scholarly journals Staphylococcus aureus bloodstream infections: diverging trends of meticillin-resistant and meticillin-susceptible isolates, EU/EEA, 2005 to 2018

2021 ◽  
Vol 26 (46) ◽  
Author(s):  
Carlo Gagliotti ◽  
Liselotte Diaz Högberg ◽  
Hanna Billström ◽  
Tim Eckmanns ◽  
Christian G Giske ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Blood Culture ◽  
Bloodstream Infections ◽  
Annual Data ◽  
European Economic Area ◽  
The European Union ◽  
Surveillance Network ◽  
Entire Study ◽  
The Eu

Background Invasive infections caused by Staphylococcus aureus have high clinical and epidemiological relevance. It is therefore important to monitor the S. aureus trends using suitable methods. Aim The study aimed to describe the trends of bloodstream infections (BSI) caused by meticillin-resistant S. aureus (MRSA) and meticillin-susceptible S. aureus (MSSA) in the European Union (EU) and the European Economic Area (EEA). Methods Annual data on S. aureus BSI from 2005 to 2018 were obtained from the European Antimicrobial Resistance Surveillance Network (EARS-Net). Trends of BSI were assessed at the EU/EEA level by adjusting for blood culture set rate (number of blood culture sets per 1,000 days of hospitalisation) and stratification by patient characteristics. Results Considering a fixed cohort of laboratories consistently reporting data over the entire study period, MRSA percentages among S. aureus BSI decreased from 30.2% in 2005 to 16.3% in 2018. Concurrently, the total number of BSI caused by S. aureus increased by 57%, MSSA BSI increased by 84% and MRSA BSI decreased by 31%. All these trends were statistically significant (p < 0.001). Conclusions The results indicate an increasing health burden of MSSA BSI in the EU/EEA despite a significant decrease in the MRSA percentage. These findings highlight the importance of monitoring antimicrobial resistance trends by assessing not only resistance percentages but also the incidence of infections. Further research is needed on the factors associated with the observed trends and on their attributable risk.

scholarly journals Decreasing and stabilising trends of antimicrobial consumption and resistance in Escherichia coli and Klebsiella pneumoniae in segmented regression analysis, European Union/European Economic Area, 2001 to 2018

2019 ◽  
Vol 24 (46) ◽  
Author(s):  
Germán Peñalva ◽  
Liselotte Diaz Högberg ◽  
Klaus Weist ◽  
Vera Vlahović-Palčevski ◽  
Ole Heuer ◽  
...  
Keyword(s):  
European Union ◽  
Antimicrobial Resistance ◽  
European Economic Area ◽  
Segmented Regression ◽  
The European Union ◽  
Antimicrobial Consumption ◽  
Surveillance Network ◽  
The Public ◽  
Early Indication ◽  
Health Agenda

Investments to reduce the spread of antimicrobial resistance (AMR) in the European Union have been made, including efforts to strengthen prudent antimicrobial use. Using segmented regression, we report decreasing and stabilising trends in data reported to the European Surveillance of Antimicrobial Consumption Network and stabilising trends in data reported to the European Antimicrobial Resistance Surveillance Network. Our results could be an early indication of the effect of prioritising AMR on the public health agenda.

scholarly journals Evaluating the Trends of Bloodstream Infections among Pediatric and Adult Patients at a Teaching Hospital of Kathmandu, Nepal: Role of Drug Resistant Pathogens

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Narayan Prasad Parajuli ◽  
Hridaya Parajuli ◽  
Roshan Pandit ◽  
Jyotsna Shakya ◽  
Puspa Raj Khanal
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Blood Culture ◽  
Teaching Hospital ◽  
Pediatric Patients ◽  
Bloodstream Infections ◽  
Adult Patients ◽  
Beta Lactamase ◽  
Drug Resistant

Bloodstream infections (BSIs) are among the significant causes of morbidity and mortality for patients of all age groups. However, very little is known about the trends of bacterial bloodstream infections and antimicrobial susceptibilities among pediatric and adult population from Nepal. In this study, we have investigated the different etiological agents responsible for bloodstream infections among pediatric and adult patients and the role of drug resistant organisms in these infections at a tertiary care teaching hospital of Kathmandu, Nepal. A total of 3,088 blood culture specimens obtained from pediatric and adult patients suspected to have bloodstream infections were processed by standard microbiological methods. Significant bacterial pathogens were identified by morphological, biochemical, and serological methods as suggested by American Society for Microbiology. In vitro antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion method and interpreted according to the guidelines of Clinical and Laboratory Standards Institute. Overall, incidence of bloodstream infections among the suspected patients was 7.48%. Pediatric patients (n=90, 9.37%) were the significant subgroup of patients affected with bloodstream infections compared to adults (p<0.05, CI-95%). Gram positive (n=49, 54.4%) bacteria in pediatric and gram negative bacteria (n=141, 78.7%) in adult patients were the most common isolates for BSI.Staphylococcus aureus(n=41, 45.6%) in pediatric patients andSalmonella enterica(n=40, 28.3%) in adult patients were the leading pathogens. Trends of antimicrobial resistance among isolated bacterial strains were significantly high in adults compared to pediatric patients. Methicillin resistantStaphylococcus aureus(MRSA) (31.4%), extended spectrum beta-lactamase (ESBL) (12.5%), and metallo-beta-lactamase (MBL) (3.9%) producing gram negatives were major resistant strains. Our study shows higher rates of bloodstream infections in pediatric patients compared to adult patients. Alarming rates of antimicrobial resistance among blood culture isolates is a serious issue. Prompt and accurate diagnosis and rational antimicrobial therapy are extremely needed.

The EU Influence on Norwegian Domestic Legislation for the Protection of the Arctic Marine Environment

2018 ◽  
Vol 33 (2) ◽  
pp. 415-435 ◽  
Author(s):  
Elise Johansen
Keyword(s):  
European Union ◽  
Marine Environment ◽  
The Arctic ◽  
European Economic Area ◽  
The European Union ◽  
Environmental Legislation ◽  
Economic Area ◽  
Domestic Legislation ◽  
Marine Areas ◽  
The Eu

Abstract In the last several decades, the European Union (EU) has demonstrated its intention to play an important role in supporting Arctic cooperation and helping to meet the challenges now facing the region. Norway, one of the five Arctic coastal states, and the EU have cooperated closely in this regard, particularly through the Agreement on the European Economic Area (EEA Agreement). This article examines how Norway’s domestic legislation applicable to its Arctic marine areas has been influenced by the development of EU environmental legislation. Specifically, this paper provides a discussion and analysis of the relevant Norwegian laws and mechanisms used to regulate how EU environmental legislation has been incorporated into Norway’s domestic legislation through the EEA Agreement.

scholarly journals The Effectiveness and Cost-Effectiveness of Hepatitis C Screening for Migrants in the EU/EEA: A Systematic Review

2018 ◽  
Vol 15 (9) ◽  
pp. 2013 ◽  
Author(s):  
Christina Greenaway ◽  
Iuliia Makarenko ◽  
Claire Abou Chakra ◽  
Balqis Alabdulkarim ◽  
Robin Christensen ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hepatitis C ◽  
Lower Risk ◽  
Linkage To Care ◽  
Cost Effective ◽  
Screening Tests ◽  
European Economic Area ◽  
The European Union ◽  
Wide Range ◽  
The Eu

Chronic hepatitis C (HCV) is a public health priority in the European Union/European Economic Area (EU/EEA) and is a leading cause of chronic liver disease and liver cancer. Migrants account for a disproportionate number of HCV cases in the EU/EEA (mean 14% of cases and >50% of cases in some countries). We conducted two systematic reviews (SR) to estimate the effectiveness and cost-effectiveness of HCV screening for migrants living in the EU/EEA. We found that screening tests for HCV are highly sensitive and specific. Clinical trials report direct acting antiviral (DAA) therapies are well-tolerated in a wide range of populations and cure almost all cases (>95%) and lead to an 85% lower risk of developing hepatocellular carcinoma and an 80% lower risk of all-cause mortality. At 2015 costs, DAA based regimens were only moderately cost-effective and as a result less than 30% of people with HCV had been screened and less 5% of all HCV cases had been treated in the EU/EEA in 2015. Migrants face additional barriers in linkage to care and treatment due to several patient, practitioner, and health system barriers. Although decreasing HCV costs have made treatment more accessible in the EU/EEA, HCV elimination will only be possible in the region if health systems include and treat migrants for HCV.

scholarly journals 1439. High Rates of Drug Resistance in Escherichia coli from a Pilot Antimicrobial Resistance Surveillance System in Cambodia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S723-S724
Author(s):  
Vandarith Nov ◽  
Darapheak Chau ◽  
Chhorvann Chhea
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Blood Culture ◽  
Klebsiella Pneumoniae ◽  
Surveillance System ◽  
Methicillin Resistance ◽  
Salmonella Typhi ◽  
Blood Samples

Abstract Background Antimicrobial resistance (AMR) is a major and growing global public health problem. The Cambodia Ministry of Health established a pilot laboratory-based AMR surveillance system for blood specimens in 2017. The objective of this study is to characterize AMR among pathogenic isolates from blood samples. Methods A retrospective analysis was performed using one year of data from a pilot AMR Surveillance system in Cambodia. Four blood culture isolate pathogens were included: Escherichia coli, Klebsiella pneumoniae, Salmonella Typhi /Salmonella Paratyphi A and Staphylococcus aureus. Blood culture isolates that were referred from eleven sentinel sites were analyzed at the National Public Health Laboratory for identification. Antibiotic susceptibility testing (AST) was done using disk diffusion, minimum inhibitory concentration method following Clinical Laboratory Standard Institute (CLSI) guidelines. Results Among 214 pathogenic isolates from blood samples, E.coli was the most common (56.1%), followed by Salmonella Typhi/Salmonella Paratyphi A (18.7%), Staphylococcus aureus (13.5%), and Klebsiella pneumoniae (11.7%). Methicillin Resistance Staphylococcus aureus (MRSA) was detected in half of the isolates. E.coli was resistant to ampicillin (94.4%), trimethoprim-sulfamethoxazole (84.5%), and ceftriaxone (79.2%). Salmonella Typhi was resistant to ampicillin (73.3%) and trimethoprim-sulfamethoxazole (60.0%) and Salmonella Paratyphi A were resistant to fluoroquinolones (91.7%). For last resort antibiotics, E.coli was resistant to carbapenem groups (3.2% for imipenem, 4.9% for meropenem, and 5.0% for ertapenem). Klebsiella pneumoniae was not resistant to any groups. Conclusion E.coli was found at high rates in blood samples and was resistant to common antibiotics used in Cambodia. These pilot data show the importance of establishing a national AMR surveillance system in Cambodia to monitor AMR trends following GLASS guidelines. Disclosures All Authors: No reported disclosures

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 Trends and Variation in Data Quality on the EU Clinical Trials Register: A Cross-Sectional Study

2021 ◽  
Author(s):  
Nicholas J DeVito ◽  
Ben Goldacre
Keyword(s):  
Data Quality ◽  
Cross Sectional Study ◽  
European Economic Area ◽  
The European Union ◽  
Cross Sectional ◽  
Reporting Requirements ◽  
Regulatory Purpose ◽  
Public Dataset ◽  
Clinical Trial Register ◽  
The Eu

The EU Clinical Trial Register (EUCTR) is a public facing portal containing information on trials of medicinal products conducted in the European Union (EU) and European Economic Area (EEA). Today, the registry holds information on over 30,000 trials. Given its distinct regulatory purpose, and results reporting requirements, the EUCTR should be a valuable open-source hub for trial information. Past work examining the EUCTR has suggested that data quality on the registry may be lacking. Using the full EUCTR public dataset, we examined areas in which national regulators are expected to ensure data quality including the posting of registrations, updating trial completion information, and monitoring results posting in line with EU guidelines. We identified issues across all areas examined with notable research hubs like France, Spain, and The Netherlands lacking consistent and complete data on the registry. These deficiencies complicate the utility of the EUCTR for research, transparency, and accountability efforts.

scholarly journals The European Union as a Manager of Global 'Business and Human Rights' Regulation: Country-by-Country Reporting Rules

2019 ◽  
Author(s):  
Aleydis Nissen
Keyword(s):  
Human Rights ◽  
Financial Reporting ◽  
Raw Materials ◽  
Tax Avoidance ◽  
Legislative Process ◽  
European Economic Area ◽  
The European Union ◽  
Global Business ◽  
Business And Human Rights ◽  
The Eu

The European Union’s 2013 Country-by-Country Reporting (CBCR) rules bring within the public domain information on corporate payments made to governments all over the world for the purpose of exploiting natural resources in the oil, gas, mining and logging sectors. In so doing, the CBCR rules enhance transparency in these sectors and aim to reduce tax avoidance and corruption in resource-rich countries. Arguably, they also contribute to the European Commission’s long-term strategy to secure sustained access to raw materials in the European Economic Area. The CBCR rules represent one of the only three binding regulatory frameworks that have been adopted at the EU level to implement the 2011 UN Guiding Principles on Business and Human Rights. Just as with the two other initiatives that came into existence (the Non-Financial Reporting Directive and the Conflict Minerals Regulation), the immediate impact on the competitiveness of corporations based in the EU was a key concern during the legislative process. This article uncovers the two strategies that were employed to overcome such concern and give the CBCR rules a ‘global’ character.

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