RESUMEN
In 2007, the Robert Koch Institute established the infrastructure for the national Antimicrobial Resistance Surveillance (ARS) system. Laboratories submit data of routine susceptibility testing of clinical samples from hospitals as well as from outpatient care settings in a standardized format to the Robert Koch Institute for central processing. The database for the period 2008-2011 comprises data of about 1.3 million samples from patients in hospital care and almost 800,000 samples from outpatients. Based on SIR interpretations of susceptibility, the trends of methicillin resistance of Staphylococcus aureus (MRSA) and cefotaxime non-susceptibility as an indicator of extended-spectrum beta-lactamases (ESBL) of Escherichia coli and Klebsiella pneumoniae were analyzed for four care settings or categories: hospital care, outpatient care, intensive care units, and isolates from blood cultures. After constant high levels of above 20%, the proportion of MRSA isolates showed a decline for the first time from 2010 to 2011 in hospital care overall, in intensive care units as well as in blood cultures; in outpatient care, MRSA proportions of about 13% were observed. Within the observed period, non-susceptibility to cefotaxime as an indicator of ESBL in E. coli showed an increasing trend in hospital care at a level above 10% in intensive care units, while cefotaxime non-susceptibility in K. pneumoniae was more frequent but without any trend. In outpatient care, the proportions of cefotaxime non-susceptibility increased year by year in both species resulting in nearly a doubling to 6%.
Asunto(s)
Cefotaxima/uso terapéutico , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infección Hospitalaria/tratamiento farmacológico , Farmacorresistencia Bacteriana , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones por Klebsiella/tratamiento farmacológico , Klebsiella pneumoniae , Staphylococcus aureus Resistente a Meticilina , Vigilancia de Guardia , Infecciones Estafilocócicas/tratamiento farmacológico , beta-Lactamasas/metabolismo , Bacteriemia/tratamiento farmacológico , Bacteriemia/epidemiología , Bacteriemia/microbiología , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Estudios Transversales , Escherichia coli/efectos de los fármacos , Escherichia coli/enzimología , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Alemania , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Infecciones por Klebsiella/epidemiología , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/enzimología , Pruebas de Sensibilidad Microbiana , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/microbiologíaRESUMEN
Prevention of infectious diseases is targeted at individuals, specific risk groups or communities. Vaccines are one of the most cost-effective medical interventions and protect the individual and the community against vaccine preventable diseases. Immunization programs aim to control, eliminate or eradicate infectious pathogens. In industrialized countries several vaccine preventable diseases are almost eliminated. Strict implementation of recommendations for influenza and pneumococcal immunization is crucial to reduce morbidity and mortality. Hence, uptake of recommended immunization among adults and elderly people is often low. Internal specialists are demanded to improve vaccine coverage in those age groups.
Asunto(s)
Control de Enfermedades Transmisibles/métodos , Brotes de Enfermedades/prevención & control , Inmunización/métodos , Control de Infecciones/métodos , Vigilancia de la Población/métodos , Vacunas/uso terapéutico , Países Desarrollados , HumanosRESUMEN
This article aims to describe the Haemorrhagic Fever with Renal Syndrome (HFRS) situation in 2005 in five neighbouring countries (Belgium, France, Germany, the Netherlands and Luxembourg) and define the most affected areas. The 2005 HFRS outbreaks in these countries were the most significant in the region since 1990, with a total of 1,114 confirmed cases. The main feature of the epidemic was the extension of the known endemic area in several of the affected countries, with the involvement of urban areas for the first time. A significant increase in the number of cases was noted for the first time in the province of Liège in Belgium and in the Jura department in France.