The TAP manual : an in-depth guide for planning and implementing tailoring antimicrobial resistance programmes

The Tailoring Antimicrobial Resistance Programmes (TAP) Manual is inspired by the Tailoring Immunization Programmes (TIP) guide and was developed at the WHO Regional Office for Europe to support countries in using a behavioural insights approach to identify appropriate and feasible interventions to begin tackling antimicrobial resistance in their contexts. The TAP Manual is accompanied by a user-friendly TAP Quick Guide and TAP Toolbox. This Manual was prepared by Marie Louise Wright (formerly WHO Regional Office for Europe) and Sahil Warsi (WHO Regional Office for Europe) under the technical guidance of Ketevan Kandelaki (WHO Regional Office for Europe) and Danilo Lo Fo Wong (WHO Regional Office for Europe). Input and review were provided by Siff Malue Nielsen (WHO Regional Office for Europe), Katrine Bach Habersaat (WHO Regional Office for Europe), Nils Fietje (WHO Regional Office for Europe) and Masse Helstrom (WHO Regional Office for Europe). Significant contributions for the technical concept were made by Karen Mah (WHO headquarters), Ponnu Padiyara (WHO headquarters), Chantal den Daas (National Institute for Public Health and the Environment, the Netherlands) and Anja Schreijer (Public Health Service, Amsterdam, the Netherlands). This document was produced with the financial assistance of the European Union. The views expressed herein can in no way be taken to reflect the official opinion of the European Union

Linking Illness to Food: Summary of a Workshop on Food Attribution

To identify and prioritize effective food safety interventions, it is critical not only to identify the pathogens responsible for illness, but also to attribute cases of foodborne disease to the specific food vehicle responsible. A wide variety of such “food attribution” approaches and data are used around the world, including the analysis of and extrapolation from outbreak and other surveillance data, case-control studies, microbial subtyping and source-tracking methods, and expert judgment, among others. The Food Safety Research Consortium sponsored the Food Attribution Data Workshop in October 2003 to discuss the virtues and limitations of these approaches and to identify future options for the collection of food attribution data in the United States. This discussion paper summarizes workshop discussions and identifies challenges that affect progress in this critical component of a risk-based approach to improving food safety.foodborne illness, food attribution, outbreaks, case-control studies, microbial fingerprinting, microbial subtyping, FoodNet

Quantification of Salmonella and Yersinia on pork carcasses by simulation modelling

Stagnation in the success of control programmes in pig production in Denmark has led to an increased interest in the development of alternative control strategies such as decontamination of carcasses to further decrease the attribution of pork meat to human foodborne illness. This project sets out to develop a model for quantitative estimation of slaughterhouse output of Salmonella and Yersinia . Distributions of the occurrence of Salmonefla, Yersinia and E. coli on pork carcasses are based on the analysis of paired faecal samples and carcass swabs from 2880 animals originating from four abattoirs. By combining the estimated quantity of faecal contamination of carcasses with a semi-quantitative distribution of the number of Safmoneffa or Yersinia per gram faeces, an output distribution describing the number of Salmonella or Yersinia bacteria per carcass can be established. In order to validate the model, carcass swabs, analysed for Salmonefla and Yersinia serve as control. After the model has been validated, the effect of various decontamination methods on human exposure to foodborne pathogens in pork will be evaluated in both economic terms as well as with regard to public health impact

Associated deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in Switzerland, 2010 to 2019.

BackgroundCassini et al. (2019) estimated that, in 2015, infections with 16 different antibiotic-resistant bacteria resulted in ca 170 disability-adjusted life-years (DALYs) per 100,000 population in the European Union and European Economic area (EU/EEA). The corresponding estimate for Switzerland was about half of this (87.8 DALYs per 100,000 population) but still higher than that of several EU/EEA countries (e.g. neighbouring Austria (77.2)).AimIn this study, the burden caused by the same infections due to antibiotic-resistant bacteria ('AMR burden') in Switzerland from 2010 to 2019 was estimated and the effect of the factors 'linguistic region' and 'hospital type' on this estimate was examined.MethodsNumber of infections, DALYs and deaths were estimated according to Cassini et al. (2019) whereas separate models were built for each linguistic region/hospital type combination.ResultsDALYs increased significantly from 3,995 (95% uncertainty interval (UI): 3;327-4,805) in 2010 to 6,805 (95% UI: 5,820-7,949) in 2019. Linguistic region and hospital type stratifications significantly affected the absolute values and the slope of the total AMR burden estimates. DALYs per population were higher in the Latin part of Switzerland (98 DALYs per 100,000 population; 95% UI: 83-115) compared with the German part (57 DALYs per 100,000 population; 95% UI: 49-66) and in university hospitals (165 DALYs per 100,000 hospitalisation days; 95% UI: 140-194) compared with non-university hospitals (62 DALYs per 100,000 hospitalisation days; 95% UI: 53-72).ConclusionsThe AMR burden estimate in Switzerland has increased significantly between 2010 and 2019. Considerable differences depending on the linguistic region and the hospital type were identified - a finding which affects the nationwide burden estimation

Associated deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in Switzerland, 2010 to 2019

Background: Cassini et al. (2019) estimated that, in 2015, infections with 16 different antibiotic-resistant bacteria resulted in ca 170 disability-adjusted life-years (DALYs) per 100,000 population in the European Union and European Economic area (EU/EEA). The corresponding estimate for Switzerland was about half of this (87.8 DALYs per 100,000 population) but still higher than that of several EU/EEA countries (e.g. neighbouring Austria (77.2)). Aim: In this study, the burden caused by the same infections due to antibiotic-resistant bacteria ('AMR burden') in Switzerland from 2010 to 2019 was estimated and the effect of the factors 'linguistic region' and 'hospital type' on this estimate was examined.MethodsNumber of infections, DALYs and deaths were estimated according to Cassini et al. (2019) whereas separate models were built for each linguistic region/hospital type combination. Results: DALYs increased significantly from 3,995 (95% uncertainty interval (UI): 3;327-4,805) in 2010 to 6,805 (95% UI: 5,820-7,949) in 2019. Linguistic region and hospital type stratifications significantly affected the absolute values and the slope of the total AMR burden estimates. DALYs per population were higher in the Latin part of Switzerland (98 DALYs per 100,000 population; 95% UI: 83-115) compared with the German part (57 DALYs per 100,000 population; 95% UI: 49-66) and in university hospitals (165 DALYs per 100,000 hospitalisation days; 95% UI: 140-194) compared with non-university hospitals (62 DALYs per 100,000 hospitalisation days; 95% UI: 53-72). Conclusions: The AMR burden estimate in Switzerland has increased significantly between 2010 and 2019. Considerable differences depending on the linguistic region and the hospital type were identified - a finding which affects the nationwide burden estimation

Knowledge, attitudes and behaviors on antimicrobial resistance among general public across 14 member states in the WHO European region: results from a cross-sectional survey

BackgroundAntimicrobial resistance (AMR) is a major global public health threat requiring urgent action. Pan-European data on knowledge, attitudes and behaviors among the general public regarding antibiotic use and AMR is limited.MethodsA multicentric, cross-sectional survey of the general public was conducted in the capital cities of 14 Member States of the WHO European Region. A validated questionnaire from the AMR Eurobarometer survey was used to collect data on antibiotic use and knowledge, access to antibiotics, and understanding of policy responses through face-to-face exit interviews.ResultsOut of 8,221 respondents from 14 Member States, 50% took antibiotics in the past 12 months and the majority (53%) obtained their most recent course from a medical practitioner. The most reported reasons for taking antibiotics orally in the past 12 months were cold (24%), sore throat (21%), cough (18%), and flu (16%). Overall, 84% of participants showed a lack of knowledge about appropriate antibiotic use. However, only 37% of respondents reported receiving any information in the past year about the importance of avoiding unnecessary antibiotic use. Doctors were the most cited (50%) and most trusted (80%) source of information. Among respondents who experienced COVID-19, 28% took antibiotics with a prescription, while 8% took antibiotics without a prescription.ConclusionThis study highlights the urgent need for targeted awareness campaigns and educational initiatives to address knowledge gaps and promote responsible antibiotic use. The findings emphasize the role of the general population in combating AMR. The data serve as baseline information for future evaluations and interventions in the Region

Isolation of Salmonella enterica in seropositive classified finishing pig herds

The aim of this study was to assess the probability of detecting Salmonella from pen faecal samples in seropositive classified finishing pig herds. The study involved 77 herds from Denmark (20), the Netherlands (20), Greece (17) and Germany (20). The serological herd status was determined by the blood- sampling of 50 finishing pigs. Bacteriological sampling was performed by 20 pen faecal samples per herd. Over-all, 47 % of the blood samples had an OD% larger than 10 and 23 % larger than 40. Salmonella was isolated from 135 (9.3 %) pen faecal samples in 32 herds (42 %). Twenty-eight of these herds (87.5 %) had a within-herd seroprevalence larger than 50% at sample cut-off OD%\u3e10. A correlation coefficient of 0.62 was found between the proportion of culture positive- and seropositive samples in a herd at cut-off OD % \u3e 10 and of 0.58 at cut-off OD % \u3e 40. Due to the low sensitivity of culture methods, apparent ‘false positive’ serological results may well represent real infections not detected by bacteriological testing. In this study, there was an increasing probability of recovering Salmonella with increasing within-herd seroprevalence