Upload
trandung
View
216
Download
3
Embed Size (px)
Citation preview
European Antibiotic Awareness Day 2009
What is the problem? ― Latest data on antibiotic resistanceZsuzsanna Jakab, ECDC DirectorLaunch Seminar for EAAD
Stockholm, 18 November 2009
Fluoroquinolone-resistant Escherichia coli in EU/EEA countries
2003 2008
Source: European Antimicrobial Resistance Surveillance System (EARSS), 2008
Methicillin-resistant Staphylococcus aureus (MRSA), blood and spinal fluid
2003 2008
Source: European Antimicrobial Resistance Surveillance System (EARSS), 2008
Relationship between antibiotic useand resistance in the community
R2=0.66
P<0.001
0
20
40
60
0 2 4 6 8
Antibiotic consumption(Outpatient consumption of
macrolides and lincosamides,
DDD per 1,000 inh-days, 1997)
Antibio
tic
resi
stance
(%M
acr
olid
e-R
S. pneum
onia
e
from
com
munity-
acq
uired R
TIs
, 1998)
Each data point represents one country
Source: Alexander Project; FINRES; STRAMA; DANMAP; Cars et al., 2001.
Antibiotic prescribing and consumption vary between European countries
Source: European Surveillance of Antimicrobial Consumption (ESAC), 2008
0
5
10
15
20
25
30
35
40
Cyp
rus*
Gre
ece
*,*
*
Fra
nce
Italy
Luxe
mbourg
Belg
ium
Slo
vaki
a
Irela
nd
Port
ugal
Bulg
aria
Icela
nd**
Spain
***
Pola
nd**
Fin
land
Lithuania
*,*
*
Cze
ch R
epublic
Denm
ark
Slo
venia
Est
onia
*
Sw
eden
Hungary
United K
ingdom
**
Norw
ay
Aust
ria
Germ
any*
*
Latv
ia
Neth
erlands
DD
D p
er
1000 inhabitants
and p
er
day
Other J01 classes (J01B, J01G, J01R, J01X)
Sulfonamides and trimethoprim (J01E)
Quinolones (J01M)
Macrolides, lincosamides and streptogramins (J01F)
Tetracyclines (J01A)
Cephalosporins and other beta-lactams (J01D)
Penicillins (J01C)
*Total use, i.e. including inpatients, for Cyprus, Estonia, Greece and Lithuania.
**2006 data for Germany, Greece, Iceland and Lithuania; 2005 data for Poland and United Kingdom.
***Reimbursement data, which do not include over-the-counter sales without prescription.
Modern medicine is not possible without effective antimicrobials
Hip replacement
Organ transplants
Cancer chemotherapy
Intensive care
Care of preterm babies
Animated slide: please waitPhoto by interplast (http://www.flickr.com/photos/interplast/115125072), reproduced under a Creative Commons license.
Survey results on intensive-care patients infected with resistant bacteria
0 20 40 60 80 100
% respondents
Gram-positivebacteria
Gram-negativebacteria
Bacteria totally or almost totallyresistant to available antibiotics
Carbapenem-resistant Enterobacteriaceae
Carbapenem-resistant Acinetobacter spp.
Carbapenem-resistant Pseudomonas aeruginosa
Third-generation cephalosporin-resistant Enterobacteriaceae
Vancomycin-resistant/intermediate S. aureus (VRSA/VISA)
Penicillin-resistant Streptococcus pneumoniae (PRSP)
Vancomycin-resistant Enterococcus spp. (VRE)
Methicillin-resistant Staphylococcus aureus (MRSA)
>10 patients 3-10 patients 1-2 patients 0 Do not know Missing
Source: Eurosurveillance, 12 Nov 2009. Alain Lepape, Dominique L. Monnet, on behalf of participating members of the European Society of Intensive Care Medicine (ESICM)
How can we stop antibiotic resistance?
• Prudent use of antibiotics (only when needed, correct dose, dose intervals, duration).
• Infection control (hand hygiene, screening, isolation).
• Development of new antibiotics (focus of Swedish EU Presidency).
www.se2009.eu
ECDC’s Antimicrobial Resistance and Healthcare-Associated Infections Programme
• Pan-European surveillance of antibiotic resistance and antibiotic consumption (outsourced).
• Ad-hoc surveys and reports when surveillance does not exist.
• Risk assessments and guidance for the prevention and control of multidrug-resistant bacteria.
• Coordination of activities through a network of National AMR Focal Points (one per country).
• Country visits to discuss AMR issues on the basis of Council Recommendation 2002/77/EC (upon invitation from the country).
• Communication.
European Antibiotic Awareness Day —targeting prudent antibiotic use
• Targeting prudent antibiotic use in primary care.
• Message – 'Cold? Flu? Take care, not antibiotics!'
• Materials targeting primary care prescribers.
• TV and Web spots
European Antibiotic Awareness Day –multilingual website
European Antibiotic Awareness Day:What is happening across Europe today
Slovenia: TV spot; point-prevalence study on antibiotic consumption in children at primary level.
France: Press release on actions organised in France; launch of French MoH antibiotic website with up-to-date treatment recommendations for clinicians; local and regional level events.
Czech Republic: Round table meeting with stakeholder representatives to mark EAAD, organised with support of WHO office; special issue of Bulletin of Association of General Practitioners with distribution for free to 5000 GPs.
Sweden: Joint launch seminar and press release with ECDC and Swedish EU Presidency; TV spots broadcast in cinema theatres; many STRAMA activities.
Spain: Scientific conferences in Madrid and Barcelona; press conference by professional societies.
Belgium: Launch of 9th national campaign, including TV spot, website, letter plus posters and leaflets to GPs and pharmacists; special issue of Huisarts Nu devoted to EAAD.
Hungary: National scientific conference and press conference with participation of Minister for Health and Chief Medical Officer; TV spots on main and regional channels.
ECDC working closely with EU Presidencies
• ECDC is working closely in support of the EU Presidency countries to keep antibiotic resistance high on the EU agenda.
• Swedish EU Presidency
− ECDC-EMEA joint report on 'The bacterial challenge – time to react' was published for the EU conference 'Innovative incentives for effective antibacterials' in Stockholm on 17 September.
− EU/US Joint Taskforce on AMR is being created following the last US-EU Summit in Washington (DC) on 3-4 November.
− In 2010, the US CDC will launch its 'Get smart' campaign on prudent use of antibiotics on 18 November.
• In 2010, European Antibiotic Awareness Day will focus on hospitals, and the EU Presidency countries will continue to prioritise AMR:– Spain: patient safety and infection control.– Belgium: healthcare acquired infections and antibiotic use.
• ECDC is already working with WHO Euro to promote the campaign beyond the EU borders.
Thank you!