"ocean_both_sidebars_sidebars_width":0,"ocean_sidebar":"0","ocean_second_sidebar":"0","ocean_disable_margins":"enable","ocean_add_body_class":"","ocean_shortcode_before_top_bar":"","ocean_shortcode_after_top_bar":"","ocean_shortcode_before_header":"","ocean_shortcode_after_header":"","ocean_has_shortcode":"","ocean_shortcode_after_title":"","ocean_shortcode_before_footer_widgets":"","ocean_shortcode_after_footer_widgets":"","ocean_shortcode_before_footer_bottom":"","ocean_shortcode_after_footer_bottom":"","ocean_display_top_bar":"off","ocean_display_header":"default","ocean_header_style":"","ocean_center_header_left_menu":"0","ocean_custom_header_template":"0","ocean_custom_logo":0,"ocean_custom_retina_logo":0,"ocean_custom_logo_max_width":0,"ocean_custom_logo_tablet_max_width":0,"ocean_custom_logo_mobile_max_width":0,"ocean_custom_logo_max_height":0,"ocean_custom_logo_tablet_max_height":0,"ocean_custom_logo_mobile_max_height":0,"ocean_header_custom_menu":"0","ocean_menu_typo_font_family":"0","ocean_menu_typo_font_subset":"","ocean_menu_typo_font_size":0,"ocean_menu_typo_font_size_tablet":0,"ocean_menu_typo_font_size_mobile":0,"ocean_menu_typo_font_size_unit":"px","ocean_menu_typo_font_weight":"","ocean_menu_typo_font_weight_tablet":"","ocean_menu_typo_font_weight_mobile":"","ocean_menu_typo_transform":"","ocean_menu_typo_transform_tablet":"","ocean_menu_typo_transform_mobile":"","ocean_menu_typo_line_height":0,"ocean_menu_typo_line_height_tablet":0,"ocean_menu_typo_line_height_mobile":0,"ocean_menu_typo_line_height_unit":"","ocean_menu_typo_spacing":0,"ocean_menu_typo_spacing_tablet":0,"ocean_menu_typo_spacing_mobile":0,"ocean_menu_typo_spacing_unit":"","ocean_menu_link_color":"","ocean_menu_link_color_hover":"","ocean_menu_link_color_active":"","ocean_menu_link_background":"","ocean_menu_link_hover_background":"","ocean_menu_link_active_background":"","ocean_menu_social_links_bg":"","ocean_menu_social_hover_links_bg":"","ocean_menu_social_links_color":"","ocean_menu_social_hover_links_color":"","ocean_disable_title":"on","ocean_disable_heading":"default","ocean_post_title":"","ocean_post_subheading":"","ocean_post_title_style":"","ocean_post_title_background_color":"","ocean_post_title_background":0,"ocean_post_title_bg_image_position":"","ocean_post_title_bg_image_attachment":"","ocean_post_title_bg_image_repeat":"","ocean_post_title_bg_image_size":"","ocean_post_title_height":0,"ocean_post_title_bg_overlay":0.5,"ocean_post_title_bg_overlay_color":"","ocean_disable_breadcrumbs":"off","ocean_breadcrumbs_color":"","ocean_breadcrumbs_separator_color":"","ocean_breadcrumbs_links_color":"","ocean_breadcrumbs_links_hover_color":"","ocean_display_footer_widgets":"default","ocean_display_footer_bottom":"default","ocean_custom_footer_template":"0","ocean_post_oembed":"","ocean_post_self_hosted_media":"","ocean_post_video_embed":"","ocean_link_format":"","ocean_link_format_target":"self","ocean_quote_format":"","ocean_quote_format_link":"post","ocean_gallery_link_images":"off","ocean_gallery_id":[],"footnotes":""},"categories":[35],"tags":[],"class_list":["post-17232","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ams","entry","has-media"],"yoast_head":"\nInterview with Dr. Paiva, drive-AMS lead in Portugal - Global PPS<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.global-pps.com\/fr\/entretien-avec-le-dr-jose-artur-paiva-drive-ams-lead-in-portugal\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Interview with Dr. Paiva, drive-AMS lead in Portugal - Global PPS\" \/>\n<meta property=\"og:description\" content=\"Dr. Jos\u00e9-Artur Paiva is director of the Intensive Care Medicine Department at the Centro Hospitalar Universit\u00e1rio Sao Joao in Portugal. 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