2022-10-30-世界卫生组织-Antimicrobial_resistance_TrACSS_Spain_2022_country_profile_10页_297kb

Spain's 2022 TrACSS Assessment: Progress on Antimicrobial Resistance (AMR)

1. National Action Plan (NAP) For AMR

   • Progress: Spain has developed an AMR NAP and is actively implementing/revising it (currently at D/E level).
   • Monitoring: Possesses a monitoring and evaluation plan for the NAP.
   • Coordination: Formally established multisectoral coordination for AMR.

2. Human Health Sector

   • The country demonstrates varying levels of progress across AMR-related indicators:
   • Strengthening training and education on AMR in healthcare (consistently D/E since 2020).
   • Monitoring antimicrobial consumption (D/E level, with slow progress).
   • Surveillance system for AMR in humans (not at target level since 2019).
   • Implementation of Infection Prevention & Control (IPC) and stewardship (not consistently at desired C-E levels).

3. Animal Health Sector

   • Training and education on AMR in veterinary/水产领域 (accessed C/D levels in the past three years).
   • Surveillance systems for AMR in terrestrial/aquatic animals (currently E/C respectively for terrestrial/aquatic).
   • Biosecurity and prudent use of antimicrobials accepted, but limited system, evaluation needed.
   • Effective AST testing for critical bacteria is available (national reference labs are performing tests).

4. Food and Agriculture Sector

   • Training and education on AMR for agricultural/farm laborers (accessed B/C levels in past years).
   • Surveillance systems for AMR in food are not robust (currently E/E since 2019).
   • Biosecurity practices limited for AMR control (D/E ranges).
   • Farm antimicrobial use reduction and resistance impact studies needed.

5. Environment Sector

   • No specific national assessments were carried out (not carried out by the country).
   • No specific legislation/regulation to prevent environmental contamination from antimicrobials (currently N in 2022, previously N).
   • No regular monitoring of antimicrobial compounds/MR genes in water (currently N).

6. Key Challenges & Recommendations

   • Recommendation areas include:
   • Strengthening multisectoral coordination and enhancing data analysis and use.
   • Enhancing surveillance (IPC, AMC use, resistance surveillance, diagnostics, etc.)
   • Improving stewardship programs (Antimicrobial use optimization guidance, AWaRE classification implementation).
   • Increasing investment in labs and surveillance system reporting and quality assurance.
   • National Priority Access Lists for animals must be completed and implemented.
   • Strengthen environmental regulations and monitoring.

7. Legislation and policy links

   • Spain has existing regulations related to antimicrobial prescription/sale for human/terrestrial/veterinary use (currently Y).
   • Legislation prohibits growth-promotion use in terrestrial animals (currently Y).
   • There is insufficient data to inform policy changes and enforce antimicrobial regulations effectively, compared to countries with higher AMC/AMR surveillance.
   • Currently, 60% of countries utilize AMC/AMR data for policy adjustments, which is lower for Spain.

Conclusion: Spain has made commendable progress in developing its AMR NAP and establishing multisectoral coordination. While capacity is generally adequate in human health aspects, there are challenges in scaling up effective interventions, particularly concerning antimicrobial consumption monitoring, food safety/animal AMR surveillance, and advancing environmental regulations. Focusing on enhancing monitoring, data analysis, and horizontal/integrating policies across sectors is crucial.