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Anderson M, Schulze K, Cassini A, Plachouras D, Mossialos E. A governance framework for development and assessment of national action plans on antimicrobial resistance. THE LANCET. INFECTIOUS DISEASES 2019; 19:e371-e384. [PMID: 31588040 DOI: 10.1016/s1473-3099(19)30415-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 06/28/2019] [Accepted: 07/03/2019] [Indexed: 12/26/2022]
Abstract
Strengthening governance is an essential strategy to tackling antimicrobial resistance (AMR) at all levels: global, national, regional, and local. To date, no systematic approach to governance of national action plans on AMR exists. To address this issue, we aimed to develop the first governance framework to offer guidance for both the development and assessment of national action plans on AMR. We reviewed health system governance framework reviews to inform the basic structure of our framework, international guidance documents from WHO, the Food and Agriculture Organization, the World Organisation for Animal Health, and the European Commission, and sought the input of 25 experts from international organisations, government ministries, policy institutes, and academic institutions to develop and refine our framework. The framework consists of 18 domains with 52 indicators that are contained within three governance areas: policy design, implementation tools, and monitoring and evaluation. To consider the dynamic nature of AMR, the framework is conceptualised as a cyclical process, which is responsive to the context and allows for continuous improvement and adaptation of national action plans on AMR.
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Affiliation(s)
- Michael Anderson
- Department of Health Policy, London School of Economics and Political Science, London, UK.
| | - Kai Schulze
- Department of Health Policy, London School of Economics and Political Science, London, UK; MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | | | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, London, UK
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Serotype Distribution and Antimicrobial Resistance of Streptococcus pneumoniae Isolates Causing Invasive and Noninvasive Pneumococcal Diseases in Korea from 2008 to 2014. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6950482. [PMID: 27314035 PMCID: PMC4904076 DOI: 10.1155/2016/6950482] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 04/24/2016] [Accepted: 05/08/2016] [Indexed: 11/23/2022]
Abstract
Introduction. Streptococcus pneumoniae is an important pathogen with high morbidity and mortality rates. The aim of this study was to evaluate the distribution of common serotypes and antimicrobial susceptibility of S. pneumoniae in Korea. Methods. A total of 378 pneumococcal isolates were collected from 2008 through 2014. We analyzed the serotype and antimicrobial susceptibility for both invasive and noninvasive isolates. Results. Over the 7 years, 3 (13.5%), 35 (10.8%), 19A (9.0%), 19F (6.6%), 6A (6.1%), and 34 (5.6%) were common serotypes/serogroups. The vaccine coverage rates of PCV7, PCV10, PCV13, and PPSV23 were 21.4%, 23.3%, 51.9%, and 62.4% in all periods. The proportions of serotypes 19A and 19F decreased and nonvaccine serotypes increased between 2008 and 2010 and 2011 and 2014. Of 378 S. pneumoniae isolates, 131 (34.7%) were multidrug resistant (MDR) and serotypes 19A and 19F were predominant. The resistance rate to levofloxacin was significantly increased (7.2%). Conclusion. We found changes of pneumococcal serotype and antimicrobial susceptibility during the 7 years after introduction of the first pneumococcal vaccine. It is important to continuously monitor pneumococcal serotypes and their susceptibilities.
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Harbarth S, Balkhy HH, Goossens H, Jarlier V, Kluytmans J, Laxminarayan R, Saam M, Van Belkum A, Pittet D. Antimicrobial resistance: one world, one fight! Antimicrob Resist Infect Control 2015. [PMCID: PMC4652432 DOI: 10.1186/s13756-015-0091-2] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The lack of new antibiotic classes calls for a cautious use of existing agents. Yet, every 10 min, almost two tons of antibiotics are used around the world, all too often without any prescription or control. The use, overuse and misuse of antibiotics select for resistance in numerous species of bacteria which then renders antimicrobial treatment ineffective. Almost all countries face increased antimicrobial resistance (AMR), not only in humans but also in livestock and along the food chain. The spread of AMR is fueled by growing human and animal populations, uncontrolled contamination of fresh water supplies, and increases in international travel, migration and trade. In this context of global concern, 68 international experts attending the fifth edition of the World HAI Resistance Forum in June 2015 shared their successes and failures in the global fight against AMR. They underlined the need for a “One Health” approach requiring research, surveillance, and interventions across human, veterinary, agricultural and environmental sectors. This strategy involves concerted actions on several fronts. Improved education and increased public awareness are a well-understood priority. Surveillance systems monitoring infections need to be expanded to include antimicrobial use, as well as the emergence and spread of AMR within clinical and environmental samples. Adherence to practices to prevent and control the spread of infections is mandatory to reduce the requirement of antimicrobials in general care and agriculture. Antibiotics need to be banned as growth promoters for farm animals in countries where it has not yet been done. Antimicrobial stewardship programmes in animal husbandry have proved to be efficient for minimising AMR, without compromising productivity. Regarding the use of antibiotics in humans, new tools to provide highly specific diagnoses of pathogens can decrease diagnostic uncertainty and improve clinical management. Finally, infection prevention and control measures – some of them as simple as hand hygiene – are essential and should be extended beyond healthcare settings. Aside from regulatory actions, all people can assist in AMR reduction by limiting antibiotic use for minor illnesses. Together, we can all work to reduce the burden of AMR.
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Kostyanev T, Bonten MJM, O'Brien S, Steel H, Ross S, François B, Tacconelli E, Winterhalter M, Stavenger RA, Karlén A, Harbarth S, Hackett J, Jafri HS, Vuong C, MacGowan A, Witschi A, Angyalosi G, Elborn JS, deWinter R, Goossens H. The Innovative Medicines Initiative's New Drugs for Bad Bugs programme: European public-private partnerships for the development of new strategies to tackle antibiotic resistance. J Antimicrob Chemother 2015; 71:290-5. [PMID: 26568581 DOI: 10.1093/jac/dkv339] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Antibiotic resistance (ABR) is a global public health threat. Despite the emergence of highly resistant organisms and the huge medical need for new drugs, the development of antibacterials has slowed to an unacceptable level worldwide. Numerous government and non-government agencies have called for public-private partnerships and innovative funding mechanisms to address this problem. To respond to this public health crisis, the Innovative Medicines Initiative Joint Undertaking programme has invested more than €660 million, with a goal of matched contributions from the European Commission and the European Federation of Pharmaceutical Industries and Associations, in the development of new antibacterial strategies. The New Drugs for Bad Bugs (ND4BB) programme, an Innovative Medicines Initiative, has the ultimate goal to boost the fight against ABR at every level from basic science and drug discovery, through clinical development to new business models and responsible use of antibiotics. Seven projects have been launched within the ND4BB programme to achieve this goal. Four of them will include clinical trials of new anti-infective compounds, as well as epidemiological studies on an unprecedented scale, which will increase our knowledge of ABR and specific pathogens, and improve the designs of the clinical trials with new investigational drugs. The need for rapid concerted action has driven the funding of seven topics, each of which should add significantly to progress in the fight against ABR. ND4BB unites expertise and provides a platform where the commitment and resources required by all parties are streamlined into a joint public-private partnership initiative of unprecedented scale.
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Affiliation(s)
- T Kostyanev
- Department of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - M J M Bonten
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - S O'Brien
- Infection Global Medicines Development, AstraZeneca, Macclesfield, Cheshire, UK
| | - H Steel
- Infectious Diseases Therapy Area Unit, GlaxoSmithKline, London, UK
| | - S Ross
- Infectious Diseases Therapy Area Unit, GlaxoSmithKline, London, UK
| | - B François
- Centre Hospitalier Universitaire Dupuytren, Limoges, France
| | - E Tacconelli
- Internal Medicine 1, Infectious Diseases, DZIF-TTU-HAARBI, University Hospital Tübingen, Tübingen, Germany
| | - M Winterhalter
- School of Engineering & Science, Jacobs University Bremen, Bremen, Germany
| | - R A Stavenger
- Antibacterial Discovery Performance Unit, GlaxoSmithKline, Collegeville, PA, USA
| | - A Karlén
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - S Harbarth
- University of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - J Hackett
- Infection Global Medicines Development, AstraZeneca, Gaithersburg, MD, USA
| | | | - C Vuong
- AiCuris GmbH & Co. KG, Wuppertal, Germany
| | - A MacGowan
- Bristol Centre for Antimicrobial Research & Evaluation, Department of Infection Sciences, North Bristol NHS Trust and Public Health England, Bristol, UK
| | - A Witschi
- Basilea Pharmaceutica International Ltd, Basel, Switzerland
| | | | - J S Elborn
- School of Medicine, Dentistry & Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - R deWinter
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - H Goossens
- Department of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium Laboratory of Medical Microbiology, University Hospital Antwerp, Antwerp, Belgium
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Shibayama K, Lee H, Kim S. Comparison of Antibiotic Resistance Rate of Medically Important Microorganisms between Japan and Korea. ANNALS OF CLINICAL MICROBIOLOGY 2015. [DOI: 10.5145/acm.2015.18.4.111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hyukmin Lee
- Department of Laboratory Medicine, Catholic Kwangdong University, Incheon, Korea
| | - Sunjoo Kim
- Department of Laboratory Medicine, Gyeongsang National University School of Medicine, Gyeongsang Health Science Institute, Jinju, Korea
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