Global coordinated action against antibiotic resistance

100 Pages·2017·4.16 MB·English

y
r
a
Global coordinated action against
r
b
antibiotic resistance
i
L
r
e
Are we achieving enough?
o

h
D
t
I u
M
a
C
y
Otto Cars
S
b
Senior Professor, Infectious Diseases
E
U© ppsala university, Sweden

ECCMID, Madrid 22 April 2018
y
r
a
The global policy response to the
r
b
antibiotic resistance challenge
i
L
r
e
o

h
D
Too slow t
I u
M
a
C
Too wyeak
S
b
E
©
Too narrow
y
• Temocillin against Enterobacteriaceae isolates from community-acquired urinary tract infections: low rate of resistance and goodaccuracy of
routine susceptibility testing methods. Journal of Antimicrobial Chemotherapy r
• In vitroactivity of ceftarolineagainst clinical Staphylococcus aureusisolates collected during a national survey coanducted in Belgian hospitals.
Journal of Antimicrobial Chemotherapy
• Ventilator-associated pneumonia in patients assisted by veno-arterial extracorporeal membrane oxygenation support: Epidemiology and risk f
r
actors of treatment failure. PLoSOne
• Low-dose CT for the diagnosis of pneumonia in elderly patients: a prospective, interventional cohorbt study. European Respiratory Journal
• Is very short-course antibiotic theraSpuy psocsesibplet iinb piolsittoyp etraetisvet iinntrga…-abdominal infections? Discussion on “Short-course antibiotic therapy for
critically ill patients treated for postoperative intra-abdominal infection: the DURAPOP randiomisedclinical trial”. Intensive Care Medicine
Risk factors of treatment failure..
• Efficacy and safety of ceftazidime/avibactam: a systematic review and meta-analysis. JLournal of Antimicrobial Chemotherapy
• Blood culture useful only in selected patients with urinary tract infections –a literature review. Infectious Diseases
Diagnostics..
r
• Re: Disparities Between Parental Expectations and Pediatric Antibiotic Prescreibing. Pediatrics
• Concomitant resolution through fecSalh moicrrotb itortae taratnmsplaenntattio tni omf Celoss.tr.idium difficile and OXA-48-producing Klebsiellaponeumonia.InfectiousDiseases
• Daptomycin and combination daptomycin-ceftarolineas salvage therapy for persistent methicillin-resistantStaphylococcus aureusbacteremia. I

• Comparison of Empiric Antibiotics fCoro Amcutbe Oinstaeotmioyenlit its hine Crhaildpreyn.. .Hospital Pediatrics
h
D
• Clinical impact of rapid bacterial identification by MALDI-TOF MS combined with the bêta-LACTA™ test on early antibiotic adaptation by an
Feacal transplants..
antimicrobial stewardship team in bloodstream infections. Infectious Diseases
t
• Pharmacokinetic and Pharmacodynamic Considerations of Antibiotics of Last Resort in Treating Gram-Negative Infections in Adult Critically
PharmacokInetic-pharmacodynamic conusiderations in
Ill Patients. Current Infectious Disease Reports
M
• Preventive Antibiotics in Stroke Stucdry i(tPiAcSaSl)l y-A i lclo spt-aeftfeicetinvetnses..s study. Neurology
a
• Invasive infection caused by Klebsiellapneumoniaeis a disease affecting patients with high
Horizontal antibiotic transfer..
comorbidity and associated with high long-term mortality. PLoSOne
C
• Horizontal antimicrobial resistance Gtralnosfbera dlri viens cerpeideamsices oinf m aulntiptleib Shioigetlilac scpoecniess.u Nmatupret Cioomnm..unications
• Global increase and geographic convergence in antibiotic consumption betweeyn 2000 and 2015. PNAS
Acinetobacter baumanniiResistancCea Trrebndasp ine Cnhieldmren irne thsei sUtnaitendt S tEatnest,e 19r9o9b–2a0c12t.e Joruiarncala oef thien P ewdiialtdricl iInffeec.t.ious Diseases Society
S
• 100 years of STIs in the UK: a review of national surveillance data. BMbJ STI
• Whole genome sequence of an MCDR-i1s-cpaarryrinitgi, eEsS BbL-eprtowduecinegn E spchaerriechniat ceolri aSTl 7e46x ipsoelactet aretcoiovenresd and
from communEity-acquired urinary tract infection. Journal of G lobal Antimicrobial Resistance
antibiotic prescribing..
• Antimicrobial Resistance in Invasive Bacterial Infections in Hospitalized Children, Cambodia, 2007–2016. Emerging Infectious Diseases
©
• Environmental surveillance and in vitro activity of antimicrobial agents against Legionella pneumophila isolated
from hospital water systems in Campania, South Italy: a 5-year study. Environmental Research
• Current epidemiology, genetic evolution and clinical impact of extended-spectrum β-lactamase-producing

• Escherichia coli and Klebsiellapneumoniae. Infection, Genetics and Evolution

• Changes in Macrolide Resistance Among Group A Streptococci in Serbia and Clonal Evolution of Resistant Isolates. Microbial Drug Resistance

• Characterization of Carbapenemase-Producing Enterobacteriaceae from Patients in Amman, Jordan. Microbial Drug Resistance

• Carbapenem-resistant Enterobacteriaceae in wildlife, food-producing and companion animals –a systematic review.ClinicalMicrobiology and Infectiona
y
r
No of articles in PubMed
a
10000
r
Antibiotic Resistance Antibiotic Policies
9000 b
8000 i
L
7000 r
e
o
6000
The gap between
h
D
5000
science and policy
t
4000 I u
M
3000 a
2000 C
y
1000 S
b
0
E
©
1980 1985 1990 1995 2000 2005 2010 2015
y
r
a
r
b
i
L
r
e
2001
o

h
D
t
I u
M
a
C
y
S
b
E
©
y
r
a
r
b
i
L
r
e
o

h
D
t
I u
M
a
C
y
S
b
E
©
y
r
a
r
b
i
L
r
e
o

h
D
t
I u
M
a
C
y
S
b
E
©
y
r
a
r
b
i
L
r
e
2001 2015
o

h
D
t
I u
M
a
C
y
S
b
E
©
y
r
Five strategic objectives of the Globaal Action Plan
r
b
1. Improve awareness and understanding of antimicrobial
i
resistance L
r
e
o
2. Strengthen the knowledge and evidence base through

D surveillance and research h
t
I u
3. Reduce the incidence of infection
M
a
4. Optimize the use of antimicrobial medicines
C
y
S 5. Develop the economic case for sustainable investment and
b
increase investment in new medicines , diagnostics, vaccines
E
©
y
Some causes for the global comprlacency
a
r
• Antibiotic resistance is not a disease
b
• Inadequate data on health and ieconomic consequences
L
• The ecological/environmeental dimensions ignored r
o

• Not seen as a global development issue
h
D
t
• Blame game
I u
M
• A slow threat a
C
• Bureaucracy with vertical structures
y
S
b
• Misaligned financial incentives
E
• Disincentives fo©r collective action

• The global self-deception: There will always

be new antibiotics