1
|
Nag S, Larsen G, Szarvas J, Birkedahl LEK, Gulyás GM, Ciok WJ, Lagermann TM, Tafaj S, Bradbury S, Collignon P, Daley D, Dougnon V, Fabiyi K, Coulibaly B, Dembélé R, Nikiema G, Magloire N, Ouindgueta IJ, Hossain ZZ, Begum A, Donchev D, Diggle M, Turnbull L, Lévesque S, Berlinger L, Sogaard KK, Guevara PD, Valderrama CD, Maikanti P, Amlerova J, Drevinek P, Tkadlec J, Dilas M, Kaasch A, Westh HT, Bachtarzi MA, Amhis W, Salazar CES, Villacis J, Lúzon MAD, Palau DB, Duployez C, Paluche M, Asante-Sefa S, Moller M, Ip M, Mareković I, Pál-Sonnevend A, Cocuzza CE, Dambrauskiene A, Macanze A, Cossa A, Mandomando I, Nwajiobi-Princewill P, Okeke IN, Kehinde AO, Adebiyi I, Akintayo I, Popoola O, Onipede A, Blomfeldt A, Nyquist NE, Bocker K, Ussher J, Ali A, Ullah N, Khan H, Gustafson NW, Jarrar I, Al-Hamad A, Luvira V, Paveenkittiporn W, Baran I, Mwansa JCL, Sikakwa L, Yamba K, Hendriksen RS, Aarestrup FM. Whole genomes from bacteria collected at diagnostic units around the world 2020. Sci Data 2023; 10:628. [PMID: 37717051 PMCID: PMC10505216 DOI: 10.1038/s41597-023-02502-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/23/2023] [Indexed: 09/18/2023] Open
Abstract
The Two Weeks in the World research project has resulted in a dataset of 3087 clinically relevant bacterial genomes with pertaining metadata, collected from 59 diagnostic units in 35 countries around the world during 2020. A relational database is available with metadata and summary data from selected bioinformatic analysis, such as species prediction and identification of acquired resistance genes.
Collapse
Affiliation(s)
- Sidsel Nag
- National Food Institute, Technical University of Denmark, Kemitorvet, Kgs, Lyngby, 2800, Denmark.
| | - Gunhild Larsen
- National Food Institute, Technical University of Denmark, Kemitorvet, Kgs, Lyngby, 2800, Denmark
| | - Judit Szarvas
- National Food Institute, Technical University of Denmark, Kemitorvet, Kgs, Lyngby, 2800, Denmark
| | | | - Gábor Máté Gulyás
- National Food Institute, Technical University of Denmark, Kemitorvet, Kgs, Lyngby, 2800, Denmark
| | - Wojchiech Jakub Ciok
- National Food Institute, Technical University of Denmark, Kemitorvet, Kgs, Lyngby, 2800, Denmark
| | - Timmie Mikkel Lagermann
- National Food Institute, Technical University of Denmark, Kemitorvet, Kgs, Lyngby, 2800, Denmark
| | - Silva Tafaj
- Microbiology Department, University Hospital "Shefqet Ndroqi", Rruga Dr. Shefqet Ndroqi. Sauk, Tirana, 1044, Albania
| | - Susan Bradbury
- Microbiology Department, Canberra Hospital, Gilmore Cresent, Garran, 2605, Australian Capital Territory, Australia
| | - Peter Collignon
- Microbiology Department, Canberra Hospital, Gilmore Cresent, Garran, 2605, Australian Capital Territory, Australia
| | - Denise Daley
- Department of Microbiology, PathWest Laboratory Medicine, Fiona Stanley Hospital, 9 Robin Warren Drive, Murdoch, 6150, Western Australia, Australia
| | - Victorien Dougnon
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, 01 PO Box, Abomey-Calavi, 2009, Cotonou, Benin
| | - Kafayath Fabiyi
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, 01 PO Box, Abomey-Calavi, 2009, Cotonou, Benin
| | - Boubacar Coulibaly
- Department of Laboratory, Nouna Health Research Centre, Rue Namory Keita, Nouna, Burkina Faso
| | - René Dembélé
- Training and Research Unit in Applied Sciences and Technologies/Biochemistry-microbiology, University of Dedougou, Dedougou, 176, Boucle du Mouhoun, Burkina Faso
| | - Georgette Nikiema
- Training and Research Unit in Applied Sciences and Technologies/Biochemistry-microbiology, University of Dedougou, Dedougou, 176, Boucle du Mouhoun, Burkina Faso
| | - Natama Magloire
- Clinical Research Unit of Nanoro, National Institutes of Medical Research, Ouagadougou, 176, Burkina Faso
| | | | | | - Anowara Begum
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Deyan Donchev
- Clinical Laboratory of Microbiology and Virology, University Hospital "Lozenetz", Str. Kozyak 1, Sofia, 1407, Sofia, Bulgaria
| | | | | | - Simon Lévesque
- Service de microbiologie, Centre Integré Universitaire de Santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke, 3001 12è avenue Nord, Sherbrooke, J1H 5N4, Québec, Canada
| | | | - Kirstine Kobberoe Sogaard
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, Petersgraben 4, Basel, 4031, Switzerland
| | - Paula Diaz Guevara
- Microbiology Group, Instituto Nacional de Salud, Avenida Calle 26·51-20 CAN, Bogotá, 111321, Colombia
| | | | - Panagiota Maikanti
- Charalampous, Microbiology Department, National Reference Laboratory for Antimicrobial Resistance Surveillance, Nicosia General Hospital, 215, Paleos Dromos Lefkosia-Lemesos str., Strovolos, 2029, Nicosia, Cyprus
| | - Jana Amlerova
- Department of Microbiology, University Hospital in Plzen, Edvarda Benese 1128/13, Plzen, 305 99, Czech Republic
| | - Pavel Drevinek
- Department of Medical Microbiology, Motol University Hospital, V Uvalu 84, Prague, 15006, Czech Republic
| | - Jan Tkadlec
- Department of Medical Microbiology, Motol University Hospital, V Uvalu 84, Prague, 15006, Czech Republic
| | - Milica Dilas
- Otto-von-Guericke University, Magdebourg, Germany
| | - Achim Kaasch
- Otto-von-Guericke University, Magdebourg, Germany
| | - Henrik Torkil Westh
- Klinisk Mikrobiologisk Afdeling, Hvidovre Hospital, Kettegårds Allé, Hvidovre, 2650, Denmark
| | - Mohamed Azzedine Bachtarzi
- Laboratoire de Microbiologie Clinique, Centre Hospitalo-universitaire, 1 place du 1er Mai 1945, Algiers, 16000, Algeria
| | - Wahiba Amhis
- Laboratoire de Microbiologie Clinique, Centre Hospitalo-universitaire, 1 place du 1er Mai 1945, Algiers, 16000, Algeria
| | - Carolina Elisabeth Satán Salazar
- National Reference Center for Antimicrobial Resistance, National Institute of Public Health Research "Dr. Leopoldo Izquieta Pérez", Iquique N14-285, Quito, 170403, Pichicha, Ecuador
| | - JoséEduardo Villacis
- Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador, Quinto, 1701-2184, Pichincha, Ecuador
| | | | | | - Claire Duployez
- Institute of Microbiology, Centre Hospitalier Universitaire de Lille, Rue du Pr. Jules Leclercq, Lille, 59037, France
| | - Maxime Paluche
- Bacteriology laboratory, Centre hospitalier de Valenciennes, Avenue Désandrouin, Valenciennes, 59300, France
| | - Solomon Asante-Sefa
- Sekondi Public Health Laboratory, Ghana Health Service, Effia Nkwanta Regional Hospital, Effia Nkwanta Regional Hospital, Takoradi, Ghana
| | - Mie Moller
- Dronning Ingrids Hospital, Nuuk, Greenland
| | - Margaret Ip
- Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ivana Mareković
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Kišpatićeva 12, Zagreb, 10000, Croatia
| | - Agnes Pál-Sonnevend
- Medical Microbiology and Immunology, University of Pecs Medical School, Szigeti ut 12, Pecs, 7631, Hungary
| | | | - Asta Dambrauskiene
- Laboratory Medicine Department, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Eiveniu Str. 2, Kaunas, 50161, Lithuania
| | | | - Anelsio Cossa
- Centro de Investigação em Saúde de Manhiça, Manhiça, Mozambique
| | | | | | - Iruka N Okeke
- Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Aderemi O Kehinde
- College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
- University College of Ibadan, Ibadan, Oyo State, Nigeria
| | - Ini Adebiyi
- Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
- University College of Ibadan, Ibadan, Oyo State, Nigeria
| | - Ifeoluwa Akintayo
- College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Oluwafemi Popoola
- College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
- University College of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Anita Blomfeldt
- Department of Microbiology and Infection Control, Akershus University Hospital, Sykehusveien 25, Lørenskog, 1478, Norway
| | - Nora Elisabeth Nyquist
- Department of Microbiology and Infection Control, Akershus University Hospital, Sykehusveien 25, Lørenskog, 1478, Norway
| | - Kiri Bocker
- Southern Community Laboratories, University of Otago, 472 George Street, Otago, 9016, Dunedin, New Zealand
| | - James Ussher
- Southern Community Laboratories, University of Otago, 472 George Street, Otago, 9016, Dunedin, New Zealand
| | - Amjad Ali
- Department of Industrial Biotechnology, Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology (NUST), H-12, Islamabad, 44000, Pakistan
| | - Nimat Ullah
- Department of Industrial Biotechnology, Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology (NUST), H-12, Islamabad, 44000, Pakistan
| | - Habibullah Khan
- Molecular Diagnostic Section, Khyber Teaching Hospital (KTH), University Road, Peshawar, 25120, Pakistan
| | - Natalie Weiler Gustafson
- Departamento de Bacteriologia, Laboratorio Central de Salud Publico, Avenida Venezuela y Tte Escurra, Asunción, CP, 1429, Paraguay
| | - Ikhlas Jarrar
- Basic Medical Sciences Department, Arab American University, AAUP st., Zababdeh, P240, Jenin, Palestine
| | - Arif Al-Hamad
- Division of Clinical Microbiology, Qatif Central Hospital, 3213 Dharan-Jubail Expressway, Al-Qatif, 32654-7376, Eastern Province, Saudi Arabia
| | - Viravarn Luvira
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Ratchawithi Road, Bangkok, 10400, Thailand
| | | | - Irmak Baran
- Medical Microbiology Department, Karadeniz Technical University Farabi Hospital, Farabi Hastanesi, Trabzon, 61080, Ortahisar, Turkey
| | | | | | | | - Rene Sjogren Hendriksen
- National Food Institute, Technical University of Denmark, Kemitorvet, Kgs, Lyngby, 2800, Denmark
| | - Frank Moller Aarestrup
- National Food Institute, Technical University of Denmark, Kemitorvet, Kgs, Lyngby, 2800, Denmark
| |
Collapse
|
2
|
Contreras J, Oguoma V, Todd L, Naunton M, Collignon P, Bushell M. Restricting access to antibiotics: The effectiveness of a 'no repeats' government policy intervention. Res Social Adm Pharm 2023; 19:800-806. [PMID: 36828673 DOI: 10.1016/j.sapharm.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/05/2022] [Accepted: 02/17/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND Australia has a high rate of antibiotic use. Government policy interventions are one strategy to optimise the use of antibiotics. On 1 April 2020, the Australian Government Department of Health introduced a policy intervention to increase the quality use of four antibiotics. OBJECTIVES To assess if the government policy intervention improved the appropriate supply of the four antibiotics amoxicillin, amoxicillin-clavulanic acid, cefalexin and roxithromycin. METHOD This study employed a retrospective cohort study design comparing a 10% sample (n = 345,018) of four antibiotics prescribed and dispensed in Australia during a three-month period (May, June, July) in 2019, and again in 2020 (after the policy intervention). The 10% sample of PBS data was obtained from the Australian Government Department of Health. Descriptive statistics, bivariate and multivariable logistic regression analysis were carried out. RESULTS The results suggest the policy change improved the appropriate supply of original prescriptions in 2020 compared to 2019 OR = 1.75 (95% CI = 1.68-1.82, p < 0.001), and appropriate supply of repeat prescriptions OR = 1.56 (95% CI = 1.25-1.96, p < 0.001). In 2020, the proportion of appropriate supply of original prescriptions increased by an absolute difference of 1.8% (95% CI = 1.6-1.9%; P < 0.001), and appropriate supply of repeat prescriptions increased by 3.9% (95% CI = 2.2-5.5%; P < 0.001). The total number of antibiotic prescriptions prescribed and dispensed in 2019 (N = 219,960) reduced in 2020 (N = 125,058) after the policy intervention. CONCLUSION The study provides evidence for the impact of a government policy intervention to improve the appropriate supply of antibiotics, although some of the reduction in antibiotic use was likely due to the concomitant COVID-19 pandemic. Further research is required to assess the impact of the intervention outside a pandemic.
Collapse
Affiliation(s)
| | - Victor Oguoma
- Health Research Institute, University of Canberra, ACT, Australia.
| | - Lyn Todd
- Faculty of Pharmacy, University of Canberra, ACT, Australia.
| | - Mark Naunton
- Faculty of Pharmacy, University of Canberra, ACT, Australia.
| | - Peter Collignon
- ANU Medical School, ANU College of Health & Medicine, ACT, Australia; Australian Capital Territory Pathology, Canberra Hospital, Garran, Australian Capital Territory, Australia.
| | - Mary Bushell
- Faculty of Pharmacy, University of Canberra, ACT, Australia.
| |
Collapse
|
3
|
Munk P, Brinch C, Møller FD, Petersen TN, Hendriksen RS, Seyfarth AM, Kjeldgaard JS, Svendsen CA, van Bunnik B, Berglund F, Larsson DGJ, Koopmans M, Woolhouse M, Aarestrup FM, Gibb K, Coventry K, Collignon P, Cassar S, Allerberger F, Begum A, Hossain ZZ, Worrell C, Vandenberg O, Pieters I, Victorien DT, Gutierrez ADS, Soria F, Grujić VR, Mazalica N, Rahube TO, Tagliati CA, Rodrigues D, Oliveira G, de Souza LCR, Ivanov I, Juste BI, Oumar T, Sopheak T, Vuthy Y, Ngandjio A, Nzouankeu A, Olivier ZAAJ, Yost CK, Kumar P, Brar SK, Tabo DA, Adell AD, Paredes-Osses E, Martinez MC, Cuadros-Orellana S, Ke C, Zheng H, Baisheng L, Lau LT, Chung T, Jiao X, Yu Y, JiaYong Z, Morales JFB, Valencia MF, Donado-Godoy P, Coulibaly KJ, Hrenovic J, Jergović M, Karpíšková R, Deogratias ZN, Elsborg B, Hansen LT, Jensen PE, Abouelnaga M, Salem MF, Koolmeister M, Legesse M, Eguale T, Heikinheimo A, Le Guyader S, Schaeffer J, Villacis JE, Sanneh B, Malania L, Nitsche A, Brinkmann A, Schubert S, Hesse S, Berendonk TU, Saba CKS, Mohammed J, Feglo PK, Banu RA, Kotzamanidis C, Lytras E, Lickes SA, Kocsis B, Solymosi N, Thorsteinsdottir TR, Hatha AM, Ballal M, Bangera SR, Fani F, Alebouyeh M, Morris D, O’Connor L, Cormican M, Moran-Gilad J, Battisti A, Diaconu EL, Corno G, Di Cesare A, Alba P, Hisatsune J, Yu L, Kuroda M, Sugai M, Kayama S, Shakenova Z, Kiiyukia C, Ng’eno E, Raka L, Jamil K, Fakhraldeen SA, Alaati T, Bērziņš A, Avsejenko J, Kokina K, Streikisa M, Bartkevics V, Matar GM, Daoud Z, Pereckienė A, Butrimaite-Ambrozeviciene C, Penny C, Bastaraud A, Rasolofoarison T, Collard JM, Samison LH, Andrianarivelo MR, Banda DL, Amin A, Rajandas H, Parimannan S, Spiteri D, Haber MV, Santchurn SJ, Vujacic A, Djurovic D, Bouchrif B, Karraouan B, Vubil DC, Pal P, Schmitt H, van Passel M, Jeunen GJ, Gemmell N, Chambers ST, Mendoza FP, Huete-Pιrez J, Vilchez S, Ahmed AO, Adisa IR, Odetokun IA, Fashae K, Sørgaard AM, Wester AL, Ryrfors P, Holmstad R, Mohsin M, Hasan R, Shakoor S, Gustafson NW, Schill CH, Rojas MLZ, Velasquez JE, Magtibay BB, Catangcatang K, Sibulo R, Yauce FC, Wasyl D, Manaia C, Rocha J, Martins J, Álvaro P, Di Yoong Wen D, Shin H, Hur HG, Yoon S, Bosevska G, Kochubovski M, Cojocaru R, Burduniuc O, Hong PY, Perry MR, Gassama A, Radosavljevic V, Tay MYF, Zuniga-Montanez R, Wuertz S, Gavačová D, Pastuchová K, Truska P, Trkov M, Keddy K, Esterhuyse K, Song MJ, Quintela-Baluja M, Lopez MG, Cerdà-Cuéllar M, Perera RRDP, Bandara NKBKRGW, Premasiri HI, Pathirage S, Charlemagne K, Rutgersson C, Norrgren L, Örn S, Boss R, Van der Heijden T, Hong YP, Kumburu HH, Mdegela RH, Hounmanou YMG, Chonsin K, Suthienkul O, Thamlikitkul V, de Roda Husman AM, Bidjada B, Njanpop-Lafourcade BM, Nikiema-Pessinaba SC, Levent B, Kurekci C, Ejobi F, Kalule JB, Thomsen J, Obaidi O, Jassim LM, Moore A, Leonard A, Graham DW, Bunce JT, Zhang L, Gaze WH, Lefor B, Capone D, Sozzi E, Brown J, Meschke JS, Sobsey MD, Davis M, Beck NK, Sukapanpatharam P, Truong P, Lilienthal R, Kang S, Wittum TE, Rigamonti N, Baklayan P, Van CD, Tran DMN, Do Phuc N, Kwenda G, Larsson DGJ, Koopmans M, Woolhouse M, Aarestrup FM. Author Correction: Genomic analysis of sewage from 101 countries reveals global landscape of antimicrobial resistance. Nat Commun 2023; 14:178. [PMID: 36635285 PMCID: PMC9837105 DOI: 10.1038/s41467-023-35890-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Patrick Munk
- grid.5170.30000 0001 2181 8870Research Group for Genomic Epidemiology, Technical University of Denmark, Kgs, Lyngby, Denmark
| | - Christian Brinch
- grid.5170.30000 0001 2181 8870Research Group for Genomic Epidemiology, Technical University of Denmark, Kgs, Lyngby, Denmark
| | - Frederik Duus Møller
- grid.5170.30000 0001 2181 8870Research Group for Genomic Epidemiology, Technical University of Denmark, Kgs, Lyngby, Denmark
| | - Thomas N. Petersen
- grid.5170.30000 0001 2181 8870Research Group for Genomic Epidemiology, Technical University of Denmark, Kgs, Lyngby, Denmark
| | - Rene S. Hendriksen
- grid.5170.30000 0001 2181 8870Research Group for Genomic Epidemiology, Technical University of Denmark, Kgs, Lyngby, Denmark
| | - Anne Mette Seyfarth
- grid.5170.30000 0001 2181 8870Research Group for Genomic Epidemiology, Technical University of Denmark, Kgs, Lyngby, Denmark
| | - Jette S. Kjeldgaard
- grid.5170.30000 0001 2181 8870Research Group for Genomic Epidemiology, Technical University of Denmark, Kgs, Lyngby, Denmark
| | - Christina Aaby Svendsen
- grid.5170.30000 0001 2181 8870Research Group for Genomic Epidemiology, Technical University of Denmark, Kgs, Lyngby, Denmark
| | - Bram van Bunnik
- grid.4305.20000 0004 1936 7988Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, UK
| | - Fanny Berglund
- grid.8761.80000 0000 9919 9582Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, Gothenburg, Sweden
| | | | - D. G. Joakim Larsson
- grid.8761.80000 0000 9919 9582Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, Gothenburg, Sweden
| | - Marion Koopmans
- grid.5645.2000000040459992XDepartment of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Mark Woolhouse
- grid.4305.20000 0004 1936 7988Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, UK
| | - Frank M. Aarestrup
- grid.5170.30000 0001 2181 8870Research Group for Genomic Epidemiology, Technical University of Denmark, Kgs, Lyngby, Denmark
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Basseal JM, Bennett CM, Collignon P, Currie BJ, Durrheim DN, Leask J, McBryde ES, McIntyre P, Russell FM, Smith DW, Sorrell TC, Marais BJ. Key lessons from the COVID-19 public health response in Australia. Lancet Reg Health West Pac 2023; 30:100616. [PMID: 36248767 PMCID: PMC9549254 DOI: 10.1016/j.lanwpc.2022.100616] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Australia avoided the worst effects of the COVID-19 pandemic, but still experienced many negative impacts. Reflecting on lessons from Australia's public health response, an Australian expert panel composed of relevant discipline experts identified the following key lessons: 1) movement restrictions were effective, but their implementation requires careful consideration of adverse impacts, 2) disease modelling was valuable, but its limitations should be acknowledged, 3) the absence of timely national data requires re-assessment of national surveillance structures, 4) the utility of advanced pathogen genomics and novel vaccine technology was clearly demonstrated, 5) decision-making that is evidence informed and consultative is essential to maintain trust, 6) major system weaknesses in the residential aged-care sector require fixing, 7) adequate infection prevention and control frameworks are critically important, 8) the interests and needs of young people should not be compromised, 9) epidemics should be recognised as a 'standing threat', 10) regional and global solidarity is important. It should be acknowledged that we were unable to capture all relevant nuances and context specific differences. However, the intent of this review of Australia's public health response is to critically reflect on key lessons learnt and to encourage constructive national discussion in countries across the Western Pacific Region.
Collapse
Affiliation(s)
- JM Basseal
- Sydney Infectious Diseases Institute (Sydney ID), University of Sydney, Sydney, Australia
| | - CM Bennett
- Institute for Health Transformation, Deakin University, Burwood, Australia
| | - P Collignon
- Medical School, Australian National University and Canberra Hospital, Canberra, Australia
| | - BJ Currie
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - DN Durrheim
- Department of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - J Leask
- Sydney Infectious Diseases Institute (Sydney ID), University of Sydney, Sydney, Australia
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, Australia
| | - ES McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
| | - P McIntyre
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - FM Russell
- Department of Paediatrics, The University of Melbourne and Murdoch Children's Research Institute, Melbourne, Australia
| | - DW Smith
- School of Medicine, University of Western Australia and PathWest Department of Microbiology, Perth, Australia
| | - TC Sorrell
- Sydney Infectious Diseases Institute (Sydney ID), University of Sydney, Sydney, Australia
| | - BJ Marais
- Sydney Infectious Diseases Institute (Sydney ID), University of Sydney, Sydney, Australia
- Corresponding author at: Clinical School, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, New South Wales, 2145 Sydney, Australia.
| |
Collapse
|
5
|
Hobday R, Collignon P. An Old Defence Against New Infections: The Open-Air Factor and COVID-19. Cureus 2022; 14:e26133. [PMID: 35875284 PMCID: PMC9300299 DOI: 10.7759/cureus.26133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 12/02/2022] Open
Abstract
Outdoors, the risks of transmission of COVID-19 and many other respiratory infections are low. Several environmental factors are known to reduce the viability of viruses and other infectious pathogens in the air. They include variations in temperature, relative humidity, solar ultraviolet radiation, and dilution effects. But one agent that reduces the viability of both viruses and bacteria outdoors, the germicidal open-air factor (OAF), has not been properly recognized for decades. This is despite robust evidence that the OAF can influence both the survival of airborne pathogens and the course of infections. The germicidal effects of outdoor air were widely exploited during the late 19th and early 20th centuries. Firstly, in the treatment of tuberculosis patients who underwent 'open-air therapy' in sanatoria; and secondly by military surgeons during the First World War. They used the same open-air regimen in specially designed hospital wards to disinfect and heal severe wounds among injured soldiers. It was also used on influenza patients during the 1918-19 pandemic. Later, in the 1950s, open-air disinfection and treatment of burns were proposed in the event of nuclear warfare. During the 1960s, the OAF briefly returned to prominence when biodefence scientists conducted experiments proving that open air has a potent germicidal effect. When this work ended in the 1970s, interest in the OAF again fell away, and it remains largely ignored. The COVID-19 pandemic has revived interest in understanding the transmission dynamics and survival of viruses in the air. The pandemic has also stimulated research in the science and practice of improved ventilation to control respiratory infections. Such work is incomplete without an appreciation of the inactivation of viruses and other pathogens by the OAF, but this needs further investigation as a matter of urgency. Research to better understand the conditions under which the OAF can be preserved indoors is urgently needed. We need to review building design with better regard to infection control and patient recovery. But we need to act without delay, as there is already sufficient evidence to show that public health generally would improve if more emphasis was placed on increased exposure to outdoor air.
Collapse
|
6
|
MacKinnon MC, McEwen SA, Pearl DL, Lyytikäinen O, Jacobsson G, Collignon P, Gregson DB, Valiquette L, Laupland KB. Increasing incidence and antimicrobial resistance in Escherichia coli bloodstream infections: a multinational population-based cohort study. Antimicrob Resist Infect Control 2021; 10:131. [PMID: 34488891 PMCID: PMC8422618 DOI: 10.1186/s13756-021-00999-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 08/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Escherichia coli is an important pathogen in humans and is the most common cause of bacterial bloodstream infections (BSIs). The objectives of our study were to determine factors associated with E. coli BSI incidence rate and third-generation cephalosporin resistance in a multinational population-based cohort. METHODS We included all incident E. coli BSIs (2014-2018) from national (Finland) and regional (Australia [Canberra], Sweden [Skaraborg], and Canada [Calgary, Sherbrooke, and western interior]) surveillance. Incidence rates were directly age and sex standardized to the European Union 28-country 2018 population. Multivariable negative binomial and logistic regression models estimated factors significantly associated with E. coli BSI incidence rate and third-generation cephalosporin resistance, respectively. The explanatory variables considered for inclusion in both models were year (2014-2018), region (six areas), age (< 70-years-old and ≥ 70-years-old), and sex (female and male). RESULTS We identified 31,889 E. coli BSIs from 40.7 million person-years of surveillance. Overall and third-generation cephalosporin-resistant standardized rates were 87.1 and 6.6 cases/100,000 person-years, respectively, and increased 14.0% and 40.1% over the five-year study. Overall, 7.8% (2483/31889) of E. coli BSIs were third-generation cephalosporin-resistant. Calgary, Canberra, Sherbrooke, and western interior had significantly lower E. coli BSI rates compared to Finland. The significant association between age and E. coli BSI rate varied with sex. Calgary, Canberra, and western interior had significantly greater odds of third-generation cephalosporin-resistant E. coli BSIs compared to Finland. Compared to 2014, the odds of third-generation cephalosporin-resistant E. coli BSIs were significantly increased in 2016, 2017, and 2018. The significant association between age and the odds of having a third-generation cephalosporin-resistant E. coli BSI varied with sex. CONCLUSIONS Increases in overall and third-generation cephalosporin-resistant standardized E. coli BSI rates were clinically important. Overall, E. coli BSI incidence rates were 40-104% greater than previous investigations from the same study areas. Region, sex, and age are important variables when analyzing E. coli BSI rates and third-generation cephalosporin resistance in E. coli BSIs. Considering E. coli is the most common cause of BSIs, this increasing burden and evolving third-generation cephalosporin resistance will have an important impact on human health, especially in aging populations.
Collapse
Affiliation(s)
- Melissa C MacKinnon
- Department of Population Medicine, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada.
| | - Scott A McEwen
- Department of Population Medicine, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada
| | - David L Pearl
- Department of Population Medicine, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada
| | - Outi Lyytikäinen
- Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland
| | - Gunnar Jacobsson
- Department of Infectious Diseases, Skaraborg Hospital, Skövde, Sweden.,CARe - Center for Antibiotic Resistance Research, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Peter Collignon
- Department of Infectious Disease and Microbiology, The Canberra Hospital, Garran, ACT, Australia.,Medical School, Australian National University, Acton, ACT, Australia
| | - Daniel B Gregson
- Departments of Medicine, and Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Health Services, Calgary Zone, Calgary, AB, Canada
| | - Louis Valiquette
- Department of Microbiology-Infectious Diseases, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Kevin B Laupland
- Department of Medicine, Royal Inland Hospital, Kamloops, BC, Canada.,Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| |
Collapse
|
7
|
MacKinnon MC, McEwen SA, Pearl DL, Lyytikäinen O, Jacobsson G, Collignon P, Gregson DB, Valiquette L, Laupland KB. Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study. BMC Infect Dis 2021; 21:606. [PMID: 34172003 PMCID: PMC8229717 DOI: 10.1186/s12879-021-06326-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 06/14/2021] [Indexed: 11/16/2022] Open
Abstract
Background Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each. Methods During 2014–2018, we identified 30-day deaths from all incident E. coli BSIs from surveillance nationally in Finland, and regionally in Sweden (Skaraborg) and Canada (Calgary, Sherbrooke, western interior). We used a multivariable logistic regression model to estimate factors associated with 30-day case fatality risk. The explanatory variables considered for inclusion were year (2014–2018), region (five areas), age (< 70-years-old, ≥70-years-old), sex (female, male), third-generation cephalosporin (3GC) resistance (susceptible, resistant), and location of onset (community-onset, hospital-onset). The European Union 28-country 2018 population was used to directly age and sex standardize mortality rates. We used a multivariable Poisson model to estimate factors associated with mortality rate, and year, region, age and sex were considered for inclusion. Results From 38.7 million person-years of surveillance, we identified 2961 30-day deaths in 30,923 incident E. coli BSIs. The overall 30-day case fatality risk was 9.6% (2961/30923). Calgary, Skaraborg, and western interior had significantly increased odds of 30-day mortality compared to Finland. Hospital-onset and 3GC-resistant E. coli BSIs had significantly increased odds of mortality compared to community-onset and 3GC-susceptible. The significant association between age and odds of mortality varied with sex, and contrasts were used to interpret this interaction relationship. The overall standardized 30-day mortality rate was 8.5 deaths/100,000 person-years. Sherbrooke had a significantly lower 30-day mortality rate compared to Finland. Patients that were either ≥70-years-old or male both experienced significantly higher mortality rates than those < 70-years-old or female. Conclusions In our study populations, region, age, and sex were significantly associated with both 30-day case fatality risk and mortality rate. Additionally, 3GC resistance and location of onset were significantly associated with 30-day case fatality risk. Escherichia coli BSIs caused a considerable burden of disease from 30-day mortality. When analyzing population-based mortality data, it is important to explore mortality through two lenses, mortality rate and case fatality risk. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06326-x.
Collapse
Affiliation(s)
- Melissa C MacKinnon
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada.
| | - Scott A McEwen
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - David L Pearl
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Outi Lyytikäinen
- Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland
| | - Gunnar Jacobsson
- Department of Infectious Diseases, Skaraborg Hospital, Skövde, Sweden.,CARe - Center for Antibiotic Resistance Research, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Peter Collignon
- Department of Infectious Disease and Microbiology, The Canberra Hospital, Garran, Australian Capital Territory, Australia.,Medical School, Australian National University, Acton, Australian Capital Territory, Australia
| | - Daniel B Gregson
- Departments of Medicine, and Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Health Services, Calgary Zone, Calgary, Alberta, Canada
| | - Louis Valiquette
- Department of Microbiology-Infectious Diseases, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Kevin B Laupland
- Department of Medicine, Royal Inland Hospital, Kamloops, British Columbia, Canada.,Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
8
|
Collignon P. COVID-19 and future pandemics: is isolation and social distancing the new norm? Intern Med J 2021; 51:647-653. [PMID: 33960091 PMCID: PMC8206944 DOI: 10.1111/imj.15287] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 01/07/2023]
Abstract
The coronavirus, named SARS‐CoV‐2, is the cause of COVID‐19. This virus spreads readily from person to person and predominantly to and from the respiratory route and through droplets. There are many different interventions that can be and are used to decrease successfully the risk and spread of COVID‐19. Most of the principles underpinning these interventions relate to isolation and social distancing. These will need to be continued, at least in part, until safe and very effective vaccines become widely available and are delivered extensively and successfully globally. This new norm is isolation, plus social and physical distancing, and this new norm will likely be with us for some time to come. It will also be with us in any future pandemics, whether caused by bacteria or viruses, but especially when the causative pathogen spreads predominantly through the respiratory route. However, lockdowns and restrictions also cause many adverse but unintended economic, social and health consequences. Therefore, what is put into place needs to be proportionate to levels of risk of disease as well as spread, and which will vary in different localities and with time.
Collapse
Affiliation(s)
- Peter Collignon
- Microbiology and Infectious Disease, Canberra Hospital, Canberra, Australian Capital Territory, Australia.,Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| |
Collapse
|
9
|
Mowlaboccus S, Daley DA, Birdsall J, Gottlieb T, Merlino J, Nimmo GR, George N, Korman T, Streitberg R, Robson J, Peachey G, Collignon P, Bradbury S, Rogers BA, Coombs GW. Molecular characterization of fosfomycin-resistant Escherichia coli urinary tract infection isolates from Australia. Clin Microbiol Infect 2021; 27:1360-1361. [PMID: 33957274 DOI: 10.1016/j.cmi.2021.04.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/20/2021] [Accepted: 04/24/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Shakeel Mowlaboccus
- Murdoch University, 90 South Street, Murdoch, Western Australia, 6150, Australia; School of Biomedical Sciences, University of Western Australia, Perth, Australia.
| | - Denise A Daley
- Fiona Stanley Hospital, PathWest Laboratory Medicine WA, Murdoch, Western Australia, Australia
| | - Jacob Birdsall
- Concord Hospital, NSW Health Pathology, Concord, New South Wales, Australia
| | - Thomas Gottlieb
- Concord Hospital, NSW Health Pathology, Concord, New South Wales, Australia; Faculty of Medicine and Health Sciences, University of Sydney, New South Wales, Australia
| | - John Merlino
- Concord Hospital, NSW Health Pathology, Concord, New South Wales, Australia; Faculty of Medicine and Health Sciences, University of Sydney, New South Wales, Australia
| | - Graeme R Nimmo
- Pathology Queensland Central Laboratory, Herston, Queensland, Australia
| | - Narelle George
- Pathology Queensland Central Laboratory, Herston, Queensland, Australia
| | - Tony Korman
- Monash University, Clayton, Victoria, Australia; Monash Pathology, Monash Health, Clayton, Victoria, Australia
| | | | - Jenny Robson
- Sullivan Nicolaides Pathology, Queensland, Australia
| | | | - Peter Collignon
- The Canberra Hospital, Garran, Australian Capital Territory, Australia
| | - Susan Bradbury
- The Canberra Hospital, Garran, Australian Capital Territory, Australia
| | | | - Geoffrey W Coombs
- Murdoch University, 90 South Street, Murdoch, Western Australia, 6150, Australia; Fiona Stanley Hospital, PathWest Laboratory Medicine WA, Murdoch, Western Australia, Australia
| |
Collapse
|
10
|
Mowlaboccus S, Daley D, Pang S, Gottlieb T, Merlino J, Nimmo GR, George N, Korman TM, Streitberg R, Robson J, Peachey G, Collignon P, Bradbury S, Colombi E, Ramsay JP, Rogers BA, Coombs GW. Identification and characterisation of fosfomycin resistance in Escherichia coli urinary tract infection isolates from Australia. Int J Antimicrob Agents 2020; 56:106121. [PMID: 32739475 DOI: 10.1016/j.ijantimicag.2020.106121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 07/08/2020] [Accepted: 07/23/2020] [Indexed: 11/17/2022]
Abstract
Of 1033 Escherichia coli urinary tract infection isolates collected from females >12 years of age in Australia in 2019, only 2 isolates were resistant to fosfomycin with a minimum inhibitory concentration (MIC) of >256 mg/L. Despite having different multilocus sequence types, the two isolates harboured an identical plasmid-encoded fosA4 gene. The fosA4 gene has previously been identified in a single clinical E. coli isolate cultured in Japan in 2014. Each fosfomycin-resistant isolate harboured two conjugative plasmids that possessed an array of genes conferring resistance to aminoglycosides, β-lactams, macrolides, quinolones, sulfonamides and/or trimethoprim.
Collapse
Affiliation(s)
| | - Denise Daley
- Fiona Stanley Hospital, PathWest Laboratory Medicine WA, Murdoch, WA, Australia
| | - Stanley Pang
- Murdoch University, 90 South Street, Murdoch, WA 6150, Australia; Fiona Stanley Hospital, PathWest Laboratory Medicine WA, Murdoch, WA, Australia
| | | | | | - Graeme R Nimmo
- Pathology Queensland Central Laboratory, Herston, QLD, Australia
| | - Narelle George
- Pathology Queensland Central Laboratory, Herston, QLD, Australia
| | - Tony M Korman
- Monash University, Clayton, VIC, Australia; Monash Pathology, Monash Health, Clayton, VIC, Australia
| | | | | | | | | | | | | | | | | | - Geoffrey W Coombs
- Murdoch University, 90 South Street, Murdoch, WA 6150, Australia; Fiona Stanley Hospital, PathWest Laboratory Medicine WA, Murdoch, WA, Australia
| |
Collapse
|
11
|
Abstract
Antimicrobial resistance (AMR) is affected by many factors, but too much of our focus has been on antimicrobial usage. The major factor that drives resistance rates globally is spread. The COVID-19 pandemic should lead to improved infection prevention and control practices, both in healthcare facilities and the community. COVID-19 will also have ongoing and profound effects on local, national and international travel. All these factors should lead to a decrease in the spread of resistant bacteria. So overall, COVID-19 should lead to a fall in resistance rates seen in many countries. For this debate we show why, overall, COVID-19 will not result in increased AMR prevalence. But globally, changes in AMR rates will not be uniform. In wealthier and developed countries, resistance rates will likely decrease, but in many other countries there are already too many factors associated with poor controls on the spread of bacteria and viruses (e.g. poor water and sanitation, poor public health, corrupt government, inadequate housing, etc.). In these countries, if economies and governance deteriorate further, we might see even more transmission of resistant bacteria.
Collapse
Affiliation(s)
- Peter Collignon
- Australian Capital Territory Pathology, Canberra Hospital, Garran, Australian Capital Territory, Australia.,Medical School, Australian National University, Canberra, Australia
| | - John J Beggs
- Monarch Institute, 10 Queen St, Melbourne, Australia
| |
Collapse
|
12
|
Tartari E, Saris K, Kenters N, Marimuthu K, Widmer A, Collignon P, Cheng VCC, Wong SC, Gottlieb T, Tambyah PA, Perencevich E, Allegranzi B, Dramowski A, Edmond MB, Voss A. Not sick enough to worry? "Influenza-like" symptoms and work-related behavior among healthcare workers and other professionals: Results of a global survey. PLoS One 2020; 15:e0232168. [PMID: 32401751 PMCID: PMC7219706 DOI: 10.1371/journal.pone.0232168] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 04/09/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Healthcare workers (HCWs) and non-HCWs may contribute to the transmission of influenza-like illness (ILI) to colleagues and susceptible patients by working while sick (presenteeism). The present study aimed to explore the views and behavior of HCWs and non-HCWs towards the phenomenon of working while experiencing ILI. METHODS The study was a cross-sectional online survey conducted between October 2018 and January 2019 to explore sickness presenteeism and the behaviour of HCWs and non-HCWs when experiencing ILI. The survey questionnaire was distributed to the members and international networks of the International Society of Antimicrobial Chemotherapy (ISAC) Infection Prevention and Control (IPC) Working Group, as well as via social media platforms, including LinkedIn, Twitter and IPC Blog. RESULTS In total, 533 respondents from 49 countries participated (Europe 69.2%, Asia-Pacific 19.1%, the Americas 10.9%, and Africa 0.8%) representing 249 HCWs (46.7%) and 284 non-HCWs (53.2%). Overall, 312 (58.5%; 95% confidence interval [CI], 56.2-64.6) would continue to work when sick with ILI, with no variation between the two categories. Sixty-seven (26.9%) HCWs and forty-six (16.2%) non-HCWs would work with fever alone (p<0 .01) Most HCWs (89.2-99.2%) and non-HCWs (80%-96.5%) would work with "minor" ILI symptoms, such as sore throat, sinus cold, fatigue, sneezing, runny nose, mild cough and reduced appetite. CONCLUSION A future strategy to successfully prevent the transmission of ILI in healthcare settings should address sick-leave policy management, in addition to encouraging the uptake of influenza vaccine.
Collapse
Affiliation(s)
- Ermira Tartari
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Katja Saris
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
- Department of Medical Microbiology, Radboudumc, Nijmegen, The Netherlands
- REshape Center for Innovation, Radboudumc, Nijmegen, The Netherlands
| | - Nikki Kenters
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
| | - Kalisvar Marimuthu
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
- National Centre for Infectious Diseases, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Andreas Widmer
- University of Basel Hospitals and Clinics, Basel, Switzerland
| | - Peter Collignon
- Medical School, The Australian National University, Canberra, ACT, Australia
| | - Vincent C. C. Cheng
- Department of Microbiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hospital Authority, Hong Kong SAR, China
| | - Shuk C. Wong
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hospital Authority, Hong Kong SAR, China
| | - Thomas Gottlieb
- Department of Microbiology and Infectious Diseases Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Paul A. Tambyah
- Department of Medicine, National University of Singapore, Singapore, Singapore
| | - Eli Perencevich
- Divisions of General Internal Medicine and Infectious Diseases, University of Iowa Carver College of Medicine, Iowa City, IA, United States of Amrerica
| | - Benedetta Allegranzi
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Angela Dramowski
- Department of Paediatrics and Child Health, Division of Paediatric Infectious Diseases, Stellenbosch University, Cape Town, South Africa
| | - Michael B. Edmond
- University of Iowa Hospitals and Clinics, Iowa City, IA, United States of America
| | - Andreas Voss
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
- Department of Medical Microbiology, Radboudumc, Nijmegen, The Netherlands
- REshape Center for Innovation, Radboudumc, Nijmegen, The Netherlands
| | | |
Collapse
|
13
|
Basseal JM, Collignon P. How do healthcare workers in diagnostic imaging minimise risks but maximise performance during the COVID-19 pandemic? Australas J Ultrasound Med 2020; 23:87-89. [PMID: 34760588 PMCID: PMC8411668 DOI: 10.1002/ajum.12207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Jocelyne M. Basseal
- Discipline of Infectious Diseases & ImmunologyFaculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
- Australasian Society for Ultrasound in MedicineSydneyNSWAustralia
| | - Peter Collignon
- Microbiology, ACT PathologyThe Canberra HospitalCanberraACTAustralia
- Medical SchoolCanberraACTAustralia
| |
Collapse
|
14
|
Limmathurotsakul D, Sandoe JAT, Barrett DC, Corley M, Hsu LY, Mendelson M, Collignon P, Laxminarayan R, Peacock SJ, Howard P. 'Antibiotic footprint' as a communication tool to aid reduction of antibiotic consumption-authors' response. J Antimicrob Chemother 2020; 75:785-786. [PMID: 31865386 PMCID: PMC7021087 DOI: 10.1093/jac/dkz533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Direk Limmathurotsakul
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford OX3 7FZ, UK
| | - Jonathan A T Sandoe
- University of Leeds/Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK
- British Society of Antimicrobial Chemotherapy, Birmingham B1 3NJ, UK
| | - David C Barrett
- Bristol Veterinary School, University of Bristol, Bristol BS40 5DU, UK
| | - Michael Corley
- British Society of Antimicrobial Chemotherapy, Birmingham B1 3NJ, UK
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore 117649, Singapore
- National Centre for Infectious Diseases, Moulmein Road, Singapore 308433, Singapore
| | - Marc Mendelson
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, 7925, South Africa
- International Society for Infectious Diseases, Brookline, MA 02446, USA
| | - Peter Collignon
- Infectious Diseases and Microbiology, Canberra Hospital, Canberra, 2605, Australia
- Medical School, Australian National University, Acton, 2606, Australia
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, New Delhi, 110024, India
- Princeton Environmental Institute, Princeton, NJ 08544, USA
| | - Sharon J Peacock
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Philip Howard
- University of Leeds/Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK
- British Society of Antimicrobial Chemotherapy, Birmingham B1 3NJ, UK
| |
Collapse
|
15
|
Furuya-Kanamori L, Stone J, Yakob L, Kirk M, Collignon P, Mills DJ, Lau CL. Risk factors for acquisition of multidrug-resistant Enterobacterales among international travellers: a synthesis of cumulative evidence. J Travel Med 2020; 27:5613537. [PMID: 31691808 DOI: 10.1093/jtm/taz083] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/13/2019] [Accepted: 10/21/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Recent studies have shown that over 50% of people travelling to Southeast Asia return colonized with multidrug-resistant Enterobacterales (MRE) including carbapenemase-producing Enterobacterales. Importation of MRE by travellers and subsequent spread to family members, communities and healthcare facilities poses real risks that have not yet been adequately assessed. This systematic review and meta-analysis aims to quantify the risk factors and interventions for reducing the risk of MRE acquisition among international travellers. METHODS A systematic search was conducted in PubMed, Web of Science and Scopus for analytical epidemiological studies containing data post-2000 that assessed the risk factors to acquire and/or interventions to reduce the risk of MRE acquisition in travellers. Two researchers independently screened all the studies and extracted the information, and disagreements were resolved through consensus. The proportions of MRE acquisition by the region of destination and the odds ratio (OR) for the different risk factors and/or interventions were pooled using the inverse variance heterogeneity model. RESULTS A total of 20 studies (5253 travellers from high-income countries) were included in the meta-analysis. South Asia [58.7%; 95% confidence interval (CI), 44.5-72.5%] and Northern Africa (43.9%; 95% CI 37.6-50.3%) were the travel destinations with the highest proportion of MRE acquisition. Inflammatory bowel disease (OR 2.1; 95% CI 1.2-3.8), use of antibiotics (OR 2.4; 95% CI 1.9-3.0), traveller's diarrhoea (OR 1.7; 95% CI 1.3-2.3) and contact with the healthcare system overseas (OR 1.5; 95% CI 1.1-2.2) were associated with MRE colonization. Vegetarians (OR 1.4; 95% CI 1.0-2.0) and backpackers (OR 1.5; 95% CI 1.2-1.8) were also at increased odds of MRE colonization. Few studies (n = 6) investigated preventive measures and found that consuming only bottled water/beverages, meticulous hand hygiene and probiotics had no protective effect on MRE colonization. CONCLUSIONS International travel is an important driver for MRE spread worldwide. Future research needs to identify effective interventions to reduce the risk of MRE acquisition as well as design strategies to reduce local transmission on return.
Collapse
Affiliation(s)
- Luis Furuya-Kanamori
- Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | - Jennifer Stone
- Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | - Laith Yakob
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Martyn Kirk
- Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | - Peter Collignon
- ACT Pathology, Canberra Hospital, Canberra, Australia.,ANU Medical School, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | | | - Colleen L Lau
- Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia.,Travel Medicine Alliance Clinics, Brisbane, Australia
| |
Collapse
|
16
|
Limmathurotsakul D, Sandoe JAT, Barrett DC, Corley M, Hsu LY, Mendelson M, Collignon P, Laxminarayan R, Peacock SJ, Howard P. 'Antibiotic footprint' as a communication tool to aid reduction of antibiotic consumption-authors' response. J Antimicrob Chemother 2019; 74:3406-3408. [PMID: 31504599 PMCID: PMC6798835 DOI: 10.1093/jac/dkz372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Direk Limmathurotsakul
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Jonathan A T Sandoe
- University of Leeds/Leeds Teaching Hospitals NHS Trust, Leeds, UK.,British Society of Antimicrobial Chemotherapy, Birmingham, UK
| | - David C Barrett
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | - Michael Corley
- British Society of Antimicrobial Chemotherapy, Birmingham, UK
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore.,National Centre for Infectious Diseases, Moulmein Road, Singapore
| | - Marc Mendelson
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa.,International Society for Infectious Diseases, Brookline, MA, USA
| | - Peter Collignon
- Infectious Diseases and Microbiology, Canberra Hospital, Canberra, Australia.,Medical School, Australian National University, Acton, Australia
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, New Delhi, 110024, India.,Princeton Environmental Institute, Princeton, NJ, USA
| | | | - Philip Howard
- University of Leeds/Leeds Teaching Hospitals NHS Trust, Leeds, UK.,British Society of Antimicrobial Chemotherapy, Birmingham, UK
| |
Collapse
|
17
|
Cheng AC, Mitchell BG, Fasugba O, Graves N, Koerner J, Collignon P. Meatal cleaning: discrepancies in need of explanation - Authors' reply. Lancet Infect Dis 2019; 19:1165. [PMID: 31657771 DOI: 10.1016/s1473-3099(19)30531-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 09/25/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Allen C Cheng
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Infectious Prevention and Healthcare Epidemiology Unit, Alfred Hospital, Melbourne, VIC, Australia
| | - Brett G Mitchell
- Faculty of Arts, Nursing and Theology, Avondale College of Higher Education, Wahroonga, NSW 2258, Australia; School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia.
| | - Oyebola Fasugba
- Nursing Research Institute, Australian Catholic University & St Vincent's Health Australia Sydney, NSW, Australia
| | - Nicholas Graves
- Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, NSW, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jane Koerner
- University of Canberra, Canberra, ACT, Australia
| | - Peter Collignon
- Medical School, Australian National University, Acton, ACT, Australia; Australian Capital Territory Pathology, Canberra Hospital and Health Services, Garran, ACT, Australia
| |
Collapse
|
18
|
Limmathurotsakul D, Sandoe JAT, Barrett DC, Corley M, Hsu LY, Mendelson M, Collignon P, Laxminarayan R, Peacock SJ, Howard P. 'Antibiotic footprint' as a communication tool to aid reduction of antibiotic consumption-authors' response. J Antimicrob Chemother 2019; 74:2823. [PMID: 31355857 DOI: 10.1093/jac/dkz276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Direk Limmathurotsakul
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Jonathan A T Sandoe
- University of Leeds/Leeds Teaching Hospitals NHS Trust, Leeds, UK.,British Society of Antimicrobial Chemotherapy, Birmingham, UK
| | - David C Barrett
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | - Michael Corley
- British Society of Antimicrobial Chemotherapy, Birmingham, UK
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore, Singapore.,National Centre for Infectious Diseases, Moulmein Road, Singapore, Singapore
| | - Marc Mendelson
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa.,International Society for Infectious Diseases, Brookline, MA, USA
| | - Peter Collignon
- Infectious Diseases and Microbiology, Canberra Hospital, Canberra, Australia.,Medical School, Australian National University, Acton, Australia
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, New Delhi, India.,Princeton Environmental Institute, Princeton, NJ, USA
| | | | - Philip Howard
- University of Leeds/Leeds Teaching Hospitals NHS Trust, Leeds, UK.,British Society of Antimicrobial Chemotherapy, Birmingham, UK
| |
Collapse
|
19
|
Limmathurotsakul D, Sandoe JAT, Barrett DC, Corley M, Hsu LY, Mendelson M, Collignon P, Laxminarayan R, Peacock SJ, Howard P. 'Antibiotic footprint' as a communication tool to aid reduction of antibiotic consumption. J Antimicrob Chemother 2019; 74:2122-2127. [PMID: 31074489 PMCID: PMC6640305 DOI: 10.1093/jac/dkz185] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
'Superbugs', bacteria that have become resistant to antibiotics, have been in numerous media headlines, raising awareness of antibiotic resistance and leading to multiple action plans from policymakers worldwide. However, many commonly used terms, such as 'the war against superbugs', risk misleading people to request 'new' or 'stronger' antibiotics from their doctors, veterinary surgeons or pharmacists, rather than addressing a fundamental issue: the misuse and overuse of antibiotics in humans and animals. Simple measures of antibiotic consumption are needed for mass communication. In this article, we describe the concept of the 'antibiotic footprint' as a tool to communicate to the public the magnitude of antibiotic use in humans, animals and industry, and how it could support the reduction of overuse and misuse of antibiotics worldwide. We propose that people need to make appropriate changes in behaviour that reduce their direct and indirect consumption of antibiotics.
Collapse
Affiliation(s)
- Direk Limmathurotsakul
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford OX3 7FZ, UK
| | - Jonathan A T Sandoe
- University of Leeds/Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK
- British Society of Antimicrobial Chemotherapy, Birmingham B1 3NJ, UK
| | - David C Barrett
- Bristol Veterinary School, University of Bristol, Bristol BS40 5DU, UK
| | - Michael Corley
- British Society of Antimicrobial Chemotherapy, Birmingham B1 3NJ, UK
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore 117649, Singapore
- National Centre for Infectious Diseases, Moulmein Road, Singapore 308433, Singapore
| | - Marc Mendelson
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, 7925, South Africa
- International Society for Infectious Diseases, Brookline, MA 02446, USA
| | - Peter Collignon
- Infectious Diseases and Microbiology, Canberra Hospital, Canberra, 2605, Australia
- Medical School, Australian National University, Acton, 2606, Australia
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, New Delhi, 110024, India
- Princeton Environmental Institute, Princeton, NJ 08544, USA
| | - Sharon J Peacock
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Philip Howard
- University of Leeds/Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK
- British Society of Antimicrobial Chemotherapy, Birmingham B1 3NJ, UK
| |
Collapse
|
20
|
Collignon P, Beggs JJ. Socioeconomic Enablers for Contagion: Factors Impelling the Antimicrobial Resistance Epidemic. Antibiotics (Basel) 2019; 8:E86. [PMID: 31261988 PMCID: PMC6784211 DOI: 10.3390/antibiotics8030086] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/30/2019] [Accepted: 06/25/2019] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial resistance is a growing global problem that causes increased deaths as well as increased suffering for people. Overall, there are two main factors that drive antimicrobial resistance: the volumes of antimicrobials used and the spread of resistant micro-organisms along with the genes encoding for resistance. Importantly, a growing body of evidence points to contagion (i.e., spread) being the major, but frequently under-appreciated and neglected, factor driving the increased prevalence of antimicrobial resistance. When we aggregate countries into regional groupings, it shows a pattern where there is an inverse aggregate relationship between AMR and usage. Poor infrastructure and corruption levels, however, are highly and positively correlated with antimicrobial resistance levels. Contagion, antibiotic volumes, governance, and the way antibiotics are used are profoundly affected by a host of social and economic factors. Only after we identify and adequately address these factors can antimicrobial resistance be better controlled.
Collapse
Affiliation(s)
- Peter Collignon
- Infectious Diseases Physician and Microbiologist, Australian Capital Territory Pathology, Canberra Hospital, Australian Capital Territory 2606, Australia.
- Medical School, Australian National University, Australian Capital Territory 0200, Australia.
| | - John J Beggs
- Monarch Institute, 10 Queen St, Melbourne 3000, Australia
| |
Collapse
|
21
|
Fasugba O, Cheng AC, Gregory V, Graves N, Koerner J, Collignon P, Gardner A, Mitchell BG. Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomised controlled trial. The Lancet Infectious Diseases 2019; 19:611-619. [DOI: 10.1016/s1473-3099(18)30736-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/30/2018] [Accepted: 11/22/2018] [Indexed: 11/28/2022]
|
22
|
Mitchell BG, Fasugba O, Cheng AC, Gregory V, Koerner J, Collignon P, Gardner A, Graves N. Chlorhexidine versus saline in reducing the risk of catheter associated urinary tract infection: A cost-effectiveness analysis. Int J Nurs Stud 2019; 97:1-6. [PMID: 31129443 DOI: 10.1016/j.ijnurstu.2019.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Catheter associated urinary tract infections are one of the most common infections acquired in hospital. A recent randomised control study demonstrated the benefit of using chlorhexidine (0.1%) for meatal cleaning prior to urinary catheter insertion, by reducing both catheter associated asymptomatic bacteriuria and infection. These findings raise the important question of whether a decision to switch from saline to chlorhexidine was likely to be cost-effective. The aim of this paper was to evaluate the cost-effectiveness of adopting routine use of chlorhexidine for meatal cleaning prior to urinary catheter insertion METHODS: The outcomes of this cost-effectiveness study are changes to health service costs in $AUD and changes to quality adjusted life years from a decision to adopt 0.1% chlorhexidine for meatal cleaning prior to urinary catheter insertion as compared to saline. Effectiveness outcomes for this study were taken from a 32 week stepped wedge randomised controlled study conducted in three Australian hospitals. RESULTS The changes in health costs from switching from saline to 0.1% chlorhexidine per 100,000 catheterisations would save hospitals AUD$387,909 per 100,000 catherisations, prevent 70 cases of catheter associated urinary tract infections, release 282 bed days and provide a small improvement in health benefits of 1.43 quality adjusted life years. Using a maximum willingness to pay for a marginal quality adjusted life year threshold of AUD$28,000 per 100,000 catherisations, suggests that adopting chlorhexidine would be cost effective and potentially cost-saving. CONCLUSION The findings from our work provide evidence to health system administrators and those responsible for drafting catheter associated urinary tract infections prevention guidelines that investing in switching from saline to chlorhexidine is not only clinically effective but also a sensible decision in the context of allocating finite healthcare resources.
Collapse
Affiliation(s)
- Brett G Mitchell
- Faculty of Arts, Nursing and Theology, Avondale College of Higher Education, 185 Fox Valley Road, Wahroonga, New South Wales 2076, Australia; School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia.
| | - Oyebola Fasugba
- Nursing Research Institute, Australian Catholic University & St Vincent's Health Australia Sydney, New South Wales, Australia; Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, New South Wales, Australia
| | - Allen C Cheng
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Infectious Prevention and Healthcare Epidemiology Unit, Alfred Hospital, Melbourne, Australia
| | - Victoria Gregory
- Faculty of Arts, Nursing and Theology, Avondale College of Higher Education, 185 Fox Valley Road, Wahroonga, New South Wales 2076, Australia
| | - Jane Koerner
- School of Nursing, Midwifery and Paramedicine Australian Catholic University, Watson Australia
| | - Peter Collignon
- Australian Capital Territory Pathology, Canberra Hospital and Health Services, Yamba Drive, Garran, Australian Capital Territory 2605, Australia; Medical School, Australian National University, Acton, Australian Capital Territory 2601, Australia
| | - Anne Gardner
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Nicholas Graves
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
23
|
Collignon P, Beggs JJ, Walsh TR, Gandra S, Laxminarayan R. Antibiotic resistance, stewardship, and consumption - Authors' reply. Lancet Planet Health 2019; 3:e68. [PMID: 30797412 DOI: 10.1016/s2542-5196(18)30263-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 11/07/2018] [Indexed: 06/09/2023]
Affiliation(s)
- Peter Collignon
- ACT Pathology, Canberra Hospital, Canberra, ACT, Australia; Medical School, Australian National University, Woden, ACT 2606, Australia.
| | | | - Timothy R Walsh
- Microbiology Research, School of Medicine, Cardiff University, Cardiff, UK
| | - Sumanth Gandra
- Center for Disease Dynamics, Economics & Policy, Washington, DC, USA
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, New Delhi, India; Princeton Environmental Institute, Princeton, NJ, USA
| |
Collapse
|
24
|
Fasugba O, Das A, Mnatzaganian G, Mitchell BG, Collignon P, Gardner A. Incidence of single-drug resistant, multidrug-resistant and extensively drug-resistant Escherichia coli urinary tract infections: An Australian laboratory-based retrospective study. J Glob Antimicrob Resist 2018; 16:254-259. [PMID: 30412781 DOI: 10.1016/j.jgar.2018.10.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/24/2018] [Accepted: 10/30/2018] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the incidence of single-drug resistant, multidrug-resistant (MDR), extensively drug-resistant (XDR) and pandrug-resistant (PDR) Escherichia coli urinary tract infections (UTIs) in a sample of Australian Capital Territory (ACT) residents. METHODS Laboratory-based retrospective data from all ACT residents whose urine samples were processed from January 2009 to December 2013 at ACT Pathology were utilised. Multivariate logistic regression models were constructed to determine the associations of age, sex, urine sample source and socioeconomic status with risk of resistant infections. RESULTS A total of 146 915 urine samples from 57 837 ACT residents were identified over 5 years. The mean±standard deviation age of residents at first sample submitted was 48±26years, and 64.4% were female. The 5-year incidence of single-drug resistant E. coli UTI was high for ampicillin, trimethoprim and cefazolin (6.8%, 3.5% and 1.9%, respectively). No PDR E. coli UTI was detected. Five-year incidences of MDR and XDR E. coli UTIs were 1.9% and 0.2%, respectively, which is low in comparison with international rates. Female sex and age ≥38 years were significantly associated with single-drug and multidrug resistance. The risk of single-drug resistance was significantly higher in samples from after-hours general practice (GP) clinics compared with hospitals, office-hours GP clinics, and community and specialist health services (adjusted odds ratio=2.6, 95% confidence interval 2.2-3.1). CONCLUSIONS These findings have significant implications for antimicrobial prescribing given the identified risk factors for the detection of resistance, especially in patients attending after-hours GP clinics.
Collapse
Affiliation(s)
- Oyebola Fasugba
- Faculty of Health Sciences, Australian Catholic University, Australian Capital Territory, Australia; Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, NSW, Australia.
| | - Anindita Das
- Australian Capital Territory (ACT) Pathology, Canberra Hospital and Health Services, Australian Capital Territory, Australia
| | - George Mnatzaganian
- La Trobe Rural Health School, College of Science, Health and Engineering, Victoria, Australia
| | - Brett G Mitchell
- Faculty of Arts, Nursing and Theology, Avondale College of Higher Education, Wahroonga, NSW, Australia
| | - Peter Collignon
- Australian Capital Territory (ACT) Pathology, Canberra Hospital and Health Services, Australian Capital Territory, Australia; Medical School, Australian National University, Australian Capital Territory, Australia
| | - Anne Gardner
- Faculty of Health Sciences, Australian Catholic University, Australian Capital Territory, Australia; School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia
| |
Collapse
|
25
|
Garland SM, Dimech W, Collignon P, Cooley L, Nimmo GR, Smith DW, Baird R, Rawlinson W, Costa A, Higgins G. The new screening program to prevent cervical cancer using HPV DNA: getting the balance right in maintaining quality. J Pathol Clin Res 2018; 4:207-212. [PMID: 30058126 PMCID: PMC6175713 DOI: 10.1002/cjp2.110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 07/09/2018] [Accepted: 07/20/2018] [Indexed: 01/26/2023]
Abstract
Along with the reduction in human papillomavirus (HPV) infection and cervical abnormalities as a result of the successful HPV vaccination program, Australia is adopting a new screening strategy. This involves a new paradigm moving from cervical cytological screening to molecular nucleic acid technology (NAT), using HPV DNA assays as primary screening methodology for cervical cancer prevention. These assays must strike a balance between sufficient clinical sensitivity to detect or predict high-grade cervical intraepithelial lesions, the precursor to cervical cancer, without being too sensitive and detecting transient infection not destined for disease. Ensuring the highest quality HPV NAT is thus a priority in order to reduce the possibility of falsely negative screens and manage the risk associated with false positive HPV NAT test results. How to do this needs informed discussion and on-going refinement of the screening algorithm. This is of relevance as more countries move to more sensitive HPV NAT tests for secondary prevention of cervical cancer and as more HPV assays become available.
Collapse
Affiliation(s)
- Suzanne M Garland
- Department of Microbiology and Infectious DiseasesRoyal Women's HospitalParkvilleAustralia
- Infection and Immunity Murdoch Children's Research InstituteParkvilleAustralia
- Department of Obstetrics and GynaecologyUniversity of MelbourneParkvilleAustralia
| | - Wayne Dimech
- National Serology Reference Laboratory, Australia (NRL)FitzroyAustralia
| | - Peter Collignon
- Infectious Diseases and MicrobiologyCanberra HospitalGarranAustralia
- Medical SchoolAustralian National UniversityAustralia
| | - On behalf of the Australian Clinical Microbiologists Infectious Diseases Group
- Department of Microbiology and Infectious DiseasesRoyal Hobart HospitalHobartAustralia
- Department of Microbiology, Pathology Queensland Central LaboratoryHerstonAustralia
- Department of Microbiology, Griffith University School of MedicineSouthportAustralia
- Department of Microbiology, PathWest Laboratory Medicine WANedlandsAustralia
- Faculty of Health and Medical SciencesUniversity of Western AustraliaNedlandsAustralia
- Territory Pathology, Infectious Diseases, Royal Darwin HospitalDepartment of Health and FamiliesTiwiAustralia
- Virology, Serology and OTDS Laboratories, NSW Health PathologyRandwickAustralia
- Department of Microbiology, The Royal Children's HospitalParkvilleAustralia
- Microbiology and Infectious Disease, South Australia PathologyNorth TerraceAustralia
| | - Louise Cooley
- Department of Microbiology and Infectious DiseasesRoyal Hobart HospitalHobartAustralia
| | - Graeme R Nimmo
- Department of Microbiology, Pathology Queensland Central LaboratoryHerstonAustralia
- Department of Microbiology, Griffith University School of MedicineSouthportAustralia
| | - David W Smith
- Department of Microbiology, PathWest Laboratory Medicine WANedlandsAustralia
- Faculty of Health and Medical SciencesUniversity of Western AustraliaNedlandsAustralia
| | - Rob Baird
- Territory Pathology, Infectious Diseases, Royal Darwin HospitalDepartment of Health and FamiliesTiwiAustralia
| | - William Rawlinson
- Virology, Serology and OTDS Laboratories, NSW Health PathologyRandwickAustralia
| | - Anna‐Maria Costa
- Department of Microbiology and Infectious DiseasesRoyal Women's HospitalParkvilleAustralia
- Department of Microbiology, The Royal Children's HospitalParkvilleAustralia
| | - Geoff Higgins
- Microbiology and Infectious Disease, South Australia PathologyNorth TerraceAustralia
| |
Collapse
|
26
|
Collignon P, Beggs JJ, Walsh TR, Gandra S, Laxminarayan R. Anthropological and socioeconomic factors contributing to global antimicrobial resistance: a univariate and multivariable analysis. Lancet Planet Health 2018; 2:e398-e405. [PMID: 30177008 DOI: 10.1016/s2542-5196(18)30186-4] [Citation(s) in RCA: 349] [Impact Index Per Article: 58.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 07/19/2018] [Accepted: 08/20/2018] [Indexed: 05/25/2023]
Abstract
BACKGROUND Understanding of the factors driving global antimicrobial resistance is limited. We analysed antimicrobial resistance and antibiotic consumption worldwide versus many potential contributing factors. METHODS Using three sources of data (ResistanceMap, the WHO 2014 report on antimicrobial resistance, and contemporary publications), we created two global indices of antimicrobial resistance for 103 countries using data from 2008 to 2014: Escherichia coli resistance-the global average prevalence of E coli bacteria that were resistant to third-generation cephalosporins and fluoroquinolones, and aggregate resistance-the combined average prevalence of E coli and Klebsiella spp resistant to third-generation cephalosporins, fluoroquinolones, and carbapenems, and meticillin-resistant Staphylococcus aureus. Antibiotic consumption data were obtained from the IQVIA MIDAS database. The World Bank DataBank was used to obtain data for governance, education, gross domestic product (GDP) per capita, health-care spending, and community infrastructure (eg, sanitation). A corruption index was derived using data from Transparency International. We examined associations between antimicrobial resistance and potential contributing factors using simple correlation for a univariate analysis and a logistic regression model for a multivariable analysis. FINDINGS In the univariate analysis, GDP per capita, education, infrastructure, public health-care spending, and antibiotic consumption were all inversely correlated with the two antimicrobial resistance indices, whereas higher temperatures, poorer governance, and the ratio of private to public health expenditure were positively correlated. In the multivariable regression analysis (confined to the 73 countries for which antibiotic consumption data were available) considering the effect of changes in indices on E coli resistance (R2 0·54) and aggregate resistance (R2 0·75), better infrastructure (p=0·014 and p=0·0052) and better governance (p=0·025 and p<0·0001) were associated with lower antimicrobial resistance indices. Antibiotic consumption was not significantly associated with either antimicrobial resistance index in the multivariable analysis (p=0·64 and p=0·070). INTERPRETATION Reduction of antibiotic consumption will not be sufficient to control antimicrobial resistance because contagion-the spread of resistant strains and resistance genes-seems to be the dominant contributing factor. Improving sanitation, increasing access to clean water, and ensuring good governance, as well as increasing public health-care expenditure and better regulating the private health sector are all necessary to reduce global antimicrobial resistance. FUNDING None.
Collapse
Affiliation(s)
- Peter Collignon
- ACT Pathology, Canberra Hospital, Canberra, ACT, Australia; Medical School, Australian National University, Woden, ACT, Australia.
| | | | - Timothy R Walsh
- Microbiology Research, School of Medicine, Cardiff University, Cardiff, UK
| | - Sumanth Gandra
- Center for Disease Dynamics, Economics & Policy, Washington, DC, USA
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, New Delhi, India; Princeton Environmental Institute, Princeton, NJ, USA
| |
Collapse
|
27
|
Jimeno MT, Collignon P, Chau Y, Giusiano B. Utilization of a Neural Network in the Elaboration of an Evaluation Scale for Pain in Cerebral Palsy. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1634630] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract:An interesting aspect of neural networks is shown in the elaboration of an evaluation scale for pain in cerebral palsy with severe mental retardation. Because of the diversity of cases, the number of items had to be limited in the final step of statistical validation. Classical analysis on prior data did not allow to decide whether the variability in results is more likely due to the type of disability (i. e., the possibility of pain expression) than to the actual presence of pain. A neural network was used to find implicit relations between the data, with the advantage of having total control on the variables’ status by applying variations in the network architecture. This allowed for the rapid identification more significant item combinations as a function of degree of relationship to pain in cerebral palsy.
Collapse
|
28
|
Vangchhia B, Blyton MDJ, Collignon P, Kennedy K, Gordon DM. Factors affecting the presence, genetic diversity and antimicrobial sensitivity of Escherichia coli in poultry meat samples collected from Canberra, Australia. Environ Microbiol 2017; 20:1350-1361. [PMID: 29266683 DOI: 10.1111/1462-2920.14030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/29/2017] [Accepted: 12/12/2017] [Indexed: 11/30/2022]
Abstract
To investigate the factors determining the clonal composition of Escherichia coli in poultry meat samples, 306 samples were collected from 16 shops, representing three supermarket chains and an independent butchery located in each of the four town centers of Canberra, Australia, during the summer, autumn and winter. A total of 3415 E. coli isolates were recovered and assigned to a phylogenetic group using the Clermont quadruplex PCR method, fingerprinted using repetitive element palindromic (REP) PCR and screened for their antimicrobial susceptibility profiles. The probability of detecting E. coli and the number of fingerprint types detected per sample, as well as the phylogroup membership of the isolates and their antimicrobial sensitivity profiles varied, with one or more of retailer, store, meat type, season and husbandry. The results of this study demonstrate that poultry meat products are likely to be contaminated with a genetically diverse community of E. coli and suggest that factors relating to the nature of the meat product and distribution chain are determinants of the observed diversity.
Collapse
Affiliation(s)
- Belinda Vangchhia
- Ecology and Evolution, Research School of Biology, The Australian National University, 116 Daley Road, Acton, ACT, 2601, Australia.,Department of Veterinary Microbiology, College of Veterinary Sciences & Animal Husbandry, Central Agricultural University, Selesih, Aizawl, Mizoram, 796014, India
| | - Michaela D J Blyton
- Ecology and Evolution, Research School of Biology, The Australian National University, 116 Daley Road, Acton, ACT, 2601, Australia.,Hawkesbury Institute for the Environment, Western Sydney University, Hawkesbury Campus, Science Rd, Richmond, NSW 2753, Australia
| | - Peter Collignon
- Infectious Disease and Microbiology, Canberra Hospital, Woden, ACT, Australia.,Medical School, Australian National University, Canberra, ACT, Australia.,ACT Pathology, Canberra, ACT, Australia
| | - Karina Kennedy
- Infectious Disease and Microbiology, Canberra Hospital, Woden, ACT, Australia.,Medical School, Australian National University, Canberra, ACT, Australia
| | - David M Gordon
- Ecology and Evolution, Research School of Biology, The Australian National University, 116 Daley Road, Acton, ACT, 2601, Australia
| |
Collapse
|
29
|
Mitchell BG, Fasugba O, Gardner A, Koerner J, Collignon P, Cheng AC, Graves N, Morey P, Gregory V. Reducing catheter-associated urinary tract infections in hospitals: study protocol for a multi-site randomised controlled study. BMJ Open 2017; 7:e018871. [PMID: 29183930 PMCID: PMC5719302 DOI: 10.1136/bmjopen-2017-018871] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Despite advances in infection prevention and control, catheter-associated urinary tract infections (CAUTIs) are common and remain problematic. A number of measures can be taken to reduce the risk of CAUTI in hospitals. Appropriate urinary catheter insertion procedures are one such method. Reducing bacterial colonisation around the meatal or urethral area has the potential to reduce CAUTI risk. However, evidence about the best antiseptic solutions for meatal cleaning is mixed, resulting in conflicting recommendations in guidelines internationally. This paper presents the protocol for a study to evaluate the effectiveness (objective 1) and cost-effectiveness (objective 2) of using chlorhexidine in meatal cleaning prior to catheter insertion, in reducing catheter-associated asymptomatic bacteriuria and CAUTI. METHODS AND ANALYSIS A stepped wedge randomised controlled trial will be undertaken in three large Australian hospitals over a 32-week period. The intervention in this study is the use of chlorhexidine (0.1%) solution for meatal cleaning prior to catheter insertion. During the first 8 weeks of the study, no hospital will receive the intervention. After 8 weeks, one hospital will cross over to the intervention with the other two participating hospitals crossing over to the intervention at 8-week intervals respectively based on randomisation. All sites complete the trial at the same time in 2018. The primary outcomes for objective 1 (effectiveness) are the number of cases of CAUTI and catheter-associated asymptomatic bacteriuria per 100 catheter days will be analysed separately using Poisson regression. The primary outcome for objective 2 (cost-effectiveness) is the changes in costs relative to health benefits (incremental cost-effectiveness ratio) from adoption of the intervention. DISSEMINATION Results will be disseminated via peer-reviewed journals and presentations at relevant conferences.A dissemination plan it being developed. Results will be published in the peer review literature, presented at relevant conferences and communicated via professional networks. ETHICS Ethics approval has been obtained. TRIAL REGISTRATION NUMBER 12617000373370, approved 13/03/2017. Protocol version 1.1.
Collapse
Affiliation(s)
- Brett G Mitchell
- Faculty of Arts, Nursing and Theology, Avondale College for Higher Education, Wahroonga, Australia
- School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
| | - Oyebola Fasugba
- Faculty of Arts, Nursing and Theology, Avondale College for Higher Education, Wahroonga, Australia
- Nursing Research Institute, St Vincent's Health Australia (Sydney) and Australian Catholic University, Watson, Australia
| | - Anne Gardner
- Faculty of Health Sciences, Australian Catholic University, Dickson, Australia
| | - Jane Koerner
- Faculty of Health Sciences, Australian Catholic University, Dickson, Australia
| | - Peter Collignon
- Australian Capital Territory Pathology, Canberra Hospital and Health Services, Garran, Australian Capital Territory, Australia
- Medical School, Australian National University, Canberra, Australia
| | - Allen C Cheng
- Infectious Prevention and Healthcare Epidemiology Unit, Alfred Hospital, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Nicholas Graves
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Peter Morey
- Faculty of Education, Business and Science, Avondale College of Higher Education, Cooranbong, Australia
| | - Victoria Gregory
- Faculty of Arts, Nursing and Theology, Avondale College for Higher Education, Wahroonga, Australia
| |
Collapse
|
30
|
Pulcini C, Collignon P. Hospital antimicrobial stewardship: the way forward. Lancet Infect Dis 2017; 17:1120. [PMID: 29115260 DOI: 10.1016/s1473-3099(17)30570-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 09/08/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Céline Pulcini
- Université de Lorraine, Nancy, France; Centre Hospitalier Universitaire de Nancy, Service de Maladies Infectieuses et Tropicales, Nancy 54511, France.
| | - Peter Collignon
- Australian Capital Territory Pathology, Canberra Hospital, Canberra, ACT, Australia; Department of Microbiology and Infectious Disease, School of Medicine, Australian National University, Canberra, ACT, Australia
| |
Collapse
|
31
|
|
32
|
Shaban R, Maloney S, Gerrard J, Collignon P, Macbeth D, Cruickshank M, Hume A, Jennison A, Graham R, Bergh H, Wilson H, Derrington P. Outbreak of healthcare-associated Burkholderia cenocepacia bacteraemia and infection attributed to contaminated ‘sterile’ gel used for central line insertion under ultrasound guidance and other procedures. Infect Dis Health 2017. [DOI: 10.1016/j.idh.2017.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
33
|
Fasugba O, Das A, Mnatzaganian G, Mitchell B, Collignon P, Gardner A. Incidence of antimicrobial resistant Escherichia coli urinary tract infections in the Australian Capital Territory. Infect Dis Health 2017. [DOI: 10.1016/j.idh.2017.09.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
34
|
Richard-De Ceaurriz B, Leymarie C, Godefroy A, Collignon P, Sigaudy S, Truc P. [Neonatal presentation of Prader-Willi syndrome: A report of five cases]. Arch Pediatr 2017; 24:1115-1120. [PMID: 28967604 DOI: 10.1016/j.arcped.2017.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 05/06/2017] [Accepted: 08/16/2017] [Indexed: 11/15/2022]
Abstract
Prader-Willi syndrome (PWS) is a fingerprint disease caused by the loss of paternally inherited chromosome 15q11.2-q13. In several populations studied, prevalence is estimated to be from 1/10,000 to 1/25,000 births. The disease initially manifests by neonatal hypotonia associated with orality disorders. Secondly, hyperphagia appears with significant obesity and hypogonadism. Motor milestones and language development are delayed, and all individuals have variable degrees of cognitive disability during childhood. Frequently, the most prominent features do not become evident until the later childhood stage, which can lead to underdiagnosis or late diagnosis in early childhood. Because of the long-term implications of this syndrome, it is important to recognize its features as soon as possible so that early counseling of parents and the affected child is possible. The diagnosis is suspected on clinical grounds and confirmed by genetic analysis. Prenatal diagnosis is possible and can be considered in polyhydramnios, decreased fetal active movements, malpresentation, oddly positioned hands and feet, and abnormal fetal heart rhythm. Since PWS can also lead to complications in both pregnancy and labor, proper prenatal diagnosis can also help optimize perinatal care for affected children. We report a series of five newborns for whom PWS was diagnosed in the neonatal period over 6 years. During this period, no prenatal signs of PWS were detected. The incidence in our population was 1/7937 births. The disease was diagnosed on clinical criteria: severe hypotonia, failure to thrive with poor sucking, and dysmorphic and abnormalities of the genitalia. Polyhydramnios was observed in only one case. The delivery was normal for only one patient. All except one were term newborns. There were three males and two females. We noted abnormal fetal heart rate for 80 % of the patients. The birth weight was close to the 10th percentile for two patients, less than the 3rd percentile for two others. All individuals had eutrophic cranial perimeter and four presented peculiar position of fingers. Genetic analyses found a deletion of the paternal chromosome 15 in three patients (60 %) and maternal uniparental disomy for the two others (40 %). The distribution by sex, weight, cranial perimeter, and mutations are those reported in the literature. PWS should be sought in cases of severe neonatal hypotonia, most particularly if it combines dysmorphism, hypogonadism, malposition of the fingers, and suggestive prenatal history. An early diagnosis provides better multidisciplinary care for the patient and family. We have no explanation for the higher incidence of the disease than in the general population. It is possible that this incidence is only fortuitous, but further studies would help to identify potential risk factors for the disease.
Collapse
Affiliation(s)
- B Richard-De Ceaurriz
- Service de néonatalogie, hôpital Sainte-Musse, avenue Henri-Sainte-Claire-Deville, 83200 Toulon, France.
| | - C Leymarie
- Service de néonatalogie, hôpital Sainte-Musse, avenue Henri-Sainte-Claire-Deville, 83200 Toulon, France
| | - A Godefroy
- Service de pédiatrie multidisciplinaire, endocrinologie et diabétologie pédiatrique, hôpital Timone-Enfant, 13385 Marseille cedex 5, France
| | - P Collignon
- Service de génétique médicale, hôpital Sainte-Musse, avenue Henri-Sainte-Claire-Deville, 83200 Toulon, France
| | - S Sigaudy
- Département de génétique médicale, hôpital Timone-Enfant, 13385 Marseille cedex 5, France
| | - P Truc
- Service de néonatalogie, hôpital Sainte-Musse, avenue Henri-Sainte-Claire-Deville, 83200 Toulon, France
| |
Collapse
|
35
|
Shaban RZ, Maloney S, Gerrard J, Collignon P, Macbeth D, Cruickshank M, Hume A, Jennison AV, Graham RM, Bergh H, Wilson HL, Derrington P. Outbreak of health care-associated Burkholderia cenocepacia bacteremia and infection attributed to contaminated sterile gel used for central line insertion under ultrasound guidance and other procedures. Am J Infect Control 2017; 45:954-958. [PMID: 28757084 DOI: 10.1016/j.ajic.2017.06.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 06/23/2017] [Accepted: 06/23/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND We report an outbreak of Burkholderia cenocepacia bacteremia and infection in 11 patients predominately in intensive care units caused by contaminated ultrasound gel used in central line insertion and sterile procedures within 4 hospitals across Australia. METHODS Burkholderia cenocepacia was first identified in the blood culture of a patient from the intensive care unit at the Gold Coast University Hospital on March 26, 2017, with 3 subsequent cases identified by April 7, 2017. The outbreak response team commenced investigative measures. RESULTS The outbreak investigation identified the point source as contaminated gel packaged in sachets for use within the sterile ultrasound probe cover. In total, 11 patient isolates of B cenocepacia with the same multilocus sequence type were identified within 4 hospitals across Australia. This typing was the same as identified in the contaminated gel isolate with single nucleotide polymorphism-based typing, demonstrating that all linked isolates clustered together. CONCLUSION Arresting the national point-source outbreak within multiple jurisdictions was critically reliant on a rapid, integrated, and coordinated response and the use of informal professional networks to first identify it. All institutions where the product is used should look back at Burkholderia sp blood culture isolates for speciation to ensure this outbreak is no larger than currently recognized given likely global distribution.
Collapse
|
36
|
De Serres G, Skowronski DM, Ward BJ, Gardam M, Lemieux C, Yassi A, Patrick DM, Krajden M, Loeb M, Collignon P, Carrat F. Influenza Vaccination of Healthcare Workers: Critical Analysis of the Evidence for Patient Benefit Underpinning Policies of Enforcement. PLoS One 2017; 12:e0163586. [PMID: 28129360 PMCID: PMC5271324 DOI: 10.1371/journal.pone.0163586] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 08/27/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Four cluster randomized controlled trials (cRCTs) conducted in long-term care facilities (LTCFs) have reported reductions in patient risk through increased healthcare worker (HCW) influenza vaccination. This evidence has led to expansive policies of enforcement that include all staff of acute care hospitals and other healthcare settings beyond LTCFs. We critique and quantify the cRCT evidence for indirect patient benefit underpinning policies of mandatory HCW influenza vaccination. METHODS Plausibility of the four cRCT findings attributing indirect patient benefits to HCW influenza vaccination was assessed by comparing percentage reductions in patient risk reported by the cRCTs to predicted values. Plausibly predicted values were derived according to the basic mathematical principle of dilution, taking into account HCW influenza vaccine coverage and the specificity of patient outcomes for influenza. Accordingly, predicted values were calculated as a function of relevant compound probabilities including vaccine efficacy (ranging 40-60% in HCWs and favourably assuming the same indirect protection conferred through them to patients) × change in proportionate HCW influenza vaccine coverage (as reported by each cRCT) × percentage of a given patient outcome (e.g. influenza-like illness (ILI) or all-cause mortality) plausibly due to influenza virus. The number needed to vaccinate (NNV) for HCWs to indirectly prevent patient death was recalibrated based on real patient data of hospital-acquired influenza, with adjustment for potential under-detection (5.2-fold), and using favourable assumptions of HCW-attributable risk (ranging 60-80%). RESULTS In attributing patient benefit to increased HCW influenza vaccine coverage, each cRCT was found to violate the basic mathematical principle of dilution by reporting greater percentage reductions with less influenza-specific patient outcomes (i.e., all-cause mortality > ILI > laboratory-confirmed influenza) and/or patient mortality reductions exceeding even favourably-derived predicted values by at least 6- to 15-fold. If extrapolated to all LTCF and hospital staff in the United States, the prior cRCT-claimed NNV of 8 would implausibly mean >200,000 and >675,000 patient deaths, respectively, could be prevented annually by HCW influenza vaccination, inconceivably exceeding total US population mortality estimates due to seasonal influenza each year, or during the 1918 pandemic, respectively. More realistic recalibration based on actual patient data instead shows that at least 6000 to 32,000 hospital workers would need to be vaccinated before a single patient death could potentially be averted. CONCLUSIONS The four cRCTs underpinning policies of enforced HCW influenza vaccination attribute implausibly large reductions in patient risk to HCW vaccination, casting serious doubts on their validity. The impression that unvaccinated HCWs place their patients at great influenza peril is exaggerated. Instead, the HCW-attributable risk and vaccine-preventable fraction both remain unknown and the NNV to achieve patient benefit still requires better understanding. Although current scientific data are inadequate to support the ethical implementation of enforced HCW influenza vaccination, they do not refute approaches to support voluntary vaccination or other more broadly protective practices, such as staying home or masking when acutely ill.
Collapse
Affiliation(s)
- Gaston De Serres
- Institut national de santé publique du Québec, Quebec City, Quebec, Canada
- Laval University, Quebec City, Quebec, Canada
| | - Danuta M. Skowronski
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian J. Ward
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Michael Gardam
- University of Toronto, University Health Network, Toronto, Ontario, Canada
| | - Camille Lemieux
- University of Toronto, University Health Network, Toronto, Ontario, Canada
| | - Annalee Yassi
- University of British Columbia, Vancouver, British Columbia, Canada
| | - David M. Patrick
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Mel Krajden
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark Loeb
- McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Peter Collignon
- Australian National University, Acton, Australia
- Canberra Hospital, Garran, ACT, Australia
| | - Fabrice Carrat
- Institut National de la Santé et de la Recherche Médicale, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- Sorbonne Universités, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint Antoine, Unité de Santé Publique, Paris, France
| |
Collapse
|
37
|
Ba H, Collignon P, Inzouddine D, Tartière-Kesri L, Tartière J. The genetic contribution in the evaluation of cardiac patients in a non-university hospital. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30153-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
38
|
Cheng AC, Stewardson AJ, Mitchell BG, Collignon P, Johnson PD, Stuart RL. Mycobacterial infections due to contaminated heater cooler units used in cardiac bypass: An approach for infection control practitioners. Infect Dis Health 2016. [DOI: 10.1016/j.idh.2016.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
39
|
Fasugba O, Mitchell BG, Mnatzaganian G, Das A, Collignon P, Gardner A. Five-Year Antimicrobial Resistance Patterns of Urinary Escherichia coli at an Australian Tertiary Hospital: Time Series Analyses of Prevalence Data. PLoS One 2016; 11:e0164306. [PMID: 27711250 PMCID: PMC5053592 DOI: 10.1371/journal.pone.0164306] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 09/22/2016] [Indexed: 11/19/2022] Open
Abstract
This study describes the antimicrobial resistance temporal trends and seasonal variation of Escherichia coli (E. coli) urinary tract infections (UTIs) over five years, from 2009 to 2013, and compares prevalence of resistance in hospital- and community-acquired E. coli UTI. A cross sectional study of E. coli UTIs from patients attending a tertiary referral hospital in Canberra, Australia was undertaken. Time series analysis was performed to illustrate resistance trends. Only the first positive E. coli UTI per patient per year was included in the analysis. A total of 15,022 positive cultures from 8724 patients were identified. Results are based on 5333 first E. coli UTIs, from 4732 patients, of which 84.2% were community-acquired. Five-year hospital and community resistance rates were highest for ampicillin (41.9%) and trimethoprim (20.7%). Resistance was lowest for meropenem (0.0%), nitrofurantoin (2.7%), piperacillin-tazobactam (2.9%) and ciprofloxacin (6.5%). Resistance to amoxycillin-clavulanate, cefazolin, gentamicin and piperacillin-tazobactam were significantly higher in hospital- compared to community-acquired UTIs (9.3% versus 6.2%; 15.4% versus 9.7%; 5.2% versus 3.7% and 5.2% versus 2.5%, respectively). Trend analysis showed significant increases in resistance over five years for amoxycillin-clavulanate, trimethoprim, ciprofloxacin, nitrofurantoin, trimethoprim-sulphamethoxazole, cefazolin, ceftriaxone and gentamicin (P<0.05, for all) with seasonal pattern observed for trimethoprim resistance (augmented Dickey-Fuller statistic = 4.136; P = 0.006). An association between ciprofloxacin resistance, cefazolin resistance and ceftriaxone resistance with older age was noted. Given the relatively high resistance rates for ampicillin and trimethoprim, these antimicrobials should be reconsidered for empirical treatment of UTIs in this patient population. Our findings have important implications for UTI treatment based on setting of acquisition.
Collapse
Affiliation(s)
- Oyebola Fasugba
- Faculty of Health Sciences, Australian Catholic University, Australian Capital Territory, Australia
- * E-mail:
| | - Brett G. Mitchell
- Faculty of Health Sciences, Australian Catholic University, Australian Capital Territory, Australia
- Faculty of Arts, Nursing and Theology, Avondale College of Higher Education, Wahroonga, New South Wales, Australia
| | - George Mnatzaganian
- College of Science, Health and Engineering, La Trobe Rural Health School, La Trobe University, Victoria, Australia
| | - Anindita Das
- Australian Capital Territory Pathology, Canberra Hospital and Health Services, Garran, Australian Capital Territory, Australia
| | - Peter Collignon
- Australian Capital Territory Pathology, Canberra Hospital and Health Services, Garran, Australian Capital Territory, Australia
- Medical School, Australian National University, Acton, Australian Capital Territory, Australia
| | - Anne Gardner
- Faculty of Health Sciences, Australian Catholic University, Australian Capital Territory, Australia
| |
Collapse
|
40
|
Vangchhia B, Abraham S, Bell JM, Collignon P, Gibson JS, Ingram PR, Johnson JR, Kennedy K, Trott DJ, Turnidge JD, Gordon DM. Phylogenetic diversity, antimicrobial susceptibility and virulence characteristics of phylogroup F Escherichia coli in Australia. Microbiology (Reading) 2016; 162:1904-1912. [PMID: 27666313 DOI: 10.1099/mic.0.000367] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Unlike Escherichia coli strains belonging to phylogroup B2, the clinical significance of strains belonging to phylogroup F is not well understood. Here we report on a collection of phylogroup F strains recovered in Australia from faeces and extra-intestinal sites from humans, companion animals and native animals, as well as from poultry meat and water samples. The distribution of sequence types was clearly non-random with respect to isolate source. The antimicrobial resistance and virulence trait profiles also varied with the sequence type of the isolate. Phylogroup F strains tended to lack the virulence traits typically associated with phylogroup B2 strains responsible for extra-intestinal infection in humans. Resistance to fluoroquinolones and/or expanded-spectrum cephalosporins was common within ST648, ST354 and ST3711. Although ST354 and ST3711 are part of the same clonal complex, the ST3711 isolates were only recovered from native birds being cared for in a single wildlife rehabilitation centre, whereas the ST354 isolates were from faeces and extra-intestinal sites of dogs and humans, as well as from poultry meat. Although ST354 isolates from chicken meat in Western Australia were distinct from all other ST354 isolates, those from poultry meat samples collected in eastern Australia shared many similarities with other ST354 isolates from humans and companion animals.
Collapse
Affiliation(s)
- Belinda Vangchhia
- Evolution, Ecology and Genetics, Research School of Biology, Australian National University, 116 Daley Road, Acton, Australian Capital Territory 2601, Australia
| | - Sam Abraham
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia 6150, Australia
| | - Jan M Bell
- Microbiology and Infectious Disease, SA Pathology, Adelaide, South Australia 5000, Australia
| | - Peter Collignon
- Infectious Disease and Microbiology, Canberra Hospital, Woden, Australian Capital Territory 2606, Australia.,Medical School, Australian National University, Canberra, Australian Capital Territory 0200, Australia.,ACT Pathology, Canberra, Australian Capital Territory, Australia
| | - Justine S Gibson
- School of Veterinary Science, University of Queensland, Gatton, Queensland 4343, Australia
| | - Paul R Ingram
- Department of Microbiology, PathWest, Fiona Stanley Hospital, Perth, Australia.,School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia
| | - James R Johnson
- VA Medical Center and Department of Medicine, University of Minnesota, Infectious Diseases (111F), 1 Veterans Drive, Minneapolis, MN 55417, USA
| | - Karina Kennedy
- Infectious Disease and Microbiology, Canberra Hospital, Woden, Australian Capital Territory 2606, Australia.,Medical School, Australian National University, Canberra, Australian Capital Territory 0200, Australia
| | - Darren J Trott
- School of Animal and Veterinary Science, University of Adelaide, Roseworthy, South Australia 5371, Australia
| | - John D Turnidge
- Australian Commission on Safety and Quality in Health Care, New South Wales, Australia.,School of Biological Sciences, University of Adelaide, Adelaide, South Australia 5005, Australia
| | - David M Gordon
- Evolution, Ecology and Genetics, Research School of Biology, Australian National University, 116 Daley Road, Acton, Australian Capital Territory 2601, Australia
| |
Collapse
|
41
|
Mazzella JM, Frank M, Collignon P, Langeois M, Legrand A, Jeunemaitre X, Albuisson J. Phenotypic variability and diffuse arterial lesions in a family with Loeys-Dietz syndrome type 4. Clin Genet 2016; 91:458-462. [PMID: 27440102 DOI: 10.1111/cge.12838] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 07/18/2016] [Accepted: 07/18/2016] [Indexed: 01/20/2023]
Abstract
Syndromic thoracic aortic aneurysm and dissection (TAAD) can suggest Marfan, vascular Ehlers-Danlos or Loeys-Dietz (LDS) syndromes. Several of the TGFβ-pathway-related genes predispose to different types of LDS. Heterozygous loss-of-function variations in TGFβ2 have been shown to be responsible for a novel form of syndromic TAAD associated with an impairment of the mitral valve and cerebrovascular disease called Loeys-Dietz syndrome type 4 (LDS4). We report the clinical characterization of a LDS4 French family with sudden deaths and diffuse vascular lesions, caused by a frameshift mutation in TGFβ2 gene: c.[995del]; p.(Leu332TrpfsTer27). Clinical characteristics include aneurysm of aortic sinus, skeletal and cutaneous features compatible with a syndromic form of TAAD (joint hypermobility, scoliosis, and easy bruises), intracranial aneurysms and rare mitral valve involvement. Iliac aneurysms, systemic medium caliber arteries dissections, and mild developmental delay were present in the family, and have not been described in LDS4. Phenotypic variability was also an important finding, including absence of clinical vascular events at advanced age in one case. Our data expand the phenotype of LDS4: we confirm that TGFβ2 mutations are responsible for true LDS syndrome with non-specific features of connective tissue disorders and diffuse vascular lesions. Adapted vascular follow up and prevention has to be proposed for these patients.
Collapse
Affiliation(s)
- J-M Mazzella
- Hôpital Européen Georges Pompidou, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux de Paris, Paris, France
| | - M Frank
- Hôpital Européen Georges Pompidou, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux de Paris, Paris, France
| | - P Collignon
- Centre Hospitalier Intercommunal Toulon-La Seyne-sur-Mer, Service de Génétique Médicale, Toulon, France
| | - M Langeois
- Centre de Référence National Syndromes de Marfan et apparentés, Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Paris, France
| | - A Legrand
- Hôpital Européen Georges Pompidou, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux de Paris, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Paris Cardiovascular Research Centre, INSERM, U970, Paris, France
| | - X Jeunemaitre
- Hôpital Européen Georges Pompidou, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux de Paris, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Paris Cardiovascular Research Centre, INSERM, U970, Paris, France
| | - J Albuisson
- Hôpital Européen Georges Pompidou, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux de Paris, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Paris Cardiovascular Research Centre, INSERM, U970, Paris, France
| |
Collapse
|
42
|
Collignon PJ, Conly JM, Andremont A, McEwen SA, Aidara-Kane A, Agerso Y, Andremont A, Collignon P, Conly J, Dang Ninh T, Donado-Godoy P, Fedorka-Cray P, Fernandez H, Galas M, Irwin R, Karp B, Matar G, McDermott P, McEwen S, Mitema E, Reid-Smith R, Scott HM, Singh R, DeWaal CS, Stelling J, Toleman M, Watanabe H, Woo GJ. World Health Organization Ranking of Antimicrobials According to Their Importance in Human Medicine: A Critical Step for Developing Risk Management Strategies to Control Antimicrobial Resistance From Food Animal Production. Clin Infect Dis 2016; 63:1087-1093. [PMID: 27439526 DOI: 10.1093/cid/ciw475] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 07/06/2016] [Indexed: 11/14/2022] Open
Abstract
Antimicrobial use in food animals selects for antimicrobial resistance in bacteria, which can spread to people. Reducing use of antimicrobials-particularly those deemed to be critically important for human medicine-in food production animals continues to be an important step for preserving the benefits of these antimicrobials for people. The World Health Organization ranking of antimicrobials according to their relative importance in human medicine was recently updated. Antimicrobials considered the highest priority among the critically important antimicrobials were quinolones, third- and fourth-generation cephalosporins, macrolides and ketolides, and glycopeptides. The updated ranking allows stakeholders in the agriculture sector and regulatory agencies to focus risk management efforts on drugs used in food animals that are the most important to human medicine. In particular, the current large-scale use of fluoroquinolones, macrolides, and third-generation cephalosporins and any potential use of glycopeptides and carbapenems need to be addressed urgently.
Collapse
Affiliation(s)
- Peter J Collignon
- Infectious Diseases and Microbiology, Canberra Hospital.,Medical School, Australian National University, Acton, Australia
| | - John M Conly
- Departments of Medicine, Microbiology, Immunology & Infectious Diseases, and Pathology & Laboratory Medicine, Synder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | | | - Scott A McEwen
- Department of Population Medicine, University of Guelph, Ontario, Canada
| | - Awa Aidara-Kane
- Department of Food Safety and Zoonosis, World Health Organization, Geneva, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Coombs GW, Daley DA, Thin Lee Y, Pearson JC, Robinson JO, Nimmo GR, Collignon P, Howden BP, Bell JM, Turnidge JD. Australian Group on Antimicrobial Resistance Australian Staphylococcus aureus Sepsis Outcome Programme annual report, 2014. Commun Dis Intell (2018) 2016; 40:E244-E254. [PMID: 27522136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
From 1 January to 31 December 2014, 27 institutions around Australia participated in the Australian Staphylococcal Sepsis Outcome Programme (ASSOP). The aim of ASSOP 2014 was to determine the proportion of Staphylococcus aureus bacteraemia (SAB) isolates in Australia that are antimicrobial resistant, with particular emphasis on susceptibility to methicillin and to characterise the molecular epidemiology of the isolates. Overall, 18.8% of the 2,206 SAB episodes were methicillin resistant, which was significantly higher than that reported in most European countries. The 30-day all-cause mortality associated with methicillin-resistant SAB was 23.4%, which was significantly higher than the 14.4% mortality associated with methicillin-sensitive SAB (P <0.0001). With the exception of the beta-lactams and erythromycin, antimicrobial resistance in methicillin-sensitive S. aureus remains rare. However in addition to the beta-lactams, approximately 50‰ of methicillin-resistant S. aureus (MRSA) were resistant to erythromycin and ciprofloxacin and approximately 15% were resistant to co-trimoxazole, tetracycline and gentamicin. When applying the European Committee on Antimicrobial Susceptibility Testing breakpoints, teicoplanin resistance was detected in 2 S. aureus isolates. Resistance was not detected for vancomycin or linezolid. Resistance to non-beta-lactam antimicrobials was largely attributable to 2 healthcare-associated MRSA clones; ST22-IV [2B] (EMRSA-15) and ST239-III [3A] (Aus-2/3 EMRSA). ST22-IV [2B] (EMRSA-15) has become the predominant healthcare associated clone in Australia. Sixty per cent of methicillin-resistant SAB were due to community-associated (CA) clones. Although polyclonal, almost 44% of community-associated clones were characterised as ST93-IV [2B] (Queensland CA-MRSA) and ST1-IV [2B] (WA1). CA-MRSA, in particular the ST45-V [5C2&5] (WA84) clone, has acquired multiple antimicrobial resistance determinants including ciprofloxacin, erythromycin, clindamycin, gentamicin and tetracycline. As CA-MRSA is well established in the Australian community it is important that antimicrobial resistance patterns in community and healthcare-associated SAB is monitored as this information will guide therapeutic practices in treating S. aureus sepsis.
Collapse
Affiliation(s)
- Geoffrey W Coombs
- Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia
- Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine-WA, Fiona Stanley Hospital, Murdoch, Western Australia
| | - Denise A Daley
- Australian Group on Antimicrobial Resistance, Fiona Stanley Hospital, Murdoch, Western Australia
| | - Yung Thin Lee
- Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia
| | - Julie C Pearson
- Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine-WA, Fiona Stanley Hospital, Murdoch, Western Australia
| | - J Owen Robinson
- Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia
- Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine-WA, Fiona Stanley Hospital, Murdoch, Western Australia
| | - Graeme R Nimmo
- Division of Microbiology, Pathology Queensland Central Laboratory, Queensland
- Griffith University School of Medicine, Gold Coast, Queensland
| | - Peter Collignon
- Department of Microbiology and Infectious Diseases, The Canberra Hospital, Australian Capital Territory
- School of Clinical Medicine, Australian National University, Australian Capital Territory
| | - Benjamin P Howden
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Doherty Institute for Infection and Immunity, Victoria
| | - Jan M Bell
- SA Pathology, Department of Microbiology and Infectious Diseases, Women's and Children's Hospital, North Adelaide, South Australia
| | - John D Turnidge
- SA Pathology, Department of Microbiology and Infectious Diseases, Women's and Children's Hospital, North Adelaide, South Australia
- Departments of Pathology, Paediatrics and Molecular and Biomedical Sciences, University of Adelaide, Adelaide, South Australia
| |
Collapse
|
44
|
Affiliation(s)
- P. Collignon
- Medical School; Australian National University; Canberra Australian Capital Territory Australia
- ACT Pathology; Canberra Australian Capital Territory Australia
- Canberra Hospital; Canberra Australian Capital Territory Australia
| |
Collapse
|
45
|
Forthomme B, Croisier J, Collignon P, Steinmetz L, Astro G, Kaux J, Bruls O, Denoel V, Schwartz C. Stretching program dedicated to shoulder stiffness: Functional consequences. Ann Phys Rehabil Med 2015. [DOI: 10.1016/j.rehab.2015.07.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
46
|
Affiliation(s)
- Peter Collignon
- Canberra Hospital, Garran Australian National University Medical School, Woden, ACT, Australia
| | - Karina J Kennedy
- Canberra Hospital, Garran Australian National University Medical School, Woden, ACT, Australia
| |
Collapse
|
47
|
Tartari E, Allegranzi B, Ang B, Calleja N, Collignon P, Hopman J, Lang L, Lee LC, Ling ML, Mehtar S, Tambyah PA, Widmer A, Voss A. Preparedness of institutions around the world for managing patients with Ebola virus disease: an infection control readiness checklist. Antimicrob Resist Infect Control 2015; 4:22. [PMID: 26056563 PMCID: PMC4459682 DOI: 10.1186/s13756-015-0061-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 05/02/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In response to global concerns about the largest Ebola virus disease (EVD), outbreak to-date in West Africa documented healthcare associated transmission and the risk of global spread, the International Society of Chemotherapy (ISC) Infection Control Working Group created an Ebola Infection Control Readiness Checklist to assess the preparedness of institutions around the globe. We report data from the electronic checklist that was disseminated to medical professionals from October to December 2014 and identify action needed towards better preparedness levels. FINDINGS Data from 192 medical professionals (one third from Africa) representing 125 hospitals in 45 countries around the globe were obtained through a specifically developed electronic survey. The survey contained 76 specific questions in 7 major sections: Administrative/operational support; Communications; Education and audit; Human resources, Supplies, Infection Prevention and Control practices and Clinical management of patients. The majority of respondents were infectious disease specialists/infection control consultants/clinical microbiologists (75; 39 %), followed by infection control professionals (59; 31 %) and medical doctors of other specialties (17; 9 %). Nearly all (149; 92 %) were directly involved in Ebola preparedness activities. Whilst, 54 % indicated that their hospital would need to handle suspected and proven Ebola cases, the others would subsequently transfer suspected cases to a specialized centre. CONCLUSION The results from our survey reveal that the general preparedness levels for management of potentially suspected cases of Ebola virus disease is only partially adequate in hospitals. Hospitals designated for admitting EVD suspected and proven patients had more frequently implemented Infection Control preparedness activities than hospitals that would subsequently transfer potential EVD cases to other centres. Results from this first international survey provide a framework for future efforts to improve hospital preparedness worldwide.
Collapse
Affiliation(s)
- Ermira Tartari
- />Infection Control Unit, Mater Dei Hospital, Msida, Malta
| | | | - Brenda Ang
- />Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
| | - Neville Calleja
- />Department of Health Information and Research, Ministry of Health, Valletta, Malta
| | - Peter Collignon
- />Infectious Diseases Unit and Microbiology, Canberra Hospital, Canberra, Australia
| | - Joost Hopman
- />Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lily Lang
- />National Healthcare Groups Polyclinics, Singapore, Singapore
| | - Lai Chee Lee
- />Infection Control, Singapore General Hospital, Singapore, Singapore
| | - Moi Lin Ling
- />Infection Control, Singapore General Hospital, Singapore, Singapore
| | - Shaheen Mehtar
- />Faculty of Medicine and Health Sciences, Stellenbosch University, Cape town, South Africa
| | - Paul A. Tambyah
- />Division of Infectious Diseases, National University of Singapore, Singapore, Singapore
| | - Andreas Widmer
- />Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Andreas Voss
- />Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
48
|
Collignon P, Voss A. China, what antibiotics and what volumes are used in food production animals? Antimicrob Resist Infect Control 2015; 4:16. [PMID: 25932325 PMCID: PMC4415312 DOI: 10.1186/s13756-015-0056-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 04/04/2015] [Indexed: 11/26/2022] Open
Affiliation(s)
- Peter Collignon
- />Canberra Hospital and Australian National University Medical School, PO Box 11, Woden, ACT 2607 Australia
| | - Andreas Voss
- />Department of Medical Microbiology, Radboud university medical centre and Canisius-Wilhelmina Hospital, PO Box 9015, 6500GS Nijmegen, The Netherlands
| |
Collapse
|
49
|
Collignon P, Athukorala PC, Senanayake S, Khan F. Antimicrobial resistance: the major contribution of poor governance and corruption to this growing problem. PLoS One 2015; 10:e0116746. [PMID: 25786027 PMCID: PMC4364737 DOI: 10.1371/journal.pone.0116746] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 12/12/2014] [Indexed: 11/18/2022] Open
Abstract
Objectives To determine how important governmental, social, and economic factors are in driving antibiotic resistance compared to the factors usually considered the main driving factors—antibiotic usage and levels of economic development. Design A retrospective multivariate analysis of the variation of antibiotic resistance in Europe in terms of human antibiotic usage, private health care expenditure, tertiary education, the level of economic advancement (per capita GDP), and quality of governance (corruption). The model was estimated using a panel data set involving 7 common human bloodstream isolates and covering 28 European countries for the period 1998–2010. Results Only 28% of the total variation in antibiotic resistance among countries is attributable to variation in antibiotic usage. If time effects are included the explanatory power increases to 33%. However when the control of corruption indicator is included as an additional variable, 63% of the total variation in antibiotic resistance is now explained by the regression. The complete multivariate regression only accomplishes an additional 7% in terms of goodness of fit, indicating that corruption is the main socioeconomic factor that explains antibiotic resistance. The income level of a country appeared to have no effect on resistance rates in the multivariate analysis. The estimated impact of corruption was statistically significant (p< 0.01). The coefficient indicates that an improvement of one unit in the corruption indicator is associated with a reduction in antibiotic resistance by approximately 0.7 units. The estimated coefficient of private health expenditure showed that one unit reduction is associated with a 0.2 unit decrease in antibiotic resistance. Conclusions These findings support the hypothesis that poor governance and corruption contributes to levels of antibiotic resistance and correlate better than antibiotic usage volumes with resistance rates. We conclude that addressing corruption and improving governance will lead to a reduction in antibiotic resistance.
Collapse
Affiliation(s)
- Peter Collignon
- ACT Pathology, Canberra Hospital, Australian National University, Garran, Australia
- Canberra Clinical School, Australian National University, Garran, Australia
- * E-mail:
| | - Prema-chandra Athukorala
- Arndt-Corden Department of Economics, Australian National University, Acton, Australia
- School of Environment and Development, University of Manchester, Manchester, England
| | - Sanjaya Senanayake
- Australian National University, Garran, Australia
- Canberra Hospital, Garran, Australia
| | - Fahad Khan
- Arndt-Corden Department of Economics, Australian National University, Acton, Australia
| |
Collapse
|
50
|
Affiliation(s)
- Peter Collignon
- Infectious Diseases Unit and Microbiology Department, Canberra Hospital, Woden, Australian Capital Territory, Australia
| | - Peter Doshi
- School of Pharmacy, University of Maryland, Baltimore
| | - Chris Del Mar
- Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia
| | | |
Collapse
|