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Confronted with the important issue of patient safety, in 2002 the Fifty-fifth World Health Assembly adopted a resolution urging countries to pay the closest possible attention to the problem and to strengthen safety and monitoring systems. In May 2004, the Fifty-seventh World Health Assembly approv
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ed the creation of an international alliance as a global initiative to improve patient safety. The World Alliance for Patient Safety was launched in October 2004 and currently has its place in the WHO Patient Safety programme included in the Information, Evidence and Research Cluster.
more
Water, sanitation, hygiene, and waste management for SARS-CoV-2, the virus that causes COVID-19
recommended
Updated Interim guidance 29 July 2020
The provision of safe water, sanitation and waste management and hygienic conditions is essential for preventing and for protecting human health during all infectious disease outbreaks, including of coronavirus disease 2019 (COVID-19). Ensuring evidenced-based
...
and consistently applied WASH and waste management practices in communities, homes, schools, marketplaces, and healthcare facilities will help prevent human-to-human transmission of pathogens including SARS-CoV-2, the virus that causes COVID-19.
more
The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance networks for 2013–2015. AMC in both sectors, exp
...
ressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors. Estimated data on AMC for pigs and poultry were used for the first time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically-significant (p < 0.05) associations between AMC and AMR for fluoroquinolones and Escherichia coli in both sectors, for 3rd- and 4th-generation cephalosporins and E. coli in humans, and tetracyclines and polymyxins and E. coli in animals. In humans, there was a statistically-significant association between AMC and AMR for carbapenems and polymyxins in Klebsiella pneumoniae. Consumption of macrolides in animals was significantly associated with macrolide resistance in Campylobacter coli in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd- and 4th-generation cephalosporin and fluoroquinolone resistance in E. coli from humans was associated with corresponding AMC in humans, whereas resistance to fluoroquinolones in Salmonella spp. and Campylobacter spp. from humans was related to consumption of fluoroquinolones in animals. These results suggest that from a ‘One-health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
more
Stewardship is defined as “the careful and responsible management of something entrusted to one’s care”. It was originally applied in the health-care setting as a tool for optimizing antimicrobial use, termed “antimicrobial stewardship” (AMS). Stewardship has since be
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en applied in the context of governance of the health sector as a whole, taking responsibility for the health and well-being of the population and guiding health systems at the national and global level.
more
The purpose of this guidance is to assist WHO Member States, and other stakeholders, in the establishment and development of programmes of integrated surveillance of antimicrobial resistance in foodborne bacteria (i.e., bacteria commonly transmitted by food). In this guidance, “integrated surveill
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ance of antimicrobial resistance in foodborne bacteria” is defined as the collection, validation, analyses and reporting of relevant microbiological and epidemiological data on antimicrobial resistance in foodborne bacteria from humans, animals, and food, and on relevant antimicrobial use in humans and animals. Integrated surveillance of antimicrobial resistance in foodborne bacteria therefore includes data from relevant food chain sectors (animals, food and humans) and includes data on both antimicrobial resistance and antimicrobial use. Integrated surveillance of antimicrobial resistance for foodborne bacteria expands on traditional public health surveillance to include multiple elements of the food chain, and to include antimicrobial use data, to better understand the sources of infection and transmission routes.
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A conceptual framework for the environmental surveillance of antibiotics and antibiotic resistance
Patricia M.C. Huijbers, Carl-Fredrik Flach, D.G. Joakim Larsson
Centre for Antibiotic Resistance Research (CARe), University of Gothenburg
(2019)
C2
The systematic surveillance of antibiotic use and antibiotic re-sistance prevalence in humans and animals is imperative for managingbacterial infectious disease (JPIAMR, 2019;WHO, 2015). Many low-income countries currently face substantial challenges in building national surveillance systems due to
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a lack of infrastructure and resources,resulting in a shortage of systematic data (FAO/OIE/WHO, 2018)
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The animal health subsector within the agriculture sector is the gatekeeper of antimicrobial resistance (AMR) in livestock, aquaculture, animal products, and the immediate animal environment. In support of member countries taking responsibility for and moving forward with putting AMR monitoring and
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surveillance in place for the animal sector, the Food and Agriculture Organization of the United Nations Regional Office for Asia and the Pacific (FAO-RAP) developed a regional AMR surveillance framework, each pillar of which is complemented by a guideline to reinforce its progressive implementation. The first of this series, Volume 1: Monitoring and surveillance of antimicrobial resistance in bacteria from healthy food animals intended for consumption, is centered on healthy animals reaching consumers and on the protection of public health.
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COVID-19: Training slides based on guidelines for case-finding, diagnosis, management and public health response in South Africa
Centre for Respiratory Diseases and Meningitis and Outbreak Response
National Department of Health, South Africa
(2020)
C2
Outline
• Welcome and objectives
• Microbiology, epidemiology and clinical presentation
• Surveillance for imported cases including case definitions
• Laboratory diagnosis • Infection prevention and hospital readiness
• Patient flow and actions required at each step
• Co-ord
...
inating a public health response
more
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
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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
more
This paper was developed to support AMR coordination committees and others tasked with addressing AMR at country level to do just that. Drawing on the published literature and the operational experience and expertise of different LMICs, the paper points to six key strategies for success and offers a
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series of practical tips and suggestions on how to implement each one.
more
The toolkit offers advice on how national public health authorities could engage with primary care prescribers so as to promote appropriate and responsible use of antibiotics. The toolkit contains template materials and some suggested key messages for health professionals, idea
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s for awareness raising activities, and suggested tactics for getting the messages across to both primary care providers and patients regarding prudent use of antibiotics.
more
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
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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.
more
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
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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
more
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
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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)
more
This handbook follows a comprehensive approach to health system strengthening at borders in order to support IHR national focal points and other national agencies in developing and implementing evidence-based action plans for IHR capacity development at ground crossings. The approach includes the mo
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vement of travellers and baggage, cargo, containers, conveyances, goods and postal parcels across ground crossings, as well as the interaction with adjacent border communities. Other factors can be considered, if needed, throughout the risk assessment.
more
Since the World Health Organization (WHO) launched the Global Antimicrobial Resistance Surveillance System (GLASS) in 2015, there has been rapidly growing awareness among many African countries that they need to be doing more to combat antimicrobial resistance (AMR). The Africa Centres fo
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r Disease Control and Prevention (CDC) was officially inaugurated in January 2017 and will support countries commencing surveillance for serious infectious disease threats in Africa, including resistance. Review of the recent WHO GLASS report suggests that, while certain nations do have some surveillance systems in place, very few countries in Africa currently conduct effective routine surveillance.
African Journal of Laboratory MedicineISSN: (Online) 2225-2010, (Print) 2225-2002
more
The ECDC, the EFSA and the EMA have for the first time jointly explored associations between consumption of antimicrobials in humans and food-producing animals, and antimicrobial resistance in bacteria from humans and food-producing animals, using 2011 and 2012 data currently available from their re
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levant five EU monitoring networks. Combined data on antimicrobial consumption and corresponding resistance in animals and humans for EU MSs and reporting countries were analysed using logistic regression models for selected combinations of bacteria and antimicrobials. A summary indicator of the proportion of resistant bacteria in the main food-producing animal species was calculated for the analysis, as consumption data in food-producing animals were not available at the species level
more
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
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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
more
WHO would like to express its gratitude and appreciation to all Member States that provided information to the WHO survey on policies and activities at the national level in the area of antimicrobial resistance. The contribution of staff in WHO Regional and Country Offices has been invaluable: in ga
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ther-ing original data and information from Member States, in supporting the process of aggregation of these data; and in reviewing the regional analysis of the findings that reflect the country situation at the point when the survey was conducted. The support and commitment of the members of the WHO Task Force on Antimicrobial Resistance, comprising WHO staff from Headquarters and Regional Offices has, is also acknowledged.
more
Antibiotic resistance has been recognized as a major global health threat and optimizing prescribing is one of the most effective measures to preserve the effectiveness of antibiotics. The quality of prescribing depends mostly on those prescribers belonging to clinical medical specialties
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having direct contact with patients. These doctors, who comprise the majority of antibiotic prescribers,undergo long-term undergraduate and postgraduate training that shapes their professional knowledge and behaviour
J Antimicrob Chemother2019;74: 3611–3618doi:10.1093/jac/dkz375 Advance Access publication 3 September 2019
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