Antimicrobial resistance (AMR) has emerged as a major public health problem all over the world. Infections caused by resistant microbes fail to respond to treatment, resulting in prolonged illness and greater risk of death. This document focuses on the mechanism to develop a practically applicable h...ospital antibiotic policy and standard treatment guidelines (STG). In addition, the document contains information on various effective strategies for implementation of STG. It also discusses various activities and information required for the development of the antibiogram, antibiotic policy and standard treatment guidelines, such as surveillance programmes, the cause and controlling strategies for AMR and HAI; performance measures of antibiogram, antibiotic policy and standard treatment guidelines. A model hospital STG for community-acquired pneumonia in adults is included.
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Les maladies infectieuses sont en constante mutation. De nouvelles maladies apparaissent, d’autres qui sont bien connues se propagent ou refont surface, et quelques rares fois, une maladie est éradiquée. Les maladies infectieuses telles que le VIH, la tuberculose et le choléra sont des causes c...onsidérables de morbidité et de mortalité dans plusieurs régions du monde. Le personnel de la santé joue un rôle primordial, en ce qui concerne la protection de leurs clients contre les maladies infectieuses et leurs traitements en cas d’infection. Dans le cadre de leur travail, le personnel de santé accomplisse des tâches cliniques ou autres activités susceptibles de les exposer ainsi que leurs clients aux microorganismes – orga- nismes potentiellement infectieux. Bon nombre de ces clients sont malades et, par conséquent, sont plus vulnérables aux infections ou peuvent avoir des infec-tions susceptibles d’être transmises à d’autres personnes. Par chance, l’ensemble du personnel travaillant dans les services de santé est en mesure d’exécuter des procédés simples visant à minimiser le risque – vis-à-vis d’eux-mêmes et de leurs clients – et réduire la propagation des infections. Ces pratiques peuvent être intégrées à moindre frais dans les habitudes quotidiennes au sein des établissements de santé du monde entier. Ce guide de référence est spécialement conçu pour l’emploi à tous les niveaux du système sanitaire, depuis les plus grands hôpitaux jusqu’aux plus petits dispensaires ou centres de santé, dans des établissements où les ressources sont rares.Ce guide, publié pour la première fois en 1999, a été mis à jour. Bien que la plu-part des pratiques restent inchangées, il a fait l’objet de quelques modifications significatives – par exemple, concernant les recommandations liées au lavage des mains et aux précautions standard. Toutefois, ce guide continue de présenter des recommandations pratiques en matière de procédés simples et relativement peu coûteux pouvant être exécutés partout, à l’aide des matériels de base et des équi-pements de niveau technologique moyen.
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In Kenya, the bacterial infections that contribute most to human disease are often those in which re-‐sistance is most evident. Examples are multidrug-‐resistant enteric bacterial pathogens such as typhoid, ... diarrhoeagenic Escherichia coli and invasive non-‐typhi salmonella, penicillin-‐resistant Streptococcus pneu-‐moniae, vancomycin-‐resistant enterococci, methicillin-‐resistant Staphylococcus aureus and multidrug-‐re-‐sistant Mycobacterium tuberculosis. Resistance to medicines commonly used to treat malaria is of particu-‐lar concern, as is the emerging resistance to anti-‐HIV drugs. Often, more expensive medicines are required to treat these infections, and this becomes a major challenge in resource-‐poor settings.
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The era of effective antibiotics is coming to a close. In just a few generations, many “miracle medicines”have been beaten into ineffectiveness by the bacteria they were intended to eradicate. Bacteria quickly adapt to the presence of antibacterial agents in order ...to survive. The misuse of antibiotics,which is an international problem, only exacerbates the steady evolution of resistance. In August 2010, the journal Lancet Infectious Diseases posed the question "Is this the end of antibiotics?" documentingthe rapid spread of multidrug-resistant bacteriaand predicting that 10 years remain in the useful life of many agents.
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Millennium Development Goal 8E aims for affordable access to essential medicines. Essential medicines, as defined by WHO, are those that “satisfy the health-care needs of the majority of the population” and that should therefore “be available at all times in adequate amounts”. However, there... is a category of medicines that faces a unique challenge in terms of availability. These are the medicines governed by the international conventions on narcotic and psychotropic substances. “Controlled medicines” is the common definition for pharmaceuticals whose active principles are listed under the 1961 United Nations Single Convention on Narcotic Drugs as amended by the 1972 Protocol, such as morphine and methadone; the 1971 United Nations Convention on Psychotropic Substances, such as diazepam and buprenorphine; and the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, such as ergometrine and ephedrine. The conventions list substances in “Schedules” according to their different levels of potential for abuse and harm, and the commensurate severity of control measures to be applied by countries.
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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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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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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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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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La résistance aux antimicrobiens (ou RAM, cette abréviation étant est ici également employée en mode adjectif pour désigner les organismes « résistants aux antimicrobiens ») est une préoccupation majeure pour la santé publique mondiale et une question de sécurité san...itaire des aliments. Lorsque des pathogènes deviennent résistants aux agents antimicrobiens, ils peuvent présenter un risque plus important pour la santé découlant d’un éventuel échec thérapeutique, de la diminution de choix thérapeutiques et de la probabilité accrue d’apparition et de gravité de la maladie. Les problèmes en rapport avec la RAM sont liés de façon inhérente à l’usage des antimicrobiens dans tous les types d’environnements, y compris les utilisations humaines et non humaines. L'utilisation d’agents antimicrobiens dans la production alimentaire animale et végétale représente un facteur de risque important pour la sélection et la transmission de micro-organismes résistants aux antimicrobiens (micro-organismes RAM) et de déterminants de la résistance aux antimicrobiens (déterminants de la RAM) des animaux et des plantes alimentaires à l’humain par sa consommation d’aliments.
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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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A l’attention des professionnels soignants, des formateurs et des observateurs des pratiques d’hygiène des mains
The ICAT is a simple and practical approach for assessing the adequacy of existing infection prevention and control practices and provides specific recommendations for improving practices and monitoring their effectiveness over time
The Global Antibiotic Resistance Partnership (GARP) aims to address the challenge of antibiotic resistance by developing actionable Policy Proposals in Vietnam and four other low- and middle-income countries: China, India, Kenya and South Africa. GARP will develop the evidence base for Policy action... on antibiotic resistance and identify policy opportunities where research, advocacy and information have the best chance of slowing the development and spread of resistance.
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The Hand Hygiene Self-Assessment Framework is a systematic tool with which to obtain a situation analysis of hand hygiene promotion and practices within an individual health-care facility.
Las infecciones relacionadas con la atención sanitaria (IRAS) plantean una seria carga de enfermedad y tienen un efecto económico considerable en los pacientes y en los sistemas sanitarios de todo el mundo. Sin embargo, la higiene de las manos, la simple t...area de limpiarse las manos en los momentos adecuados y de la forma adecuada, puede salvar vidas.
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