Antimicrobial resistance (AMR) is a serious public health concern with economic, social and political implications that are global in scope, and cross all environmental and ethnic boundaries. As a global threat, AMR risks the achievements of modern medicine, and has the po...tential to impact overall global development. It is important, therefore, to elevate AMR beyond health as part of a larger development agenda in the context of the Sustainable Development Goals (SDGs). This report provides in-depth technical discussions in areas that have direct implications to the containment of AMR as a development agenda. The report is organized in five chapters which served as the technical background documents for the Biregional Technical Consultation on AMR in Asia, 14-15 April 2016. More information from the meeting is available in the WHO Meeting Report: Biregional Technical Consultation on Antimicrobial Resistance in Asia. The meeting was the first time senior officials from the Ministry of Health and Ministry of Agriculture across Asia came together to tackle AMR
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The WHO CIA List should be used as a reference to help formulate and prioritize risk assessment and risk management strategies for containing antimicrobial resistance. The WHO CIA List supports strategies to mitigate the human health risks associated with antimicrobial use in ...food-producing animals and has been used by both public and private sector organizations. The list helps regulators and stakeholders know which types of antimicrobials used in animals present potentially higher risks to human populations and how use of antimicrobials might be managed to minimize antimicrobial resistance of medical importance. The use of the WHO CIA List, in conjunction with the OIE list of antimicrobials of veterinary importance (1) and the WHO Model Lists of Essential Medicines (2) , will allow for prioritization of risk management strategies in the human sector, the food animal sector, inagriculture (crops) and horticulture, through a coordinated multisectoral One Health approach.
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This document updates the 2014 Core Elements for Hospital Antibiotic Stewardship Programs and incorporates new evidence and lessons learned from experience with the Core Elements. The Core Elements are applicable in all hospitals, regardless of size. There are suggestions specific to small and criti...cal access hospitals in Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals (12).There is no single template for a program to optimize antibiotic prescribing in hospitals. Implementation of antibiotic stewardship programs requires flexibility due to the complexity of medical decision-making surrounding antibiotic use and the variability in the size and types of care among U.S. hospitals. In some sections, CDC has identified priorities for implementation, based on the experiences of successful stewardship programs and published data. The Core Elements are intended to be an adaptable framework that hospitals can use to guide efforts to improve antibiotic prescribing. The assessment tool that accompanies this document can help hospitals identify gaps to address.
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Produced by Training and Research Support Centre for the Regional Network for Equity in Health in east and southern Africa (EQUINET), March 20, 2020.
This brief summarises and provides links to official, scientific and other resources to support an understanding of and individual to regional level... responses to the epidemic of ‘novel coronavirus’, also known as COVID-19.
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Das Management von Krisen hat in den letzten Jahren erheblich an Bedeutung gewonnen, insbesondere auch im Öffentlichen Gesundheitsdienst (ÖGD). Grundsätzlich liegt die Entscheidungshoheit im Rahmen des Krisenmanagements infektiologischer Gefahrenlagen bei den kommunalen Gesundheitsämtern. Aufgru...nd der aktuellen Lage (Stand 18. März 2020) in Zusammenhang mit der Verbreitung des neuen Coronavirus stellen wir hiermit in einer Vorabversion Auszüge unseres Lehrbuchs zur Verfügung.
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Nosocomial infections and antimicrobial resistance are two special health issues listed in Annex 1 of Commission Decision 2000/96/EC of 22 December 1999 on the communicable diseases to be progressively covered by the Community network under Decision No 2119/98/EC of the European Parliament and of th...e Council.
Nosocomial infections correspond to infections acquired in hospitals. The term “Healthcare-associated infections” is now preferred because it includes not only infections acquired in hospitals, but also in other settings where healthcare is provided, e.g. long-term care facilities, nursing homes, home care, etc.
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Intensive Care Med (2009) 35:9–29DOI 10.1007/s00134-008-1336-9
Although thousands of papers have been devoted tohospital-acquired pneumonia (HAP), many controversiesremain, and management of HAP is probably often sub-optimal. Several reviews or guidelines have been pub-lished rec...ently, mostly by North American initiatives(CDC, ATS). Three European Societies (ERS, ESCMID andESICM) were interested in producing a document thatcould complement in some way the last IDSA/ATS guidelines published 3 years ago. In addition, the Helics
working group supported this initiative.
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The guidelines are to be used to guide the management of adults with lower respiratory tract infection (LRTI). As will be seen in the following text, this diagnosis, and the other clinical syndromes within this grouping, can be difficult to make accurately. In the absence of agreed definitions of th...ese syndromes these guidelines are to be used when, in the opinion of a clinician, an LRTI syndrome is present. The following are put forward as def-initions to guide the clinician, but it will be seen in the ensuingtext that some of these labels will always be inaccurate. These definitions are pragmatic and based on a synthesis of available studies. They are primarily meant to be simple to apply in clinical practice, and this might be at the expense of scientific accuracy. These definitions are not mutually exclusive, with lower respiratory tract infection being an umbrella term that includes all others, which can also be used for cases that cannot be classified into one of the other groups. No new evidence has been identified that would lead to a change in the clinical definitions,which are therefore unchanged from the 2005 publication.
Clin Microbiol Infect 2011;17(Suppl. 6): 1–24 The full version of these guidelines can be found on Wiley Online Library.
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The international community sits at the tipping pointof a post-‐antibiotic era, where common bacterial infections are no longer treatable with the antibiotic armamentarium that exists. In South Africa, t...he identification of the first case of pan-‐resistant Klebsiella pneumoniae(Brink et al, J Clin Microbiol. 2013;51(1):369-‐72) marks a watershed moment and highlights ourtip of the antibiotic resistance ‘iceberg’ in this country. Multi-‐drug resistant (MDR)-‐bacterial infections, predominantly in Gram-‐negative bacteria such as Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosaand Acinetobacter baumanniiare now commonplace in South African hospitals. Whilst a number of expensive new antibiotics for Gram-‐positive bacterial infections have been manufactured recently (some of which are licenced for usein South Africa), no new antibiotics active against Gram-‐negative infections are expected in the next 10-‐15years. Hence what we have now, needs conserving
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This interim guidance is for LTCF managers and corresponding infection prevention and control (IPC) focal persons in LTCF and updates the guidance published in March 2020. The objective of this document is to provide guidance on IPC in LTCFs in the context of COVID-19 to 1) prevent COVID-19-virus fr...om entering the facility and spreading within the facility, and 2) to support safe conditions for visiting through the rigorous application of IPC procedures for the residents’ well-being. WHO will update these recommendations as new information becomes available.
Availabel in English, French, Russian and Spanish
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The product of all this work is the Standard Treatment Guideline and Essential Medicines List of Common Medical Conditions in the Kingdom of Swaziland. These systematically developed statements are designed to assist practitioners in making decisions about appropriate treatment for specific clinical... conditions. They are meant to reflect expert consensus based on a review of current and published scientific evidence of acceptable approaches to diagnosis, man-agement, or prevention of specific conditions.It is enlightening to note that section A of the document contains the STG, and effort has been made to have the conditions commonly encountered in Swaziland classified according to systems. Written in simple, clear language, each section consists of a short definition followed by common symptoms and signs of the disease or condition and then management (pharmacological and nonpharmacological)
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The Core Elements of Outpatient Antibiotic Stewardship provides a framework for antibiotic stewardship for outpatient clinicians and facilities that routinely provide antibiotic treatment. This report augments existing guidance for other clinical settings. In 2014 and 2015, respectively, CDC release...d the Core Elements of Hospital Antibiotic Stewardship Programs and the Core Elements of Antibiotic Stewardship for Nursing Homes. Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management.
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The protection of children and educational facilities is particularly important. Precautions are necessary to prevent the potential spread of COVID-19 in school settings; however, care must also be taken to avoid stigmatizing students and staff who may have been exposed to the virus. It is important... to remember that COVID-19 does not differentiate between borders, ethnicities, disability status, age or gender. Education settings should continue to be welcoming, respectful, inclusive, and supportive environments to all. Measures taken by schools can prevent the entry and spread of COVID-19 by students and staff who may have been exposed to the virus, while minimizing disruption and protecting students and staff from discrimination.
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Antibiotics and other antimicrobial agents are invaluable life savers, particularly in resource-limited countries where infectious diseases are abundant. Both uncomplicated and severe infections are potentially curable as long as the aetiological agents are susceptible to the ...antimicrobial drugs. The rapid rate with which antimicrobial agents are becoming ineffective due to resistance acquired as a result of unchecked overuse and misuse threatens to undo the benefit of controlling infections. The evidence for resistant microorganisms, many times to more than a single antimicrobial agent, has been observed globally. In Tanzania, there is evidence in the form of few scattered studies conducted in different parts of the country in a multitude of settings including health care facilities, the community, domesticated animals and wild animals
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In May 2015, the Sixty-eighth World Health Assembly recognized the importance of the public health problem posed by antimicrobial resistance by adopting the global action plan on antimicrobial resistance (“global action plan”). The global action plan proposes interve...ntions to control antimicrobial resistance, including reducing the unnecessary use of antimicrobials in humans and in animals. The global action plan also emphasizes the need to take a cross-sectoral, “One Health” approach for controlling antimicrobial resistance, involving efforts by actors from many disciplines including human and veterinary medicine.
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Using antimicrobials responsibly is an essential component ofefforts to contain antimicrobial resistance (AMR), and to ensurethat patients receive appropriate treatment. The WHO global action plan on AMR emphasizes the importance of training healthcare professionals in antimicrobial prescribing and ...stew-ardship (AMPS). There are several challenges, however, such asthe wide range of healthcare professionals involved in the pre-scribing process, and the heterogeneity of prescribing rights and practices of different professional groups within and between countries. One way to address these challenges is through developing competencies, which define the minimum standards that all antimicrobial prescribers should reach.
Clinical Microbiology and Infection 25 (2019) 13e19
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A guide for practical implementation in adult and pediatric emergency department and urgent care settings
This situation analysis has gathered information about the current state of AMR, contributing factors and antimicrobial use in Zimbabwe from the human, animal, agricultural and environmental sectors. Data has been gathered from different sectors such as the general public, academia, the Ministry of ...Health and Child Care, the Ministry of Agriculture Mechanization and Irrigation Development and the Ministry of Environment, Water and Climate. It shows that AMR is a real concern in Zimbabwe and a threat to the health outcomes of humans, to the economic productivity of the livestock industry and a risk to the environment.
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In Kenya, the bacterial infections that contribute most to human disease are often those in which re-‐sistance is most evident. Examples are multidrug-‐resistant enteric bacterial pathogens such as typhoid, ... diarrhoeagenic Escherichia coli and invasive non-‐typhi salmonella, penicillin-‐resistant Streptococcus pneu-‐moniae, vancomycin-‐resistant enterococci, methicillin-‐resistant Staphylococcus aureus and multidrug-‐re-‐sistant Mycobacterium tuberculosis. Resistance to medicines commonly used to treat malaria is of particu-‐lar concern, as is the emerging resistance to anti-‐HIV drugs. Often, more expensive medicines are required to treat these infections, and this becomes a major challenge in resource-‐poor settings.
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