Prevalence and antibiotic resistance of commensal Streptococcus pneumoniae in nine European countries.

The human microbiota represents an important reservoir of antibiotic resistance. Moreover, the majority of antibiotics are prescribed in primary care. For this reason, we assessed the prevalence and antibiotic resistance of nasal carriage strains of Streptococcus pneumoniae, the most prevalent bacterial causative agent of community-acquired respiratory tract infections, in outpatients in nine European countries.

A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance.

Background: Greater use of antibiotics during the past 50 years has exerted selective pressure on susceptible bacteria and may have favoured the survival of resistant strains. Existing information on antibiotic resistance patterns from pathogens circulating among community-based patients is substantially less than from hospitalized patients on whom guidelines are often based. We therefore chose to assess the relationship between the antibiotic resistance pattern of bacteria circulating in the community and the consumption of antibiotics in the community.

Prevalence and resistance of commensal Staphylococcus aureus, including meticillin-resistant S aureus, in nine European countries: a cross-sectional study.

Background: Information about the prevalence of Staphylococcus aureus resistance to antimicrobial drugs has mainly been obtained from invasive strains, although the commensal microbiota is thought to be an important reservoir of resistance. We aimed to compare the prevalence of nasal S aureus carriage and antibiotic resistance, including meticillin-resistant S aureus (MRSA), in healthy patients across nine European countries.

Methods: In this cross-sectional study, nasal swabs were obtained from 32,206 patients recruited by family doctors participating in existing nationwide family doctor networks in Austria, Belgium, Croatia, France, Hungary, Spain, Sweden, the Netherlands, and the UK.

The appropriateness of prescribing antibiotics in the community in Europe: study design.

Background: Over 90% of all antibiotics in Europe are prescribed in primary care. It is important that antibiotics are prescribed that are likely to be effective; however, information about antibiotic resistance in the community is incomplete. The aim of our study is to investigate the appropriateness of antibiotic prescribing in primary care in Europe by collecting and combining patterns of antibiotic resistance patterns and antibiotic prescription patterns in primary care.

International consensus on Vibrant Soundbridge® implantation in children and adolescents.

Objective: Active middle ear implants augment hearing in patients with sensorineural, conductive, and mixed hearing losses with great success. However, the application of active middle ear implants has been restricted to compromised ears in adults only. Recently, active middle ear implants have been successfully implanted in patients younger than 18 years of age with all types of hearing losses.

Research using electronic patient records in general practice. The EGPRN meeting in Bertinoro, Italy, May 2009.

The European General Practice Research Network organized an international workshop on research using electronic patient records in Bertinoro, Italy, in May 2009. The authors were keynote speakers at the workshop, tasked with summarizing the theme research presentations on each of the two days of the meeting. The conference discussed the utility of capturing data in a way that can be appropriately analysed.

Evaluating eHealth: how to make evaluation more methodologically robust.

In the third in a series of articles on evaluating eHealth, Richard Lilford and colleagues consider the evaluation of health IT systems as they are rolled out following preimplementation testing.

Survey of prophylactic antibiotic use amongst UK cochlear implant surgeons.

Cochlear implant patients are at an increased risk of pneumococcal meningitis. Recent government guidelines require all implant patients to undergo pneumococcal vaccination. The guidelines also suggest antibiotic prophylaxis but no clear guidelines regarding which antibiotic to use or for how long were issued.

Mental Capacity Act 2005.

Should guide doctors to help protect vulnerable people

Inequalities in uptake of influenza vaccine by deprivation and risk group: time trends analysis.

The aim of this study was to investigate influenza immunisation rates in the United Kingdom over a 6-year period and examine trends in uptake by deprivation, ethnicity, rurality and risk group. Influenza immunisation rates were determined from 1999/2000 to 2004/2005 using a large general practice database (QRESEARCH). There was a relative increase of 59.

Delayed presentation of paediatric tracheal foreign body.

We report the case of a 21-month-old child who, after a choking episode, presented with a 4 week history of occasional respiratory wheeze on exertion. A plastic foreign body in the mid trachea was retrieved on bronchoscopy. The delay in presentation was related to the presence of a lumen within the foreign body permitting ventilation.

Developing a national primary care-based early warning system for health protection--a surveillance tool for the future? Analysis of routinely collected data.

The increasing threat of infections with pandemic potential such as influenza has focussed attention on the information needed to inform those managing a pandemic. The Health Protection Agency, Nottingham University and EMIS have developed a new national health protection surveillance system using QRESEARCH, an established primary care-derived database, to provide timely and local information on trends in community illness and prescribing. This article describes the first year of the surveillance project.

General practice characteristics associated with rates of testing and detection of hepatitis C: cross-sectional study in Nottingham and Derbyshire.

The aim of this study was to determine general practice characteristics associated with testing rates for hepatitis C virus (HCV) and the proportion of tests with a positive result. The study included all patients tested for HCV from all general practices in the primary care trusts in Nottingham and Southern Derbyshire, UK over 2 years. There was a large variation between practices in HCV testing rates and the proportion of positive tests.

Sex inequalities in access to care for patients with diabetes in primary care: questionnaire survey.

Background: Health experiences differ between men and women. The health services have focused their attention on gynaecological health problems in women, however women with non-gynaecological health problems could be unintentionally neglected. Given the increased prevalence of diabetes, the healthcare needs and experiences of women with diabetes are increasing.