September 2010, Volume 32, No. 3
Internet

What’s in the web for family physicians — emerging antibacterial resistance

Alfred KY Tang 鄧權恩

Center of Health Protection (CHP), Department of Health, HKSAR
http://www.chp.gov.hk/en/content/9/460/13039.html

CHP website is giving updates on status of antibiotics resistance bacteria in Hong Kong, notably the press release on New Delhi metallo-b-lactamase 1 (NDM-1) on 12th August, as well as the CA-MRSA on 2nd September. In their website, there are also educational resources on Proper Use of Antibiotics including pamphlets and health talk slides. Guidelines issued to health professionals are also included at the website including ‘Reducing bacterial resistance with IMPACT’ and ‘Guideline on antimicrobial use in primary health care clinics’. Related links to antibiotic resistant bacteria are also posted at the website.

World Health Organization (WHO)
http://www.who.int/topics/drug_resistance/en/

The above WHO webpage provides links to activities, reports, news and their efforts on managing antibiotics resistance. Specific components include: What WHO is doing, WHO Global Strategy for Containment of Antimicrobial Resistance and Global Patient Safety Challenge: Tackling Antimicrobial Resistance. Related links and Fact sheets on the issue can also be found at the website.

Centers for Disease Control and Prevention (CDC)
http://www.cdc.gov/drugresistance/index.html 

On their webpage for antibiotics/antimicrobial resistance, CDC classified the information into six main areas, namely ‘About Antimicrobial Resistance’, ‘Disease/ Pathogens’, ‘Education and Campaigns’, ‘Surveillance System’, ‘Laboratory Testing and Training Resources’. It also features The interagency effort in bringing together multiple federal agencies to coordinate their efforts in addressing this complex issue. The overview section on antimicrobial resistance (http://www.cdc.gov/drugresistance/about.html) is informative in telling the current status and present trend of the issue. There is another page which contains links to diseases associated with antimicrobial resistance. (http://www.cdc.gov/drugresistance/DiseasesConnectedAR.html).

Association of Public Health Laboratories (APHL): Continuing Education and Training
http://www.aphl.org/profdev/training/Documents/DCET_2010June3_SummerFallCatalog.pdf

The APHL offers a range of high-quality continuing education programs to strengthen the skills of health professionals and promote excellence in laboratory practice. It sponsors education programs both independently and through the National Laboratory Training Network (NLTNTM), a highly respected 20-year collaboration with the CDC. Participants can receive continuing education credits (PACE®, CDC, etc.) for most APHL or NLTNTM programs.

Montana Antibiotic Resistance
http://mara.mt.gov/mara-index.shtml

The Montana Antimicrobial Resistance Awareness (MARA) program aims to increase awareness about the appropriate use of antimicrobials in order to prevent the development of multi-drug resistant organisms. An interim Guidelines for the Control and Prevention of Methicillin Resistant Staphylococcus aureus (MRSA) Skin and Soft Tissue Infections in NonHealthcare Settings is available at http://mara.mt.gov/documents/MTDPHHSMRSAGuidelinesFINAL090507.pdf It is the belief of MARA that appropriate use of antibiotics is everyone’s responsibility, and not just an issue of health care provider.

US Food and Drug Adminstration (FDA)
http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm135344.htm
 

FDA, in cooperation with other Public Health Service Agencies, has embarked on several major initiatives to address what is considered to be a major threat to the Public Health in the new millennium: the emergence of drug-resistant bacteria. Public workshop was held in July to evaluate the current status and set future research directions on the issue (http://www.fda.gov/Drugs/NewsEvents/ucm211146.htm) FDA’s Center for Veterinary Medicine (CVM) produced a nine-minute animation explaining how antimicrobial resistance both emerges and proliferates among bacteria, and explain how, over time, the use of antimicrobial drugs will result in the development of resistant strains of bacteria, complicating clinician’s efforts to select the appropriate antimicrobial for treatment. (http://www.fda.gov/AnimalVeterinary/SafetyHealth/AntimicrobialResistance/ucm134359.htm).

Infectious Diseases Society of America (IDSA)
http://www.idsociety.org/Content.aspx?id=16658
 

Online video presentations are available on the FDA/NIAID/IDSA Public Workshop titled Antibacterial Resistance and Diagnostic Device and Drug Development Research for Bacterial Diseases held in July 2010. The workshop and brought together key researchers, physicians, regulators, and government officials to discuss the science around antibacterial resistance and new antibacterial drug and related rapid diagnostics. At the website of the IDSA, information on recent examples of drug resistance including vancomycin – resistant Staphylococcus aureus (VRSA) and community-associated methicillin-resistant Staphylococcus aureus (MRSA). The emergence of these are of great concern to clinicians and public health officials. Now, it is occurring across the country in local communities, infecting healthy and strong individuals. There is also a webpage on special area of focus on Bad Bugs, No Drugs (http://www.idsociety.org/Content.aspx?id=4810) giving detailed and useful information on the issue.


Alfred KY Tang, MBBS (HK), MFM (Monash)
Family Physician in Private Practice

Correspondence to: Dr Alfred KY Tang, Shop 3A, 2/F, Hsin Kuang Shopping Centre, Wong Tai Sin, Kowloon, Hong Kong SAR, China.

E-mail: alfredtang@hkma.org