Toxigenic and zoonotic Corynebacterium ulcerans emerges from widespread hedgehog disease

AbstractToxin-producing Corynebacterium ulcerans, causing diphtheria in humans, were isolated from 53 diseased hedgehogs during spring 2020 in Belgium. Isolates showed low levels of acquired antimicrobial resistance. Pronounced strain diversity suggests emergence from an endemic situation. These findings stress the need for raising public awareness and improved wildlife disease surveillance.

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Practice of dispensing antimicrobial medicines from community pharmacies

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.546 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Amirkhanyan ◽

L Vardanyan ◽

A Sevikyan ◽

I Kazaryan ◽

M Melikyan

Keyword(s):

Antimicrobial Resistance ◽

Public Awareness ◽

Family Members ◽

Professional Knowledge ◽

Community Pharmacies ◽

Rational Use ◽

Rational Use Of Medicines ◽

Inappropriate Use ◽

Otc Medicines

Abstract Background Inappropriate use of antimicrobial medicines is one of the main causes of antimicrobial resistance (AMR). The objective of this work was to study the situation on dispensing antimicrobials from pharmacy outlets in Armenia. Methods The study was implemented in 30 community pharmacies from different regions of Yerevan. Medicines dispensed to 900 patients/caregivers (30 visitors in each pharmacy outlet) were analyzed. The following indicators were calculated: the percentage of antimicrobials prescribed by physicians, the percentage of visitors, who got antimicrobials without providing a prescription and so on. Results Antimicribials (n = 171) consisted 11.3% of all the dispensed medicines (N = 1513). Only 25 (14.6%) antimicrobials were dispensed to visitors who had prescriptions. Only 19 (12.6%) of 151 medicines provided without prescription were OTC-medicines, other 132 (87.4%) were prescription only medicines. According to information received from visitors, 58.5% of all dispensed antimicrobials were selected by physicians, 10.5% of antimicrobials were advised by pharmacists and almost one third was selected by patients, family members, etc. More than 90% of the total number of visitors, whom antimicrobials were dispensed, got them without providing a prescription. 13 patients received 2 and more antimicrobials. Conclusions Many prescription only antimicrobials are dispensed from community pharmacies without prescription and some medicines are not prescribed by physicians. That means many antimicrobials are used inappropriately. There is need in strategy that could prevent dispensing antimicrobials without prescription. Key messages Dispensing prescription only antimicrobials without prescription can compromise rational use of medicines. Professional knowledge and public awareness about AMR should be improved.

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Changes in the Framing of Antimicrobial Resistance in Print Media in Australia and the United Kingdom (2011–2020): A Comparative Qualitative Content and Trends Analysis

Antibiotics ◽

10.3390/antibiotics10121432 ◽

2021 ◽

Vol 10 (12) ◽

pp. 1432

Author(s):

Chris Degeling ◽

Victoria Brookes ◽

Tarant Hill ◽

Julie Hall ◽

Anastacia Rowles ◽

...

Keyword(s):

United Kingdom ◽

Antimicrobial Resistance ◽

Scientific Discovery ◽

Public Awareness ◽

Media Framing ◽

Public Health Response ◽

Large Hospital ◽

The United Kingdom ◽

Health Response ◽

Community Outbreaks

Educating the public about antimicrobial resistance (AMR) is considered a key part of an optimal public health response. In both media depictions and policy discourses around health risks, how a problem is framed underpins public awareness and understanding, while also guiding opinions on what actions can and should be taken. Using a mixed methods approach we analyse newspaper content in Australia and the United Kingdom (UK) from 2011 to 2020 to track how causes, consequences and solutions to AMR are represented in countries with different policy approaches. Analyses demonstrate greater variability in the frames used in UK newspapers reflecting large hospital and community outbreaks and a sustained period of policy reform mid-decade. Newspapers in Australia focus more on AMR causes and consequences, highlighting the importance of scientific discovery, whereas UK coverage has greater discussion of the social and economic drivers of AMR and their associated solutions. Variations in the trends of different frames around AMR in UK newspapers indicate greater levels of public deliberation and debate around immediate and actionable solutions; whereas AMR has not had the same health and political impacts in Australia resulting in a media framing that potentially encourages greater public complacency about the issue.

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Wildlife Disease Surveillance

Basics of Wildlife Health Care and Management ◽

10.1201/9781003202691-29 ◽

2021 ◽

pp. 253-261

Author(s):

Rajesh Jani

Keyword(s):

Disease Surveillance ◽

Wildlife Disease

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An agent-based framework for improving wildlife disease surveillance: A case study of chronic wasting disease in Missouri white-tailed deer

Ecological Modelling ◽

10.1016/j.ecolmodel.2019.108919 ◽

2020 ◽

Vol 417 ◽

pp. 108919 ◽

Cited By ~ 5

Author(s):

Aniruddha V. Belsare ◽

Matthew E. Gompper ◽

Barbara Keller ◽

Jason Sumners ◽

Lonnie Hansen ◽

...

Keyword(s):

Disease Surveillance ◽

Chronic Wasting Disease ◽

Wildlife Disease ◽

Wasting Disease ◽

Agent Based

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Victor Robert Simpson

Veterinary Record ◽

10.1136/vr.k5074 ◽

2018 ◽

Vol 183 (21) ◽

pp. 664-664

Author(s):

Becki Lawson ◽

Fieke Molenaar ◽

Paul Duff

Keyword(s):

Great Britain ◽

Disease Surveillance ◽

Wildlife Disease ◽

Evidence Based ◽

The Impact

A founder of wildlife disease surveillance in Great Britain and passionate advocate for evidence-based conservation: the impact of his work studying the diseases of wildlife was immense.

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Combating Antimicrobial Resistance in Singapore: A Qualitative Study Exploring the Policy Context, Challenges, Facilitators, and Proposed Strategies

Antibiotics ◽

10.3390/antibiotics8040201 ◽

2019 ◽

Vol 8 (4) ◽

pp. 201 ◽

Cited By ~ 1

Author(s):

Shweta Rajkumar Singh ◽

Alvin Qijia Chua ◽

Sok Teng Tan ◽

Clarence C. Tam ◽

Li Yang Hsu ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Resource Constraints ◽

Public Awareness ◽

Public Hospitals ◽

Global Public Health ◽

Structured Interviews ◽

Control Programs ◽

Policy Context ◽

National Environment ◽

Interpretative Approach

Antimicrobial resistance (AMR) is a global public health threat that warrants urgent attention. However, the multifaceted nature of AMR often complicates the development and implementation of comprehensive policies. In this study, we describe the policy context and explore experts’ perspectives on the challenges, facilitators, and strategies for combating AMR in Singapore. We conducted semi-structured interviews with 21 participants. Interviews were transcribed verbatim and were analyzed thematically, adopting an interpretative approach. Participants reported that the Ministry of Health (MOH) has effectively funded AMR control programs and research in all public hospitals. In addition, a preexisting One Health platform, among MOH, Agri-Food & Veterinary Authority (restructured to form the Singapore Food Agency and the Animal & Veterinary Service under NParks in April 2019), National Environment Agency, and Singapore’s National Water Agency, was perceived to have facilitated the coordination and formulation of Singapore’s AMR strategies. Nonetheless, participants highlighted that the success of AMR strategies is compounded by various challenges such as surveillance in private clinics, resource constraints at community-level health facilities, sub-optimal public awareness, patchy regulation on antimicrobial use in animals, and environmental contamination. This study shows that the process of planning and executing AMR policies is complicated even in a well-resourced country such as Singapore. It has also highlighted the increasing need to address the social, political, cultural, and behavioral aspects influencing AMR. Ultimately, it will be difficult to design policy interventions that cater for the needs of individuals, families, and the community, unless we understand how all these aspects interact and shape the AMR response.

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O3A.1 Assessing the under-estimation of occupational respiratory diseases in taiwan: analyses of disease burdens and healthcare costs

Occupational and Environmental Medicine ◽

10.1136/oem-2019-epi.58 ◽

2019 ◽

Vol 76 (Suppl 1) ◽

pp. A22.1-A22

Author(s):

Chung-Yen Chen ◽

Yawen Cheng

Keyword(s):

Disease Surveillance ◽

Healthcare Costs ◽

Respiratory Diseases ◽

Occupational Injuries ◽

Public Awareness ◽

Population Attributable Risk ◽

Occupational Exposures ◽

Chronic Obstructive ◽

Occupational Factors ◽

Long Latency

BackgroundRespiratory diseases, including pneumoconiosis, asthma, chronic obstructive pulmonary disease (COPD) and respiratory malignancies, are featured by their multi-etiological nature and long latency periods, adding to the difficulties in recognizing their work-relatedness. Due to their heavy overall disease burdens and high healthcare spending, examining the fraction of respiratory diseases attributable to occupational factors is helpful in understanding the magnitude of under-estimation of occupational injuries and diseases.MethodsPrevalence rates of various occupational exposures were assessed retrospectively with self-reported surveys or job-exposure matrices. Relative risks of theses exposures were drawn from international epidemiological literatures. The above two parameters were used to calculate population attributable risk percentages (PAR%), and with that the numbers of visiting and amounts of payment attributable to occupational factors were estimated based on the claim data of the National Health Insurance (NHI). The estimates were compared with the data of actual payment by the Workers’ Compensation Insurance (WCI).ResultsWe estimated that around 15 000 patients visited medical facilities for occupational respiratory diseases in 2015, costing a total of 10 million USD. In contrast, less than 200 cases were approved by WCI in the same year. A 100-fold gap between the estimated and actual payment was also noted. Estimation analyses further indicated that 9.6% of cases and 48.1% of healthcare costs were asbestos-related.ConclusionFor occupational respiratory diseases with long latency periods and great causal complexity, the scope of under-estimation was substantial, and their medical expenses had been largely paid by NHI rather than WCI. To increase the visibility of occupational respiratory diseases, workplace exposure assessment and disease surveillance should be improved and public awareness of occupational diseases should be raised.

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20 years of national wildlife disease surveillance

Veterinary Record ◽

10.1136/vr.l1903 ◽

2019 ◽

Vol 184 (17) ◽

pp. 520-521 ◽

Cited By ~ 2

Author(s):

J Paul Holmes ◽

J Paul Duff ◽

Alex Barlow ◽

Dave Everest ◽

Cat Man ◽

...

Keyword(s):

Disease Surveillance ◽

Wildlife Disease

The need for wildlife surveillance is as great now as it ever has been. Here, members of the APHA’s Diseases of Wildlife Scheme explain why their work is important.

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Cost-effectiveness of selective digestive decontamination (SDD) versus selective oropharyngeal decontamination (SOD) in intensive care units with low levels of antimicrobial resistance: an individual patient data meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-028876 ◽

2019 ◽

Vol 9 (9) ◽

pp. e028876 ◽

Cited By ~ 3

Author(s):

Denise van Hout ◽

Nienke L Plantinga ◽

Patricia C Bruijning-Verhagen ◽

Evelien A N Oostdijk ◽

Anne Marie G A de Smet ◽

...

Keyword(s):

Intensive Care ◽

Cost Effectiveness ◽

Antimicrobial Resistance ◽

Hospital Mortality ◽

Willingness To Pay ◽

Individual Patient Data ◽

Meta Analysis ◽

Hospital Death ◽

Selective Oropharyngeal Decontamination ◽

Low Levels

ObjectiveTo determine the cost-effectiveness of selective digestive decontamination (SDD) as compared to selective oropharyngeal decontamination (SOD) in intensive care units (ICUs) with low levels of antimicrobial resistance.DesignPost-hoc analysis of a previously performed individual patient data meta-analysis of two cluster-randomised cross-over trials.Setting24 ICUs in the Netherlands.Participants12 952 ICU patients who were treated with ≥1 dose of SDD (n=6720) or SOD (n=6232).InterventionsSDD versus SOD.Primary and secondary outcome measuresThe incremental cost-effectiveness ratio (ICER; ie, costs to prevent one in-hospital death) was calculated by comparing differences in direct healthcare costs and in-hospital mortality of patients treated with SDD versus SOD. A willingness-to-pay curve was plotted to reflect the probability of cost-effectiveness of SDD for a range of different values of maximum costs per prevented in-hospital death.ResultsThe ICER resulting from the fixed-effect meta-analysis, adjusted for clustering and differences in baseline characteristics, showed that SDD significantly reduced in-hospital mortality (adjusted absolute risk reduction 0.0195, 95% CI 0.0050 to 0.0338) with no difference in costs (adjusted cost difference €62 in favour of SDD, 95% CI –€1079 to €935). Thus, SDD yielded significantly lower in-hospital mortality and comparable costs as compared with SOD. At a willingness-to-pay value of €33 633 per one prevented in-hospital death, SDD had a probability of 90.0% to be cost-effective as compared with SOD.ConclusionIn Dutch ICUs, SDD has a very high probability of cost-effectiveness as compared to SOD. These data support the implementation of SDD in settings with low levels of antimicrobial resistance.

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