The rise of carbapenem resistance in Europe : just the tip of the iceberg?

The European Antimicrobial Resistance Surveillance Network (EARS-Net) collects data on carbapenem resistance from invasive bacterial infections. Increasing percentages of carbapenem resistance in K. pneumoniae isolates were reported from progressively more countries in Europe between 2005 and 2010. A trend analysis showed increasing trends for Greece, Cyprus, Hungary and Italy (p < 0.01). EARS-Net collects data on invasive bacterial isolates, which likely correspond to a fraction of the total number of infections. Increasing reports of community cases suggest that dissemination of carbapenem-resistant K. pneumoniae has penetrated into the community. Good surveillance and infection control measures are urgently needed to contain this spread.peer-reviewe

Green Networks Exarchia

The phenomenon of urban heat islands (UHI) in Athens is well documented (LIVADA, S ANTAMOURIS and ASSIMAKOPOULOS 2007; MIHALAKAKOU , S ANTAMOURIS , P APANIKOLAOU , CARTALIS and T SANGRASSOULIS 2004). Studies range from descriptive research on the phenomenon and its development for the last decades to impact studies and adaption measures (S ANTAMOURIS et al. 2015). However, the relevance of this topic is shown by this year’s temperatures of over 40°C in the inner city and its densely populated districts accompanied by increased ozone levels (E UROMETEO 2017, www). Impacts are of environmental, economic and social nature (ibid.). The “Green Networks Exarchia” is a plan on how to tackle the problems of urban heat island in the city district of Exarchia in Athens. The “Green Networks Exarchia” describes the idea of connecting parks and micro-parks by transforming the streets into green corridors. The overall goal is to reduce the problems heat islands to determine the problem in general, to identify the problem in the district of Exarchia, to assess the goals and to elaborate ways to improve the situation. To conduct these tasks, a variety of knowledge and different points of view were necessary. This included, on the one hand, the views from different academic fields such as architecture, environmental planning and urban planning and on the other hand considers the different scales of the problem. Each field player an important role to achieve the results. Environmental planning, for instance, played a huge role in identifying the problem and designing the ways of how to green the spaces. The field of architecture contributed a lot in terms of concrete measures and how to implement them in the city district. The field of urban planning was important to coordinate the project and to plan the network itself. Although the project focused on the district level, all scales were important to observe. While the likelihood of heat waves react to the increase of heat days and UHI must be implemented on the local level

The rise of carbapenem resistance in Europe: just the tip of the iceberg?

The European Antimicrobial Resistance Surveillance Network (EARS-Net) collects data on carbapenem resistance from invasive bacterial infections. Increasing percentages of carbapenem resistance in K. pneumoniae isolates were reported from progressively more countries in Europe between 2005 and 2010. A trend analysis showed increasing trends for Greece, Cyprus, Hungary and Italy (p < 0.01). EARS-Net collects data on invasive bacterial isolates, which likely correspond to a fraction of the total number of infections. Increasing reports of community cases suggest that dissemination of carbapenem-resistant K. pneumoniae has penetrated into the community. Good surveillance and infection control measures are urgently needed to contain this spread

Decreasing and stabilising trends of antimicrobial consumption and resistance in Escherichia coli and Klebsiella pneumoniae in segmented regression analysis, European Union/European Economic Area, 2001 to 2018

Investments to reduce the spread of antimicrobial resistance (AMR) in the European Union have been made, including efforts to strengthen prudent antimicrobial use. Using segmented regression, we report decreasing and stabilising trends in data reported to the European Surveillance of Antimicrobial Consumption Network and stabilising trends in data reported to the European Antimicrobial Resistance Surveillance Network. Our results could be an early indication of the effect of prioritising AMR on the public health agenda

Danish Integrated Antimicrobial Resistance Monitoring and Research Program

This program has led to changes in the use of antimicrobial agents in Denmark and other countries

Change-points in antibiotic consumption in the community, European Union/European Economic Area, 1997-2017

Surveillance of antibiotic consumption in the community is of utmost importance to inform and evaluate control strategies. Data on two decades of antibiotic consumption in the community were collected from 30 EU/European Economic Area (EEA) countries. This article reviews temporal trends and the presence of abrupt changes in subgroups of relevance in antimicrobial stewardship.For the period 1997-2017, data on yearly antibiotic consumption in the community, aggregated at the level of the active substance, were collected using the WHO ATC classification and expressed in DDD (ATC/DDD index 2019) per 1000 inhabitants per day. We applied a range of non-linear mixed models to assess the presence of changes in the consumption of antibacterials for systemic use (ATC group J01) and eight antibiotic subgroups.For the majority of the studied groups, a country-specific change-point model provided the best fit. Depending on the antibiotic group/subgroup and on the country, change-points were spread out between 2000 and 2013.Due to the heterogeneity in antibiotic consumption in the community across EU/EEA countries, a country-specific change-point model provided the better fit. Given the limitations of this model, our recommendation for the included countries is to carefully interpret the country-specific results presented in this article and to use the tutorial included in this series to conduct their own change-point analysis when evaluating the impact of changes in regulations, public awareness campaigns, and other national interventions to improve antibiotic consumption in the community