de Greeff SC; Mouton JW (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2017-06-29)
The number of bacteria that are resistant to antimicrobials is increasing worldwide. In the Netherlands, the number of resistant bacteria that can cause infections in humans has remained broadly stable. Nevertheless there is cause for concern and caution. Compared to 2015, in 2016 more 'outbreaks' in healthcare institutions of bacteria that are resistant to last-resort antimicrobials were reported. There is a chance that these bacteria will become more and more common. Although healthy people are not affected, these bacteria can make vulnerable people very sick. If more and more bacteria become resistant to antimicrobials, the treatment options will eventually become limited and it will also become more difficult to treat less serious conditions such as urinary tract infections. The more antimicrobials are used, the greater the chance that bacteria will develop resistance. In 2016, general practitioners wrote approximately two percent fewer prescriptions for antimicrobials than in 2015. The total use of antimicrobials in Dutch hospitals remained stable in 2015, compared to an increase in antimicrobial use in the previous year. The use of antimicrobials for animals decreased further in 2016 compared to 2015, but has been decreasing more slowly in recent years than it did previously. The degree of bacterial resistance in animals also decreased further. This is shown in the annual NethMap/MARAN 2017 report, in which various organisations present their data on antimicrobial use and resistance in the Netherlands, for humans as well as animals. Firstly, to combat resistance, it is important to base the choice to prescribe antimicrobials on the individual patient and the infection concerned. Secondly, it is important that it quickly becomes clear when resistant bacteria are involved and that proper tests are used to determine this. Thirdly, it is important that healthcare providers carefully follow existing hygiene procedures, such as handwashing, in order to prevent resistant bacteria from spreading. For example, thanks to these measures, the number of MRSA bacteria in hospitals has remained low in recent years. This type of 'hospital bacteria' is transmitted via skin-to-skin contact, particularly via the hands, and is insensitive to many types of antimicrobials. Part 1: NethMap 2017 pg 1 - 160 Part 2: MARAN 2017 pg 1 - 80
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