PAHO Pan American Health Organization Pan American Sanitary Bureau Regional Office for the Americas for the World Health Organization

PAHO What is Antimicrobial Resistance? The ability of bacteria and other microorganisms to survive an antibiotic to which they were once sensitive (and were once stalled or killed completely)

PAHO Mechanism of resistance Natural or intrinsic resistance Acquired resistance –Chromosomal mutation –Transfer of genetic material

PAHO Contributing Factors Human medicine Animal medicine Agriculture

PAHO

6 Implications of Antimicrobial Resistance CLINICAL Morbidity Mortality COST LIMITED SOLUTIONS

PAHO SURVEILLANCE Surveillance is the ongoing systematic collection, analysis, interpretation and dissemination of the health data to those persons who have the responsibility for disease prevention and control

PAHO Characteristics Quality data Timely Enables comparison Linked to policy and clinical practice

PAHO Use of Surveillance Estimate the magnitude of a health problem problem

PAHO Percentage of S. pneumonie Resistant to penicillin, American Region 1993/

PAHO Use of Surveillance Epidemic detection

PAHO NICARAGUA, Vibrio cholerae: Antibiotic susceptibility

PAHO Use of Surveillance Follow trends and patterns of antimicrobial resistance

PAHO

PAHO Percentage of Shigella spp. isolates resistant to different antibiotics. Peru,

PAHO Percentage of Shigella flexneri isolates resistant to different antibiotics. Ecuador,

PAHO Use of Surveillance Determine geographical distribution and spread of antimicrobial resistance

PAHO

PAHO Goal To preserve the effectiveness of currently available antimicrobial drugs Improve the availability of drugs of assured quality Ensure appropriate use of drugs when they are required Decrease use of drugs when they are not required

PAHO Approaches to address AMR Health System strengthening Policy and regulation Provider and consumer behavior

PAHO Antimicrobial Resistance Surveillance Program IN 1996, PAHO’s DIRECTING BODIES RECOMMENDED THAT THE ORGANIZATION PUT IN PLACE AN ANTIMICROBIAL RESISTANCE SURVEILLANCE PROGRAM

PAHO Participating Countries } Caribbean Countries Countries starting in 1996 Countries incorporated w/ USAID project

PAHO A network of national reference laboratories was established A database set for the American Region was created A web page in PAHO web site was created Results

PAHO Results Protocol for quality assurance and proficiency testing for antibiotic susceptibility Workshops to provide training in bacterial identification and testing for antimicrobial resistance were implemented Protocol for assessing the cost of hospital infections and selected antimicrobial resistance were developed and implemented

PAHO Results TOT on rational use of antimicrobial drugs Training material Drugs therapeutics committees Regional treatment guidelines

PAHO Results Different materials on antimicrobial resistance were produced and distributed References on antimicrobial resistance were compiled into a bibliography, which will be published in a month