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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
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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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Los servicios de emergencias médicas prehospitalarias (SEM) facilitan atención inicial de soporte vital básico y/o avanzado y traslado de heridos o enfermos desde el lugar donde ocurre la emergencia hasta el centro sanitario donde le van a prestar cuidados definitivos. Los SEM también pueden pre
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star traslado de pacientes desde una instalación de salud a otra de mayor nivel o complejidad, en lo que se conoce como traslado interhospitalario. Los servicios de ambulancia es el componente más conocido y puede ser prestado por diferentes proveedores que pueden ir desde departamentos de bomberos, organizaciones de voluntarios o servicios adscritos a universidades hasta hospitales que cuentan con su propio servicio de ambulancias para cubrir a sus usuarios. Los SEM prehospitalarios también incluyen otros componentes como los centros tipo 911 o los Centro Reguladores de Urgencia y Emergencias (CRUE) y los programas de primer respondiente. Todos ellos deben integrase de una forma coordinada con las redes integradas de servicios de salud para asegurar una continuidad de los cuidados de salud prestados a la persona herida o enferma. Durante emergencias de salud pública, los servicios de emergencia medicas prehospitalarias pueden verse superados por el número de llamadas o demanda de traslados médicos.
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La capacidad de respuesta de un hospital puede ser superada por la llegada masiva de pacientes que soliciten atención médica como consecuencia de una situación de emergencia. Ante este escenario, se debe considerar si el establecimiento de salud está organizado para garantizar la gestión integr
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al de la respuesta hospitalaria, el funcionamiento de los mecanismos de coordinación, el manejo integral de la información, las capacidades logísticas para facilitar la respuesta, y los recursos necesarios para su ejecución, así como para una respuesta integral a los pacientes, precautelando la salud y bienestar de los trabajadores de salud. (7)
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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
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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.
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Comprehensive Reviews in Food Science and Food Safety, Vol.12 (2013) pp.234-248
In 2006, the Institute of Food Technologists (IFT) published an Expert Report entitled “Antimicrobial Resistance: Implications for the Food System” (IFT 2006). That report summarized current scientific knowledge pe
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rtaining to the public-health impact of antimicrobial use in the food system and the development and control of antimicrobial resistance. Since that time, intense interest in this topic has continued within the regulatory and scientific communities as well as the general public. This IFT Scientific Status Summary serves to update that 2006 IFT Expert Report by briefly reviewing new scientific evidence relevant to the goals of the initial report and providing a number of key observations and conclusions.
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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
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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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This book provides significantly expanded content and experience in relation to a broader stewardship context- for example, stewardship in specific populations, different countries as well as the role of different professions in stewardship to political and media engagement. We hope this book has so
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mething to offer everyone practicing in this area. Therefore, The British Society for Antimicrobial Chemotherapy [BSAC] in collaboration with ESGAP are very pleased to present this e-book on Global Antimicrobial Stewardship that is relevant to health care professions working in preventing and managing infection across the healthcare communities and health care facilities. It aims to support health care professionals, or teams, or policy makers interested in learning about bringing the principles of stewardship to the bed side
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This guideline covers making people aware of how to correctly use antimicrobial medicines (including antibiotics) and the dangers associated with their overuse and misuse. It also includesmeasures to prevent and control infection that can stop people needing antimicrobials or spreadinginfection to o
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thers. It aims to change people's behaviour to reduce antimicrobial resistance and thespread of resistant microbes.
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Antibiotic Stewardship (AS) is a coordinated program that promotes the appropriate use of antimicrobials to improve patient outcomes, reduce microbial resistance, and decrease the spread of multi-drug resistant organisms. In clinical settings, stewardship activities focus on measuring and improving
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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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Handbook of COVID-19 Prevention and Treatment
recommended
Handbook of COVID-19 Prevention and Treatment, expecting to share their invaluable practical advice and references with medical staff around the world. This handbook compared and analyzed the experience of other experts in China, and provides good reference to key departments such as hospital infect
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ion management, nursing, and outpatient clinics. This handbook provides comprehensive guidelines and best practices by China's top experts for coping with COVID-19.
This handbook, provided by the First Affiliated Hospital of Zhejiang University, describes how organizations can minimize the cost while maximizing the effect of measures to manage and control the coronavirus outbreak. The handbook also discusses why hospitals and other healthcare institutions should have command centers when encountering a large-scale emergency in the context of COVID-19. This handbook also includes the following：
- Technical strategies for addressing issues during emergencies.
- Treatment methods to treat the critically ill.
- Efficient clinical decision-making support.
- Best practices for key departments like inflection management and outpatient clinics.
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Interim Version 24, February 2020
This checklist has been prepared with the aim of supporting hospital managers and emergency planners in achieving the above by defining and initiating actions needed to ensure a rapid response to the COVID-19 outbreak. The checklist is structured on eleven key co
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mponents; under each component, there is a list of questions regarding the status of implementation of the recommended action specific to that component. Hospitals at risk of increased health service demand should be prepared to initiate the implementation of each action promptly. The section on “Recommended reading” lists selected tools, guidelines and strategies relevant to each component, as well as other supporting documentation.
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Community Health Impact Coalition members & colleagues from across the world are sharing COVID-19 explainers, internal policies, clinical protocols, & more live
O Plano Nacional de Preparação e Resposta para a doença por novo coronavírus (COVID-19) é uma ferramenta estratégica de preparação e resposta a uma potencial epidemia pelo vírus SARS-CoV-2. Este Plano tem como referencial as orientações da Organização Mundial da Saúde e do Centro Europ
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eu de Prevenção e Controlo de Doenças, sendo o documento de referência nacional no que respeita ao planeamento da resposta a COVID-19. Apesar do conhecimento atualmente disponível em relação a características do SARSCoV-2 nomeadamente o seu comportamento patogénico, potencial de transmissibilidade e outros fatores determinantes não estar completo, é útil considerar, para efeitos de implementação de medidas, uma analogia entre a atual epidemia por SARS-CoV-2 e a gripe pandémica. Apesar de desafiantes, estas características tornam ainda mais premente o planeamento estruturado para diferentes cenários nesta emergência de saúde pública.
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Em 22 de janeiro de 2020, foi ativado o Centro de Operações de Emergências em Saúde Pública para o novo Coronavírus (COE – nCoV), estratégia prevista no Plano Nacional de Resposta às Emergências em Saúde Pública do Ministério da Saúde.
O novo Coronavírus (2019-nCoV) é um vírus ide
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ntificado como a causa de um surto de doença respiratória detectado pela primeira vez em Wuhan, China.
Desde 2005, o Sistema Único de Saúde (SUS) está aprimorando suas capacidades de responder às emergências por síndromes respiratórias, dispondo de planos, protocolos, procedimentos e guias para identificação, monitoramento e resposta às emergências em saúde pública.
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Le NCPI a été rempli au cours du 1er trimestre 2014 par une équipe technique de 17 personnes responsabilisées en sous-groupes pour les parties A, B et UA. Les réponses aux différentes questions se sont référées à celles de NCPI de 2012 pour permettre une meilleure logique. La responsabilit
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é générale pour collecter et soumettre les informations requises dans le NCPI partie
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Este documento ha sido revisado y aprobado por la Ponencia de Alertas y Planes de Preparación y Respuesta. Este protocolo está en revisión permanente en función de la evolución y nueva información que se disponga de la infección por el nuevo coronavirus (SARS-CoV-2 ) .
ObjetivoEl objetivodel documento es servir de guía de actuación para el manejo casos de COVID-19 en atención primaria.3.Recomendaciones generalesSe recomienda la colocación de información visual (carteles, folletos, etc.) en lugares estratégicosde los centros de atenció
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n primaria (de ahora en adelante CAP)para proporcionar a la poblaciónlas instrucciones sobre higiene de manosehigiene respiratoria.Se ofrecerá una mascarilla quirúrgica a aquellos pacientes que acudan al centro sanitario con síntomas de infección respiratoria aguda.Se debedisponer de dispensadores con solución hidroalcohólica al alcance de la poblacióny el personal. Se deberá disponer de contenedores de residuos, con tapa de apertura con pedal, para la eliminación de los residuos generados.
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El 31 de diciembrede 2019 las Autoridades de la República Popular China, comunicaron a la OMS varios casos de neumonía de etiología desconocida en Wuhan, una ciudad situada en la provincia china de Hubei. Una semana más tarde confirmaron que se trataba de un nuevo co
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ronavirus que ha sido denominado SARS-CoV-2. Al igual que otros de la familia de los coronavirus, este virus causa diversas manifestaciones clínicas englobadas bajoel término COVID-19, que incluyen cuadros respiratorios que varían desde el resfriado común hastacuadros de neumonía grave con síndrome de distrés respiratorio, shock séptico y fallo multi-orgánico. La mayoría de los casos de COVID-19 notificados hasta el momento debutan con cuadros leves.Un punto de detección importante de casos de COVID-19es la urgencia hospitalaria. El triaje tiene como objetivo identificar y priorizar al paciente más grave. Al tratarse deuna enfermedad transmisiblese debenextremar las medidas deprecaución.
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La Agencia Española de Medicamentos y Producto Sanitarios (AEMPS) está monitorizando de manera continua con los expertos de las agencias europeas, la EMA y el resto de agencias mundiales todos los datos relativos al uso de medicamentos para tratar la COVID-19. Se trata de
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un escenario que puede ir cambiando por la enorme cantidad de datos, comunicaciones y publicaciones que se están generando a nivel mundial. El presente documento técnico tiene la finalidad de guiar el manejoclínicode los pacientes conCOVID-19 con un doble objetivo: lograr el mejor tratamiento del paciente que contribuya a su buena evolución clínica; y garantizar los niveles adecuados de prevención y control de la infección para la protección de los trabajadores sanitarios y de la población en su conjunto.
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