Background: Solomon Islands is a nation of 700,000 people with a small health workforce and no infectious disease physician. Bloodstream infections (BSIs) are a significant cause of mortality. Historically management of BSI in Solomon Islands had been challenging, including delays in notification, lack of clinician understanding, non-standardised approach to patient management and lack of appropriate antibiotics.
Purpose: A multidisciplinary group with local and international clinicians was established with the purpose of improving clinical management of patients with BSIs within a larger program to support training, and capacity building to address the threat of antimicrobial resistance (COMBAT-AMR).
Methods/description of process/experience: The Solomon Blood Stream Infection group includes physicians, surgeons, infection prevention and control (IPC) nurses, microbiology scientists and pharmacists at the National Referral Hospital with online support from international counterparts (PRIDA and Alfred Hospital). Weekly hybrid meetings provide real time review and patient management advice for positive blood cultures and multi-resistant organisms (MROs). There is a strong mentoring and information sharing focus. The meetings provide a forum to discuss issues relating to IPC, antimicrobial stewardship and microbiology.
Results: Weekly meetings have been held since March 2022 with discussions on diagnosis and management of conditions such as infective endocarditis and surgical site infections. Participants have reported better dissemination of information and improved collaboration between teams. This resulted in the early identification and containment of two MRO outbreaks. Audits, policies, and training have been developed and implemented from gaps identified during meetings.
Conclusion: This project highlights the importance of multidisciplinary involvement and local engagement in the successful management of complex infections in low resource settings. It is expected that the same approach could be effectively applied to the management of non-communicable diseases. The provision of regular online expert support is an effective and sustainable method to provide mentoring and support development of local champions.