Interim guidance 19 March 2020
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.
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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.
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Medizinische KlinikIntensivmedizin und Notfallmedizin
https://doi.org/10.1007/s00063-020-00674-3
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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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.
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Molecular methods for antimicrobial resistance (AMR)diagnostics to enhance the Global Antimicrobial Resistance Surveillance System
How we respond both now and going forward will help mitigate the impact of COVID-19, and to the extent possible preserve children’s rights to Survive, Learn, and Be Protected. We will focus our efforts on the most critical work essential to maintaining these commitments to the extent possible.
Lancet Respir Med 2020Published OnlineMarch 20, 2020https://doi.org/10.1016/S2213-2600(20)30121-1
A regional guide for governments in Asia and the Pacific to review, update and develop policies to address antimicrobial resistance and antimicrobial use in animal production
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.
Updated 8 June 2021. Coronavirus is spreading globally. How can individuals, communities, humanitarian actors, local and national authorities best respond to uphold the rights of all affected people?
Historically, the discovery of the sulfa drugs in the 1930s and the subsequent development of penicillin during World War II ushered in a new era in the treatment of infectious diseases. Infections that were common causes of death and disease in the pre-...antibiotic era - rheumatic fever, syphilis, cellulitis and bacterial pneumonia - became treatable, and over the next 20 years most of the classes of antibiotics that find clinical use today were discovered and changed medicine in a profound way. The availability of antibiotics enabled revolutionary medical interventions such as cancer chemotherapy, organ transplants and essentially all major invasive surgeries from joint replacements to coronary bypass. Antibiotics, though, are unique among drugs in that their use precipitates their obsolescence. Paradoxically, these cures select for organisms that can evade them, fueling an arms race between microbes, clinicians and drug discoverers.
Wright BMC Biology 2010, 8:123 http://www.biomedcentral.com/1741-7007/8/12
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Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance wh...ile maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
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A guide for practical implementation in adult and pediatric emergency department and urgent care settings
Infectious diseases like COVID-19 can disrupt the environments in which children grow and develop. Disruptions to families, friendships, daily routines and the wider community can have negative consequences for children’s well-being, development and protection. In addition, measures used to preven...t and control the spread of COVID-19 can expose children to protection risks. Home-based, facility-based and zonal-based quarantine and isolation measures can all negatively impact children and their families.
The aim of this brief is to support child protection practitioners to better respond to the child protection risks during a COVID-19 pandemic. Part 1 presents the potential child protection risks COVID-19 can pose to children. Part 2 presents programmatic options in line with the 2019 Minimum Standards for Child Protection in Humanitarian Action (CPMS) and the Guidance Note: Protection of Children During Infectious Disease Outbreaks.
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Accessed on 31.03.2020
This Guidance Note aims to provide humanitarian child protection practitioners, particularly child protection advisors and program managers, with guidance on how to engage in responses to infectious disease outbreaks to ensure children’s protection needs are taken into ac...count in preparedness for, and during responses to, the outbreaks. The Guidance Note draws upon lessons learned during infectious disease outbreaks globally in a variety of contexts.
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