ObjetivoEl objetivodel documento es servir de guía de actuación para el manejo casos de COVID-19 en atención primaria.3.Recomendaciones generalesSe recomienda la colocación de información visual (carteles, folletos, etc.) en lugares estratégicosde los centros de atenció...n primaria (de ahora en adelante CAP)para proporcionar a la poblaciónlas instrucciones sobre higiene de manosehigiene respiratoria.Se ofrecerá una mascarilla quirúrgica a aquellos pacientes que acudan al centro sanitario con síntomas de infección respiratoria aguda.Se debedisponer de dispensadores con solución hidroalcohólica al alcance de la poblacióny el personal. Se deberá disponer de contenedores de residuos, con tapa de apertura con pedal, para la eliminación de los residuos generados.
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El 31 de diciembrede 2019 las Autoridades de la República Popular China, comunicaron a la OMS varios casos de neumonía de etiología desconocida en Wuhan, una ciudad situada en la provincia china de Hubei. Una semana más tarde confirmaron que se trataba de un nuevo co...ronavirus que ha sido denominado SARS-CoV-2. Al igual que otros de la familia de los coronavirus, este virus causa diversas manifestaciones clínicas englobadas bajoel término COVID-19, que incluyen cuadros respiratorios que varían desde el resfriado común hastacuadros de neumonía grave con síndrome de distrés respiratorio, shock séptico y fallo multi-orgánico. La mayoría de los casos de COVID-19 notificados hasta el momento debutan con cuadros leves.Un punto de detección importante de casos de COVID-19es la urgencia hospitalaria. El triaje tiene como objetivo identificar y priorizar al paciente más grave. Al tratarse deuna enfermedad transmisiblese debenextremar las medidas deprecaución.
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La Agencia Española de Medicamentos y Producto Sanitarios (AEMPS) está monitorizando de manera continua con los expertos de las agencias europeas, la EMA y el resto de agencias mundiales todos los datos relativos al uso de medicamentos para tratar la COVID-19. Se trata de... un escenario que puede ir cambiando por la enorme cantidad de datos, comunicaciones y publicaciones que se están generando a nivel mundial. El presente documento técnico tiene la finalidad de guiar el manejoclínicode los pacientes conCOVID-19 con un doble objetivo: lograr el mejor tratamiento del paciente que contribuya a su buena evolución clínica; y garantizar los niveles adecuados de prevención y control de la infección para la protección de los trabajadores sanitarios y de la población en su conjunto.
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El presente documento técnico tiene la finalidad de guiar el manejode cuidados intensivosde los pacientes conCOVID-19 con undoble objetivo: lograr el mejor tratamiento del paciente que contribuya a subuena evolución clínica; ygarantizar los niveles adecuados de prevención y control de la... infección para la protección de los trabajadores sanitarios y de la población en su conjunto.
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Se sabe que las mujeres embarazadas experimentan cambios inmunológicos y fisiológicos que pueden hacerlas más susceptibles a las infecciones respiratorias virales, incluido COVID-19. Varios estudios revelaron que las mujeres embarazadas con diferentes enfermedades resp...iratorias virales tenían un alto riesgo de desarrollar complicaciones obstétricas y resultados adversos perinatales en comparación con las mujeres no grávidas, debido a los cambios en las respuestas inmunes. También sabemos que las mujeres embarazadas pueden estar en riesgo de enfermedad grave, morbilidad o mortalidad en comparación con la población general, tal y como se observa en los casos de otras infecciones por coronavirus
5relacionadas [incluido el coronavirus del síndrome respiratorio agudo severo (SARS-CoV) y el coronavirus del síndrome respiratorio del Medio Oriente (MERS-CoV)] y otras infecciones respiratorias virales, como la gripe, durante el embarazo.
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Medizinische KlinikIntensivmedizin und Notfallmedizin
https://doi.org/10.1007/s00063-020-00674-3
Molecular methods for antimicrobial resistance (AMR)diagnostics to enhance the Global Antimicrobial Resistance Surveillance System
This policy brief identifies and explains the main reasons behind the rise of antimicrobial resistance (AMR) associated with improper use of antibiotics in the livestock sector. Focusing on the low- and middle- income country setting, this brief provides recommendations for a deliberated policy stra...tegy aimed to prevent healthcare crisis that could happen as a result of AMR.
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The era of effective antibiotics is coming to a close. In just a few generations, many “miracle medicines”have been beaten into ineffectiveness by the bacteria they were intended to eradicate. Bacteria quickly adapt to the presence of antibacterial agents in order ...to survive. The misuse of antibiotics,which is an international problem, only exacerbates the steady evolution of resistance. In August 2010, the journal Lancet Infectious Diseases posed the question "Is this the end of antibiotics?" documentingthe rapid spread of multidrug-resistant bacteriaand predicting that 10 years remain in the useful life of many agents.
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As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicro...bial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
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Timely detection of novel coronavirus (2019-nCoV) infection cases is crucial to interrupt the spread of this virus. We assessed the required expertise and capacity for molecular detection of 2019-nCoV in specialised laboratories in 30 European Union/European Economic Area (EU/EEA) countries. Thirty-...eight laboratories in 24 EU/EEA countries had diagnostic tests available by 29 January 2020. A coverage of all EU/EEA countries was expected by mid-February. Availability of primers/probes, positive controls and personnel were main implementation barriers.
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Lancet Respir Med 2020Published OnlineMarch 20, 2020https://doi.org/10.1016/S2213-2600(20)30121-1
Lancet Respir Med 2020Published OnlineMarch 20, 2020 https://doi.org/10.1016/S2213-2600(20)30134-
BMJ 2020;368:m800 doi: 10.1136/bmj.m800 (Published 5 March 2020)
Le présent document a été élaboré pour aiderles comités de coordination RAM et d’autres comités chargés de la RAM au niveau des pays àparvenir à cet objectif. S’appuyant sur la littérature publiée ainsi que sur l’expérience opérationnelle et l’expertise de différents PRFI, le ...document présente six stratégies clés pour atteindre l’objectif et offre une série de conseils pratiques et de suggestions sur la façon de mettre en œuvre chacune d’entre elles.
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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... series of practical tips and suggestions on how to implement each one.
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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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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 current document is anupdate of the guidelines developed by the EUCAST subcommittee on detection of resistance mechanisms. The EUCAST Steering Committee has carried out the current update. The document has been developed mainly for routine use in clinical laboratories and doesnot cover technical... procedures for identification of resistance mechanisms at a molecular level by reference or expert laboratories. However, much of the content is also applicable tonational reference laboratories. Furthermore, it is important to note that the document does not cover screening for asymptomatic carriage (colonization) of multidrug-resistant microorganismsor direct detectionof resistancein clinical samples.
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This interim guidance has been updated with advice on safe and appropriate home care for patients with coronavirus disease 2019 (COVID-19) and on the public health measures related to the management of their contacts.