In this interview information is provided about the Center for Infectious Diseases Research and Policy’s Antimicrobial Stewardship Project (CIDRAP-ASP). Learn here about why CIDRAP-ASP is a great initiative for antimicrobial stewardship!
Interview with: Marnie Peterson, Pharm.D., Ph.D. and Natalie Vestin, M.P.H.
Interview by: Timothy P. Gauthier, Pharm.D., BCPS-AQ ID
[Last updated: 14 July 2019]
Antimicrobial stewardship efforts seek to enhance the safety and efficacy of antimicrobial drugs while avoiding unnecessary use that can worsen the antimicrobial resistance (AMR) problems of today. Employing effective antimicrobial stewardship initiatives can be a major challenge and acquiring the resources to understand the needs of a given institution can be vital to a project’s success.
As an antimicrobial stewardship pharmacist I am extremely interested in resources for antimicrobial stewardship that can help myself and others use antibiotics wisely. As such, I am always on the lookout for new materials. A while back I discovered the Center for Infectious Diseases Research and Policy (CIDRAP) and not too long after their Antimicrobial Stewardship Project (CIDRAP-ASP) popped up on my radar. You can find the CIDRAP website here and they are on Twitter @CIDRAP. You can find the CIDRAP-ASP website here and they are on Twitter @CIDRAP_ASP.
Today I am a huge fan of CIDRAP-ASP. Their free open-access webinars on YouTube are fantastic and includes one with Dr. Brad Spellberg that should honestly be required viewing for every student in healthcare (available here). The CIDRAP-ASP newsletters are incredibly informative (can sign up here). Their website is packed with helpful resources and includes a section dedicated towards a variety of stewardship resources. And these are just a few of the great things coming out of CIDRAP-ASP.
Knowing that CIDRAP-ASP is something worth being familiar with, I reached out to the people managing the program and asked if we could do an interview, with a goal of brining more attention to their efforts. They agreed and the following was created. Here is information about a great initiative all antimicrobial stewards should know about: CIDRAP-ASP!
What is the difference between CIDRAP and CIDRAP-ASP?
The Center for Infectious Disease Research and Policy (CIDRAP) was founded almost 20 years ago with a mission to prevent illness and death from targeted infectious diseases threats through research and translation of scientific information into practical applications, policies, and solutions. While CIDRAP focuses broadly on infectious disease news and research, CIDRAP-ASP is a project within CIDRAP that was created to address the global crisis of antibiotic resistance with a focus on antimicrobial stewardship strategies.
CIDRAP-ASP receives guidance from an international advisory panel of experts in antimicrobial stewardship and infectious disease that encompasses a One-Health approach. CIDRAP-ASP’s identity is twofold: (1) we are a source of original news stories, webinars and podcasts with global experts, and in-depth analysis of antimicrobial stewardship events and research; and (2) we are a meticulously curated clearinghouse of the latest global antimicrobial stewardship research, tools, policy, and education translated into formats and analysis that make it as accessible as possible.
How did CIDRAP-ASP come to be?
CIDRAP-ASP launched in the summer of 2016 with leadership from CIDRAP Director Dr. Michael Osterholm, CIDRAP Medical Director Dr. Kristine Moore, and a team of researchers and journalists. The project began with the goal of building an online international community focused on antimicrobial stewardship. It was also a way to address the fact that you cannot escape the reality of global AMR if you are working in infectious disease research and policy. Not only can you not escape it, but once you realize how vast and dire are the problems and how creative and persistent are the solutions, you have a responsibility to do what you can to help others with what you can bring together as a team of skilled researchers and journalists. The initial funding for the project was obtained via Merck but has since expanded to include additional diagnostics and pharmaceutical companies and foundations.
Since the launch of the site, we have added quite a few new features, largely due to feedback from our Advisory Committee members and other people who shared with us what they need to do their work on a daily basis. In the summer of 2017, we launched a database of about 200 clinical tools that has since grown to more than 700 resources! These are stewardship tools developed by programs around the world that can be studied, downloaded, and adapted by clinicians or health administrators.
We have come into our own as to how we can be of service as a clearinghouse in the past three years, and we have also developed a database of educational multimedia, extensive bibliographies, and resources pertaining to diagnostics. Chris Dall, a CIDRAP news journalist who writes exclusively on antimicrobial stewardship and AMR issues, has also been able to do more feature journalism on issues that may be too complex or multifaceted for traditional reporting.
CIDRAP-ASP has also produced 50 podcasts and webinars since the launch that are now archived for on-demand listening and viewing. So much of this development has arisen from the opportunity we have to see an enormous amount and variety of stewardship information every day and then share it with others who may not have that opportunity due to their roles in providing patient care, public health, veterinary medicine, or other demanding jobs.
What are the top 3 things antimicrobial stewards should know about CIDRAP-ASP?
1. The true heart of CIDRAP-ASP is the team. I know it is cliche, but it is 100% true. I feel that our team is unique in that we all have very clear areas of expertise and enjoyment, and we work somewhat autonomously. While there is some cross-over, each area of CIDRAP-ASP is largely maintained by an individual, which permits it to have its own character and allows people to develop their engagement with that area into true expertise. I do not think we do as good a job of presenting ourselves as individuals as we could (though I have a “Meet Our Team” social media feature in the works!), but I think it is important to know that behind every area of CIDRAP-ASP, there’s a smart and caring person working to make it the best it can be. And I would append to this fact that our team comprises of only seven people!
2. Our outreach and communication strategies have seen tremendous growth. Through the webinars and podcasts that Dr. Marnie Peterson organizes and hosts, we have been able to feature the expertise of clinicians and researchers doing nuanced work and share these as stories and processes that make available this expertise to others who might be struggling with similar situations or ideas. And with the newsletter, clinical tools, bibliographies, diagnostics resources, educational multimedia, and social media accounts coordinated by Natalie Vestin, we have been able to translate research and reportage into cohesive formats that enhance how people can access timely and necessary information. With Chris Dall’s news stories and Jim Wappes’s editorial direction, we have been able to bring a nuanced and complex treatment to stories about super-resistant gonorrhea, antimicrobial stewardship in perinatal care, and more. Carlos Cruz has shepherded our web presence into something more user- and design-focused. Maya Peters has used her public health skills to develop quarterly reports of global stewardship policy information and respond to user experience to develop enhancements to the website.
3. We are pretty responsive to current topics of interest. We were able to develop a separate page earlier this year on diagnostics for antimicrobial stewardship (more on that below), and we maintain a pretty robust collection of literature, more than 700 clinical tools, diverse educational multimedia, and more. Part of this responsiveness stems from having the time to be aware of and synthesize a lot of information, and we try to disseminate that awareness in a format that is accessible to people who might be engaged in clinical, research, public health, or policy work.
Where has CIDRAP-ASP found success so far?
We have been really successful in building an online community. Since the launch, our ASP newsletter has gained 3,477 subscribers. We have more than 3,200 followers on Twitter and 554 follows and likes on Facebook. Our top five countries for reach are: the US, Egypt, Saudi Arabia, Philippines, and Pakistan. Our YouTube channel, which archives our webinars with subject-matter experts, has 3,607 subscribers
Our partnerships are also a key to our success. We formed a unique partnership with the British Society for Antimicrobial Chemotherapy (BSAC) which has lead to the launch of the online open-access journal JAC-Antimicrobial Resistance. We also have connections with the Society of Infectious Diseases Pharmacists and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID). Additionally, we work collaboratively with industry partners to understand their leading educational initiatives.
The ability to grow into new areas of focus is also a measure of success for us. For the past few months, we have been hard at work on a redesign for the diagnostics section of our website. We launched this page in June of 2019 with funding from bioMérieux and web page design from Us Creative Works. It allowed us to add a great deal of nuance to the understanding of diagnostics as they are used for antimicrobial stewardship in different settings. For instance, we have included information on rapid diagnostics and susceptibility testing, alongside resources for building lab capacity in low-resource areas, applying diagnostic information therapeutically, and using clinical evaluation as a diagnostic tool alongside or in the absence of rapid testing.
We were also able to expand our section on antibiograms, susceptibility testing, and breakpoint interpretation to include not only available research and education, but also to capture some of the really interesting conversations happening around susceptibility and how clinicians and microbiologists are supported in interpreting information for patient care. We are currently working on a similarly designed page for AMR surveillance.
Can other people get involved in the activities of CIDRAP-ASP?
Yes! We are a small team, and we are always looking for ways to collaborate, even if it is just helping someone getting the word out about stewardship work they are doing. We are currently partnering with the British Society for Antimicrobial Chemotherapy to make our catalogue of educational tools available on the JAC-Antimicrobial Resistance (JAC-AMR) website. Last month, bioMérieux gave us funding and assistance to produce a webinar on diagnostics case studies for antimicrobial stewardship with Dr. Ed Septimus and offer continuing pharmacy education.
We have had a number of more informal activities that reflect our staff’s curiosity and desire to do and communicate good work. We helped to co-host a student infectious diseases journal club at the University of Minnesota, and Dr. Eili Klein and Rachel Heckscher from the Center for Disease Dynamics, Economics & Policy were kind enough to join us on Twitter and answer the students’ questions about AMR modelling. We also help to communicate the initiatives of the Minnesota One Health Antibiotic Stewardship Collaborative, because they’re in our backyard and they do really incredible work.
We are continuously working to build a global online network which provides current and comprehensive content. Experts can engage with us through providing content for us to highlight, recording webinars and podcasts, and through our social media outlets such as Twitter and Facebook.
Being on #IDTwitter and stewardship Twitter for @CIDRAP_ASP has really changed how we view clinicians and researchers. Every day, we are blown away by the integrity of people working in stewardship, and we are always thinking: “How can I work more closely with this person or this organization?” So just know that when you see the CIDRAP-ASP logo pop up in you feed, there are people behind it rooting for the work that you do!
What does the future hold for CIDRAP-ASP?
One future goal is to become financially sustainable while maintaining the quality and diversity of work that is characterized the past three years.
Another big goal is to better reflect the interests and expertise of our team members. We consider everything we do to be a work in progress, because our work has to be responsive to the changing needs and demands of the clinicians, researchers, and readers that we ultimately serve. Because each of us sees and thinks about a tremendous amount of information every day, we are planning on ways to reflect that growing expertise as part of CIDRAP-ASP; this might look like a blog, more feature CIDRAP News stories, etc.
However, I think all else is meaningless if our work does not have an effect on other organizations and people working hard to make sure that antimicrobials are used appropriately and that patients receive the best possible care and preventive services. Maybe that looks like being supportive of others work, research, and struggles. Maybe it looks like making sure people have access to published research or to diverse opinions and arguments in the field. Whatever integrity looks like on a given day, we have the best models in people working globally toward antimicrobial stewardship, and we are here for it.
ABOUT THE INTERVIEWEES
Marnie Peterson, Pharm.D., Ph.D., is the outreach coordinator for CIDRAP-ASP and is an expert in antibiotic resistance, antimicrobial stewardship, experimental therapeutics, and microbial pathogenesis. She has 20 years of experience in clinical pharmacy, research in antimicrobial resistance and development of therapeutics for infectious diseases. Before joining CIDRAP, she was tenured faculty at the University of Minnesota, Department of Experimental and Clinical Pharmacology. In that position, she successfully established a research and training program in infectious diseases with support from the National Institutes of Health, Department of Defense, foundations and industrial partners. She holds a patent for a new antimicrobial in development which served as the basis for the establishment of a clinical stage start-up company, Hennepin Life Sciences. She earned a Ph.D. in Infection from the University of Birmingham, Medical School, United Kingdom, and Pharm.D. and B.S. degrees from the University of Minnesota. She also completed an American College of Clinical Pharmacy fellowship, residency and post-doctoral fellowship in microbial pathogenesis at the University of Minnesota. She has recently joined the University of Wyoming faculty as a Professor. She was a Minnesota Business Magazine 2014 Leader’s in Health Care Finalist, which is awarded to an individual who is driving advancements in discovery and innovation through research, delivery of care, or a new procedure.
Natalie Vestin, M.P.H., is a research associate and communications specialist for CIDRAP-ASP. She has worked as a consultant for national and local public health organizations, and she received the Carol Young Anderson Collaborative Research Grant to study tuberculosis transmission in refugee populations. She received her Master of Public Health (MPH) degree from the University of Minnesota, where she received the Most Outstanding Master’s Project award for her work on homicide risk factors in the Twin Cities.
I would like to sincerely express my gratitude to the interviewees for their important work in the field and for taking the time out of their busy schedules to complete this interview.
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