Infectious diseases are constantly in transition. New diseases develop, known dis-eases become widespread or reemerge, and occasionally a disease is eradicated.Infectious diseases such as HIV, tuberculosis, and cholera are significant causes ofillness and death in many parts of the world. Health car...e personnel are on thefront lines, helping to protect their clients from infectious diseases and treatingthem when infections occur. During the course of their work, health care person-nel perform clinical procedures or other activities that can expose both them andtheir clients to potentially infectious microorganisms. Many of their clients aresick and thus may be more susceptible to infections or may have infections thatcan be transmitted to others. Fortunately, all staff working at health care facilities can perform simple proce-dures to minimize risk—to themselves and clients—and reduce the spread ofinfections. These practices can be integrated at minimal cost into the routineworkday at clinics and hospitals around the world. This reference booklet isspecifically designed for use at all levels of the health care system, from thelargest hospitals to the smallest dispensaries or health posts, in settings whereresources are scarce. This booklet, which was first published in 1999, has now been updated. Whilemost practices remain the same, there have been a few important changes—forexample, in recommendations related to hand hygiene and standard precautions.Nonetheless, this booklet continues to present practical recommendations forsimple and relatively low-cost procedures that can be implemented anywhere,with basic supplies and little to no high-technology equipment.
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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...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.
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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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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...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.
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La resistencia a los antimicrobianos (RAM, utilizado también como equivalente de "resistente a los antimicrobianos en este documento) constituye un importante motivo de preocupación mundial en el ámbito de la salud pública y un problema para la inocuidad de los alimentos. Cuando l...os patógenos se hacen resistentes a los agentes antimicrobianos, pueden ser más peligrosos para la salud humana a causa de un posible fracaso de los tratamientos, de la pérdida de opciones para los tratamientos y de la mayor probabilidad y gravedad de las enfermedades. Los problemas relacionados con la RAM están intrínsecamente relacionados con el uso de antimicrobianos en cualquier ámbito, lo que comprende los usos humanos y no humanos. El uso de agentes antimicrobianos en animales/cultivos destinados a la producción de alimentos constituye un factor potencialmente importante de riesgo de selección y propagación a los seres humanos de microorganismos resistentes y determinantes de RAM a partir de dichos cultivos/animales a través del consumo de alimentos.
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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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L’Assemblée mondiale de la Santé, tenue en mai 2015, a adopté un Plan d’action mondial pour combattre la résistance aux antimicrobiens, qui définit 5 objectifs:
mieux faire connaître et comprendre le problème de la résistance aux antimicrobiens grâce à une communication, une éduc...ation et une formation efficaces;
renforcer les connaissances et les bases factuelles par la surveillance et la recherche;
réduire l’incidence des infections par des mesures efficaces d’assainissement, d’hygiène et de prévention des infections;
optimiser l’usage des médicaments antimicrobiens en santé humaine et animale;
dégager les arguments économiques en faveur d’investissements durables qui tiennent compte des besoins de tous les pays et accroître les investissements dans la mise au point de nouveaux médicaments, outils diagnostiques, vaccins et autres interventions.
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Recommendations from the American Nurses Association/Centers for Disease Control and Prevention Workgroup on the Role of Registered Nurses in Hospital Antibiotic Stewardship Practices
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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Les infections associées aux soins (IAS) touchent des centaines de millions de patients dans le monde chaque année. Ces infections sont à l’origine de pathologies graves, de prolongements de la durée du séjour en établissement de soins, d’invalidités à long terme, de coûts personnels im...portants pour les patients et leurs familles, de charges financières supplémentaires élevées pour les systèmes de santé, et pire encore, de la perte tragique de la vie.
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Pakistan Global Antibiotic Resistance Partnership (GARP) was formed in the wake of international and national efforts for AMR curtailment. A group of experts from microbiology, infectious diseases and veterinary medicine formed a core group at the organizational meet...ing of GARP in Kathmandu, Nepal in July 2016. In the meeting, this core group was expanded to include other members from different sectors with the selection of the Chair and co-chairs. These were asked to serve on a voluntary basis, in their own individual capacities, with no personal gains, or gains to the institutions to which they are affiliated. The first phase of GARP took place from 2009 to 2011 and involved four countries: India, Kenya, South Africa and Vietnam. Phase one culminated in the 1st Global Forum on Bacterial Infections, held in October 2011 in New Delhi, India. In 2012, phase two of GARP was initiated with the addition of working groups in Mozambique, Tanzania, Nepal and Uganda. Phase three has added Bangladesh, Lao PDR, Nigeria, Pakistan and Zimbabwe to the network to date.
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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
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Résultats de l’enquête nationale à indicateurs multiples couplée avec la sérologie VIH et anémie en RCA 2006
El uso de los antimicrobianos en seres humanos es imprescindible para combatir a los microorganismos causantes de distintas enfermedades, no obstante, el uso y abuso de estos productos farmacéuticos ha propiciado un aumento en la resistencia, desarrollo y propagación de microorganismos multirresis...tentes. Consecuentemente, esto ha ocasionado una amenaza para la salud pública y un impacto en las Infecciones Asociadas a la Atención en Salud (IAAS). Las IAAS producen un aumento en la mortalidad, morbilidad, estancia hospitalaria, discapacidades en los pacientes, gastos en los servicios de salud, entre otros. Las IAAS son causadas por microorganismos tales como bacterias, virus, hongos, parásitos o priones y pueden afectar tanto a los pacientes como al personal sanitario du- rante la atención de la salud
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Using the WHO model list of essential medicines to update a national essential medicines list
Since 1977, WHO has been working with countries to design the package of essential medicines as an integral component of treatment within the continuum of care, developing and disseminating the Model List ...of Essential Medicines (Model List). WHO is committed to supporting Member States in sharing best practices in selecting
essential medicines, and in developing processes for the selection of medicines for national essential medicines lists (national EMLs, or NEMLs) consistent with the evidence-based methods used for updating the WHO Model List.
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Antibiotics have been useful in fighting infectious diseases in our country for decades, but because of the overuse and misuse of these agents, an increasing number of organisms are now resistant to them. The Philippines, like other Southeast Asian countries, has already been encountering the many c...hallenges of antimicrobial resistance (AMR) which include increasing social and economic costs and rising patient mortality. Although considered a global threat, it is already an emerging local health concern which calls for an urgent collaboration among different sectors to provide solutions addressing this growing problem.
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The National Department of Health and Department of Agriculture, Forestry and Fisheries have collectively engaged to determine the key interventions that will form the basis for this strategy taking into account the recommendations from the WHO and OIE.
The development and implementation of a Natio...nal Antimicrobial Resistance Strategy Framework that complements international efforts is a major step towards containment of the growing threat of antimicrobial resistance in human and animal health. Global partnerships need to be strengthened because the responsibility for reducing resistance is a shared one. This responsibility is not only limited to the health care sector, but calls for collaborative action in all sectors - human, animal and agriculture.
The National Antimicrobial Resistance Strategy Framework will affect South Africa’s response to this looming threat. We already have the tools and expertise to make a difference, now all we need is to work together toward a better future.
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Human rights must be at the centre of all prevention, preparedness, containment and treatment efforts from the start, in order to best protect public health and support the groups and people who are most at risk. States have an obligation to protect and guarantee everyone the right to the highest at...tainable standard of health.
All European states have committed to fulfilling the right to health and have signed international and regional human rights treaties to that purpose. In the context of the current pandemic, authorities should engage all available resources to counter the pandemic while fulfilling the right to health.
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