Antimicrobial Stewardship: efective implementation for improved clinical outcomes
|
|
- Samuel Barber
- 5 years ago
- Views:
Transcription
1 The Challenge of MDR and XDR infections; Barcelona September 2018 Antimicrobial Stewardship: efective implementation for improved clinical outcomes José Miguel Cisneros Herreros Infectious Diseases Department University Hospital Virgen del Rocío, Sevilla, Spain
2 Competing interests Andalusian Health Service Ministry of Health (ISCIII), European Commission Novartis, Astellas, Pfizer, MSD, Janssen y Astra-Zeneca 2
3 Antimicrobial use 1 Laxaminarayan R et al. Science
4 SAMR P. aeruginosa CeftaR E. coli QR Acinetobacter sp CR (access 2 July 2017) 4 4
5 Clinical impact MDR infections Design: - 82 hospitals (26% Spain) - March 12 to 18 - Follow-up 30 days after diagnosis Results: pacients with MDR infections deaths (19,6%) Estimates for Spain in 2018: pacients with MDR infections deaths
6 3 Spain: National plan to fight antimicrobial resistance
7 Antimicrobials consumption in hospitals
8 Profile of prescriptions Colistina +58% Carbapenem + 42% Informe JIACRA España; 5 de junio de 2018
9 Evolution of E. coli and K. pneumoniae Cefalosporins Resistant Informe JIACRA España; 5 de junio de
10 4 The Specialty of Infectious Diseases in the EU Spain, Belgium, Luxembourg and Cyprus are the only countries without EEII 2016 Read RC et al. Lancet Infect Dis
11 The PIRASOA programme Institutional Programme for the Prevention and Control of Healthcare Associated Infections and Appropriate Use of Antimicrobials
12 General objectives 1. To reduce the incidence of HAIs until reaching the level of the European countries with the best outcomes. 2. To optimize the use of antibiotics until reaching the level of the European countries with the best outcomes. 12
13 The setting: Andalucía 8.4 M habitants 13
14 Andalusian Public Healthcare Service >90% population 34 Hospitals 8 University 27 primary care areas physicians 8683 million 14
15 Definition 1. Quality programme 2. Integral Healthcare Acquired Infections Antimicrobial Stewardship Programs 3. Professional lidership 4. Institutional support 15
16 The PIRASOA programme PIRASOA Hospitals Primary Care Nursing home Infection control ASP ASP ASP (2019) 16
17 Structure and organization Scientific committee Hospitals - Local team Primary Care Area - Local team Clinical Management Units (UGCs) - Counselors Clinical Management Units (UGCs) - Counselors Digital platform Reference laboratory 17
18 PIRASOA teams Profesionals n = 638 Local teams in hospitals (HAIs and ASP) n = 34 - Infectious diseases - Pharmaceuticals - Microbiologists - Preventivits - Nurses Local teams in primary care areas (ASP) n = 27 - Primary care doctor - Pediatrician - Pharmaceuticals 18
19 Indicators n = Antimicrobials: use, quality use, cost - Resistance: density in clinical samples - Nosocomial infections: prevalence and incidence - Clínical: mortality of patients with bacteremia 19
20 Interventions: training 1. Symposium (18th november) n = 4 2. Massive Online Open Course (MOOC) n = 6979 participants Basic ASP ASP for severe infections Infection Control Infection Control and ASP (forthcoming) 3. Local guides for antimicrobial therapy 4. Quarterly reports n = Educational interviews n =
21 2. Massive Online Open Course (MOOC) n = 6979 participants 21
22 Educational interviews: methodology Cisneros JM et al. Clin Microbiol Infect 2014;20:82-8 Molina J et al. Clin Infect Dis 2017;65:
23 Educational interview form
24 Institucional support Official program Andalusian Health Service Presentation in the Andalusian Parliament Official councils of Medicine, Pharmacists and Dentists The management agreements Specific budget for reference Laboratory 24
25 PIRASOA s RESULTS January 2014 to Marz
26 DDD/1000 OBD Antibiotic use in hospitals % T2014 2T2014 3T2014 4T2014 1T2015 2T2015 3T2015 4T2015 1T2016 2T2016 3T2016 4T2016 1T2017 2T2017 3T2017 4T2017 1T
27 DDD/1000 OBD Carbapenem use % T2014 2T2014 3T2014 4T2014 1T2015 2T2015 3T2015 4T2015 1T2016 2T2016 3T2016 4T2016 1T2017 2T2017 3T2017 4T2017 1T
28 Antimicrobial expenditure in hospitals T2014 2T2014 3T2014 4T2014 1T2015 2T2015 3T2015 4T2015 1T2016 2T2016 3T2016 4T2016 1T2017 2T2017 3T2017 4T2017 1T
29 Hand hygiene 60 % 62 % 65 % 62 % 63 % 63 % 64 % % 52 % 58 % 55 % 56 % 57 % 55 % 58 % 52 % 50 % 57 % +23% 1T2014 2T2014 3T2014 4T2014 1T2015 2T2015 3T2015 4T2015 1T2016 2T2016 3T2016 4T2016 1T2017 2T2017 3T2017 4T2017 1T
30 Nº isolates/1000 OBD 0,450 Evolution of MDR bacteria 0,400 0,350 0,300 0,250 0,200 0,150 0,100 0,050 0,000 1T2014 2T2014 3T2014 4T2014 1T2015 2T2015 3T2015 4T2015 1T2016 2T2016 3T2016 4T2016 1T2017 2T2017 3T2017 4T2017 1T2018 E. coli BLEE KP BLEE EPCarbepemasas PAMR ABMR SAMR C. difficile 30
31 Nº isolates / 1000 OBD Evolution of enterobacterial CR infections/colonizations 0,14 0,12 0,12 0,12 0,1 0,1 0,08 0,09 0,08 0,09 0,08 0,08 0,09 0,08 0,08 0,08 0,09 0,08 0,06 0,07 0,04 0,02 0 1T2014 2T 3T 4T 1T2015 2T 3T 4T 1T2016 2T 3T 4T 1T2017 2T 3T 31
32 Clinical outcomes in hospitals Variation Q1- Q14 Trend QPC CI95% p value Overall inappropriate treatment rate (%) % (-4.7%,-3.5%) <0.001 Total DDDs/1000 OBD % (-1.3%,-0.5%) <0.001 DDDs/1000 OBD carbapenems % (-1.8%,-0.5%) DDDs/1000 OBD amoxycillin/clavulanic % (-1.8%,-1.3%) <0.001 DDDs/1000 OBD piperacillin/tazobactam % (0%,0.7%) DDDs/1000 OBD quinolones % (-1.9%,-1.2%) <0.001 DDDs/1000 OBD antifungal agents % (-2.1%,-0.8%) <0.001 ID multidrug-resistant pathogens/1000 OBD (1) % (-3.3%,-1.3%) <0.001 Overall crude mortality rate associated with bacteraemias (%) (2) % (-0.8%,1.1%) : Multiresistant both Pseudomonas aeruginosa and Acinetobacter baumanii, methicillin-resistant Staphylococcus aureus, vancomicin-resistant Enterococcus sp, Extended-Spectrum β-lactamase-producing both Escherichia coli and Klebsiella Pneumoniae and carbapenemase-producing Enterobacteriaceae. 2: Bacteraemias caused by Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanii, Staphylococcus aureus and Candida sp. 32
33 DDD/1000 hab. día Antibiotic use in primary care , ,8 16,6 21,1 18,7 15,6 19,5 22,6 18,4 14,4 18,5 21,6 16,5 13,9 18,3-26,8% P <0,
34 DDD/1000 hab. día Annual antibiotics consumption in Primary Care 21 20,5 20,6 20, ,5 4.8 millon DDD 19 18,7 18, ,5 17,5 2.8 millon DDD 17 16, ,
35 DDD/1000 hab. día Antibiotic use in primary care: Andalucia, Spain and Germany 26,0 Andalucía España (excl. AND) Alemania 24,0 24,0 + 23% +2,6 p<0,01 22,0 20,0 21,5 18,0 16,0 19,4 18,5 17,5-19% - 1,7 p<0,01 14,0 14,6 14,1 P =0,7 12,0 10, PIRASOA 35
36 DDD J01 por 1000 people Antibiotic use in primare care, Andalucia: Estimated prediction 23,5 22,0 20,5 19,0 17,5 16,0 14,5 13,0 11,5 10, PIRASOA 36
37 DDD/1000 hab. día Amoxicillin/clavulanic use in primary care , ,7 7,9 9,1 7,4 6,7 7,5 8,2 6,4 5,6 6,3 7 5,5 5 5,6-49% P <0,
38 Ecological impact in primary care: E. coli BLEE +2,9% (p<0,01-10,5% p<0,05) Peñalva G et al. ECCMID
39 Conclusions: 1. It is possible to implement and maintain an ASP in an entire health system. 2. This program is able to optimize the use of antimicrobials agents, reducing total consumption and improving the prescription profile, and probably contributing to reduce the incidence of MDR pathogens, without increasing the crude death rate associated with bloodstream infections. 39
40 Clinical Infectious Diseases 2017;65:
41 Antimicrobial use DDD/1000 OBDs -19,9% Clinical Infectious Diseases 2017;65:
42 Incidence of nosocomial bloodstream infections by MDR bacteria and candidemia Clinical Infectious Diseases 2017;65:
43 Incidence of nosocomial bloodstream infections by no-mdr bacteria and candidemia Clinical Infectious Diseases 2017;65:
44 Mortality of nosocomial bloodstream infections by MDR bacteria and candidemia Clinical Infectious Diseases 2017;65:
45 Conclusions: The results of this study show that the decrease and better use of antibiotics achieved by our ASP had a sustained ecological and clinical impact, reducing the incidence and mortality rate of hospital-acquired candidemia and MDR BSIs 45
46 Acknowledgments Local teams: 638 professionals Thousands of professionals of the Andalusian Public Healthcare System who have participated Reference Laboratory Scientific Committee (18) Scientific societies (10) Andalusian Government Health Counselor Secretary of Public Health Managing Director of the Andalusian Health Service General Director of Health Care Support Services of the Andalusian Health Service Strategic Direction of IT IAVANTE Canal SUR television 46
47
Antimicrobial stewardship as a tool to fight resistance
Havana, septiembre 2018 Antimicrobial stewardship as a tool to fight resistance José Miguel Cisneros Herreros Infectious Diseases Department University Hospital Virgen del Rocío, Sevilla, SPAIN Competing
More informationStronger Bacteria Weaker Antimicrobial
DIRECTORATE GENERAL FOR INTERNAL POLICIES POLICY DEPARTMENT A: ECONOMIC AND SCIENTIFIC POLICY Stronger Bacteria Weaker Antimicrobial The fight against antimicrobial resistance in Europe through research,
More informationCollecting and Interpreting Stewardship Data: Breakout Session
Collecting and Interpreting Stewardship Data: Breakout Session Michael S. Calderwood, MD, MPH Regional Hospital Epidemiologist, Dartmouth-Hitchcock Medical Center March 20, 2019 None Disclosures Outline
More informationSummary of the latest data on antibiotic consumption in the European Union
Summary of the latest data on antibiotic consumption in the European Union ESAC-Net surveillance data November 2016 Provision of reliable and comparable national antimicrobial consumption data is a prerequisite
More informationThe International Collaborative Conference in Clinical Microbiology & Infectious Diseases
The International Collaborative Conference in Clinical Microbiology & Infectious Diseases PLUS: Antimicrobial stewardship in hospitals: Improving outcomes through better education and implementation of
More informationAntimicrobial Stewardship. October 2012
Antimicrobial Stewardship October 2012 Rising Antimicrobial Resistance Methicillin resistant staphylococcus aureus (MRSA) Vancomycin resistant enterococci (VRE) MDR and extremely drug resistant (XDR TB)
More informationANTIBIOTIC STEWARDSHIP
ANTIBIOTIC STEWARDSHIP S.A. Dehghan Manshadi M.D. Assistant Professor of Infectious Diseases and Tropical Medicine Tehran University of Medical Sciences Issues associated with use of antibiotics were recognized
More informationStratégie et action européennes
Résistance aux antibiotiques : une impasse thérapeutique? Implications nationales et internationales Stratégie et action européennes Dominique L. Monnet, Senior Expert and Head of Disease Programme Antimicrobial
More informationThe threat of multidrug-resistant microorganisms and how to deal with it in Europe
The threat of multidrug-resistant microorganisms and how to deal with it in Europe Dominique L. Monnet, Senior Expert and Head of Disease Programme Antimicrobial resistance and Healthcare-associated infections
More informationAMR epidemiological situation: ECDC update
One Health Network on Antimicrobial Resistance (AMR) AMR epidemiological situation: ECDC update Dominique L. Monnet, on behalf of ECDC Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI)
More informationAntibiotic Resistance. Antibiotic Resistance: A Growing Concern. Antibiotic resistance is not new 3/21/2011
Antibiotic Resistance Antibiotic Resistance: A Growing Concern Judy Ptak RN MSN Infection Prevention Practitioner Dartmouth-Hitchcock Medical Center Lebanon, NH Occurs when a microorganism fails to respond
More informationDR. MICHAEL A. BORG DIRECTOR OF INFECTION PREVENTION & CONTROL MATER DEI HOSPITAL - MALTA
DR. MICHAEL A. BORG DIRECTOR OF INFECTION PREVENTION & CONTROL MATER DEI HOSPITAL - MALTA The good old days The dread (of) infections that used to rage through the whole communities is muted Their retreat
More informationWhat is the problem? Latest data on antibiotic resistance
European Antibiotic Awareness Day 2009 What is the problem? Latest data on antibiotic resistance Zsuzsanna Jakab, ECDC Director Launch Seminar for EAAD Stockholm, 18 November 2009 Fluoroquinolone-resistant
More informationAntimicrobial Stewardship: The South African Perspective
Antimicrobial Stewardship: The South African Perspective Precious Matsoso Director General; National Department of Health; South Africa 13 th November 2015 Why do we need an AMR strategy and implementation
More informationAntimicrobial resistance and antimicrobial consumption in Europe
Antimicrobial resistance and antimicrobial consumption in Europe Dominique L. Monnet, on behalf of ECDC Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Programme Vilnius, 28 November
More informationSummary of the latest data on antibiotic resistance in the European Union
Summary of the latest data on antibiotic resistance in the European Union EARS-Net surveillance data November 2017 For most bacteria reported to the European Antimicrobial Resistance Surveillance Network
More informationPublic Health Response to Emerging Resistance
National Center for Emerging and Zoonotic Infectious Diseases Public Health Response to Emerging Resistance Alex Kallen, MD, MPH, FACP Lead Antimicrobial Resistance and Emerging Pathogens Team Prevention
More information9/30/2016. Dr. Janell Mayer, Pharm.D., CGP, BCPS Dr. Lindsey Votaw, Pharm.D., CGP, BCPS
Dr. Janell Mayer, Pharm.D., CGP, BCPS Dr. Lindsey Votaw, Pharm.D., CGP, BCPS 1 2 Untoward Effects of Antibiotics Antibiotic resistance Adverse drug events (ADEs) Hypersensitivity/allergy Drug side effects
More informationAntimicrobial consumption and resistance in humans in the EU and conclusions from the ECDC-EFSA- EMA JIACRA report
Antimicrobial consumption and resistance in humans in the EU and conclusions from the ECDC-EFSA- EMA JIACRA report Dominique L. Monnet, on behalf of ECDC Antimicrobial Resistance and Healthcare-Associated
More informationAntibiotics in the future tense: The Application of Antibiotic Stewardship in Veterinary Medicine. Mike Apley Kansas State University
Antibiotics in the future tense: The Application of Antibiotic Stewardship in Veterinary Medicine Mike Apley Kansas State University Changes in Food Animal Antibiotic Use How the uses of antibiotics in
More informationAntibiotic Stewardship in Nursing Homes SAM GUREVITZ PHARM D, CGP ASSOCIATE PROFESSOR BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCE
Antibiotic Stewardship in Nursing Homes SAM GUREVITZ PHARM D, CGP ASSOCIATE PROFESSOR BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCE Crisis: Antibiotic Resistance Success Strategy WWW.optimistic-care.org
More informationANTIBIOTIC STEWARDSHIP
ANTIBIOTIC STEWARDSHIP Adrie Bekker - Kenya 2018 Department of Pediatric and Child Health, Division of Neonatology University of Stellenbosch, Tygerberg Hospital DEFINITION OF ANTIMICROBIAL STEWARDSHIP
More informationEvaluation of EU strategy to combat AMR
Evaluation of EU strategy to combat AMR Advisory Group of the Food Chain 30 April 2015 Martial Plantady Legislative officer DDG2.G4: Food, Alert Systems & Training DG Health and Food Safety Antimicrobial
More informationAdvances in Antimicrobial Stewardship (AMS) at University Hospital Southampton
Advances in Antimicrobial Stewardship (AMS) at University Hospital Southampton Dr Julian Sutton Consultant in Infectious Diseases & Medical Microbiology Federation of Infection Societies 1 st December,
More informationPreserving bacterial susceptibility Implementing Antimicrobial Stewardship Programs Debra A. Goff, Pharm.D., FCCP
Preserving bacterial susceptibility Implementing Antimicrobial Stewardship Programs Debra A. Goff, Pharm.D., FCCP Clinical Associate Professor Infectious Diseases Specialist The Ohio State University Medical
More informationPrevention and control of antimicrobial resistance in healthcare settings: raising awareness about best practices
Prevention and control of antimicrobial resistance in healthcare settings: raising awareness about best practices Dominique L. Monnet, on behalf of ECDC Antimicrobial Resistance and Healthcare-Associated
More informationBirgit Ross Hospital Hygiene University Hospital Essen Essen, Germany. Should we screen for multiresistant gramnegative Bacteria?
Birgit Ross Hospital Hygiene University Hospital Essen Essen, Germany Should we screen for multiresistant gramnegative Bacteria? CONCLUSIONS: A program of universal surveillance, contact precautions,
More informationThe challenge of growing resistance
EXECUTIVE SUMMARY Around 2.4 million people could die in Europe, North America and Australia between 2015-2050 due to superbug infections unless more is done to stem antibiotic resistance. However, three
More informationSummary of the latest data on antibiotic consumption in the European Union
Summary of the latest data on antibiotic consumption in the European Union November 2012 Highlights on antibiotic consumption Antibiotic use is one of the main factors responsible for the development and
More informationCouncil Conclusions on Antimicrobial Resistance (AMR) 2876th EMPLOYMENT, SOCIAL POLICY, HEALTH AND CONSUMER AFFAIRS Council meeting
COUNCIL OF THE EUROPEAN UNION Council Conclusions on Antimicrobial Resistance (AMR) 2876th EMPLOYMT, SOCIAL POLICY, HEALTH AND CONSUMER AFFAIRS Council meeting Luxembourg, 10 June 2008 The Council adopted
More informationPreventing Multi-Drug Resistant Organism (MDRO) Infections. For National Patient Safety Goal
Preventing Multi-Drug Resistant Organism (MDRO) Infections For National Patient Safety Goal 07.03.01 2009 Methicillin Resistant Staphlococcus aureus (MRSA) About 3-8% of the population at large is a carrier
More informationAntimicrobial resistance (EARS-Net)
SURVEILLANCE REPORT Annual Epidemiological Report for 2014 Antimicrobial resistance (EARS-Net) Key facts Over the last four years (2011 to 2014), the percentages of Klebsiella pneumoniae resistant to fluoroquinolones,
More informationMultidrug-Resistant Organisms: How Do We Define them? How do We Stop Them?
Multidrug-Resistant Organisms: How Do We Define them? How do We Stop Them? Roberta B. Carey, PhD Centers for Disease Control and Prevention Division of Healthcare Quality Promotion Why worry? MDROs Clinical
More informationRecommendations for Implementation of Antimicrobial Stewardship Restrictive Interventions in Acute Hospitals in Ireland
Recommendations for Implementation of Antimicrobial Stewardship Restrictive Interventions in Acute Hospitals in Ireland A report by the Hospital Antimicrobial Stewardship Working Group, a subgroup of the
More informationINCIDENCE OF BACTERIAL COLONISATION IN HOSPITALISED PATIENTS WITH DRUG-RESISTANT TUBERCULOSIS
INCIDENCE OF BACTERIAL COLONISATION IN HOSPITALISED PATIENTS WITH DRUG-RESISTANT TUBERCULOSIS 1 Research Associate, Drug Utilisation Research Unit, Nelson Mandela University 2 Human Sciences Research Council,
More informationHand Hygiene and MDRO (Multidrug-resistant Organisms) - Science and Myth PROF MARGARET IP DEPT OF MICROBIOLOGY
Hand Hygiene and MDRO (Multidrug-resistant Organisms) - Science and Myth PROF MARGARET IP DEPT OF MICROBIOLOGY MDROs and Hand Hygiene Guidelines HH Apr14 The Science of Hand Hygiene in Healthcare Settings
More informationWhat bugs are keeping YOU up at night?
What bugs are keeping YOU up at night? Barbara DeBaun, RN, MSN, CIC 26 th Annual Medical Surgical Nursing Conference South San Francisco, CA April 15, 2016 Objectives Describe the top three infectious
More informationVaccination as a potential strategy to combat Antimicrobial Resistance in the elderly
Vaccination as a potential strategy to combat Antimicrobial Resistance in the elderly Wilbur Chen, MD, MS 22-23 March 2017 WHO meeting on Immunization of the Elderly The Problem Increasing consumption
More informationStratégies et actions au niveau européen et international: populations humaines
Stratégies et actions au niveau européen et international: populations humaines Dominique L. Monnet, Senior Expert and Head of Disease Programme Antimicrobial resistance and Healthcare-associated infections
More informationAntimicrobial Resistance Update for Community Health Services
Antimicrobial Resistance Update for Community Health Services Elizabeth Beech Healthcare Acquired Infection and Antimicrobial Resistance Project Lead NHS England October 2015 elizabeth.beech@nhs.net Superbugs
More information03/09/2014. Infection Prevention and Control A Foundation Course. Talk outline
Infection Prevention and Control A Foundation Course 2014 What is healthcare-associated infection (HCAI), antimicrobial resistance (AMR) and multi-drug resistant organisms (MDROs)? Why we should be worried?
More informationECDC country visit to Luxembourg to discuss antimicrobial resistance issues
MISSION REPORT ECDC country visit to Luxembourg to discuss antimicrobial resistance issues 29 May-2 June 2017 www.ecdc.europa.eu ECDC MISSION REPORT ECDC country visit to Luxembourg to discuss antimicrobial
More informationDoes Screening for MRSA Colonization Have A Role In Healthcare-Associated Infection Prevention Programs?
Does Screening for MRSA Colonization Have A Role In Healthcare-Associated Infection Prevention Programs? John A. Jernigan, MD, MS Division of Healthcare Quality Promotion Centers for Disease Control and
More informationAntimicrobial Cycling. Donald E Low University of Toronto
Antimicrobial Cycling Donald E Low University of Toronto Bad Bugs, No Drugs 1 The Antimicrobial Availability Task Force of the IDSA 1 identified as particularly problematic pathogens A. baumannii and
More informationAntimicrobial stewardship in companion animals: Welcome to a whole new era
Antimicrobial stewardship in companion animals: Welcome to a whole new era John F. Prescott, University Professor Emeritus, Department of Pathobiology, University of Guelph, Guelph, Ontario NG 2W1 prescott@uoguelph.ca
More informationSurveillance of AMR in PHE: a multidisciplinary,
Surveillance of AMR in PHE: a multidisciplinary, integrated approach Professor Neil Woodford Antimicrobial Resistance & Healthcare Associated Infections (AMRHAI) Reference Unit Crown copyright International
More informationThe South African AMR strategy. 3 rd Annual Regulatory Workshop Gavin Steel Sector wide Procurement National Department of Health; South Africa
The South African AMR strategy 3 rd Annual Regulatory Workshop Gavin Steel Sector wide Procurement National Department of Health; South Africa Background to AMR 2 What is Antimicrobial stewardship and
More informationAntimicrobial Stewardship:
Antimicrobial Stewardship: Inpatient and Outpatient Elements Angela Perhac, PharmD afperhac@carilionclinic.org Disclosure I have no relevant finances to disclose. Objectives Review the core elements of
More informationAntibiotic resistance: the rise of the superbugs
Antibiotic resistance: the rise of the superbugs Allen Cheng Associate Professor of Infectious Diseases Epidemiology, Alfred Health; Monash University About me Specialist in infectious diseases Head, Infection
More informationHospital Acquired Infections in the Era of Antimicrobial Resistance
Hospital Acquired Infections in the Era of Antimicrobial Resistance Datuk Dr Christopher KC Lee Infectious Diseases Unit Department of Medicine Sungai Buloh Hospital Patient Story 23 Year old female admitted
More informationAntimicrobial Stewardship Esperienza Torinese
Pisa 15 Novembre 2016 Antimicrobial Stewardship Esperienza Torinese Francesco G. De Rosa Dipartimento di Scienze Mediche Università di Torino Antimicrobial Stewardship First introduced by Dale Gerding
More information1/30/ Division of Disease Control and Health Protection. Division of Disease Control and Health Protection
Surveillance, Outbreaks, and Reportable Diseases, Oh My! Assisted Living Facility, Nursing Home and Surveyor Infection Prevention Training February 2015 A.C. Burke, MA, CIC Health Care-Associated Infection
More informationANTIMICROBIAL STEWARDSHIP: ADVANCING PATIENT CARE BY IMPROVING MEDICATION USE
ANTIMICROBIAL STEWARDSHIP: ADVANCING PATIENT CARE BY IMPROVING MEDICATION USE ANTHONY M. CASAPAO, PHARM.D. ASSISTANT PROFESSOR OF PHARMACY PRACTICE HUSSON UNIVERSITY SCHOOL OF PHARMACY CLINICAL INFECTIOUS
More informationNew Drugs for Bad Bugs- Statewide Antibiogram
New Drugs for Bad Bugs- Statewide Antibiogram Felicia Matthews, Pharm.D., BCPS Senior Consultant, Pharmacy Specialty BE MedMined Services Disclosures Employee of BD Corporation MedMined Services Agenda
More informationNosocomial Infections: What Are the Unmet Needs
Nosocomial Infections: What Are the Unmet Needs Jean Chastre, MD Service de Réanimation Médicale Hôpital Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Paris 6, France www.reamedpitie.com
More informationEpidemiology and Economics of Antibiotic Resistance
Epidemiology and Economics of Antibiotic Resistance Eili Y. Klein February 17, 2016 Health Watch USA Meeting I. The burden of antibiotic resistance is a growing global threat, but hard numbers are lacking
More informationTestimony of the Natural Resources Defense Council on Senate Bill 785
Testimony of the Natural Resources Defense Council on Senate Bill 785 Senate Committee on Healthcare March 16, 2017 Position: Support with -1 amendments I thank you for the opportunity to address the senate
More informationPotential Conflicts of Interest. Schematic. Reporting AST. Clinically-Oriented AST Reporting & Antimicrobial Stewardship
Potential Conflicts of Interest Clinically-Oriented AST Reporting & Antimicrobial Stewardship Hsu Li Yang 27 th September 2013 Research Funding: Pfizer Singapore AstraZeneca Janssen-Cilag Merck, Sharpe
More informationECDC activities on antimicrobial resistance & healthcare-associated infections (ARHAI Programme) Ülla-Karin Nurm, ECDC Tallinn, 13 May 2013
ECDC activities on antimicrobial resistance & healthcare-associated infections (ARHAI Programme) Ülla-Karin Nurm, ECDC Tallinn, 13 May 2013 What is the European Union? 27 Member States 24 official languages
More informationAntimicrobial Stewardship. Where are we now and where do we need to go?
Safe Patient Care Bugs and Drugs The ongoing challenge of MDROs and AMR 2017 @SPC2016Cork Antimicrobial Stewardship. Where are we now and where do we need to go? Frank O Riordan Antimicrobial pharmacist,
More informationNew Opportunities for Microbiology Labs to Add Value to Antimicrobial Stewardship Programs
New Opportunities for Microbiology Labs to Add Value to Antimicrobial Stewardship Programs Patrick R. Murray, PhD Senior Director, WW Scientific Affairs 2017 BD. BD, the BD Logo and all other trademarks
More informationAntimicrobial stewardship
Antimicrobial stewardship Magali Dodemont, Pharm. with the support of Wallonie-Bruxelles International WHY IMPLEMENT ANTIMICROBIAL STEWARDSHIP IN HOSPITALS? Optimization of antimicrobial use To limit the
More informationInfection Linelist. Infections Occurred Between 10/1/ :00:00 AM To 11/1/ :00:00 AM 2RCW2. Gastroenteritis (Adult) Urinary Tract
Infection Linelist Infections Occurred Between 10/1/2013 12:00:00 AM To 11/1/2013 12:00:00 AM 2RCW2 10/9/13 02407693 36890294 2094 1 32 M CLOSTRIDIUM DIFFICILE 10/26/13 99342791 37024716 2046 1 42 M CLOSTRIDIUM
More informationHealthcare Facilities and Healthcare Professionals. Public
Document Title: DOH Guidelines for Antimicrobial Stewardship Programs Document Ref. Number: DOH/ASP/GL/1.0 Version: 1.0 Approval Date: 13/12/2017 Effective Date: 14/12/2017 Document Owner: Applies to:
More informationThe relevance of Gram-negative pathogens for public health situation in India
The relevance of Gram-negative pathogens for public health situation in India Dr. Sanjay Bhattacharya MD, DNB, DipRCPath, FRCPath, CCT (UK) Consultant Microbiologist Tata Medical Center www.tmckolkata.com
More informationMulti-drug resistant microorganisms
Multi-drug resistant microorganisms Arzu TOPELI Director of MICU Hacettepe University Faculty of Medicine, Ankara-Turkey Council Member of WFSICCM Deaths in the US declined by 220 per 100,000 with the
More informationAntimicrobial Stewardship/Statewide Antibiogram. Felicia Matthews Senior Consultant, Pharmacy Specialty BD MedMined Services
Antimicrobial Stewardship/Statewide Antibiogram Felicia Matthews Senior Consultant, Pharmacy Specialty BD MedMined Services Disclosures Employee of BD Corporation MedMined Services Agenda CMS and JCAHO
More informationOther Enterobacteriaceae
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER NUMBER 50: Other Enterobacteriaceae Author Kalisvar Marimuthu, MD Chapter Editor Michelle Doll, MD, MPH Topic Outline Topic outline - Key Issues Known
More informationThe UK 5-year AMR Strategy - a brief overview - Dr Berit Muller-Pebody National Infection Service Public Health England
The UK 5-year AMR Strategy - a brief overview - Dr Berit Muller-Pebody National Infection Service Public Health England Chief Medical Officer - Annual Report 2013 Antimicrobial resistance poses catastrophic
More informationUPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM
UPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM Diane Rhee, Pharm.D. Associate Professor of Pharmacy Practice Roseman University of Health Sciences Chair, Valley Health
More informationPresenter: Ombeva Malande. Red Cross Children's Hospital Paed ID /University of Cape Town Friday 6 November 2015: Session:- Paediatric ID Update
Emergence of invasive Carbapenem Resistant Enterobacteriaceae CRE infection at RCWMCH Ombeva Oliver Malande, Annerie du Plessis, Colleen Bamford, Brian Eley Presenter: Ombeva Malande Red Cross Children's
More informationAntimicrobial Stewardship
Antimicrobial Stewardship Preventing the Spread of Antibiotic Resistance and Improving Patient Care (Adapted from the Centers for Disease Control and Prevention) What is Stewardship? Antimicrobial stewardship
More informationRegional Workshop on AMR in South East Asia Penang (Malaysia): March 2018
Regional Workshop on AMR in South East Asia Penang (Malaysia): 26-28 March 2018 Prof : Htay Htay Tin drhtayhtaytin@gmail.com DDG ( Laboratory) National Focal Point for AMR Ministry of Health and Sports
More informationImplementation of a National Action Plan and International standards especially with regard to Responsible and prudent use of antimicrobials
Implementation of a National Action Plan and International standards especially with regard to Responsible and prudent use of antimicrobials Dr. Sasi Jaroenpoj, D.V.M Head of Veterinary Products and AMR
More informationAntimicrobial Stewardship Program: Local Experience
Antimicrobial Stewardship Program: Local Experience Dr. WU Tak Chiu Associate Consultant Division of Infectious Diseases Department of Medicine Queen Elizabeth Hospital 18th January 2011 QUEEN ELIZABETH
More informationModels for stewardship in Hospital - UK Models Philip Howard Consultant Antimicrobial Pharmacist
Models for stewardship in Hospital - UK Models Philip Howard Consultant Antimicrobial Pharmacist philip.howard2@nhs.net Twitter: @AntibioticLeeds United Kingdom of England, Scotland, Wales & Northern Ireland
More informationAntimicrobial consumption
Antimicrobial consumption Annual Epidemiological Report for 2017 Key facts Twenty-seven countries, comprising 25 EU Member States and two EEA countries (Iceland and Norway) reported data on antimicrobial
More informationAntimicrobial Stewardship
Antimicrobial Stewardship Background Why Antimicrobial Stewardship 30-50% of antibiotic use in hospitals are unnecessary or inappropriate Appropriate antimicrobial use is a medication-safety and patient-safety
More informationAntibiotic Stewardship in the Hospital Setting
Antibiotic Stewardship in the Hospital Setting G. Evans, MD FRCPC Medical Director, Infection Prevention & Control Kingston General Hospital & Hotel Dieu Hospital EOPIC September 26, 2012 Stewardship stew-ard-ship
More informationDr Nata Menabde Executive Director World Health Organization Office at the United Nations Global action plan on antimicrobial resistance
Global action plan on antimicrobial resistance Dr Nata Menabde Executive Director World Health Organization Office at the United Nations Proportion of MDR among previously treated TB cases, 1994-2010 0-
More informationASCENSION TEXAS Antimicrobial Stewardship: Practical Implementation Strategies
ASCENSION TEXAS Antimicrobial Stewardship: Practical Implementation Strategies Theresa Jaso, PharmD, BCPS (AQ-ID) Network Clinical Pharmacy Specialist Infectious Diseases Seton Healthcare Family Ascension
More informationSurveillance of Antimicrobial Resistance among Bacterial Pathogens Isolated from Hospitalized Patients at Chiang Mai University Hospital,
Original Article Vol. 28 No. 1 Surveillance of Antimicrobial Resistance:- Chaiwarith R, et al. 3 Surveillance of Antimicrobial Resistance among Bacterial Pathogens Isolated from Hospitalized Patients at
More informationOECD WORK ON AMR: TACKLING THE NEGATIVE CONSEQUENCES OF ANTIBIOTIC RESISTANCE ON HUMAN HEALTH. Michele Cecchini OECD Health Division
OECD WORK ON AMR: TACKLING THE NEGATIVE CONSEQUENCES OF ANTIBIOTIC RESISTANCE ON HUMAN HEALTH Michele Cecchini OECD Health Division Antimicrobial Resistance is a Global Threat Modern medicine and surgery
More information2016/LSIF/FOR/007 Improving Antimicrobial Use and Awareness in Korea
2016/LSIF/FOR/007 Improving Antimicrobial Use and Awareness in Korea Submitted by: Asia Pacific Foundation for Infectious Diseases Policy Forum on Strengthening Surveillance and Laboratory Capacity to
More informationEARS Net Report, Quarter
EARS Net Report, Quarter 4 213 March 214 Key Points for 213* Escherichia coli: The proportion of patients with invasive infections caused by E. coli producing extended spectrum β lactamases (ESBLs) increased
More informationAntibiotic Stewardship Program (ASP) CHRISTUS SETX
Antibiotic Stewardship Program (ASP) CHRISTUS SETX Program Goals I. Judicious use of antibiotics Decrease use of broad spectrum antibiotics and deescalate use based on clinical symptoms Therapeutic duplication:
More informationAppropriate antimicrobial therapy in HAP: What does this mean?
Appropriate antimicrobial therapy in HAP: What does this mean? Jaehee Lee, M.D. Kyungpook National University Hospital, Korea KNUH since 1907 Presentation outline Empiric antimicrobial choice: right spectrum,
More informationSolution Title: Antibiotic Stewardship: A Journey Toward the Triple Aim
Solution Title: Antibiotic Stewardship: A Journey Toward the Triple Aim Program/Project Description, including Goals What was the problem to be solved? How was it identified? What baseline data existed?
More informationSurveillance of Antimicrobial Resistance and Healthcare-associated Infections in Europe
Surveillance of Antimicrobial Resistance and Healthcare-associated Infections in Europe Carl Suetens, ECDC Presented by Håkan Hanberger ecdc.europa.eu Message/Questions from C Suetens to Workshop 7, MIE2009
More informationKonsequenzen für Bevölkerung und Gesundheitssysteme. Stephan Harbarth Infection Control Program
Konsequenzen für Bevölkerung und Gesundheitssysteme Stephan Harbarth Infection Control Program University of Geneva Hospitals Outline Introduction What data sources are available? AMR-associated outcomes
More informationMDRO s, Stewardship and Beyond. Linda R. Greene RN, MPS, CIC
MDRO s, Stewardship and Beyond Linda R. Greene RN, MPS, CIC linda_greene@urmc.rochester.edu Evolving Threat of Antimicrobial Resistance Why are MDROs important? Limited treatment options Associated with:
More informationMulti-Drug Resistant Organisms (MDRO)
Multi-Drug Resistant Organisms (MDRO) 2016 What are MDROs? Multi-drug resistant organisms, or MDROs, are bacteria resistant to current antibiotic therapy and therefore difficult to treat. MDROs can cause
More informationMike Apley Kansas State University
Mike Apley Kansas State University 2003 - Daptomycin cyclic lipopeptides 2000 - Linezolid - oxazolidinones 1985 Imipenem - carbapenems 1978 - Norfloxacin - fluoroquinolones 1970 Cephalexin - cephalosporins
More informationPromoting Appropriate Antimicrobial Prescribing in Secondary Care
Promoting Appropriate Antimicrobial Prescribing in Secondary Care Stuart Brown Healthcare Acquired Infection and Antimicrobial Resistance Project Lead NHS England March 2015 Introduction Background ESPAUR
More informationBacterial infections complicating cirrhosis
PHC www.aphc.info Bacterial infections complicating cirrhosis P. Angeli, Dept. of Medicine, Unit of Internal Medicine and Hepatology (), University of Padova (Italy) pangeli@unipd.it Agenda Epidemiology
More informationEU strategy to fight against Antimicrobial Resistance
EU strategy to fight against Antimicrobial Resistance OECD workshop on the Economics of Antimicrobial Use in the Livestock Sector and Development of Antimicrobial Resistance Paris, 12 October 2015 Martial
More informationAntibiotic. Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting
Antibiotic Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting Any substance of natural, synthetic or semisynthetic origin which at low concentrations kills or inhibits the growth of bacteria
More informationAntibiotic usage in nosocomial infections in hospitals. Dr. Birgit Ross Hospital Hygiene University Hospital Essen
Antibiotic usage in nosocomial infections in hospitals Dr. Birgit Ross Hospital Hygiene University Hospital Essen Infection control in healthcare settings - Isolation - Hand Hygiene - Environmental Hygiene
More informationSafe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times
Safe Patient Care Keeping our Residents Safe 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare Do bugs need drugs? Dr Deirdre O Brien Consultant Microbiologist Mercy University
More informationSECOND REPORT FROM THE COMMISSION TO THE COUNCIL
SECOND REPORT FROM THE COMMISSION TO THE COUNCIL ON THE BASIS OF MEMBER STATES REPORTS ON THE IMPLEMENTATION OF THE COUNCIL RECOMMENDATION (2002/77/EC) ON THE PRUDENT USE OF ANTIMICROBIAL AGENTS IN HUMAN
More information