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
This book provides significantly expanded content and experience in relation to a broader stewardship context- for example, stewardship in specific populations, different countries as well as the role of different professions in stewardship to political and media engagement. We hope this book has so...mething to offer everyone practicing in this area. Therefore, The British Society for Antimicrobial Chemotherapy [BSAC] in collaboration with ESGAP are very pleased to present this e-book on Global Antimicrobial Stewardship that is relevant to health care professions working in preventing and managing infection across the healthcare communities and health care facilities. It aims to support health care professionals, or teams, or policy makers interested in learning about bringing the principles of stewardship to the bed side
more
This document provides additional guidance for the responsible and prudent use of antimicrobials in food-producing animals, and should be read in conjunction with the Recommended International Code of Practice for Control of the Use of Veterinary Drugs CAC/RCP 38-1993. Its obj...ectives are to minimize the potential adverse impact on public health resulting from the use of antimicrobial agents in food-producing animals, in particular the development of antimicrobial resistance. It is also important to provide for the safe and effective use of veterinary antimicrobial drugs in veterinary medicine by maintaining their efficacy. This document defines the respective responsibilities of authorities and groups involved in the authorization, production, control, distribution and use of veterinary antimicrobials such as the national regulatory authorities, the veterinary pharmaceutical industry, veterinarians, distributors and producers of food-producing animals.
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...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.
more
Burkina Faso has approximately 10.5 million inhabitants and is divided into 30 provinces. The study took place in the districts of Tougan, Nouna, and Solenzo, in provinces Sourou and Kossi, in north-west Burkina Faso. There is one medical centre in every district capital and 6 to 14 health centres i...n the surrounding villages. Each health centre covers a population of 10 000 to 15 000. The staff of one health centre generally consists of one nurse, a nurse aid and a midwife as well as one drug vendor for the nearby village pharmacy. The health personnel are trained and paid by the state.
more
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.
more
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 ...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.
more
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.
more
Lancet Respir Med 2020Published OnlineMarch 20, 2020https://doi.org/10.1016/S2213-2600(20)30121-1
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.
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...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
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.
more
Recommendations from the American Nurses Association/Centers for Disease Control and Prevention Workgroup on the Role of Registered Nurses in Hospital Antibiotic Stewardship Practices
An essential participant in antimicrobial stewardship who has been unrecognized and underutilized is the“staff nurse.”Although the role of staff nurses has not formally been recognized in guidelines for implementing and operating antimicrobial stewardship programs (ASPs) or defined in the medica...l literature, they have always performed numerous functions that are integral to successful antimicrobial stewardship. Nurses are antibiotic first responders, central communicators, coordinators of care, as well as 24-hour monitors of patient status, safety, and response to antibiotic therapy. An operational analysis of inpatient admissions evaluates these nursing stewardship activities and analyzes the potential benefits of nurses’formal education about, and inclusion into, ASPs.
Clinical Infectious Diseases - CID 2016:62 (1 January)•CLINICAL PRACTICE
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...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
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...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
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
more
South Africa has faced many challenges over the past two decades, accomplishing profound positive changes in the social structure and government of the nation. This has not yet fully translated into better health for the population, however, particularly the poorest segment. In fact, the p...opulation has lost ground since the 1990s in virtually all important health indicators, leaving South Africa with a high burden of infectious disease.
August 2011, Vol. 101, No. 8 SAMJ
more
Haematologica has published European guidelines for empirical and targeted antibacterial therapy forfebrile neutropenic patients in the era of emerging resistance (ECIL-4). Indeed, collateral damage by broad-spectrum antibiotic therapy includes selection of multidrugresistant pathogens, and incr...eased predisposition to infec-tion by fungi and Clostridium difficile. Antibiotic resistance has become a major public health concern, with fears expressed that we will soon run out of antibiotics.
Haematologica December 2013 98: 1821-1825; doi:10.3324/haematol.2013.091769
more
In the kingdom of Bahrain, the national antibiotic committee will set the framework for the national response to AMR, especially bacterial resistance to antibiotics. It will be aligned with the World Health Organization’s (WHO) Global Action Plan on Antimicrobial Resistance, and with standards and... guidelines from the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE).
more