resistance-surveillance-2015-6.html
DANMAP 2015 3D
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7 danmap
2015
1. massively. today, fast track systems such as whole-genome sequencing present a wide variety of opportunities for the future. interpretation and standardization of these massive data files will be the challenge over the next decade. it is important to keep in mind that the discovery of a resistance gene not necessarily renders that specific strain resistant to the antimicrobial
. we therefore need
to keep qualified resis- tance testing methods like broth dilution for determination of phenotypic colistin resistance in bacteria and ensure robust and representative comparative studies, before we choose to abandon classic and standardized methods. there are several lessons to be learned from the emerged mobile colistin resistance: firstly, surveillance has never been more important - and no national surveillance and control system, no matter how good, is adequate in the face of a global amr threat. we need global interactions and interventions, also in the fight for a more pru- dent use of antimicrobial agents in both veterinary and human medicine. secondly, it is clear that minor antimicrobials may suddenly rise to prominence. this applies to colistin but may apply to other antimicrobial classes as well. an example is the use of coccidiostats, which is monitored by vetstat, but has not been reported since 2004 as we have focused on prescription anti- microbials. in danmap 2015, data on the use of coccidiostats are shown in textbox 4.1. we believe that amr levels in denmark would have been sig- nificantly higher without the detailed research and monitoring of antimicrobial consumption in food animals and in humans. this has provided significant tools for timely decision-making for authorities and other stakeholders. in other words, dan- map provides data for action. today we acknowledge the need for new and better surveil- lance tools and especially the need for a more timely dissemi- nation of the results to medical and veterinary professionals. in this respect, other countries with younger models and systems might be of inspiration to us. as we face a pandemic and extremely costly threat from amr [o?neill, 2016] we need to reinvent our model of ?data for action?. we are thankful for all the collaboration, formal and informal, that has developed and stabilised through the years, in den- mark and around the world. we would like to thank all con- tributors to this edition of danmap without whom, the report would not exist. on the threshold to the next twenty years, we would like to ask: the times they are a-changing - are we able to keep up? flemming bager, dtu national food institute ute wolff sönksen, statens serum institut references lui yy, et al. emergence of plasmid-mediated colistin resis- tance mechanism mcr-1 in animals and human beings in china: a microbiological and molecular biological study. the lancet infectious diseases. retrieved 2015-11-19 hasman h et al. detection of mcr-1 encoding plasmid-medi- ated colistin-resistant escherichia coli isolates from human bloodstream infection and imported chicken meat, denmark 2015. euro surveill. 2015;20(49). doi: 10.2807/1560-7917. es.2015.20.49.30085. o?neill j. tackling drug-resistant infections globally: final report and recommendations 2016. wellcome trust, and hm govern- ment, united kingdom. http://amr-review.org/.
dcm-hospital-danish-8.html
