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Pan American Health Organization. Pan American Sanitary Bureau Regional Office for the Americas for the World Health Organization. What is Antimicrobial Resistance?.
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Pan American Health Organization Pan American Sanitary BureauRegional Office for the Americas for theWorld Health Organization
What is Antimicrobial Resistance? The ability of bacteria and other microorganisms to survive an antibiotic to which they were once sensitive (and were once stalled or killed completely)
Mechanism of resistance • Natural or intrinsic resistance • Acquired resistance • Chromosomal mutation • Transfer of genetic material
Contributing Factors • Human medicine • Animal medicine • Agriculture
Implications of Antimicrobial Resistance • CLINICAL • Morbidity • Mortality • COST • LIMITED SOLUTIONS
SURVEILLANCE • Surveillance is the ongoing systematic collection, analysis, interpretation and dissemination of the health data to those persons who have the responsibility for disease prevention and control
Characteristics • Quality data • Timely • Enables comparison • Linked to policy and clinical practice
Use of Surveillance Estimatethe magnitude of a health problem problem
Percentage of S. pneumonie Resistant to penicillin, American Region1993/4 - 1999
Use of Surveillance Epidemic detection
NICARAGUA, 1993-1999Vibrio cholerae: Antibiotic susceptibility
Use of Surveillance Follow trends and patterns of antimicrobial resistance
Percentage of Shigella spp. isolates resistant to different antibiotics. Peru, 1996-1999 .
Percentage of Shigella flexneri isolates resistant to different antibiotics. Ecuador, 1996-1999 .
Use of Surveillance Determine geographical distribution and spread of antimicrobial resistance
Goal • To preserve the effectiveness of currently available antimicrobial drugs • Improve the availability of drugs of assured quality • Ensure appropriate use of drugs when they are required • Decrease use of drugs when they are not required
Approaches to address AMR • Health System strengthening • Policy and regulation • Provider and consumer behavior
Antimicrobial Resistance Surveillance Program IN 1996, PAHO’s DIRECTING BODIES RECOMMENDED THAT THE ORGANIZATION PUT IN PLACE AN ANTIMICROBIAL RESISTANCE SURVEILLANCE PROGRAM
} Caribbean Countries Countries starting in 1996 Countries incorporated w/ USAID project Participating Countries
Results • A network of national reference laboratories was established • A database set for the American Region was created • A web page in PAHO web site was created
Results • Protocol for quality assurance and proficiency testing for antibiotic susceptibility • Workshops to provide training in bacterial identification and testing for antimicrobial resistance were implemented • Protocol for assessing the cost of hospital infections and selected antimicrobial resistance were developed and implemented
Results • TOT on rational use of antimicrobial drugs • Training material • Drugs therapeutics committees • Regional treatment guidelines
Results • Different materials on antimicrobial resistance were produced and distributed • References on antimicrobial resistance were compiled into a bibliography, which will be published in a month