Search

Antimicrobial agents used to treat infections are lifesaving. Overuse may result in more frequent adverse effects and emergence of multidrug-resistant microorganisms. In 2016–17, we performed the second pointprevalence survey (PPS) of healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals. We included 1,209 hospitals and 310,755 patients in 28 of 31 European Union/European Economic Area (EU/EEA) countries. The weighted prevalence of antimicrobial use in the EU/EEA was 30.5% (95% CI: 29.2–31.9%). The most common indication for prescribing antimicrobials was treatment of a community-acquired infection, followed by treatment of HAI and surgical prophylaxis. Over half (54.2%) of antimicrobials for surgical prophylaxis were prescribed for more than 1 day. The most common infections treated by antimicrobials were respiratory tract infections and the most commonly prescribed antimicrobial agents were penicillins with beta-lactamase inhibitors. There was wide variation of patients on antimicrobials, in the selection of antimicrobial agents and in antimicrobial stewardship resources and activities across the participating countries. The results of the PPS provide detailed information on antimicrobial use in European acute care hospitals, enable comparisons between countries and hospitals, and highlight key areas for national and European action that will support efforts towards prudent use of antimicrobials., peer-reviewed

Following the European Union (EU) Council Recommendation on prudent use of antimicrobial agents in human medicine in 2001, and the success of national campaigns, i.e. Belgium and France, the European Centre for Disease Prevention and Control (ECDC) decided to establish the European Antibiotic Awareness Day (EAAD) on 18 November as platform to support national campaigns across Europe. This article provides an overview of EAAD tools, materials, and activities developed during the first five years. It shows that EAAD has been successful due to good cooperation between ECDC and national institutions, strong political and stakeholder support and evidence-based development of campaign materials. EAAD has provided a platform for pre-existing national campaigns and encouraged similar campaigns to develop where neither political support had been secured, nor financial support had been available. As a result, participating countries have continuously expressed strong support for ECDC to continue its work on EAAD. This has been endorsed by a steadily increasing number of countries participating and the growing interest of varied professional and stakeholder organisations. We conclude that EAAD should continue to act as catalyst for discussion and as mechanism to raise awareness of the public and prescribers about prudent use of antibiotics., peer-reviewed

The spread of carbapenemase-producing Enterobacteriaceae (CPE) is a threat to healthcare delivery, although its extent differs substantially from country to country. In February 2013, national experts from 39 European countries were invited to self-assess the current epidemiological situation of CPE in their country. Information about national management of CPE was also reported. The results highlight the urgent need for a coordinated European effort on early diagnosis, active surveillance, and guidance on infection control measures. The present report summarises the results from 39 European countries of a self-assessment of the epidemiological stage and the management of carbapenemase-producing Enterobacteriaceae (CPE) at national level.

Many different definitions for multidrug-resistant (MDR), extensively drug-resistant (XDR) and pandrug-resistant (PDR) bacteria are being used in the medical literature to characterize the different patterns of resistance found in healthcare-associated, antimicrobial-resistant bacteria. A group of international experts came together through a joint initiative by the European Centre for Disease Prevention and Control (ECDC) and the Centers for Disease Control and Prevention (CDC), to create a standardized international terminology with which to describe acquired resistance profiles in Staphylococcus aureus, Enterococcus spp., Enterobacteriaceae (other than Salmonella and Shigella), Pseudomonas aeruginosa and Acinetobacter spp., all bacteria often responsible for healthcare-associated infections and prone to multidrug resistance. Epidemiologically significant antimicrobial categories were constructed for each bacterium. Lists of antimicrobial categories proposed for antimicrobial susceptibility testing were created using documents and breakpoints from the Clinical Laboratory Standards Institute (CLSI), the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the United States Food and Drug Administration (FDA). MDR was defined as acquired non-susceptibility to at least one agent in three or more antimicrobial categories, XDR was defined as non-susceptibility to at least one agent in all but two or fewer antimicrobial categories (i.e. bacterial isolates remain susceptible to only one or two categories) and PDR was defined as non-susceptibility to all agents in all antimicrobial categories. To ensure correct application of these definitions, bacterial isolates should be tested against all or nearly all of the antimicrobial agents within the antimicrobial categories and selective reporting and suppression of results should be avoided.

Purpose: The leaves of Erigeron floribundus (Kunth) Sch. Beep. or (syn: Conyza sumatrensis (Retz) E.K. Walker) (Asteraceae) are used by some traditional healers in West Africa in HIV/AIDS therapy. The purpose of this study was to assess the immune-boosting properties of the aqueous leaf extract of Erigeron floribundus (Ef) by monitoring blood markers of cellular immunity in rabbit.Methods: Two sets each of five groups (six rabbits per group) were used in this study. The groups in the first set each received intraperitoneally a single dose of Ef (25, 50, 75 or 100 mg/kg) or 0.9 % NaCl (control). The groups in the second set received methylprednisolone (15 mg/kg, MP15) and mixtures of MP15 with Ef (50, 75 or 100 mg/kg), MP15 or isoprinosine 50 mg/kg (Ip50, reference standard). Whole blood was collected in EDTA tubes from the marginal vein of the rabbit ear on Days 0, 3, 9, 15 and 21after administration for the determination of CD4+ count by flow cytometry, and also of neutrophils and total lymphocytes in the blood.Results: Each plant extract dose tested (50, 75 and 100 mg/kg) induced a significant increase in neutrophils (p < 0.001), total lymphocytes and TCD4+ (p < 0.0001) from the 3rd to 15th day after administration, compared to control (0.9 % NaCl). Furthermore, the same test extract doses significantly reversed the immunosuppressive effect of methylprednisolone (p < 0.001) to the same extent as isoprinosine.Conclusion: The aqueous extract of the leaves of Erigeron floribundus stimulated the increase of neutrophils, total lymphocytes and TCD4+ in rabbit blood and thus provides some justification for its use in the traditional treatment of AIDS.

The European NDM-1 Survey Participants: Manuela Caniça (Departamento de Doenças Infecciosas do INSA) Acquired carbapenemases confer extensive antibiotic resistance to Enterobacteriaceae and represent a public health threat. A novel acquired carbapenemase, New Delhi metallo-beta-lactamase 1 (NDM-1), has recently been described in the United Kingdom and Sweden, mostly in patients who had received care on the Indian subcontinent. We conducted a survey among 29 European countries (the European Union Member States, Iceland and Norway) to gather information on the spread of NDM-1-producing Enterobacteriaceae in Europe, on public health responses and on available national guidance on detection, surveillance and control. A total of 77 cases were reported from 13 countries from 2008 to 2010. Klebsiella pneumoniae was the most frequently reported species with 54%. Among 55 cases with recorded travel history, 31 had previously travelled or been admitted to a hospital in India or Pakistan and five had been hospitalised in the Balkan region. Possible nosocomial acquisition accounted for 13 of 77 cases. National guidance on NDM-1 detection was available in 14 countries and on NDM-1 control in 11 countries. In conclusion, NDM-1 is spreading across Europe, where it is frequently linked to a history of healthcare abroad, but also to emerging nosocomial transmission. National guidance in response to the threat of carbapenemase-producing Enterobacteriaceae is available in approximately half of the surveyed European countries. Surveillance of carbapenemase- producing Enterobacteriaceae must be enhanced in Europe and effective control measures identified and implemented.

Purpose: The asexual proliferation of Plasmodium, inside the erythrocyte, is accompanied by the synthesis of huge quantities of phosphatidylcholine (PtdCho) and phosphatidylethanolamine (PtdEtn). These needful phospholipids for the cytoplasmic membrane of the merozoites are provided by the precursors choline and ethanolamine. PtdCho and PtdEtn are synthesized by the parasite because the erythrocyte is unable to do it. In order to assess the dynamism of the phospholipid pathways, we aimed to investigate the respective shape of the uptake of choline and ethanolamine by Plasmodium falciparum. Method: Time-course experiments and kinetic assays were performed respectively with fixed and ranged concentrations of radioactively-labelled choline and ethanolamine. The labelled-precursors were added in the culture of P. falciparum infected-erythrocytes and the incorporated molecules in phospholipids were measured with a scintigraph counter. Result: The results showed that the incorporation of precursors in the infected-erythrocyte occurred with a Michaelis-Menten\'s kinetic shape. According to the maximum rate (Vmax), the pathway of ethanolamine incorporation was faster than that of choline. Similarly, affinity for ethanolamine was greater than that of choline. Conclusion: Although PtdCho is the major phospholipid in the membrane, this study rules out that the influx of ethanolamine in the infected-erythrocyte, in vivo conditions, is more dynamic than choline. Keywords: Plasmodium, phospholipids, kinetics, metabolism, choline, ethanolamine Tropical Journal of Pharmaceutical Research Vol. 7 (2) 2008: pp. 953-959

We analysed the situation concerned with actual self-medication with antibiotics within the Slovak republic. The results were compared with the prevalence of self -medication with antibiotics within 18 European countries. Our target was to determine and compare the prevalence of actual self-medication with antibiotics in the previous 12 months, intended self-medication and storage, and to identify the associated demographic characteristics. Self-medication with systemic antibiotics occurs in all countries participating in this survey, with highest prevalence rates in eastern and southern Europe and lowest in North and West. The main sources were "directly from the pharmacy" and "leftovers". Younger age, high education and presence of a chronic disease were significantly associated with self-medication. On the basis of this data, actions to reduce inappropriate use should target the general public.

The European Surveillance of Antimicrobial Consumption (ESAC) project collects data on antimicrobial consumption in ambulatory care and hospital settings from 34 European countries.