Joint Document of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Preventive Medicine, Public Health and Hygiene (SEMPSPH) for Combating Antimicrobial Resistance
Documento compartido de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC) y la Sociedad Española de Medicina Preventiva, Salud Pública e Higiene (SEMPSPH) para combatir la resistencia antimicrobiana
Steering Committees of the Spanish Society of Preventive Medicine, Public Health and Hygiene (SEMPSPH) and of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC)
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"2017-03-01" "aid" => "1633" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Enferm Infecc Microbiol Clin. 2017;35:137-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 7520 "formatos" => array:3 [ "EPUB" => 16 "HTML" => 5786 "PDF" => 1718 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Epidemiología y mecanismos de resistencia a carbapenemas en <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span>: papel de los clones de alto riesgo en la multirresistencia" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "137" "paginaFinal" => "138" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Epidemiology and 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Medicina Preventiva, Salud Pública e Higiene (SEMPSPH) para combatir la resistencia antimicrobiana" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">January 2017</p><p id="par0010" class="elsevierStylePara elsevierViewall">Infectious diseases have undergone extraordinary changes in the past 30 years. Highly lethal infections have in the past been confined to middle and low income countries, where malaria, cholera and the Ebola virus have caused considerable mortality in native populations. In contrast, infections in developed countries have mostly been curable diseases, thanks to vaccines, antibiotics and modern hospitals. However, the influx of emerging infections (such as those caused by the human immunodeficiency virus, avian influenza, Ebola and Zika), antimicrobial-resistant microorganisms and the globalization of these pathogens have transformed this scenario.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The rising antimicrobial resistance has been so consistent that in less than one generation, the scientific community has gone from envisioning the end of microbial infections to being unable to help patients with severe microbial infections due to a lack of effective antimicrobials. We are now witnessing how these infections occupy the top positions among the most significant causes of death.</p><p id="par0020" class="elsevierStylePara elsevierViewall">This is a tragic irony, even more so when we consider that the antimicrobial arsenal is the most powerful and numerous we have ever had. It is also a lesson in humility for the humans, which, at the height of its technical scientific capacity, is being defeated by such primitive beings. Although multi-drug resistant infections affect patients wherever they are (homes, hospitals and other institutions), the epicenter of the problem lies in hospitals where the considerable majority of severe infections and deaths caused by these bacteria occur. Hospitals are also where the microbes are transmitted with greatest efficiency.</p><p id="par0025" class="elsevierStylePara elsevierViewall">We have reached this dire situation, among other reasons, because of the improper use of antimicrobials and infection control. The quality indicators for both procedures attest to this situation; 1 in 2 antimicrobial prescriptions is inadequate, and hand hygiene compliance is less than 50%, this despite the years-long work to improve them.</p><p id="par0030" class="elsevierStylePara elsevierViewall">This problem has already been recognized by the Director of the World Health Organization who stated that antimicrobial resistance was one of the greatest global public health threats.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a> In May 2016, the economist Jim O’Neill published the document “Tackling Drug-Resistant Infections Globally: Final Report and Recommendations”,<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">2</span></a> which was commissioned by the ex-prime minister of the United Kingdom David Cameron. The document analyzed the problem of resistance, described its magnitude, proposed 10 recommendations to resolve them (which included reducing and optimizing the use of antimicrobials and improving control over the spread of infection) and estimated a cost of 40 billion dollars to achieve these recommendations. The problem achieved worldwide recognition in the General Assembly of the United Nations, in a high level meeting held on September 21, 2016, in New York, during which (with votes in favor from all member states) the Global Action Plan for Combatting Antimicrobial Resistance was approved.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Having achieved this recognition, we now need to get the United Nations plan into effect in most countries. A number of countries (such as the United States, United Kingdom and France) have launched plans to combat antimicrobial resistance with millions in funding and with the explicit support of its political leaders.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">4–6</span></a> Although Spain has had the National Plan Against Antibiotic Resistance (<span class="elsevierStyleItalic">Plan Nacional frente a la Resistencia a los Antibióticos</span>, PNRA) since November 2013, for now it is no more than a document without results and without funding.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> The funding is the responsibility of the various national, territorial and local health authorities, in accordance with their obligation to protect the health of citizens and the commitment undertaken in signing the United Nations document. These authorities must also consider that the problem is even more severe in Spain, given that Spain is one of the top consumers of antibiotics and has one of the highest levels of antimicrobial resistance.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">8,9</span></a> However, we lack information on Spain's problem. One estimate based on data from the US Centers for Disease Control calculated at least 3500 deaths per year in Spain due to infections caused by these microorganisms, a number 3-fold larger than the number of traffic deaths in 2015.<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">10,11</span></a> The difficulty in obtaining funding in Spain to combat antimicrobial resistance has recently been analyzed.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">12</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Implementing the recommendations of the national and global plans for combating resistance<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">3,7</span></a> requires not only funding but also professional leadership, which is our task. The SEMPSPH and SEIMC assume the responsibility for leading the fight against antimicrobial resistance, because the prevention, diagnosis and treatment of infectious diseases form the core of our specialties’ expertise: preventive medicine, public health, microbiology and infectious diseases. In 2012, in conjunction with the Spanish Society of Hospital Pharmacy (SEFH), we wrote the consensus document on optimization programs for the use of antimicrobials in Spanish hospitals (<span class="elsevierStyleItalic">programas de optimización del uso de los antimicrobianos en los hospitales españoles</span>, PROA).<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">13</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">It seems that healthcare practitioners and politicians have at last understood that to address this formidable challenge we urgently need comprehensive actions that differ from those we have been doing so far. With this commitment document, SEMPSPH and SEIMC call on our associates’ professionalism to carry out these actions without delay, through work in multidisciplinary teams led by preventivists, microbiologists and infectious disease specialists and coordinated by consensus documents until we have managed to control infections and optimize the use of antimicrobials. We exhort our leaders to facilitate the necessary tasks and funding. Only with comprehensive professional leadership and institutional support will we be able to reach the necessary level of competence and resources to defeat the extraordinary threat represented by antimicrobial resistance.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:13 [ 0 => array:3 [ "identificador" => "bib0070" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available at: <span class="elsevierStyleInterRef" id="intr0005" href="http://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_20-en.pdf">http://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_20-en.pdf</span>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antimicrobial Resistance Draft global action plan on antimicrobial resistance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "WHO" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2015" "editorial" => "WHO" "editorialLocalizacion" => "Geneva" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0075" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available at: https://amr-review.org/" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tackling drugs resistant globally: final report and recommendations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "O¿Neill" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2016" "editorial" => "Welcome Trust" "editorialLocalizacion" => "London" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0080" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Geneva, WHO, pp 127–144 (Document WHA64/2015/REC/1, annex 3) (Available at: <span class="elsevierStyleInterRef" id="intr0010" href="http://apps.who.int/gb/ebwha/pdf_files/WHA68-REC1/A68_R1_REC1-en.pdf">http://apps.who.int/gb/ebwha/pdf_files/WHA68-REC1/A68_R1_REC1-en.pdf</span>)." 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Cercenado" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2012" "volumen" => "30" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/0213005X/0000003500000003/v2_201706011649/S0213005X17300691/v2_201706011649/en/main.assets" "Apartado" => array:4 [ "identificador" => "8678" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Artículo especial" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/0213005X/0000003500000003/v2_201706011649/S0213005X17300691/v2_201706011649/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X17300691?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 12 | 5 | 17 |
| 2024 September | 26 | 10 | 36 |
| 2024 August | 17 | 6 | 23 |
| 2024 July | 34 | 6 | 40 |
| 2024 June | 27 | 26 | 53 |
| 2024 May | 16 | 12 | 28 |
| 2024 April | 23 | 17 | 40 |
| 2024 March | 32 | 18 | 50 |
| 2024 February | 36 | 17 | 53 |
| 2024 January | 38 | 19 | 57 |
| 2023 December | 32 | 22 | 54 |
| 2023 November | 19 | 13 | 32 |
| 2023 October | 29 | 28 | 57 |
| 2023 September | 20 | 26 | 46 |
| 2023 August | 18 | 4 | 22 |
| 2023 July | 9 | 39 | 48 |
| 2023 June | 17 | 41 | 58 |
| 2023 May | 18 | 8 | 26 |
| 2023 April | 13 | 5 | 18 |
| 2023 March | 16 | 8 | 24 |
| 2023 February | 13 | 11 | 24 |
| 2023 January | 14 | 14 | 28 |
| 2022 December | 33 | 16 | 49 |
| 2022 November | 23 | 22 | 45 |
| 2022 October | 30 | 18 | 48 |
| 2022 September | 25 | 24 | 49 |
| 2022 August | 31 | 29 | 60 |
| 2022 July | 29 | 25 | 54 |
| 2022 June | 39 | 27 | 66 |
| 2022 May | 59 | 13 | 72 |
| 2022 April | 47 | 27 | 74 |
| 2022 March | 23 | 21 | 44 |
| 2022 February | 21 | 10 | 31 |
| 2022 January | 21 | 17 | 38 |
| 2021 December | 24 | 26 | 50 |
| 2021 November | 30 | 19 | 49 |
| 2021 October | 21 | 20 | 41 |
| 2021 September | 18 | 12 | 30 |
| 2021 August | 19 | 22 | 41 |
| 2021 July | 25 | 11 | 36 |
| 2021 June | 28 | 37 | 65 |
| 2021 May | 35 | 16 | 51 |
| 2021 April | 61 | 39 | 100 |
| 2021 March | 34 | 12 | 46 |
| 2021 February | 45 | 9 | 54 |
| 2021 January | 23 | 17 | 40 |
| 2020 December | 24 | 13 | 37 |
| 2020 November | 14 | 9 | 23 |
| 2020 October | 17 | 14 | 31 |
| 2020 September | 28 | 24 | 52 |
| 2020 August | 23 | 21 | 44 |
| 2020 July | 21 | 14 | 35 |
| 2020 June | 14 | 14 | 28 |
| 2020 May | 23 | 24 | 47 |
| 2020 April | 27 | 16 | 43 |
| 2020 March | 31 | 24 | 55 |
| 2020 February | 23 | 10 | 33 |
| 2020 January | 20 | 28 | 48 |
| 2019 December | 37 | 39 | 76 |
| 2019 November | 16 | 18 | 34 |
| 2019 October | 18 | 14 | 32 |
| 2019 September | 14 | 19 | 33 |
| 2019 August | 17 | 15 | 32 |
| 2019 July | 23 | 19 | 42 |
| 2019 June | 46 | 36 | 82 |
| 2019 May | 86 | 67 | 153 |
| 2019 April | 63 | 47 | 110 |
| 2019 March | 21 | 16 | 37 |
| 2019 February | 20 | 24 | 44 |
| 2019 January | 10 | 11 | 21 |
| 2018 December | 13 | 16 | 29 |
| 2018 November | 21 | 17 | 38 |
| 2018 October | 37 | 24 | 61 |
| 2018 September | 29 | 7 | 36 |
| 2018 August | 9 | 2 | 11 |
| 2018 July | 16 | 8 | 24 |
| 2018 June | 31 | 3 | 34 |
| 2018 May | 26 | 6 | 32 |
| 2018 April | 489 | 0 | 489 |
| 2018 March | 19 | 5 | 24 |
| 2018 February | 19 | 4 | 23 |
| 2018 January | 26 | 4 | 30 |
| 2017 December | 26 | 2 | 28 |
| 2017 November | 29 | 10 | 39 |
| 2017 October | 19 | 7 | 26 |
| 2017 September | 21 | 8 | 29 |
| 2017 August | 7 | 1 | 8 |
| 2017 July | 6 | 0 | 6 |
| 2017 June | 6 | 2 | 8 |
| 2017 May | 23 | 16 | 39 |
| 2017 April | 146 | 226 | 372 |
| 2017 March | 51 | 37 | 88 |
| 2017 February | 0 | 5 | 5 |
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