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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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.
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Временные рекомендации
13 марта 2020 г.
Настоящий документ является вторым изданием руководства (версия 1.2), которое первоначально представляло собой адаптированн...ый вариант Руководства по клиническому ведению тяжелой острой респираторной инфекции при подозрении на инфекцию MERS-CoV (ВОЗ, 2019 г.).
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While infections that develop during hospitalization may appear to be an uncommon but recognized risk of hospital care today, the incidence of these infections has been increasing dramatically during the last 2 to 3 decades, and the risk of acquiring an organism that is resistant to 1 or more antibi...otics is becoming increasingly common.
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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...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.
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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
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The Core Elements of Outpatient Antibiotic Stewardship provides a framework for antibiotic stewardship for outpatient clinicians and facilities that routinely provide antibiotic treatment. This report augments existing guidance for other clinical settings. In 2014 and 2015, respectively, CDC release...d the Core Elements of Hospital Antibiotic Stewardship Programs and the Core Elements of Antibiotic Stewardship for Nursing Homes. Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management.
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The escalating antimicrobial resistance (AMR) pandemic is a global public health threat with extensive health, economic and societal implications. Resistance emerges because of selection pressure from rational and indiscriminate antimicrobial use in human health as well as in the veterinary, agricul...ture and environmental sectors. Infections caused by resistant bacteria result in longer duration of illness, higher mortality rates and increased costs associated with alternative treatment. AMR further constrains procedures that rely on antimicrobial prophylaxis, and AMR is recognized as a threat to theworld economy.
Journal of Public Health | Vol. 39, No. 1, pp. 8–13 | doi:10.1093/pubmed/fdw015 | Advance Access Publication March 3 2016
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Overuse of antimicrobial agents occurs globally in both community and hospital settings. Misuse of antibiotics can lead to a variety of adverse outcomes, including the development of antimicrobial resistanceand increased cost of hospitalization. This issuehas been particularly problematic in de...veloping countries, where antibiotic-management programs rarely exist and where antibiotics can be purchased without aprescription. In Thailand, the rate of antibiotic resistance among gram-positive and gram-negative or-ganisms has increased significantly over the past decade. These findings provide compelling evidence ofthe need for more-rational use of antimicrobial agents in Thailand.
Clinical Infectious Diseases2006; 42:768–752006 by the Infectious Diseases Society of America.
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This study addresses part of the Terms of Reference for a scoping report ‘An analysis of approaches to laboratory capacity strengthening for drug resistant infections in low and middle income countries’. It has been produced as a separate report because it is also very relevant for a second stud...y ‘Supporting Surveillance Capacity for Antimicrobial Resistance: Regional Networks and Educational Resources’. This study compares antimicrobial surveillance systems in three low and middle income countries in order to describe the components of these systems and to understand which surveillance models are best suited to particular contexts. Ghana, Nigeria and Nepal were selected as study countries because they cover different continents and include one ‘fragile’ context (Nigeria). Brief information from Malawi is also included.
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Global actions to reduce antimicrobial resistance (AMR) include optimising the use of antimicrobial medicines in human and animal health. In countries with weak healthcare regulation, this requires a greater understanding of the drivers of antibiotic use from the perspective of providers and consume...rs. In Bangladesh, there is limited research on household decision-making and healthcare seeking in relation to antibiotic use and consumption for humans and livestock. Knowledge is similarly lacking on factors influencing the supply and demand for antibiotics among qualified and unqualified healthcare providers. The aim of this study is to conduct integrated research on household decision-making for healthcare and antibiotic use, as well as the awareness, behaviours and priorities of healthcare providers and sellers of antibiotics to translate into policy development and implementation
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Stenotrophomonas maltophiliais a nonfermenting Gram-negative rod that is ubiquitous in nature (predominantly occurring in aquatic environments and on plants). Biochemically, it iscatalase positive and oxidase negative, and it produces acid frommaltose (hence the name“maltophilia”). Due to it...s chargedcell wall surface and biofilm production, it may attach to and survive on abiotic surfaces in clinical settings (eg, central venouscatheters, disinfectant and hand-washing solutions, solutions for hemodialysis, endoscopes, inspiration/expiration circuits of ventilators, nebulizers, tap water, and showerheads).
Health Services Research and Managerial Epidemiology Volume 6: 1-9ªThe Author(s) 2019
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Nosocomial infections, or hospital-acquired infec-tions (HAI), are among the most significant causesof morbidity and mortality in healthcare settingsthroughout the world.Prevention of HAIs iscentral to providing high quality and safe health-care, even in settings with limited resources.Transmi...ssion of infectious agents between patientsby health workers and irrational use of antibioticsare two important preventable factors involved inmany HAIs.
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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... 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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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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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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The Global Antibiotic Resistance Partnership (GARP)-Mozambique team, in partnership with the Center for Disease Dynamics, Economics & Policy (CDDEP), has produced this report as part of a solid com-mitment to develop actionable policy proposals to tackle antibiotic resistance and improve appropriate... antibiotic access. It is the result of a thorough review of published and unpublished data on antibiotic resistance and a long internal consultation effort that engaged academic scientists, health professionals and other stakeholders within Mozambique.
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The global emergence of antimicrobial resistance (AMR) is posing a threat to human health. Putting resources into the containment of AMR – including surveillance – is one of the highest-yield investments a country can make to mitigate its impact. In 2015, WHO launched the Global Antimicrobial Re...sistance Surveillance System (GLASS), the first global collaborative effort to foster AMR surveillance in bacteria causing acute infections. As of December 2018, 71 countries are enrolled in GLASS. The aim of this report is to document participation efforts and outcomes across these countries, and highlight differences and constraints identified to date. This report follows on from the first GLASS Report – Early implementation 2016-17, published in January 2018, and drawing on data from GLASS first data call in 2017.
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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
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Antimicrobial resistant (AMR) organisms are increasing globally, threatening to render existing treatments ineffective against many infectious diseases. In Africa, AMR has already been documented to be a problem for HIV and the pathogens that cause malaria, tuberculosis, typhoid, cholera, meningitis..., gonorrhea, and dysentery. Recognizing the urgent need for action, the World Health Assembly adopted the Global Action Plan on Antimicrobial Resistance in May 2015. In accordance with the Global Action Plan and to meet needs specific to Africa, Africa CDC will establish the Anti-Microbial Resistance Surveillance Network (AMRSNET). AMRSNET is a network of public health institutions and leaders from human and animal health sectors who will collaborate to measure, prevent, and mitigate harms from AMR organisms.
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