Scholarly record
ANTIMICROBIAL RESISTANCE IN ARAD REGION , ROMANIA
Abstract
Antimicrobial resistance is a serious threat to global public health and requires action across all government sectors and society. The European Centre for Disease Prevention and Control (ECDC), an EU agency, monitors 52 communicable diseases, having programmes which cover antimicrobial resistance. The highest rates of non prescription use of antibiotics are in Romania (20%). Objectives: To determine if there is any significant difference between antimicrobial resistance of Gram negative bacteria isolated in hospital settings in comparison with those found in ambulatory settings. Materials and Methods: We performed a systematic review and meta-analysis of unpublished studies (as reports that are produced by all levels of government, academics, business and industry in print and electronic formats but that are not controlled by commercial publishers) of Gram negativ bacteria's antimicrobial resistance in Arad County (n=17.166, between 2010-2016). As for factor analysis we extracted six factors, labeled as: Total Gram negative isolates, Hospital Gram negative antibiotic resistant isolates, Ambulatory Gram negative antibiotic resistant isolates, Relative Risk, Risk Difference and Odds ratio for hospital versus ambulatory bacteria's antimicrobial resistance. Results: The highest incidence for antimicrobial resistance was in 2011 (41,9% in hospitals and 20,91% in ambulatory settings). Gram negative hospitals bacteria would be 1,493 - 3,544 times as likely as Gram negative ambulatory bacteria to develop antimicrobial resistance isolates and Odds ratio (OR) has had a range of values between 1,36-4,16. Conclusion: Because antimicrobial resistance is endemic both in hospital and ambulatory settings, education programmes are needed for health professional as well as for all Romanian citizens. Recommendation: To limit antibiotic availability for consumption without prescription.
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References6
http://www.who.int/antimicrobial-resistance/en/;
http://www.who.int/mediacentre/factsheets/fs194/en/;
Surveillance of antimicrobial resistance in Europe, https://ecdc.europa.eu/sites/portal/files/documents/AMR-surveillance-Europe-2016.pdf;
Antimicrobial resistance and causes of non-prudent use of antibiotics in human medicine in the EU, EUROPEAN COMMISSION, April 2017, pp 11;
Cook DJ1, Guyatt GH, Ryan G, Clifton J, Buckingham L, Willan A, McIlroy W, Oxman AD., Should unpublished data be included in meta-analyses? Current convictions and controversies, JAMA. 1993 Jun 2;269(21):2749-53.
Christine M. Schmucker, Anette Blümle, Lisa K. Schell, Guido Schwarzer, Patrick Oeller, Laura Cabrera, Erik von Elm, Matthias Briel, Joerg J. Meerpohl, and on behalf of the OPEN consortium, Systematic review finds that study data not published in full text articles have unclear impact on meta-analyses results in medical research, PLoS One. 2017; 12(4): e0176210. Published online 2017 Apr 25. DOI: 10.1371/journal.pone.0176210
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