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Wang X, Zhang H, Li H, Ding Y, Li J, Zhao C, Yao S. A smartphone-enabled colorimetric platform based on enzyme cascade amplification strategy for detection of Staphylococcus aureus in milk. J Dairy Sci 2024; 107:5438-5448. [PMID: 38608956 DOI: 10.3168/jds.2023-24439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/06/2024] [Indexed: 04/14/2024]
Abstract
Staphylococcus aureus is a pathogenic bacterium contaminating milk and dairy foods causing food poisoning and foodborne pathogens. In this work, a smartphone-enabled enzyme cascade-triggered colorimetric platform was constructed using a cascade bio-nanozyme formed by immobilized glucose oxidase (GOx) on Fe3O4@Ag for rapid detection of S. aureus. Benefiting from reasonable experimental design, a bio-nanozyme cascade-triggered reaction was achieved through H2O2 produced by GOx oxidation of glucose, followed by in situ catalysis of 3,3',5,5'-tetramethylbenzidine (TMB) by the inherent peroxidase-like activity of Fe3O4@Ag to produce color signals. Staphylococcus aureus detection could be performed through naked-eye observation and smartphone measurement, and the developed assay can achieve quantitative and qualitative detection of S. aureus. The on-site nanoplatform had satisfactory specificity and sensitivity with a low detection limit of 6.9 cfu·mL-1 in 50 min. Moreover, the nanoplatform has good practicality in the detection of S. aureus in milk samples. Therefore, the assay has potential application prospects in food safety inspection.
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Affiliation(s)
- Xuechen Wang
- School of Public Health, Jilin University, Changchun, 130021, China
| | - Huiqian Zhang
- School of Public Health, Jilin University, Changchun, 130021, China
| | - Hang Li
- School of Public Health, Jilin University, Changchun, 130021, China
| | - Yukun Ding
- School of Public Health, Jilin University, Changchun, 130021, China
| | - Jinhua Li
- School of Public Health, Jilin University, Changchun, 130021, China
| | - Chao Zhao
- School of Public Health, Jilin University, Changchun, 130021, China.
| | - Shuo Yao
- School of Public Health, Jilin University, Changchun, 130021, China.
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Abia ALK, Baloyi T, Traore AN, Potgieter N. The African Wastewater Resistome: Identifying Knowledge Gaps to Inform Future Research Directions. Antibiotics (Basel) 2023; 12:805. [PMID: 37237708 PMCID: PMC10215879 DOI: 10.3390/antibiotics12050805] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
Antimicrobial resistance (AMR) is a growing global public health threat. Furthermore, wastewater is increasingly recognized as a significant environmental reservoir for AMR. Wastewater is a complex mixture of organic and inorganic compounds, including antibiotics and other antimicrobial agents, discharged from hospitals, pharmaceutical industries, and households. Therefore, wastewater treatment plants (WWTPs) are critical components of urban infrastructure that play a vital role in protecting public health and the environment. However, they can also be a source of AMR. WWTPs serve as a point of convergence for antibiotics and resistant bacteria from various sources, creating an environment that favours the selection and spread of AMR. The effluent from WWTPs can also contaminate surface freshwater and groundwater resources, which can subsequently spread resistant bacteria to the wider environment. In Africa, the prevalence of AMR in wastewater is of particular concern due to the inadequate sanitation and wastewater treatment facilities, coupled with the overuse and misuse of antibiotics in healthcare and agriculture. Therefore, the present review evaluated studies that reported on wastewater in Africa between 2012 and 2022 to identify knowledge gaps and propose future perspectives, informing the use of wastewater-based epidemiology as a proxy for determining the resistome circulating within the continent. The study found that although wastewater resistome studies have increased over time in Africa, this is not the case in every country, with most studies conducted in South Africa. Furthermore, the study identified, among others, methodology and reporting gaps, driven by a lack of skills. Finally, the review suggests solutions including standardisation of protocols in wastewater resistome works and an urgent need to build genomic skills within the continent to handle the big data generated from these studies.
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Affiliation(s)
- Akebe Luther King Abia
- One Health Research Group, Biochemistry & Microbiology Department, University of Venda, Private Bag X5050, Thohoyandou 0950, South Africa; (T.B.); (A.N.T.)
- Environmental Research Foundation, Westville 3630, South Africa
| | - Themba Baloyi
- One Health Research Group, Biochemistry & Microbiology Department, University of Venda, Private Bag X5050, Thohoyandou 0950, South Africa; (T.B.); (A.N.T.)
| | - Afsatou N. Traore
- One Health Research Group, Biochemistry & Microbiology Department, University of Venda, Private Bag X5050, Thohoyandou 0950, South Africa; (T.B.); (A.N.T.)
| | - Natasha Potgieter
- One Health Research Group, Biochemistry & Microbiology Department, University of Venda, Private Bag X5050, Thohoyandou 0950, South Africa; (T.B.); (A.N.T.)
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Machado EC, Freitas DL, Leal CD, de Oliveira AT, Zerbini A, Chernicharo CA, de Araújo JC. Antibiotic resistance profile of wastewater treatment plants in Brazil reveals different patterns of resistance and multi resistant bacteria in final effluents. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159376. [PMID: 36240935 DOI: 10.1016/j.scitotenv.2022.159376] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 10/07/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Wastewater treatment plants (WWTPs) are recognized as important sources of Antibiotic Resistant Bacteria (ARBs) and Antibiotic Resistant Genes (ARGs), and might play a role in the removal and dissemination of antimicrobial resistance (AMR) in the environment. Detailed information about AMR removal by the different treatment technologies commonly applied in urban WWTPs is needed. This study investigated the occurrence, removal and characterization of ARBs in WWTPs employing different technologies: WWTP-A (conventional activated sludge-CAS), WWTP-B (UASB reactor followed by biological trickling filter) and WWTP-C (modified activated sludge followed by UV disinfection-MAS/UV). Samples of raw sewage (RI) and treated effluent (TE) were collected and, through the cultivation-based method using 11 antibiotics, the antibiotic resistance profiles were characterized in a one-year period. MAS was effective in reducing ARB counts (2 to 3 log units), compared to CAS (1 log unit) and UASB/BTF (0.5 log unit). The composition of cultivable ARB differed between RI and TE samples. Escherichia was predominant in RI (56/118); whilst in TE Escherichia (31/118) was followed by Bacillus (22/118), Shigella (14/118) and Enterococcus (14/118). Most of the isolates identified (370/394) harboured at least two ARGs and in over 80 % of the isolates, 4 or more ARG (int1, blaTEM, TetA, sul1 and qnrB) were detected. A reduction in the resistance prevalence was observed in effluents after CAS and MAS processes; whilst a slight increase was observed in treated effluents from UASB/BTF and after UV disinfection stage. The multi-drug resistance (MDR) phenotype was attributed to 84.3 % of the isolates from RI (27/32) and 63.6 % from TE (21/33) samples and 52.3 % of the isolates (34/65) were resistant to carbapenems (imipenem, meropenem, ertapenem). The results indicate that treated effluents are still a source for MDR bacteria and ARGs dissemination to aquatic environments. The importance of biological sewage treatment was reinforced by the significant reductions in ARB counts observed. However, implementation of additional treatments is needed to mitigate MDR bacteria release into the environment.
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Affiliation(s)
- Elayne Cristina Machado
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - Deborah Leroy Freitas
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - Cintia Dutra Leal
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - Amanda Teodoro de Oliveira
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - Adriana Zerbini
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - Carlos Augusto Chernicharo
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - Juliana Calábria de Araújo
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil.
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Ogunlaja A, Ogunlaja OO, Olukanni OD, Taylor GO, Olorunnisola CG, Dougnon VT, Mousse W, Fatta-Kassinos D, Msagati TAM, Unuabonah EI. Antibiotic resistomes and their chemical residues in aquatic environments in Africa. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 312:119783. [PMID: 35863703 DOI: 10.1016/j.envpol.2022.119783] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
The aquatic environment is a hotspot for the transfer of antibiotic resistance to humans and animals. Several reviews have put together research efforts on the presence and distribution of antibiotic resistant bacteria (ARB), antibiotic resistance genes (ARGs), and antibiotic chemical residue (ACRs) in food, hospital wastewater, and even in other aquatic environments. However, these reports are largely focused on data from developed countries, while data from developing countries and especially those in Africa, are only marginally discussed. This review is the first effort that distills information on the presence and distribution of ARGs and ACRs in the African aquatic environments (2012-2021). This review provides critical information on efforts put into the study of ARB, ARGs, and ACRs in aquatic environments in Africa through the lens of the different sub-regions in the continent. The picture provided is compared with those from some other continents in the world. It turns out that the large economies in Africa (South Africa, Nigeria, Tunisia, Kenya) all have a few reports of ARB and ARGs in their aquatic environment while smaller economies in the continent could barely provide reports of these in their aquatic environment (in most cases no report was found) even though they have some reports on resistomes from clinical studies. Interestingly, the frequency of these reports of ARB and ARGs in aquatic environments in Africa suggests that the continent is ahead of the South American continent but behind Europe and Asia in relation to providing information on these contaminants. Common ARGs found in African aquatic environment encode resistance to sulfonamide, tetracycline, β-lactam, and macrolide classes of antibiotics. The efforts and studies from African scientists in eliminating ARB and ARGs from the aquatic environment in Africa are also highlighted. Overall, this document is a ready source of credible information for scientists, policy makers, governments, and regional bodies on ARB, ARGs, and ACRs in aquatic environments in Africa. Hopefully, the information provided in this review will inspire some necessary responses from all stakeholders in the water quality sector in Africa to put in more effort into providing more scientific evidence of the presence of ARB, ARGs, and ACRs in their aquatic environment and seek more efficient ways to handle them to curtail the spread of antibiotic resistance among the population in the continent. This will in turn, put the continent on the right path to meeting the United Nations Sustainable Development Goals #3 and #6, which at the moment, appears to be largely missed by most countries in the continent.
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Affiliation(s)
- Aemere Ogunlaja
- African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer's University, P.M.B 230, Ede, 232101, Osun State, Nigeria; Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, P.M.B 230, Ede, Osun State, Nigeria.
| | - Olumuyiwa O Ogunlaja
- African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer's University, P.M.B 230, Ede, 232101, Osun State, Nigeria; Department of Chemical Sciences, Faculty of Natural and Applied Sciences, Lead City University, Ibadan, Nigeria
| | - Olumide D Olukanni
- African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer's University, P.M.B 230, Ede, 232101, Osun State, Nigeria; Department of Biochemistry, Faculty of Basic Medical Sciences, Redeemer's University, P.M.B. 230, Ede, Nigeria
| | - Gloria O Taylor
- African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer's University, P.M.B 230, Ede, 232101, Osun State, Nigeria; Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, P.M.B 230, Ede, Osun State, Nigeria
| | - Chidinma G Olorunnisola
- African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer's University, P.M.B 230, Ede, 232101, Osun State, Nigeria; Department of Chemical Sciences, Faculty of Natural Sciences, Redeemer's University, P.M.B 230, Ede, Osun State, Nigeria
| | - Victorien T Dougnon
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Wassiyath Mousse
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Despo Fatta-Kassinos
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, PO Box 20537, 1678 Nicosia, Cyprus
| | - Titus A M Msagati
- Institute for Nanotechnology and Water Sustainability (iNanoWS), College of Science Engineering and Technology, University of South Africa, South Africa
| | - Emmanuel I Unuabonah
- African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer's University, P.M.B 230, Ede, 232101, Osun State, Nigeria; Department of Chemical Sciences, Faculty of Natural Sciences, Redeemer's University, P.M.B 230, Ede, Osun State, Nigeria
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Denissen J, Reyneke B, Waso-Reyneke M, Havenga B, Barnard T, Khan S, Khan W. Prevalence of ESKAPE pathogens in the environment: Antibiotic resistance status, community-acquired infection and risk to human health. Int J Hyg Environ Health 2022; 244:114006. [PMID: 35841823 DOI: 10.1016/j.ijheh.2022.114006] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 01/10/2023]
Abstract
The ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) pathogens are characterised by increased levels of resistance towards multiple classes of first line and last-resort antibiotics. Although these pathogens are frequently isolated from clinical environments and are implicated in a variety of life-threatening, hospital-associated infections; antibiotic resistant ESKAPE strains have been isolated from environmental reservoirs such as surface water, wastewater, food, and soil. Literature on the persistence and subsequent health risks posed by the ESKAPE isolates in extra-hospital settings is however, limited and the current review aims to elucidate the primary reservoirs of these pathogens in the environment, their antibiotic resistance profiles, and the link to community-acquired infections. Additionally, information on the current state of research regarding health-risk assessments linked to exposure of the ESKAPE pathogens in the natural environment, is outlined.
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Affiliation(s)
- Julia Denissen
- Department of Microbiology, Faculty of Science, Stellenbosch University, Private Bag X1, Stellenbosch, 7602, South Africa
| | - Brandon Reyneke
- Department of Microbiology, Faculty of Science, Stellenbosch University, Private Bag X1, Stellenbosch, 7602, South Africa
| | - Monique Waso-Reyneke
- Faculty of Health Sciences, University of Johannesburg, PO Box 17011, Doornfontein, 2028, South Africa
| | - Benjamin Havenga
- Department of Microbiology, Faculty of Science, Stellenbosch University, Private Bag X1, Stellenbosch, 7602, South Africa
| | - Tobias Barnard
- Water and Health Research Centre, University of Johannesburg, PO Box 17011, Doornfontein, 7305, South Africa
| | - Sehaam Khan
- Faculty of Health Sciences, University of Johannesburg, PO Box 17011, Doornfontein, 2028, South Africa
| | - Wesaal Khan
- Department of Microbiology, Faculty of Science, Stellenbosch University, Private Bag X1, Stellenbosch, 7602, South Africa.
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Calefi DG, Haddad JPA, Pedroso SHSP, Magalhães PP, Farias LM, Vieira CD, Dos Santos SG. Evidence of cross-contamination of waste workers and transmission of antimicrobial resistance genes by coagulase-negative Staphylococcus isolated from dental solid waste: an intriguing study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1291-1303. [PMID: 33499654 DOI: 10.1080/09603123.2021.1877634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
The aim of this study was to phenotypically and genotypically identify coagulase-negative Staphylococcus (CoNS) recovered from the nostrils of waste workers and from dental waste; 135 strains were recovered and S. epidermidis was the prevailing species. Genetic similarity (100%) was observed between the two S. epidermidis isolated from different employees on the same shift and 85% similarity between the S. epidermidis recovered from an employee's nostril and from waste. The mecA gene was found in 20 CoNS, and 20% were also found to possess the vanA gene. The blaZ gene was detected in 46.7%, and the icaA (34.8%), B and C genes (11.8% each). Our findings emphasized the biological risk to which waste workers are exposed and unprecedently confirms that it was possible to recover genetically identical bacterial species from waste and from workers' nostrils. It is important to highlight that this risk is raised by the detection of relevant antimicrobial resistance genes. The results also suggest that effective measures to correctly manage waste and promote the rational use of antimicrobials should be adopted.
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Affiliation(s)
- Débora Guimarães Calefi
- Departamento De Microbiologia, Instituto De Ciências Biológicas, Universidade Federal De Minas Gerais, Belo Horizonte, Brasil
| | - João Paulo Amaral Haddad
- Departamento De Medicina Veterinária Preventiva, Faculdade De Veterinária, Universidade Federal De Minas Gerais, Belo Horizonte, Brasil
| | | | - Paula Prazeres Magalhães
- Departamento De Microbiologia, Instituto De Ciências Biológicas, Universidade Federal De Minas Gerais, Belo Horizonte, Brasil
| | - Luiz Macêdo Farias
- Departamento De Microbiologia, Instituto De Ciências Biológicas, Universidade Federal De Minas Gerais, Belo Horizonte, Brasil
| | - Cristina Dutra Vieira
- Departamento De Microbiologia, Instituto De Ciências Biológicas, Universidade Federal De Minas Gerais, Belo Horizonte, Brasil
| | - Simone Gonçalves Dos Santos
- Departamento De Microbiologia, Instituto De Ciências Biológicas, Universidade Federal De Minas Gerais, Belo Horizonte, Brasil
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Khamesi F, Ehrampoush MH, Dad V, Jambarsang S, Ghaneian MT. Prevalence of MRSA as an Infectious Agent in Sanitary Swimming Pools and Jacuzzis. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2022; 20:139-146. [PMID: 35669818 PMCID: PMC9163221 DOI: 10.1007/s40201-021-00761-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 11/15/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Methicillin-resistant Staphylococcus aureus (MRSA) is considered resistant to beta-lactam antibiotic groups. Infection caused by this strain is more difficult to treat with antibiotics, and hence, it will be more dangerous. This study focused on detecting the mecA gene Staphylococcus in sanitary swimming pools and Jacuzzis in Yazd city, Iran (2019). Also, the relationship between methicillin-resistant Staphylococcus aureus (MRSA) and the water quality standards has been investigated. MATERIALS AND METHODS 60 samples were randomly collected in sterile bottles from 20 active pools and Jacuzzis. Quality parameters were analyzed by standard methods. Antibiotic resistance and the mecA gene's presence were detected by the disk diffusion and PCR method, respectively. RESULTS The results of this study showed that the resistance of Staphylococcus aureus isolates was high against erythromycin (41.20%), tetracycline (35.10%), clindamycin (28.90%), and cefoxitin (25.80%). Out of 97 samples, 9 (25.80%) strains of Staphylococcus aureus were identified as MRSA, 30 samples (30.92%) showed multiple patterns of antibiotic resistance, and 9 samples (9.27%) carried the mecA gene. The results revealed that water quality has greatly impacted the mecA gene strain presence, especially microbial parameters. On the other hand, in the presence of mecA gene strains, the averages of microbial qualities were higher than standard in Jacuzzis; the latter finding was confirmed for swimming pools due to physicochemical parameters. CONCLUSION The number of reported sanitary water is increasing, and this study's results are useful examples of these findings. Therefore, a lack of careful and regular monitoring of swimming pools and Jacuzzis can lead to MSRA prevalence and outbreak sources.
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Affiliation(s)
- Fatemeh Khamesi
- Student Research Committee, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hasan Ehrampoush
- Environmental Science and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Vali Dad
- Medical Microbiologist (Master of Science) Reference Laboratory of Water and Wastewater, Environment and Occupational Department, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sara Jambarsang
- Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Taghi Ghaneian
- Environmental Science and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Rajan V, Sivaraman GK, Vijayan A, Elangovan R, Prendiville A, Bachmann TT. Genotypes and phenotypes of methicillin-resistant staphylococci isolated from shrimp aquaculture farms. ENVIRONMENTAL MICROBIOLOGY REPORTS 2022; 14:391-399. [PMID: 34344057 DOI: 10.1111/1758-2229.12995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/18/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
The population of methicillin-resistant (MR) staphylococci in aquatic environment is rarely investigated. Here, we characterized a collection of MR staphylococci recovered from shrimp aquaculture farms (n = 37) in Kerala, India. A total of 261 samples yielded 47 MR isolates (16 S. aureus, 13 S. haemolyticus, 11 S. epidermidis, 3 S. saprophytics and 2 each of S.intermedius and S. kloosii). Multi-drug resistance was evident in 72.3% of the isolates, with resistance mainly towards erythromycin (78.7%), norfloxacin and trimethoprim-sulfamethoxazole (53.2%), and gentamicin (34%). Major resistance genes identified included mecA (100%), ermC (38.3%), aacA-aphD (21.3%), tetK (14.9%) and tetM (21.3%). Almost 60% of the isolates carried type V SCCmec (Staphylococcal Cassette Chromosome mec), and the remaining harboured untypeable SCCmec elements. Comprehensive genotyping of the methicillin-resistant Staphylococcus aureus isolates revealed high prevalence of ST772-t345-V (sequence type-spa type-SCCmec type) (75%), followed by minor representations of ST6657-t345-V and ST3190-t12353. The isolates of S. haemolyticus and S. epidermidis were genotypically diverse as shown by their pulsed-field gel electrophoresis (PFGE) profiles. Genes encoding staphylococcal enterotoxins were observed in 53.2% of the isolates. Various genes involved in adhesion and biofilm formation were also identified. In conclusion, our findings provide evidence that shrimp aquaculture settings can act as reservoirs of methicillin-resistant staphylococci.
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Affiliation(s)
- Vineeth Rajan
- Microbiology, Fermentation and Biotechnology Division, ICAR-Central Institute of Fisheries Technology, Cochin, Kerala, India
| | - Gopalan Krishnan Sivaraman
- Microbiology, Fermentation and Biotechnology Division, ICAR-Central Institute of Fisheries Technology, Cochin, Kerala, India
| | - Ardhra Vijayan
- Microbiology, Fermentation and Biotechnology Division, ICAR-Central Institute of Fisheries Technology, Cochin, Kerala, India
| | - Ravikrishnan Elangovan
- Department of Biochemical Engineering and Biotechnology, Indian Institute of Technology Delhi, New Delhi, India
| | - Alison Prendiville
- Division of Infection and Pathway Medicine, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
| | - Till T Bachmann
- London College of Communication, University of the Arts London, London, UK
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Hobeika W, Gaschet M, Ploy MC, Buelow E, Sarkis DK, Dagot C. Resistome Diversity and Dissemination of WHO Priority Antibiotic Resistant Pathogens in Lebanese Estuaries. Antibiotics (Basel) 2022; 11:antibiotics11030306. [PMID: 35326767 PMCID: PMC8944630 DOI: 10.3390/antibiotics11030306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 11/23/2022] Open
Abstract
Anthropogenic pressure is known to be a key driver of antimicrobial resistance (AMR) dissemination in the environment. Especially in lower income countries, with poor infrastructure, the level of AMR dissemination is high. Therefore, we assessed the levels and diversity of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in Lebanese rivers at estuaries’ sites (n = 72) of the Mediterranean Sea in spring 2017 and winter 2018. Methods: A combined approach using culture techniques and high throughput qPCR were applied to identify ARB and ARGs in rivers along the Lebanese coast. Results: Multidrug-resistant Gram-negative (Enterobacterales and Pseudomonas spp.) and Gram-positive bacterial pathogens were isolated. Levels of ARGs were highest in the winter campaign and areas with high anthropogenic activities and population growth with an influx of refugees. Conclusion: Qualitative analysis of ARB and the analysis of the Lebanese estuaries’ resistome revealed critical levels of contamination with pathogenic bacteria and provided significant information about the spread of ARGs in anthropogenically impacted estuaries.
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Affiliation(s)
- Wadad Hobeika
- Université de Limoges, INSERM, CHU Limoges, 87085 Limoges, France; (W.H.); (M.G.); (M.-C.P.)
- Microbiology Laboratory, School of Pharmacy, Saint-Joseph University, Beirut 17-5208, Lebanon;
| | - Margaux Gaschet
- Université de Limoges, INSERM, CHU Limoges, 87085 Limoges, France; (W.H.); (M.G.); (M.-C.P.)
| | - Marie-Cécile Ploy
- Université de Limoges, INSERM, CHU Limoges, 87085 Limoges, France; (W.H.); (M.G.); (M.-C.P.)
| | - Elena Buelow
- Université Grenoble Alpes, CNRS, TIMC, 38000 Grenoble, France
- Correspondence: (E.B.); (C.D.)
| | - Dolla Karam Sarkis
- Microbiology Laboratory, School of Pharmacy, Saint-Joseph University, Beirut 17-5208, Lebanon;
| | - Christophe Dagot
- Université de Limoges, INSERM, CHU Limoges, 87085 Limoges, France; (W.H.); (M.G.); (M.-C.P.)
- Correspondence: (E.B.); (C.D.)
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Silva V, Ferreira E, Manageiro V, Reis L, Tejedor-Junco MT, Sampaio A, Capelo JL, Caniça M, Igrejas G, Poeta P. Distribution and Clonal Diversity of Staphylococcus aureus and Other Staphylococci in Surface Waters: Detection of ST425-t742 and ST130-t843 mecC-Positive MRSA Strains. Antibiotics (Basel) 2021; 10:antibiotics10111416. [PMID: 34827354 PMCID: PMC8614751 DOI: 10.3390/antibiotics10111416] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 02/07/2023] Open
Abstract
Natural aquatic environments represent one of the most important vehicles of bacterial dissemination. Therefore, we aimed to isolate staphylococci from surface waters and to investigate the presence of antimicrobial resistance genes and virulence factors as well as the genetic lineages of all Staphylococcus aureus isolates. Staphylococci were recovered from water samples collected from 78 surface waters, including rivers, streams, irrigation ditches, dams, lakes, and fountains. The presence of antimicrobial resistance genes and virulence factors was investigated by PCR. Multilocus sequence typing and spa-typing were performed in all S. aureus isolates. From the 78 water samples, 33 S. aureus, one S. pseudintermedius, and 51 coagulase-negative staphylococci (CoNS) were identified. Among the S. aureus isolates, four MRSA were identified, and all harbored the mecC gene. Fourteen S. aureus were susceptible to all antimicrobials tested and the remaining showed resistance to penicillin, erythromycin and/or tetracycline encoded by the blaZ, ermT, msr(A/B), tetL, and vgaA genes. Regarding the clonal lineages, one mecC-MRSA isolate belonged to spa-type t843 and sequence type (ST) 130 and the other three to t742 and ST425. The remaining S. aureus were ascribed 14 spa-types and 17 sequence types. Eleven species of CoNS were isolated: S. sciuri, S. lentus, S. xylosus, S. epidermidis, S. cohnii spp. urealyticus, S. vitulinus, S. caprae, S. carnosus spp. Carnosus, S. equorum, S. simulans, and S. succinus. Thirteen CoNS isolates had a multidrug resistance profile and carried the following genes: mecA, msr(A/B), mph(C), aph(3′)-IIIa, aac(6′)-Ie–aph(2′’)-Ia, dfrA, fusB, catpC221, and tetK. A high diversity of staphylococci was isolated from surface waters including mecCMRSA strains and isolates presenting multidrug-resistance profiles. Studies on the prevalence of antibiotic-resistant staphylococci in surface waters are still very scarce but extremely important to estimate the contribution of the aquatic environment in the spread of these bacteria.
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Affiliation(s)
- Vanessa Silva
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal;
- Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal;
- Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, 2825-466 Lisbon, Portugal
| | - Eugénia Ferreira
- National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections (NRL-AMR/HAI), Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon, Portugal; (E.F.); (V.M.); (L.R.); (M.C.)
- Centre for the Studies of Animal Science, Institute of Agrarian and Agri-Food Sciences and Technologies, Oporto University, 4051-401 Oporto, Portugal
| | - Vera Manageiro
- National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections (NRL-AMR/HAI), Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon, Portugal; (E.F.); (V.M.); (L.R.); (M.C.)
- Centre for the Studies of Animal Science, Institute of Agrarian and Agri-Food Sciences and Technologies, Oporto University, 4051-401 Oporto, Portugal
| | - Lígia Reis
- National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections (NRL-AMR/HAI), Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon, Portugal; (E.F.); (V.M.); (L.R.); (M.C.)
| | - María Teresa Tejedor-Junco
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, 35001 Canary Islands, Spain;
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, 35001 Canary Islands, Spain
| | - Ana Sampaio
- Department of Biology and Environment, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal;
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), UTAD, 5000-801 Vila Real, Portugal
| | - José Luis Capelo
- BIOSCOPE Group, LAQV@REQUIMTE, Chemistry Department, Faculty of Science and Technology, NOVA University of Lisbon, 2825-466 Almada, Portugal;
- Proteomass Scientific Society, 2825-466 Setubal, Portugal
| | - Manuela Caniça
- National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections (NRL-AMR/HAI), Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon, Portugal; (E.F.); (V.M.); (L.R.); (M.C.)
- Centre for the Studies of Animal Science, Institute of Agrarian and Agri-Food Sciences and Technologies, Oporto University, 4051-401 Oporto, Portugal
| | - Gilberto Igrejas
- Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal;
- Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, 2825-466 Lisbon, Portugal
| | - Patrícia Poeta
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal;
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, 2825-466 Lisbon, Portugal
- Correspondence: ; Tel.: +351-259350466
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Ramaite K, Ekwanzala MD, Dewar JB, Momba MNB. Human-Associated Methicillin-Resistant Staphylococcus aureus Clonal Complex 80 Isolated from Cattle and Aquatic Environments. Antibiotics (Basel) 2021; 10:antibiotics10091038. [PMID: 34572619 PMCID: PMC8468323 DOI: 10.3390/antibiotics10091038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/06/2021] [Accepted: 08/21/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Human-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) has mainly been reported in South African pig and chicken farms. The prevalence of antibiotic-resistant genes (ARGs), virulence factors (VFs), and multilocus sequence types (MLSTs) associated with HA-MRSA in cattle farms has not been reported. Consequently, this study characterised LA-MRSA and its spread from cattle farms into the environment. Method: Husbandry soil (HS), nearby river water (NRW), animal manure (AM) and animal drinking water (ADW) were collected on and around a cattle farm. Presumptive MRSA isolates were identified from these samples using CHROMagar media and genotyped as MRSA sequence types (STs), selected ARGs, and VFs, using polymerase chain reaction. An MLST-based dendrogram was generated to link the farm MRSA strains with those in a nearby river. Results: The prevalence of MRSA was 30.61% for HS, 28.57% for ADW, 22.44% for NRW, and 10.20% for AM. Isolates from HS harboured the highest number of resistant genes, with 100% for mecA, 91.66% for ermA, and 58.33% for blaZ. However, no ermC or tetM genes were detected. MRSA isolates from AM harboured the lowest number of resistant genes. Only sec and seq enterotoxins were found in all the assessed MRSA isolates. MRSA from the farm revealed six STs (ST80, ST728, ST1931, ST2030, ST3247, and ST5440); all of STs belonged to clonal complex 80 (CC80). An MLST-based dendrogram based on the concatenated sequences of MLST genes under the maximum likelihood criterion revealed four clades of amalgamated MRSA isolates from various livestock environmental matrices, including the NRW. Conclusion: The results suggest that livestock environmental matrices might be reservoirs of MRSA that could subsequently disseminate through runoff to pollute water resources. Therefore, continued surveillance of HA-MRSA in livestock environments is warranted.
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Affiliation(s)
- Khuliso Ramaite
- Department of Environmental, Water and Earth Sciences, Tshwane University of Technology, Arcadia Campus, Pretoria 0001, South Africa; (K.R.); (M.D.E.)
| | - Mutshiene Deogratias Ekwanzala
- Department of Environmental, Water and Earth Sciences, Tshwane University of Technology, Arcadia Campus, Pretoria 0001, South Africa; (K.R.); (M.D.E.)
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, 41346 Gothenburg, Sweden
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, 41346 Gothenburg, Sweden
| | - John Barr Dewar
- Department of Life and Consumer Sciences, University of South Africa, Florida Campus, Johannesburg 1709, South Africa;
| | - Maggy Ndombo Benteke Momba
- Department of Environmental, Water and Earth Sciences, Tshwane University of Technology, Arcadia Campus, Pretoria 0001, South Africa; (K.R.); (M.D.E.)
- Correspondence: ; Tel.: +27-123826365
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Silva V, Caniça M, Capelo JL, Igrejas G, Poeta P. Diversity and genetic lineages of environmental staphylococci: a surface water overview. FEMS Microbiol Ecol 2021; 96:5909032. [PMID: 32949464 DOI: 10.1093/femsec/fiaa191] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 09/17/2020] [Indexed: 12/11/2022] Open
Abstract
Antimicrobial resistance in the environmental dimension is one of the greatest challenges and emerging threats. The presence of resistant bacteria and resistance genes in the environment, especially in aquatic systems, has been a matter of growing concern in the past decade. Monitoring the presence of antimicrobial resistance species, in this particular case, Staphylococcus spp., in natural water environments could lead to a better understanding of the epidemiology of staphylococci infections. Thus, the investigation of natural waters as a potential reservoir and vehicle for transmission of these bacteria is imperative. Only a few studies have investigated the prevalence, antimicrobial resistance and genetic lineages of staphylococci in natural waters. Those studies reported a high diversity of staphylococci species and lineages in surface waters. Methicillin-resistant S. aureus were relatively prevalent in surface waters and, as expected, often presented a multidrug-resistant profile. There was a high diversity of S. aureus lineages in surface waters. The presence of S. aureus CC8 and CC5 suggests a human origin. Among the coagulase-negative staphylococci, the most frequently found in natural waters was S. warneri and S. epidermidis. These studies are extremely important to estimate the contribution of the aquatic environment in the spread of pathogenic bacteria.
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Affiliation(s)
- Vanessa Silva
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5001-801 Vila Real, Portugal
- Department of Genetics and Biotechnology, Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
- Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro (UTAD), 5001-801 Vila Real, Portugal
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), NOVA University of Lisbon, Lisboa, 2829-516 Caparica, Portugal
| | - Manuela Caniça
- National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections (NRL-AMR/HAI), Department of Infectious Diseases, National Institute of Health Dr Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon, Portugal
- Centre for the Studies of Animal Science, Institute of Agrarian and Agri-Food Sciences and Technologies, Oporto University, 4051-401 Oporto, Portugal
| | - José L Capelo
- BIOSCOPE Group, LAQV-REQUIMTE, Department of Chemistry, Faculty of Science and Technology, NOVA University of Lisbon, 2825-466 Almada, Portugal
- Proteomass Scientific Society, 2825-466 Costa de Caparica, Portugal
| | - Gilberto Igrejas
- Department of Genetics and Biotechnology, Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
- Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro (UTAD), 5001-801 Vila Real, Portugal
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), NOVA University of Lisbon, Lisboa, 2829-516 Caparica, Portugal
| | - Patrícia Poeta
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5001-801 Vila Real, Portugal
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), NOVA University of Lisbon, Lisboa, 2829-516 Caparica, Portugal
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Kolokotsa A, Leotsinidis M, Kalavrouziotis I, Sazakli E. Effects of tourist flows on antibiotic resistance in wastewater of a Greek island. J Appl Microbiol 2020; 130:516-527. [PMID: 32743833 DOI: 10.1111/jam.14808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/09/2020] [Accepted: 07/24/2020] [Indexed: 12/01/2022]
Abstract
AIM Antibiotic resistance in wastewaters reflects the clinical resistome. This study aimed at investigating whether changes in the population size and composition in the popular tourist destination of Zakynthos island are associated with differentiation in the antibiotic resistance of environmental micro-organisms isolated from wastewater. METHODS AND RESULTS The resistance profiles of four species (Escherichia coli, Staphylococcus sp., Pseudomonas sp. and Enterococcus sp.) were studied in 124 raw and treated municipal wastewaters from November 2015 to August 2016. Isolates were tested against their susceptibility to several antibiotics of different antimicrobial categories. Data concerning the alteration in the population size and composition, due to the tourist mobility, were collected and logistic regression models were used to examine the relationships between antimicrobial resistance and population changes. The decrease in resistance of E. coli to amoxicillin-clavulanate, of enterococci to norfloxacin and ampicillin, and of pseudomonads to almost all antibiotics tested was associated with population increase due to tourist flows. In contrast, the presence of tourists was linked to an increase in quinupristin-dalfopristin resistant enterococci. Resistance of staphylococci did not change during the tourist period. CONCLUSION Changes in population composition in touristic areas are reflected in antibiotic resistance of environmental bacteria in wastewater. SIGNIFICANCE AND IMPACT OF THE STUDY In touristic areas, where people carrying different resistomes are merged, medication should be adapted accordingly.
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Affiliation(s)
- A Kolokotsa
- School of Science and Technology, Hellenic Open University, Patras, Greece
| | - M Leotsinidis
- Laboratory of Public Health, School of Medicine, University of Patras, Patras, Greece
| | - I Kalavrouziotis
- School of Science and Technology, Hellenic Open University, Patras, Greece
| | - E Sazakli
- School of Science and Technology, Hellenic Open University, Patras, Greece.,Laboratory of Public Health, School of Medicine, University of Patras, Patras, Greece
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Akya A, Chegenelorestani R, Shahvaisi-Zadeh J, Bozorgomid A. Antimicrobial Resistance of Staphylococcus aureus Isolated from Hospital Wastewater in Kermanshah, Iran. Risk Manag Healthc Policy 2020; 13:1035-1042. [PMID: 32801976 PMCID: PMC7415457 DOI: 10.2147/rmhp.s261311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/08/2020] [Indexed: 12/20/2022] Open
Abstract
Introduction Hospital wastewater contains highly resistant and virulent bacteria that can spread into the environment. This study was conducted to investigate the antimicrobial resistance of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) in raw and treated hospital wastewater. Methods During a three-month period, 40 sewage samples were collected from the hospital sewage (Kermanshah, Iran), and S. aureus were identified using culture and biochemical tests. MRSA was detected by resistance to cefoxitin. Antibiotic resistance (AR) was determined using disk diffusion according to the Clinical and Laboratory Standards Institute (CLSI) in 20 MSSA (10 raw and 10 treated sewage) and 40 MRSA isolates (20 raw and 20 treated sewage). The antimicrobial resistance genes (ARGs) were determined by PCR. Results Eleven and eight percent of the isolates were MRSA in raw and treated sewage samples, respectively. Out of 60 isolates, 59 (98%) were multidrug resistant (MDR). The most common ARGs were mecA (raw=100%, treated=100%), aacA-D (raw=100%, treated=85%) and tetK (raw =95%, treated =45%) in MRSA, while the tetM gene was the most abundant gene (raw=50%, treated=80%) in MSSA. None of isolates (n=60) was positive for the vanB gene. MSSR (n=20) had the highest level of resistance against penicillin (100%), clindamycin (raw=90%, treated=90%), azithromycin (raw=80%, treated=90%). All MRSA isolates (n=40,100%) in both raw and treated sewage samples were non-susceptible to penicillin, oxacillin and azithromycin. There was no significant difference in the frequency AR and ARGs between raw and treated sewage samples (p>0.05). Conclusion The results indicated a high frequency of MDR and ARGs in both raw and treated sewage isolates which could be released into the environment through sewage system and pose a serious threat to public health. Hospital wastewater treatment processes should be improved in order to prevent the dissemination of the most resistant strains of S. aureus.
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Affiliation(s)
- Alisha Akya
- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Department of Microbiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roya Chegenelorestani
- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jila Shahvaisi-Zadeh
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arezoo Bozorgomid
- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Rickard J. Bacterial Resistance in Surgical Infections in Low-Resource Settings. Surg Infect (Larchmt) 2020; 21:509-515. [PMID: 32380936 DOI: 10.1089/sur.2020.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: There is an alarming increase in antimicrobial resistance (AMR) globally, complicating management of surgical infections, especially in low-resource settings. Of particular concern for surgeons are third generation cephalosporin-resistant and carbapenem-resistant Enterobacteriaceae. Methods: The published literature was searched to identify the scope and causative factors of emerging bacterial resistance in low- and middle-income countries (LMICs). Results: Antimicrobial resistance impacts economics, human development, health equity, health security, and food production. Factors that contribute to AMR include use of antibiotic agents in livestock, antibiotic agents in wastewater and sewage, poor sanitation, and overprescribing or unregulated use of antibiotic agents. Because the factors influencing AMR globally are multi-factorial, solutions must be addressed at multiple levels. In LMICs, these can occur through national initiatives, at the facility level, or at the community level with coordination engaging government agencies, the private sector, civil service, and professional groups. Conclusions: There is a growing recognition of the need for national AMR prevention programs. Meanwhile, infection prevention and control programs and antimicrobial stewardship remain cornerstones of management at the facility level.
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Affiliation(s)
- Jennifer Rickard
- Department of Surgery, University of Minnesota Minneapolis, Minnesota, USA
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