The purpose of this manual is to provide guidance for countries on the methods and metrics for the surveillance of AMR in selected bacteria causing common human infections. This manual is part of a package of documents and tools designed to inform GLASS implementation and describes the objectives and methodology of GLASS AMR, the GLASS component dealing with the global surveillance of AMR in selected bacteria causing common human infections.
"In May 2015, the Sixty-eighth World Health Assembly adopted the Global action plan on antimicrobial resistance, which reflects the global consensus that AMR poses a profound threat to human health. One of the five strategic objectives of the Global action plan is to strengthen the evidence base through enhanced global surveillance and research. The Global Antimicrobial Resistance Surveillance System (GLASS) has been developed to facilitate and encourage a standardized approach to AMR surveillance globally and in turn support the implementation of the Global action plan on antimicrobial resistance. This manual addresses the early phase of implementation of GLASS, focussing on surveillance of resistance in common human bacterial pathogens. The intended readership of this publication is public health professionals and health authorities responsible for national AMR surveillance. It outlines the GLASS standards and describes the road map for implementation of the system between 2015 and 2019. Further development of GLASS will be based on the lessons learnt during this period"--Publisher's description.
Avoiding infection has always been expensive. Some human populations escaped tropical infections by migrating into cold climates but then had to procure fuel, warm clothing, durable housing, and crops from a short growing season. Waterborne infections were averted by owning your own well or supporting a community reservoir. Everyone got vaccines in rich countries, while people in others got them later if at all. Antimicrobial agents seemed at first to be an exception. They did not need to be delivered through a cold chain and to everyone, as vaccines did. They had to be given only to infected patients and often then as relatively cheap injectables or pills off a shelf for only a few days to get astonishing cures. Antimicrobials not only were better than most other innovations but also reached more of the world’s people sooner. The problem appeared later. After each new antimicrobial became widely used, genes expressing resistance to it began to emerge and spread through bacterial populations. Patients infected with bacteria expressing such resistance genes then failed treatment and remained infected or died. Growing resistance to antimicrobial agents began to take away more and more of the cures that the agents had brought.
Legionnaires' disease, a pneumonia caused by the Legionella bacterium, is the leading cause of reported waterborne disease outbreaks in the United States. Legionella occur naturally in water from many different environmental sources, but grow rapidly in the warm, stagnant conditions that can be found in engineered water systems such as cooling towers, building plumbing, and hot tubs. Humans are primarily exposed to Legionella through inhalation of contaminated aerosols into the respiratory system. Legionnaires' disease can be fatal, with between 3 and 33 percent of Legionella infections leading to death, and studies show the incidence of Legionnaires' disease in the United States increased five-fold from 2000 to 2017. Management of Legionella in Water Systems reviews the state of science on Legionella contamination of water systems, specifically the ecology and diagnosis. This report explores the process of transmission via water systems, quantification, prevention and control, and policy and training issues that affect the incidence of Legionnaires' disease. It also analyzes existing knowledge gaps and recommends research priorities moving forward.
The National Strategy for Combating Antibiotic Resistant Bacteria, published in 2014, sets out a plan for government work to mitigate the emergence and spread of resistant bacteria. Direction on the implementation of this strategy is provided in five-year national action plans, the first covering 2015 to 2020, and the second covering 2020 to 2025. Combating Antimicrobial Resistance and Protecting the Miracle of Modern Medicine evaluates progress made against the national strategy. This report discusses ways to improve detection of resistant infections and estimate the risk to human health from environmental sources of resistance. In addition, the report considers the effect of agricultural practices on human and animal health and animal welfare and ways these practices could be improved, and advises on key drugs and diseases for which animal-specific test breakpoints are needed.
Antibiotic resistance has become a worldwide health issue, globally recognized as the first priority by WHO. Many forms of resistance can spread with remarkable speed and cross international boundaries. World health leaders are devoting efforts to the problem by planning strategies for monitoring the effectiveness of public health interventions and detecting new trends and threats. This volume focuses on the problem from different perspectives, taking into consideration geographical dissemination (soil and water), human medicine (methicillin-resistant Staphylococcus aureus and Klebsiella pneumoniae) and veterinary (Enterococcus spp.) impact and molecular analysis. The purpose of this volume is to provide a useful tool for control and prevention and to discuss useful epidemiological data concerning ways of obtaining an accurate picture of resistance in different communities.
When Antibiotics Fail examines the current impacts of AMR on our healthcare system, projects the future impact on Canada’s GDP, and looks at how widespread resistance will influence the day-to-day lives of Canadians. The report examines these issues through a One Health lens, recognizing the interconnected nature of AMR, from healthcare settings to the environment to the agriculture sector. It is the most comprehensive report to date on the economic impact of AMR in Canada.
Development and Implications of Antimicrobial Resistance One of the most ominous trends in the field of antimicrobial chemotherapy over the past decade has been the increasing pace of development of antimicrobial resistance among microbial pathogens. The hypothesis that man can discover a magic bullet to always cure a particular infection has proved false. Physicians are now seeing and treating patients for which there are few therapeutic alternatives, and in some cases, none at all. Until recently there was little concern that physicians might be losing the war in our ability to compete with the evolving resistance patterns of microbial pathogens. Now the general public is very aware of the threat to them if they become infected, thanks to cover story articles in major magazines such as Time, Newsweek, newspapers, and other news sources. Antimicrobial resistance is not a novel problem. Shortly after the widespread introduction of penicillin in the early 1940s, the first strains of penicillin-resistant staphylococci were described. Today it is an uncommon event for a clinical laboratory to isolate an S. aureus that is sensitive to penicillin. Other gram-positive strains of bacteria have become resistant, including the exquisitely sensitive Streptococcus pneumoniae. Sensitivity to vancomycin was once so uniform that it was used in routine clinical laboratories as a surrogate marker for whether an organism should be classified as a gram-positive. That criterion can no longer be relied upon because of emerging resistance among some species. Gram-negative bacteria, viruses, fungi, and parasites all have succeeded in developing resistance.
An accessible overview of the challenges in tackling AMR, and the economic and policy responses of the 'One Health' approach. It will appeal to policy-makers seeking to strengthen national and local polices tackling AMR, as well as students and academics who want an overview of the latest scientific evidence regarding effective AMR policies.
This is the third edition of this manual which contains updated practical guidance on biosafety techniques in laboratories at all levels. It is organised into nine sections and issues covered include: microbiological risk assessment; lab design and facilities; biosecurity concepts; safety equipment; contingency planning; disinfection and sterilisation; the transport of infectious substances; biosafety and the safe use of recombinant DNA technology; chemical, fire and electrical safety aspects; safety organisation and training programmes; and the safety checklist.
