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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.
more
MICROBIAL DRUG RESISTANCEVolume 24, Number 5, 2018ªMary Ann Liebert, Inc.DOI: 10.1089/mdr.2017.0383
Antibiotic resistance (ABR) is a worldwide publichealth concern, with serious health, economic, and so-cietal repercussions. Its emergence is attributed to the se-lective pressure exerted by antib
...
iotic use in the community, hospitals, veterinary health, agriculture, aquaculture, and the environment. Additionally aggravating the situation is the fact that very few new antibiotics have recently been produced by pharmaceutical companies. It is widely acknowledged that food animals are key reservoirs of antibiotic-resistant bacteria and that antibiotic usage in this population favors the emergence, selection, and spread of resistance among animals and humans, both through zoonoses (infectious diseases trans-mitted between animals and humans) and the food chain.
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.
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Updated with information on Ebola virus disease and Middle East respiratory syndrome coronavirus
A wide variety of health events ranging in severity may occur related to air transport, requiring different responses or, perhaps, no response at all. The target audience for this guidance document incl
...
udes the national focal points (NFP) for the IHR and public health authorities at PoE, as well as national aviation regulatory authorities, airport operators and personnel, aircraft operators, air crew and other stakeholders involved in air transport and emergency preparedness and response to public health events
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Molecular methods for antimicrobial resistance (AMR)diagnostics to enhance the Global Antimicrobial Resistance Surveillance System
In 1998 the Swedish Veterinary Association decided to adopt a general policy for the use of antibiotics in animals. Since then specifi c policies for the use of antibiotics in dogs and cats have been adopted and in 2011 Guidelines for the use of Antibiotics in Production animals – Cattle and Pigs,
...
were accepted. By decision of the board of the Swedish Veterinary Society (SVS) these guidelines have been updated. Th e over-arching goal of SVS is to achieve a low and controlled use of antibiotics in Swedish animal production so that the fi rst-hand choices of treatment remain effi cient and that the spread of antimicrobial resistance – among animals and herds as well as in the food chain – is kept at a minimum. Keeping antimicrobial resistance in animals low is important also for human health, since we are all part of the same ecosystem. Th e authors of these guidelines hope that they may be useful for veteri-narians in clinical practice when deciding on treatments for common diseases and ailments caused by bacteria. Sometimes the decision may even be to refrain from use of antibiotics and chose other ways of improving herd health.
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The infectious disease burden in India is among the highest in the world. A large amount of antibiot-ics are consumed in fighting infections, some of them saving lives, but every use adding to antibiotic resistance in bacteria. Antibiotic use is increasing steadily (table 1), particularly
...
certain antibiotic classes (beta-lactam antibacterials), most notably in the more prosperous states. Resistance follows in lock-step.
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The objectives of NAP are aligned with the global action plan based on national needs and priorities. The emphasis is on One Health approach with all sectors especially human health, animal health and environment contributing towards minimizing the emergence and impact of AMR in Jordan.
Antimicrobials have been a critical public health tool since the discovery of penicillin in 1928, saving the lives of millions of people around the world. Today, however, the emergence of drug resistance is reversing the miracles of the past eighty years, with drug choices for the treatment of many
...
infections becoming increasingly limited, expensive, and, in some cases, non-existent.
Conscious of the public health threats of AMR to both humans, animals and the environment, the ministries of health and sanitation, agriculture forestry and food security and the environmental protection agency put together a national multi-sectoral coordinating group tasked with the responsibility of establishing mechanisms to integrate all initiatives into a single concerted action and development of the national AMR strategic plan (2018-2022). The National Strategic Plan on Antimicrobial Resistance is the first approach which addresses AMR specifically.
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23 December 2020 This document summarizes WHO recommendations for the rational use of personal protective equipment (PPE) in health care settings and temporary strategies during acute supply shortages. This document also contains 2 Annex sections describing updated PPE use recommendations for health
...
workers based on the transmission scenario, setting, and activity in the context of COVID-19 (Annex 1), and updated considerations for the decontamination or reprocessing of PPE (Annex 2). This guidance is intended for public health authorities, organizations, and focal persons involved in decisions regarding PPE distribution, management, and use by health workers.
Available in Arabic, French, English, Spanish and Russian
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A practical approach for developing policy and strategy to improve quality of care
The handbook outlines an approach for the development of national policies and strategies to improve the quality of care. Such policy and strategy can help clarify the structures, roles and responsibilities within n
...
ational quality efforts, support the institutionalization of a culture of quality, and secure buy-in from health system leaders and stakeholders
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Considerations for implementing and adjusting public health and social measures in the context of COVID-19
recommended
interim guidance, 14 June 2021
This document is intended for national authorities and decision makers in countries that have introduced large scale public health and social measures. It offers guidance for adjusting public health and social measures, while managing the risk of a resurgence of cases
...
.
Available in English, Arabic, Chinese, French, Russian and Spanish
more
April 2020
This Guidance Note offers a list of recommendations based on a combination of WHO guidelines, good practice and expert advice based on the latest scientific research. The situation with COVID-19 is evolving rapidly and the guidance will continue to be updated if and when new evidence o
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r information becomes available.
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orientaciones provisionales, 23 de diciembre de 2020
En este documento se resumen las recomendaciones de la OMS para utilizar de forma racional los equipos de protección personal (EPP) tanto en los centros sanitarioscomo en los domicilios, así como durante la manipulación
...
de mercancías. Además, se analizan las interrupciones actuales que sufre la cadena mundial de suministro y se tratan aspectos que cabe tener en cuenta para tomar decisiones durante periodos de escasez grave de estos equipos.
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Options for the decontamination and reuse of respirators in the context of the COVID-19 pandemic
recommended
Guiding principles for reuse are:
Respirators which have been visibly contaminated (e.g. during procedure at intubated patients, such as suction cleaning of airways, taking probes, extubation attempts, etc.) or are damaged or not fitting, should be discarded and cannot be taken for re-use or de
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contamination procedures.
Respirators may be protected by a medical face mask in order to prevent soiling.
Use of new ‘expired respirators’ (manufacturers expiry date) is possible if they were properly stored until use.
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This policy paper underscores that, although children do not represent a high-risk group for direct COVID-19 fatality, the pandemic posts far-reaching secondary impacts that heighten risks to African children’s rights and wellbeing.
Updated 2022. This guide addresses the care pathway from presentation of the patient to a health facility to patient discharge. It considers different levels of disease severity, from asymptomatic individuals to critically ill patients. Accounting for variations in the benefits and harms of chest im
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aging in different situations, remarks are provided to describe the circumstances under which each recommendation would benefit patients. The guide also includes implementation considerations for different settings, provides suggestions for impact monitoring and evaluation and identifies knowledge gaps meriting further research.
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The arrival of COVID-19 in Afghanistan has brought heartache to millions of people who are now battling a deadly pandemic while simultaneously fighting for their survival amid poverty, disaster and war. Over my three years as Humanitarian Coordinator, I have marvelled at the resilience of the people
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of this country to cope with the hardships of life in the world’s deadliest conflict – but even this remarkable strength is now being tested by the health, social and economic consequences of COVID-19. The virus is spreading across the country with frightening speed. Every province is now impacted, and people are understandably frightened.
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While many of the countries hit by the COVID-19 in the first few months of the year are now beginning to relax lockdown measures as infection and death rates fall, in the regions most affected by HIV, TB and malaria, such as Africa, South Asia and Latin America, the pandemic continues to accelerate.
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In lower resource settings, lockdowns are less effective and hard to sustain, and clinical care facilities are extremely limited. In such environments, the response to COVID-19 must focus on containing the pandemic’s spread as far as possible through testing, contact tracing and isolation, protecting the health workforce through training and the provision of personal protective equipment (PPE) and minimizing the knock-on impact on other diseases through shoring up fragile health systems, and adapting existing disease programs.
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