Mielke presentation at 24 BSPC

Common challenges and future needs to combatantimicrobial resistanceAwareness - Knowledge - Responsibility„(Re-)Search and Follow“M. Mielke, Robert Koch-InstitutePublic Awarenessfor Healthcare and PatientsafetyVulnerable PopulationsSepsisPneumoniaDevice associatedinfectionsEffective antimicrobial agentsare essential for modern healthcareCommon Threat PathogensS. aureus/ MRSAS. pneumoniaeMDR-TbcE. coli, Klebsiella spp.; Pseudomonas spp.Acinetobacter spp.(ESBL, CRE, 3/4 MRGN)Enterococcus/ VREC. difficileSalmonella, Shigella, Campylobacter(Chinoloneresistance)GO (Ceftriaxonresistance)CandidaHuman microbial floraS. pyogenes (Erythromycin-,Clindamycinresistance)Northern Dimension PartnershipPromote sustainabledevelopment in theNorthern Dimension areathroughimproving human healthand social well-being.Objective 2:Contained antimicrobial resistance –through the implementation of regionaland global strategies and/or actionplansThe WHO/ European strategic action plan onantibiotic resistance.Key areas of action:• strengthen surveillance of AMR and promote stewardship ofantimicrobial drug use;• improve infection control in health care settings;• strengthen surveillance of resistance to and use ofantimicrobial agents in the food animal industry;• promote research and innovation on new drugs andtechnology; and• ensure patient safety and improve awareness of antimicrobialuse and resistance.(adopted by Member States in the WHO European Region in September 2011)Sustained Awareness throughNational Campaigns / Action DaysHandhygiene 5.5.Antimicrobial Resistance 18.11.Patientsafety 17.9.Information (Transparancy) for Patientsabout Infection Control on Hospital WebsitesUse of Antimicrobial Agents – Regional DifferencesSurveillance of AMR:European and Global Dimension- Migration: East and South-East Europe, Turkey, Eastern MediterraneanRegion, Africa- Travelling: India, South-East Asia (Access to Health Care System,Prescription and ABS, separation of drinking and waste water !)- (Action R & DResearch structuresWHO, USA, EU/ ECDC, GermanyTATFAR (Common basis; HHS, CDC,- Public awareness (Campaigns)NIH/NIAID, FDA, EC-DG SANCO/DGRTD,- Action plans (34 of 133 states/ WHO)EMA, EFSA, ECDC)- Best practice guidelines (One health)(prudent use of Ab; hygiene and IC)Germany (DART, GERMAP, NRC):- Implementation and evaluation (Audits/Epidemiological Competency, dataassessment and reports)management (RKI, ARS, KISS, SARI)Broad and easy acccess to health care system,NRC (RKI, COMPARE), Clinical investigationsurveillance structures, laboratory capacity,centers (DZIF/HZI)Education and training- Rapid and reliable diagnosis- Treatment options (new drugs,International Activities:combinations and valid outcome indicators)e.g. ANDEMIA- Prevention, outbreak detection and controlFields for innovation- Rapid diagnosis : sepsis, pneumonia / biomarkers ?; rapid detection of MRSA,Klebsiella spp., Pseudomonas spp., Acinetobacter spp., Carbapenemases; in RTsecretions, blood; N. gonorrhoeae in urine- Prevention : optimal use of skin and mucosal antiseptics on ICU and in surgery- Therapy: Combinations of antimicrobial drugs and drug monitoring; newantibiotics; prognostic and outcome parameters- Reducing selective pressure in gut and environment (pharmacokinetics), C. difficile- Vaccination : e.g. encapsulated MDR bacteria; S. aureus; anti-toxin Ab, anti-LPS Ab- Alternative treatments : e.g. phage therapy/ phage derived enzymes; stooltransplantation/ microbiota (decolonisation)- „One-Health“ approaches: e.g. success in the prudent use of antimicrobial agentsin the human and veterinary field; research in zoonoses / vaccinesResearch Centershttp://www.helmholtz-hzi.de/de/forschung/kooperationen/deutsches_zentrum_fuer_infektionsforschung/Surveillance (RKI, SARI, Berlin)Sepsis : Clinical studies and Biomarkers (Jena,Greifswald)Implant Infections: HICARE (Rostock, Greifswald)RTI: ABS/ CHANGE (Rostock, Berlin;Hannover/CAPNETZ)UTI: ABS/ ICUTI (Göttingen, Hannover)Acinetobacter spp. (Köln, Frankfurt, RKI)C. difficile (Köln)Fungi (Jena, HKI)Mycobacteria (MPI/Berlin; NRC/Borstel)New antibacterial agents (Köln/Bonn;Hannover/Braunschweig; Tübingen;InfectControl2020)Phage-derived enzymes (Münster)Vaccines: PEI (Frankfurt)Zoonoses (Münster, Berlin; MedVetStaph; RESET;Hannover, Berlin VetMed; VetMAB)EndoprotheticsurgeryPrevention ofimplant infectionsUniversityRostockThank You for Your Interest