Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis

Background: Infections due to antibiotic-resistant bacteria are threatening modern health care. However, estimating their incidence, complications, and attributable mortality is challenging. We aimed to estimate the burden of infections caused by antibiotic-resistant bacteria of public health concern in countries of the EU and European Economic Area (EEA) in 2015, measured in number of cases, attributable deaths, and disability-adjusted life-years (DALYs). Methods: We estimated the incidence of infections with 16 antibiotic resistance–bacterium combinations from European Antimicrobial Resistance Surveillance Network (EARS-Net) 2015 data that was country-corrected for population coverage. We multiplied the number of bloodstream infections (BSIs) by a conversion factor derived from the European Centre for Disease Prevention and Control point prevalence survey of health-care-associated infections in European acute care hospitals in 2011–12 to estimate the number of non-BSIs. We developed disease outcome models for five types of infection on the basis of systematic reviews of the literature. Findings: From EARS-Net data collected between Jan 1, 2015, and Dec 31, 2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148–763 966) infections with antibiotic-resistant bacteria, of which 63·5% (426 277 of 671 689) were associated with health care. These infections accounted for an estimated 33 110 (28 480–38 430) attributable deaths and 874 541 (768 837–989 068) DALYs. The burden for the EU and EEA was highest in infants (aged <1 year) and people aged 65 years or older, had increased since 2007, and was highest in Italy and Greece. Interpretation: Our results present the health burden of five types of infection with antibiotic-resistant bacteria expressed, for the first time, in DALYs. The estimated burden of infections with antibiotic-resistant bacteria in the EU and EEA is substantial compared with that of other infectious diseases, and has increased since 2007. Our burden estimates provide useful information for public health decision-makers prioritising interventions for infectious diseases

Training infection control and hospital hygiene professionals in Europe, 2010 : agreed core competencies among 33 European countries

The harmonisation of training programmes for infection control and hospital hygiene (IC/HH) professionals in Europe is a requirement of the Council recommendation on patient safety. The European Centre for Disease Prevention and Control commissioned the ‘Training Infection Control in Europe’ project to develop a consensus on core competencies for IC/HH professionals in the European Union (EU). Core competencies were drafted on the basis of the Improving Patient Safety in Europe (IPSE) project’s core curriculum (CC), evaluated by questionnaire and approved by National Representatives (NRs) for IC/HH training. NRs also re-assessed the status of IC/HH training in European countries in 2010 in comparison with the situation before the IPSE CC in 2006. The IPSE CC had been used to develop or update 28 of 51 IC/HH courses. Only 10 of 33 countries offered training and qualification for IC/ HH doctors and nurses. The proposed core competencies are structured in four areas and 16 professional tasks at junior and senior level. They form a reference for standardisation of IC/HH professional competencies and support recognition of training initiatives.peer-reviewe

Automobile industry: Recent development in car production of Czech market

The primary goal of this paper is to present a framework that enables one to obtain estimates on production for a Czech Republic automotive market. This paper firstly reviews previously selected studies on the Czech automotive sector while discusses the importance of automotive industry at the global level, as well. Secondly, this paper declares evidence of yearly development in the production of Czech automotive sector and sales since 2005 and previously trends in relation to GDP per capita and CCI, covering periods before, during and after crisis (GFC) period. Our sample is based on the observation of the production of finished vehicles between the period 2005 to 2015. For this case study, we have investigated companies involved in the Automobile Industry Association. Our findings suggest potential future research directions with respect to production that could be potentially helpful for the automotive sector and for developing predictive business models in this industry.Czech Science Foundation (GA CR) [16-25536S

The prevalence of and risk factors for healthcare-associated infections in Slovenia: results of the second national survey

In the second Slovenian national healthcare-associated infections (HAIs) prevalence survey, conducted within the European point prevalence survey of HAIs and antimicrobial use in acute-care hospitals, we estimated the prevalence of all types of HAIs and identified risk factors

Genetska opredelitev za meticilin občutljivih in proti meticilinu odpornih sevov Staphylococcus aureus, izoliranih iz hemokultur v slovenskih bolnišnicah, s tipizacijo SPA

Staphylococcus aureus je drugi najpogostejši bakterijski povzročitelj invazivnih okužb v Sloveniji. S tipizacijo izolatov za meticilin občutljivih S. aureus (MSSA) in proti meticilinu odpornih S. aureus (MRSA) iz hemokultur bolnikov z bakteriemijo iz vse Slovenije v 6- mesečnem obdobju smo poskušali ugotoviti, katerim spa tipom pripadajo invazivni izolati MSSA in MRSA v Sloveniji, kakšna je genetska raznolikost MSSA in MRSA ter preveriti uporabnost tipizacije spa za epidemiološke raziskave S. aureus v Sloveniji. Od 1. septembra 2006 do 28. februarja 2007 smo v 11 slovenskih laboratorijih, ki izvajajo mikrobiološko diagnostiko za 15 bolnišnic, zbirali zaporedno izolirane primoizolate MSSA (največ pet) in zaporedno izolirane primoizolate MRSA (največ pet) iz hemokultur bolnikov. Izolate S. aureus smo tipizirali s tipizacijo spa, to je z določanjem nukleotidnega zaporedja polimorfnega X dela gena spa, ki kodira protein A. Od 58 zbranih izolatov S. aureus iz vse Slovenije smo uspeli tipizirati 54 izolatov. Prevladujoči spa tipi med izolatiMSSA so bili t091, t015 in t005, med izolati MRSA pa t041. Ugotovili smo, da spa tipi, ki prevladujejo med invazivnimi izolati S. aureus pri nas, prevladujejo tudi v sosednjih državah. Tipizacija S. aureus z metodo spa je pokazala veliko genetsko raznolikost invazivnih sevov MSSA in manjšo raznolikost invazivnih sevov MRSA. Tipizacija spa je uporabna tipizacijska metoda za lokalno epidemiologijo MSSA v kratkem in daljšem časovnem obdobju.Staphylococcus aureus is the second leading cause of invasive bacterial infections in Slovenia. The aims of this 6-month study were to identify the most prevalent spa types among invasive isolates of methicillin-susceptible S.aureus (MSSA) and methicillin-resistant S. aureus (MRSA) in Slovene hospitals, to determine genetic diversity of MSSA and MRSA, and to test the applicability of spa typing to epidemiological studies of S. aureus in Slovenia. Over a period of six months(1 September 2006 - 28 February 2007), upto five successive methicillin-susceptible (MSSA) blood culture isolates anda maximum of five successive methicillin- resistant (MRSA) blood culture isolates per hospital were obtained from different patients with bacteremia. The isolates were characterized by spa typing based on sequencing of polymorphic region X of the S. aureus protein A gene. Among the 58 isolates collected 54 were succesfully spa typed. The predominant spa types among MSSA isolates were t091, t015, t005, and among MRSA, t041 . The predominant spa types among invasive S. aureus strains isolated in Slovenia predominated also in the neighbouring countries. The study showed high genetic diversity of invasive MSSA isolates and lower genetic diversity of invasive MRSA isolates in Slovenia. Spa typing is a good typing method for short- and long-term epidemiological studies of MSSA on a local scale

Susceptibility to Telithromycin in 1,011 Streptococcus pyogenes Isolates from 10 Central and Eastern European Countries

Among 1,011 recently isolated Streptococcus pyogenes isolates from 10 Central and Eastern European centers, the MICs at which 50% of isolates are inhibited (MIC(50)s) and the MIC(90)s were as follows: for telithromycin, 0.03 and 0.06 μg/ml, respectively; for erythromycin, azithromycin, and clarithromycin, 0.06 to 0.125 and 1 to 8 μg/ml, respectively; and for clindamycin, 0.125 and 0.125 μg/ml, respectively. Erythromycin resistance occurred in 12.3% of strains. Erm(A) [subclass erm(TR)] was most commonly encountered (60.5%), followed by mef(A) (23.4%) and erm(B) (14.5%). At <0.5 μg/ml, telithromycin was active against 98.5% of the strains tested