Infektionen durch multiresistente Gram-negative Erreger

2018 ◽  
Vol 47 (06) ◽  
pp. 252-258
Author(s):  
Alexander Mischnik
Keyword(s):  
Antimicrobial Resistance ◽  
Surveillance Network ◽  
Gram Negative ◽  
Antimicrobial Resistance Surveillance ◽  
Resistente Erreger

ZusammenfassungDie Ausbreitung von resistenten Gram-negativen Erregern weltweit ist besorgniserregend. Von besonderem Interesse ist die Verbreitung von Resistenzen gegen Beta-Laktam-Antibiotika, die in vielen Fällen Mittel der Wahl zur Therapie sind. Im European Antimicrobial Resistance Surveillance Network (EARS-Net) wird die Resistenzentwicklung bei schweren Infektionskrankheiten in Europa regelmäßig überwacht. In Deutschland können Isolate zur Abklärung und/oder Bestätigung von Carbapenemasen an das Nationale Referenzzentrum (NRZ) für Gram-negative Krankenhauserreger an der Uniklinik Bochum eingeschickt werden.Im ersten Teil der Arbeit werden die aktuell publizierten Daten für Europa ausgewertet und dargestellt sowie mit den aktuell verfügbaren Daten aus Deutschland verglichen. Im zweiten Teil werden Therapieoptionen von Infektionen durch resistente Erreger dargestellt.

scholarly journals Building the European Antimicrobial Resistance Surveillance network in veterinary medicine (EARS-Vet)

2021 ◽  
Vol 26 (4) ◽  
Author(s):  
Rodolphe Mader ◽  
Peter Damborg ◽  
Jean-Philippe Amat ◽  
Björn Bengtsson ◽  
Clémence Bourély ◽  
...  
Keyword(s):  
Veterinary Medicine ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
One Health ◽  
Action Plan ◽  
Animal Health ◽  
World Health ◽  
European Economic Area ◽  
Surveillance Network ◽  
Antimicrobial Resistance Surveillance

Antimicrobial resistance (AMR) should be tackled through a One Health approach, as stated in the World Health Organization Global Action Plan on AMR. We describe the landscape of AMR surveillance in the European Union/European Economic Area (EU/EEA) and underline a gap regarding veterinary medicine. Current AMR surveillance efforts are of limited help to veterinary practitioners and policymakers seeking to improve antimicrobial stewardship in animal health. We propose to establish the European Antimicrobial Resistance Surveillance network in Veterinary medicine (EARS-Vet) to report on the AMR situation, follow AMR trends and detect emerging AMR in selected bacterial pathogens of animals. This information could be useful to advise policymakers, explore efficacy of interventions, support antimicrobial stewardship initiatives, (re-)evaluate marketing authorisations of antimicrobials, generate epidemiological cut-off values, assess risk of zoonotic AMR transmission and evaluate the burden of AMR in animal health. EARS-Vet could be integrated with other AMR monitoring systems in the animal and medical sectors to ensure a One Health approach. Herein, we present a strategy to establish EARS-Vet as a network of national surveillance systems and highlight challenges of data harmonisation and bias. Strong political commitment at national and EU/EEA levels is required for the success of EARS-Vet.

scholarly journals ACORN (A Clinically-Oriented Antimicrobial Resistance Surveillance Network): a pilot protocol for case based antimicrobial resistance surveillance

2020 ◽  
Vol 5 ◽  
pp. 13
Author(s):  
Paul Turner ◽  
Elizabeth A. Ashley ◽  
Olivier J. Celhay ◽  
Anousone Douangnouvong ◽  
Raph L. Hamers ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Treatment Guidelines ◽  
Clinical Care ◽  
Local Treatment ◽  
Laboratory Data ◽  
Added Value ◽  
Pilot Phase ◽  
Surveillance Network ◽  
Antimicrobial Resistance Surveillance ◽  
The Impact

Background: Antimicrobial resistance (AMR) / drug resistant infections (DRIs) are a major global health priority. Surveillance data is critical to inform infection treatment guidelines, monitor trends, and to assess interventions. However, most existing AMR / DRI surveillance systems are passive and pathogen-based with many potential biases. Addition of clinical and patient outcome data would provide considerable added value to pathogen-based surveillance. Methods: The aim of the ACORN project is to develop an efficient clinically-oriented AMR surveillance system, implemented alongside routine clinical care in hospitals in low- and middle-income country settings. In an initial pilot phase, clinical and microbiology data will be collected from patients presenting with clinically suspected meningitis, pneumonia, or sepsis. Community-acquired infections will be identified by daily review of new admissions, and hospital-acquired infections will be enrolled during weekly point prevalence surveys, on surveillance wards. Clinical variables will be collected at enrolment, hospital discharge, and at day 28 post-enrolment using an electronic questionnaire on a mobile device. These data will be merged with laboratory data onsite using a flexible automated computer script. Specific target pathogens will be Streptococcus pneumoniae, Staphylococcus aureus, Salmonella spp., Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii. A bespoke browser-based app will provide sites with fully interactive data visualisation, analysis, and reporting tools. Discussion: ACORN will generate data on the burden of DRI which can be used to inform local treatment guidelines / national policy and serve as indicators to measure the impact of interventions. Following development, testing and iteration of the surveillance tools during an initial six-month pilot phase, a wider rollout is planned.

scholarly journals ACORN (A Clinically-Oriented Antimicrobial Resistance Surveillance Network): a pilot protocol for case based antimicrobial resistance surveillance

2020 ◽  
Vol 5 ◽  
pp. 13 ◽  
Author(s):  
Paul Turner ◽  
Elizabeth A. Ashley ◽  
Olivier J. Celhay ◽  
Anousone Douangnouvong ◽  
Raph L. Hamers ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Treatment Guidelines ◽  
Clinical Care ◽  
Local Treatment ◽  
Laboratory Data ◽  
Added Value ◽  
Pilot Phase ◽  
Surveillance Network ◽  
Antimicrobial Resistance Surveillance ◽  
The Impact

Background: Antimicrobial resistance (AMR) / drug resistant infections (DRIs) are a major global health priority. Surveillance data is critical to inform infection treatment guidelines, monitor trends, and to assess interventions. However, most existing AMR / DRI surveillance systems are passive and pathogen-based with many potential biases. Addition of clinical and patient outcome data would provide considerable added value to pathogen-based surveillance. Methods: The aim of the ACORN project is to develop an efficient clinically-oriented AMR surveillance system, implemented alongside routine clinical care in hospitals in low- and middle-income country settings. In an initial pilot phase, clinical and microbiology data will be collected from patients presenting with clinically suspected meningitis, pneumonia, or sepsis. Community-acquired infections will be identified by daily review of new admissions, and hospital-acquired infections will be enrolled during weekly point prevalence surveys, on surveillance wards. Clinical variables will be collected at enrolment, hospital discharge, and at day 28 post-enrolment using an electronic questionnaire on a mobile device. These data will be merged with laboratory data onsite using a flexible automated computer script. Specific target pathogens will be Streptococcus pneumoniae, Staphylococcus aureus, Salmonella spp., Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii. A bespoke browser-based app will provide sites with fully interactive data visualisation, analysis, and reporting tools. Discussion: ACORN will generate data on the burden of DRI which can be used to inform local treatment guidelines / national policy and serve as indicators to measure the impact of interventions. Following development, testing and iteration of the surveillance tools during an initial six-month pilot phase, a wider rollout is planned.

scholarly journals Long-Term Continuous Antimicrobial Resistance Surveillance Among Nosocomial Gram-Negative Bacilli in China from 2010 to 2018 (CMSS)

2020 ◽  
Vol Volume 13 ◽  
pp. 2617-2629
Author(s):  
Qi Wang ◽  
Zhanwei Wang ◽  
Feifei Zhang ◽  
Chunjiang Zhao ◽  
Bin Yang ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Gram Negative ◽  
Antimicrobial Resistance Surveillance

Progress towards a coordinated, national paediatric antimicrobial resistance surveillance programme: Staphylococcus aureus, enterococcal and Gram-negative bacteraemia in Australia

2020 ◽  
Vol 75 (6) ◽  
pp. 1639-1644
Author(s):  
Anita J Campbell ◽  
Denise A Daley ◽  
Jan M Bell ◽  
Stanley Pang ◽  
Geoffrey W Coombs ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Bloodstream Infections ◽  
Negative Resistance ◽  
Data Set ◽  
Surveillance Programme ◽  
Gram Negative ◽  
Antimicrobial Resistance Surveillance ◽  
Nationally Representative ◽  
Molecular Phenotypes

Abstract Background There is increasing knowledge of antimicrobial usage in children yet limited availability of nationally representative paediatric-specific data on antimicrobial resistance. Objectives Paediatric data from this national surveillance programme are presented to explore differences between childhood and adult bloodstream infections and antimicrobial resistance surveillance. Methods Using information collected from a prospective coordinated antimicrobial resistance surveillance programme, children ≤18 years and adults >18 years with a positive blood culture for Staphylococcus aureus, Enterococcus spp. or Gram-negative spp. presenting to one of 34 Australian hospitals during 2013–16 were evaluated. Consistent methodologies for key sepsis pathogens were employed and a comparative analysis between children and adults was conducted. Results There are stark contrasts between children and adults in this national antimicrobial resistance (AMR) data set. Notable differences include lower rates of AMR, different clinical and molecular phenotypes and lower mortality amongst children. The burden of Gram-negative resistance is disproportionately experienced in children, with higher odds of death with an ESBL versus non-ESBL bacteraemia in comparison with adults. Conclusions These data support that children are not just ‘little adults’ in the AMR era, and analyses by age group are important to detect differences in antibiotic susceptibility, clinical phenotype and genetic virulence factors. Antimicrobial surveillance incorporated into routine laboratory practice is vital to inform an array of wider applications including antimicrobial guidelines, stewardship and direction for prioritization of novel antimicrobial development.

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