As described in Nature Communications, these viruses could be the product of soil heating, and could therefore be linked to experiments that have been taking place for many years in this forest, heated by cables in the ground that keep the surface warmer by 5 degrees compared to the ambient temperature, creating an external laboratory that reproduces the effects of climate change. Having found 16 in one fell swoop, all different from each other, for Blanchard, "was shocking", even considering that the discovery happened by chance: "We were not looking for giant viruses - he notes - our goal was to isolate bacteria directly from the environment to understand how micro-organism communities are changing in response to soil warming ". That is, that makes the discovery particularly interesting, according to bioinformatics Frederik Schulzn, of the Joint Genome Institute (Jgi) of the US Department of Energy, is to have found the viruses in the soil, because "most of the giant viruses, previously described have been discovered in water". Moreover, the exceptionality of the finding, for Schulzn, is in having found all these viruses only scratching the surface: "If we went deeper this number could easily double, triple or even quadruple."

Killer bacteria, the Ministry of Health takes the field after the suspected deaths in Veneto and Emilia Romagna.   "The Mycobacterium chimaera - reads on the website of the Ministry - commonly known as" killer bacterium ", is a bacteria identified for the first time in 2004, widespread in nature, mainly present in drinking water and generally not dangerous for human health .   Invasive cases of M. chimaera have been found in Europe, and not only, and have been associated with the use of cooling / heating devices (Heater-Cooler Devices, HCD) necessary to regulate the temperature of the blood in extra-body circulation during interventions cardiac surgery, mostly due to patient contamination by aerosols from the water of the device tanks. The first identification of a case of infection associated with this type of device dates back to 2014, even if through retrospective surveys it was possible to recognize even cases that occurred previously, starting from 2011 ". "The incubation period - it is evident - after exposure to M. chimaera is long, with a median of 17 months (range 3-72 months). Signs and symptoms are generally non-specific and include fatigue, fever and weight loss. There is no established therapy and the mortality rate is about 50%. Currently, the magnitude of the global epidemic is not known exactly. Before the death of the Vicenza anesthesiologist, on 2 November, Italy seemed excluded from the emergence of these new infections ".   The Ministry of Health recalls that a few months ago, within the institutional framework represented by the National Anti-Combative-Resistance Plan (PNCAR) 2017-2019, "started a risk assessment activity for our country at purpose of issuing specific recommendations ".   This preliminary phase includes several actions, including: - an in-depth analysis of the data collected since 2016 by the ISS, which highlighted the circulation of mycobacterium also in Italy - the request to the regions of data concerning any cases, sporadic or in clusters, of invasive Mycobacterium infection, also through a retrospective analysis of the data themselves - a check on Dispovigilance (information system for the national accident monitoring network involving medical devices) of any reported events.   "We are waiting - concludes the Ministry - to receive feedback from the regions and the delay is probably due to the fact that the long incubation period and the lack of specificity of the clinical picture make complex and laborious the identification of possible cases that must, however , be confirmed by specific laboratory investigations, not always available for cases identified retrospectively ".

After a spike in new confirmed cases in the Beni area, where the worst Ebola epidemic does not stop in the history of the Democratic Republic of Congo (DRC), Msf strengthens its action to contain the contagion by opening a new transit center for cases suspects. "The goal of this transit center is to strengthen the overall care capacity of Beni. Since the city became the center of the epidemic in October, many new cases have emerged confirmed in different neighborhoods. The Transit Center was built near the existing Ebola Treatment Center, whose capacity is now saturated. The proximity of the two centers will make our response to the Beni epidemic more effective, "explains Marie Burton, MSF project manager at Beni. The transit center was built on a former football field of 8 thousand square meters and required a week of intense construction work. Helped by the same young people who once played football on that field, MSF teams have worked despite frequent storms and have overcome big logistical challenges to complete the work as quickly as possible. Suspicious patients will be welcomed to the Transit Center while they wait to know the results of their tests. In the meantime MSF medical staff will immediately provide adequate care for people's clinical conditions. When the diagnosis is confirmed, Ebola-positive patients will be transferred to the nearby treatment center, while the negative ones will be transferred to other health facilities, where they will receive further treatment. So far, both suspected and confirmed cases were received in the treatment center, in two isolated departments. In the new center, individual rooms have been built instead of large marquees, to improve patient isolation. The divisions between the rooms have been fitted with large Plexiglass windows so that the medical staff can maintain eye contact with the patients, but also because patients can see their family and loved ones when they come to visit them. The basic capacity of the center, equal to 16 beds, can reach up to 32 or 48 beds in case of need, depending on how the epidemic will evolve. Our teams are increasingly committed to tracking suspicious cases since the epidemic has reached a new level. At least 30 new suspected cases are identified every day and admitted to the Ebola Center of Beni. The worst Ebola epidemic in the Democratic Republic of the Congo In just three months since it was declared, this Ebola outbreak - the tenth in the history of DRC - has become the worst ever recorded in the country. To date, 341 cases have been identified, 303 of which have been confirmed. The epicenter has moved from the small town of Mangina, where the first few cases have emerged, to the largest city of Beni, where the number of suspected and confirmed patients has grown steadily for weeks, until the total saturation of the medical ability to cure the patients. Since August 1, the virus has killed 215 people and several organizations are doing their best to prevent it from spreading further. More than 100 patients have managed to heal so far. In an area of ​​heavy insecurity caused by the ongoing conflict, where access to parts of the population is very complex, the medical response has faced major challenges and the epidemic has not yet been stopped. "Since the center of the epidemic has moved from Mangina to Beni, the epidemic has become more difficult to control. We now observe a growing number of new cases further south, in the even larger city of Butembo. We fear that the situation can become even more difficult to manage, unless the response in this area is significantly strengthened "says Chiara Montaldo, MSF medical coordinator in Beni. In recent weeks there has been a noticeable increase in new cases at Butembo, a regional business hub, just a stone's throw from the Uganda border. The latest developments are a call to devote more resources and attention, for the risk that this big city could become a new hotspot of the epidemic. The involvement of the communities In addition to the obstacle of an ever-moving population, many of the difficulties in the response were caused by the fear of the population for such a deadly disease - which can hamper the relationship between communities and health workers. As a result, we often observe the reluctance to report new cases, to be transferred to treatment centers or to accept the intervention of the teams who are responsible for ensuring safe and dignified burials for the victims of Ebola. "We find the need for better and more effective communication from all the players involved in the response against Ebola to gain people's trust. Mortality rates are very high; people can be led to think that treatment centers are places where they go to die, when dozens of patients have been hospitalized. Being admitted to a treatment center during the initial stage of the disease increases the chances of recovery, "says Axelle Ronsse, MSF emergency coordinator for Ebola surgery. Msf active on the pillars of the intervention against Ebola Msf is present at Beni since the beginning of the epidemic in August 2018 and is active on several fronts, to contain the spread of the virus and respond to the needs of the North Kivu population. Together with other organizations participating in the intervention, MSF teams regularly visit 24 health centers to provide training and material; they hold regular meetings with local communities to share information about the disease and methods to avoid infection. Among the prevention and control activities, MSF teams are involved in the decontamination of health centers after the identification and transfer of confirmed Ebola cases to the appropriate facilities. MSF teams also vaccinated more than 600 people at Beni in October, including frontline health workers and potential contacts of patients who had already contracted the virus. In November, vaccines were also administered in the city of Butembo. Since the beginning of the epidemic on August 1, 2018, MSF teams have participated in the Ebola response in North Kivu and Ituri. MSF has opened treatment centers in the cities of Mangina, Butembo and Tchomia (the latter has now been closed), an isolation center in the city of Bunia and now a transit center in Beni. Independent of any political, religious or military authority, Msf acts impartially, according to the assessment of medical needs. The independence of the association is ensured by private donations, which represent more than 80% of its funds.

Coping with the spread of antibiotic-resistant bacteria is today a top priority that must involve everyone: the health workers, who prescribe antibiotics but also the common citizen, who often takes them as self-medication. Also because that of the antibiotic resistance is now a real world emergency.   The antibiotic-resistant bacteria kill about 30 thousand people in Europe each year, of which one third Italians, with an economic loss, between health costs and loss of productivity, of about 1.5 billion euro (EC 2017 / C 212/01) . In the next twenty years, according to the WHO, they will become the leading cause of death, overcoming tumors among the causes of death. Since the last Report ECdc 2016 it emerges that more than half (58.6%) of Escherichia coli isolates, 34.5% of Klebsiella pneumoniae, 33.9% of Pseudomonas aeruginosa and 13.7% of Staphylococcus aureus is resistant to at least one of the classes of antibiotics to which he was previously sensitive. Italy is fifth in Europe for antibiotic consumption and the antibiotic-resistance rates are among the highest. Not only that, our country is still in first place for the amount of antimicrobials used in animals for the production of meat for food use. This is the starting point for the alarm of the Italian Society of Neonatology (Sin). Infants are biologically susceptible to infections because the immaturity of their immune system makes them vulnerable to the attack of bacteria: 40% of the three million neonatal deaths every year in the world are due to infections. If the baby is born before the end, the situation becomes more complicated. Preterm infants associate with biological immaturity the need for very invasive procedures and therapies, which favor the entry of germs responsible for generalized, very serious hospital infections. Therefore, in Neonatal Intensive Therapies, the use of antibiotics as a therapy or as prevention is usual, to save the life of the newborn.   Surveillance data on bacterial resistance among infants are currently limited to individual care centers, or to individual regions, but the current perception is that Gram-negative bacteria such as Klebsiella and Escherichia coli are emerging as responsible for a third of cases of generalized infection. In 18% of cases the infection is caused by resistant bacteria, and the mortality is double that due to unselected germs (about 20% Vs 10%).   But what are the solutions? The tendency to increase the antibiotic-resistance in our country can only be reversed by creating a complicity between structures and organizations aimed at patient care. Considering the relevance of the problem, the Sin as a Scientific Society is alongside the Public Health Administrators in the realization of the objectives of the National Plan of Contrast of the Anticrobic-resistance (PnCar) 2017-2020.   Among the priorities of the Italian Society of Neonatology for the next three years, there will certainly be to provide the Neonatologists who work, both in the hospital and in the area, the tools for the most correct use of antibiotics, based on the most up-to-date scientific evidence provided from international literature, through the implementation of antibiotic stewardship policies. Curing and healing infectious diseases remains a priority, but at the same time it protects the most vulnerable populations, such as the neonatal, from the damage caused by the emergence of increasingly resistant bacterial strains.

A study by the ECDC (European Center for Disease Prevention and Control) estimates the burden of five types of infections caused by antibiotic-resistant bacteria of public health interest in the European Union and in the European Economic Area (EU / IF IT'S). The weight of the disease is measured in number of cases, attributable deaths and years of life adjustable for disability (DALY). These estimates are based on data from the European antimicrobial surveillance network (EARS-Net) of 2015. The authors stated that the estimated burden of infections with antibiotic-resistant bacteria in the EU / EEA is substantial compared to other infectious diseases and increased since 2007. Strategies to prevent and control antibiotic-resistant bacteria require coordination at EU / EEA and global level. However, it is shown that the contribution of various antibiotic-resistant bacteria to the overall burden varies widely from one country to another, thus highlighting the need for prevention and control strategies tailored to the needs of each EU / EEA country. The study estimates that about 33,000 people die each year as a direct result of an infection due to antibiotic-resistant bacteria and that the weight of these infections is comparable to that of influenza, tuberculosis and HIV / AIDS combined. It also explains that 75% of the disease burden is due to healthcare-associated infections (HAI) and that reducing this through appropriate infection prevention and control measures, as well as antibiotic management, could be an achievable goal in health. Finally, the study shows that 39% of the load is caused by bacterial infections resistant to the latest generation of antibiotics such as carbapenems and colistin. This is an increase compared to 2007 and is of concern because these antibiotics are the latest treatment options available. When these are no longer effective, it is extremely difficult or, in many cases, impossible to treat infections. The study was developed by ECDC and Burden of AMR Collaborative Group experts and published in The Lancet Infectious Diseases. The results of this study are also used by the Organization for Economic Cooperation and Development (OECD) to estimate the economic weight of antibiotic resistance.

Hospital infections are not the fault of the person who treated the patient but of the structure where this was treated and should be condemned. With this principle, the Court of Rome condemned a hospital company to compensate a patient of almost 10 thousand euros for having contracted during a hospitalization and as a consequence of this infection that had forced him to undergo further surgery. The fact One patient underwent surgery and the mechanical valves were implanted in the aortic and mitral position after median resternotomy sutured at the end of the operation with staples on the sternum and superficial planes.  An infection of the sternal wound was then manifested and the presence of Corynebaiterium Amyiolatum was ascertained. The patient underwent targeted antibiotic therapy associated with Vac-therapy. Once the infection is resolved, the VAC has been removed and the wound sutured.  Once discharged, almost a year later, there was a recurrence of the infection and the patient was hospitalized again and subjected to new surgery for the removal of the wires of the sternotopia. On that occasion the presence of Corynebaiterium Amyiolatum infection was also ascertained and was subjected again to antibiotic therapy. The patient did not complain of the intervention, but the hospital infection for which he claimed compensation and the hospital was constituted by challenging the application and show that the patient had been given the best therapies to eradicate the infection, while not c 'was no correlation with the infection arising and diagnosed with the operation.   A first report found the causal link between the intervention and the wound infection to be considered for all hospital effects. He believed in any case that the infection was not attributable to medical malpractce as to the structural and organizational deficiencies of the hospital.   To deepen this aspect assumed by the CTU the judge had a new advice according to which: - there was no doubt that the bacterium was of hospital origin. As for the first contagion it is concomitant to the surgical intervention and therefore the thing seems obvious, as for the second contagion the CTU motIva (also for the type of bacterium detected) that also this case was tied to the first one, without which there would not have been The second one; - secondly, it considers that contagion presupposes some deficiency, a lack of attention and implementation in relation to sanitation and aseptic procedures that must constantly guarantee the patient's safety against infections from infections in the hospital. The sentence According to the judge it is almost impossible, even ascertaining the hospital nature and provenance of the bacterium that has infected the patient hospitalized, and also in the certainty that this was not affected before the admission from the relative infectious pathology, identify the place and the moment, the sector of activity, the triggering factor, the weak point in the protection chain of sanitation measures. In other words, the lack of identification of where and when and how the bacterium was transmitted to the patient is a constant of the story, even in court.   Once established then that the patient has contracted the infection, it reads in the sentence, "in virtue of the principles that regulate the burden of proof, in the matter of contract there can be no doubt that it is incumbent to the hospital structure to try to have adopted all the measures necessary and necessary for proper environmental sanitation, in order to avoid contamination. In other words, the AO had to provide proof that the harmful event (contagion) is not among the foreseeable and avoidable complications. What is the way to fulfill this negative test? To provide positive proof of having done everything the science of the sector has so far devised to avoid or at least reduce to the maximum the risk of contamination and spread of the infection ".   Further, detailed, appraisal requested by the Judge can be affirmed, it is still read in the sentence, "with absolute certainty, that is added to the probative deficit of the Company, and in absence of contributions of some effectiveness of the CTP of the parts .... that the dutiful and payable attention, by the hospital, to the preparation and implementation of adequate sanitation measures has been missed ".   In this sense, the Judge's comment in the sentence is that "the disconsolate truthful conclusion to which the infectious judge consultant arrives can not be appreciated:" From everything expressed it is right to conclude that it is completely useless to elaborate protocols and guidelines from the Committees for hospital infections, but it is necessary instead to monitor daily, in the possible and feasible ways, the application of these in the field, something that happens rarely, as studies have shown and that obviously did not happen in the case that we have treated ' ".   The ruling therefore points out the biological damage both temporary and permanent, highlighting that hospital infections, besides being a contradiction, represent a real problem of public health, which implies an economic burden on citizens and a failure of assistance. And he concludes, condemning the structure to the patient's compensation, that in the absence of proof by the latter of having taken all the necessary and necessary measures for a correct environmental sanitation and therefore the contagion is not a predictable and avoidable complication of the patient's performance , "It must be assumed that the hospital has not prepared and adopted adequate sanitation measures, with acceptance of the claims for compensation of the patient who eventually took him to court".

"Umbria is at the forefront of the fight against sepsis, a complex and difficult to manage syndrome, with concrete actions promoted by the 'Center for the management of health risk and patient safety' and activities to raise awareness among citizens and health personnel for recognition and timely treatment of the same ". This is stated by the Regional Councilor for Health, Social Cohesion and Welfare, Luca Barberini, who intervenes with a note on the occasion of the "World Sepsis Day", scheduled for September 13 and established to inform people about this pathology, which in the world it afflicts millions of people and in 2017 in Umbria has recorded 3,003 hospitalizations, with a mortality of 31 percent. "The sepsis - explains Barberini - is generated by an infection that can give rise to an abnormal reaction, capable of damaging the organs making them no longer functioning. It represents a frequent clinical condition, difficult to diagnose and the first cause of death from infection if not recognized and not treated promptly. According to experts, it kills ten times more than heart attack, four times more than colon cancer, five times more than stroke and is a cause or contributing factor in half of the deaths in the hospital. In Umbria there has been a gradual increase in septic hospitalizations: 2,040 cases in 2014, 2,338 in 2015, 2,473 in 2016 and 3,003 in 2017 with a mortality of between 31 and 33 percent ". "With the aim of recognizing and timely treating this disease and reducing its mortality - concludes the councilor - the Umbria Region, thanks to the 'Center for the Management of Health Risk and Patient Safety' has defined regional guidelines, for health professionals, for the management of sepsis and septic shock, in order to guarantee homogeneous diagnostic-therapeutic interventions, both at hospital and extra hospital level ".

Pollution kills. Not just the lungs, but also the heart. This was reiterated by a study just published in the European Heart Journal, conducted by Thomas Münzel, director of cardiology at the Johannes Gutenberg University Medical Center in Mainz (Germany). Air pollution, in particular that sustained by fine particulate matter, is responsible for at least 4 million deaths a year and 60% of these occur for cardiovascular diseases.   The German researchers, together with British and American experts, have therefore gone on to review the mechanisms underlying vascular damage resulting from polluted air. This review article focused in particular on the components of air pollution (particulate matter, ozone, nitrogen dioxide, carbon monoxide and sulfur dioxide) which have a particular impact on the cardiovascular system and on the mechanisms underlying vessel damage. "This article - comments Münzel - is another important contribution of our Working Group on the Environment and Cardiovascular Diseases. In summary, what we have ascertained is that the main contribution to the vascular damage caused by pollution comes from the particulate matter. What worries us most are the poor ultrathin ones, those that have the size of a virus. Once inhaled, they immediately enter the circulation through the lungs and reach the vessels where they cause local inflammation. In the end, this mechanism causes more atherosclerosis and causes cardiovascular conditions such as heart attack, heart failure and arrhythmias. Particularly important is the fact that compared to the much discussed and feared emissions from diesel engines, particulate matter and not nitrogen dioxide damage the vessel function ". "The fine particulate - explains Jos Lelieveld of the Max Planck Institute of Chemistry (MPIC) in Mainz - consists of particles that form in the atmosphere from the emissions of cars, industry and agriculture. To reduce the concentrations in the air we breathe, it is therefore necessary to intervene simultaneously on all these sources. "   The authors also urge to officially include air pollution in the list of major cardiovascular risk factors in the guidelines of scientific societies, providing specific recommendations to prevent adverse cardiovascular effects attributable to pollution.

More than 150 cases of pneumonia are ascertained these days in the area of ??the Lower Brescia region, between Montichiari and Calvisano. An alarm that Ats, the health protection agency, has collected and on which it is investigating to understand the causes of this epidemic.   In a note, the Ats Brescia explains that in-depth analyzes are being conducted on the drinking water distribution network, with corresponding sampling.   General Practitioners, Family Pediatricians and Continuity Medical Practitioners (formerly the Medical Guard) are paying particular attention to cases of patients presenting with respiratory symptoms. The Territorial Social Health Companies are providing timely updates on the number of cases and on the results of the assessments.   The administrations of the municipalities: Carpenedolo, Montichiari, Calvisano, Remedello, Acquafredda, Ghedi, Isorella, Visano, Montirone, informed about the evolution of the events, are collaborating to provide adequate information to the population, which are reported below for maximum dissemination. This is the notice to the Population:  There is no type of risk for the use of drinking water and there is no harassment to the normal running of the activity in the various communities (schools, workplaces, etc. ..). The population is invited, as a precautionary measure, to activate preventive measures as good behavioral norms. We invite you to provide: - to the maintenance of the tap water outlet points in homes by replacing the filters or leaving them in the bathroom with anti-limescale; - to let the hot water flow and then the cold water before using it, moving away from the emission point after opening the taps and opening the windows. This operation should always be carried out after periods of absence from the home (eg holiday period). Please avoid, always on a precautionary basis, outside the houses: the sources of emission of steamed water, for example not standing near automatic sprinklers or fountains at the dwellings; - to take a shower only after having run the hot and cold water and having momentarily moved away from the point of emission of the water and having opened the windows; - to avoid using whirlpool tubs; - to avoid irrigating the gardens using pumps with spray diffusers; - to avoid leaving the reeds for irrigation gardens and gardens exposed to the sun; - to avoid using tap water to fill aerosol therapy or oxygen therapy devices; - to disassemble, disperse and disinfect the filters of the faucets, the shower heads and the flexible pipes of the showers. If necessary, replace them; - to bring the hot water temperature to 70 ° - 80 ° C for three consecutive days ensuring its outflow from all dispensing points for at least 30 minutes a day. People suffering from chronic diseases such as diabetes, chronic lung diseases, heart disease or other diseases that depress the immune system as tumors, current infectious diseases must pay particular attention to some symptoms: the onset of breathing difficulties and fever should be addressed as soon as possible to your doctor.

Fewer people fell ill and died of tuberculosis (TB) last year, but countries are still not doing enough to end TB by 2030. Although global efforts have avoided death by about 54 million TB from 2000, tuberculosis remains the world's deadliest infectious disease.    This is the warning issued today by the World Health Organization (WHO) that today published the WHO Global TBC Report 2018, which calls for an unprecedented mobilization of national and international commitments. The report urges political leaders to meet next week for the first high-level UN meeting on tuberculosis and to take decisive action, building on the recent moves by leaders in India, the Russian Federation, Rwanda and South Africa . Almost 50 heads of state and government should attend the meeting.   "We have never seen high-level political attention and understanding of what the world needs to do to end tuberculosis and drug-resistant tuberculosis," said Dr. Tedros Adhanom Ghebreyesus, Director General of the WHO. "We must capitalize on this new momentum and act together to end this terrible disease". To reach the global goal of ending the TB by 2030, countries urgently need to speed up their response, including by increasing national and international funding to fight the disease. The WHO report provides an overview of the state of the epidemic and the challenges and opportunities that countries face in responding to it. Status of the tuberculosis epidemic: Overall, tuberculosis deaths have decreased over the last year. In 2017, there were 1.6 million deaths (including 300,000 HIV-positive people). Since 2000, a 44% reduction in tuberculosis deaths has occurred among people with HIV compared to a decrease of 29% among HIV-positive people.   Globally, around 10 million people have developed tuberculosis in 2017. The number of new cases decreases by 2% per year, even if faster reductions occurred in Europe (5% per year) and in Africa (4% per year) between 2013 and 2017. Some countries are moving faster than others - as highlighted in southern Africa, with annual decreases (in new cases) of 4% -8% in countries like Lesotho, Eswatini, Namibia, South Africa, Zambia and Zimbabwe, thanks to better TB and HIV prevention and treatment. In the Russian Federation, high-level political commitment and intense TB efforts have led to a more rapid drop in cases (5% per year) and deaths (13% per year)   Drug-resistant TB remains a global public health crisis: in 2017, an estimated 558,000 people have developed a disease resistant to at least rifampicin, the most effective first-line TB drug. The overwhelming majority of these people had a multiresistant TB (MDR-TB), which is a combined resistance to rifampicin and isoniazid (another fundamental medicine for first-line tuberculosis). The WHO estimates that a quarter of the world's population has a tuberculosis infection. The answer to tuberculosis: challenges and opportunities Access to assistance and prevention: Understanding and under-reporting of tuberculosis cases is a major challenge. Of the 10 million people who became ill with tuberculosis in 2017, only 6.4 million were officially registered by national reporting systems, leaving 3.6 million people undiagnosed, or detected but not reported. Ten countries accounted for 80% of this gap, with India, Indonesia and Nigeria topping the list.   Less than 50% of one million children with estimated TB were reported in 2017, which makes a much higher gap in detection than in adults.   The coverage of the treatment is delayed by 64% and must increase at least 90% by 2025 to reach the objectives of TB. In order to urgently improve detection, diagnosis and treatment rates, the WHO, the Stop TBC Partnership and the Global Fund launched the new initiative in 2018, Find. Treat. All. #EndTB, which set the goal of providing quality care to 40 million people with TB from 2018 to 2022. Only about half of the approximately 920,000 people with HIV-associated TB were reported in 2017. Of these, 84% were on antiretroviral therapy. Most of the gaps in detection and treatment were in the WHO African region, where the weight of HIV-associated tuberculosis is higher. Only one in four people with MDR-TB received treatment with a second-line regimen. Only China and India were home to 40% of patients who needed treatment for MDR-TB but did not report receiving it. Globally, the success of MDR-TB treatment remains low at 55%, often due to the toxicity of the drug which makes it impossible for patients to remain in treatment. A month ago, WHO published a rapid communication on the main changes in the treatment of drug-resistant tuberculosis based on the latest scientific evidence. These changes should result in better therapeutic results and more lives saved. The Organization predicts that at least 30 million people should be able to access the preventive treatment of tuberculosis between 2018 and 2022, based on a new WHO guide.   Although the preventive treatment for latent tuberculosis infection is expanding, most people who need it do not yet have access to treatment.   WHO strongly recommends preventive treatment for people with HIV and children under 5 who live in families with tuberculosis.   In 2018, investments in the prevention and treatment of tuberculosis in low- and middle-income countries decreased $ 3.5 billion less than needed. The report points out that without an increase in funding, the annual gap will widen to $ 5.4 billion in 2020 and at least $ 6.1 billion in 2022. $ 1.3 billion a year is needed to accelerate the development of new vaccines, diagnostics and drugs.   "It is unacceptable that millions lose their lives and many others suffer from this preventable and treatable disease every day", said Dr. Tereza Kasaeva, director of the WHO Global TB Program. "We need to join forces to eradicate this disease that has a devastating social and economic impact on those who are" left behind ", whose human rights and dignity are limited and struggling to access treatment. and now."   WHO is leading national and global actions to reach everyone with care, including those with tuberculosis, through a transformative health agenda and push towards universal health coverage. This includes a proactive engagement with civil society and other key stakeholders to jointly help countries come to terms with the end of TB.

The growing threat posed by antibiotic-resistant bacteria can only be addressed through a 'One Health' approach. This was stated by MEPs on Wednesday who voted a non-binding resolution that was approved with 589 votes in favor, 12 against and 36 abstentions. MEPs stressed that "the correct and prudent use of antimicrobials is essential to limit the emergence of antimicrobial resistance in human health care, animal husbandry and aquaculture. The food chain and the environment must also be taken into account, as they can spread resistant microorganisms ". "If nothing is done, antimicrobial resistance can cause more cancer deaths by 2050. We need to start observing the whole cycle, because the health of people and animals are interconnected, and diseases are transmitted from people to animals and On the other hand, it is for this reason that we support the holistic approach of the One Health initiative, said the "One Health" action plan rapporteur Karin Kadenbach (S & D, AT). "EU Member States manage this problem in different ways, so we ask the Commission to consider the possibility of requiring EU countries to regularly collect and submit monitoring data so that they are available at EU level and to establish indicators to measure progress in the fight against antimicrobial resistance, "he added. What is the resolution? In the text, the European Commission and the Member States are asked to limit the sale of antibiotics by the human and animal health workers who prescribe them and to eliminate any financial incentive. It is necessary to take concrete measures against illegal sales and non-prescription sales of antimicrobials in the EU. The European Commission should develop a priority list of EU pathogens for both humans and animals, clearly defining future research and development priorities. Incentives must be created to stimulate investment in new substances. The numbers of the Amr. Infection with drug-resistant bacteria causes about 25,000 deaths a year (for an extra annual total cost of 1.5 billion euros in the EU alone). The increase in antimicrobial resistance is due to a number of factors, such as excessive and inappropriate use of antibiotics in humans and livestock, poor sanitary conditions in health facilities or in the food chain.   According to a 2016 Eurobarometer survey, lack of awareness remains a key factor: 57% of Europeans do not know that antibiotics are ineffective against viruses, 44% do not know they are ineffective against colds and flu. There are significant differences between EU countries regarding the use of antimicrobials, the emergence of resistance and the effectiveness of national policies on antimicrobial resistance.

We use too much antibiotics and we often use them badly. The result is that resistance to these drugs is increasing. According to data from the European Center for Disease Prevention and Control, in their consumption, Italy is fifth in Europe and among the countries with the highest rate of resistant microorganisms. The WHO is also launching the alarm, which underlines the urgent need for global strategies to avoid abuse, such as strengthening or setting up surveillance networks and improving prescriptive adequacy. Especially since there are no new drugs at the corredium; the last class of antibiotics discovered dates back to the eighties. How resistance-animals and cultures spreads: resistance is favored by the practice of treating farm animals with low doses of antibiotics to facilitate growth and avoid diseases. Animals can thus develop resistant bacteria in their intestines. Resistant antibiotic bacteria can be transferred to humans if meat is not handled or cooked properly. Contaminants or contaminated water or animal feces containing resistant bacteria can contaminate agricultural cultures. Fruits and vegetables can transmit insensitive bacteria to antibiotics to humans. How man-resistance spreads: people with bacterial infections are treated with antibiotics and develop resistant strains in the intestine. The sick person can stay home and pass on resistant bacteria to cohabitants. The sick person is admitted to hospital or another health facility: resistant germs can be transmitted to other patients directly by the patient or indirectly (contaminated surfaces, dirty hands of the sanitary workers).

Walter Ricciardi, the president of the Istituto Superiore di Sanità, and the recent convention on antibiotic resistance c hosted by the institute, shows the antibiogram of a patient with Klebsiella, pneumoniae, one of the many Italian hospitals, the resistant finds knows twenty different molecules of antibiotic, and sensitive only to one of them. "A common situation and all in all fortunate reflects Ricciardi because instead they are, hundreds of people with antibiograms resistant to any antibiotic. And in these cases the patient dies ». The antibiotic resistance and development of resistant superbugs is one of the global health problems and is among the priorities of both the World Health Organization (WHO) and individual governments, considering that it is responsible for over fifty thousand deaths between Europe and the United States and that estimates for 2050 make it the leading cause of death in the world. In this panorama Italy is among the worst in the European Union, with about 4500-7000 deaths per year and about 284,000 patients affected, from 7 to 10 percent of all hospitalizations. Drug resistance makes infection treatment difficult. And we talk about very common pathologies, from respiratory infections, such as pneumonia, to those of the urinary tract, skin and post-surgery. "The Klebsiella, for example, points out Gianni Rezza, director of the infectious diseases department, the SS has more than doubled in a short time and is the scourge of intensive care where there are also the most fragile patients. And resistance to the Escherichiacoli and Staphylococcus is increasing, which has already reached 35%. How to get out of it? First of all, we must do everything possible to limit the spread of infections in the hospital, the real nodal point. And then intervene for an appropriate use of drugs for the observance of simple sanitation