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da Rocha Santos LMB, de Paula Ramos L, Santos CER, Miranda DG, Gimenez MG, Meccatti VM, Abu Hasna A, Dos Santos Oliveira M, Neto MB, Dias de Oliveira L. Saliva culture as a predictive indicator for current blood infections and antimicrobial resistance in the ICU setting. Sci Rep 2023; 13:20317. [PMID: 37985806 PMCID: PMC10662427 DOI: 10.1038/s41598-023-47143-3] [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: 09/09/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023] Open
Abstract
Antimicrobial resistance is a worldwide health problem and patients in intensive care are more vulnerable, requiring strict control measures and early identification. Currently, clinical culture materials are used to identify the bacterial agent, but saliva culture is not validated, which has great clinical relevance because it participates in several pathophysiological processes. The aim of this study was to validate saliva culture in an intensive care unit environment, determining its diagnostic value for infection. For this purpose, the results of the 39-month surveillance cultures, from the database of a private hospital were evaluated. A total of 323 cultures were paired between saliva, tracheal secretions, blood and urine from patients who were hospitalized for more than 5 days. The search for correlations between the results was performed using the Spearman correlation test. Severity and evolution data were also correlated. It was possible to correlate the presence of Klebsiella spp. between blood culture and saliva culture in 25% of the results (r = 0.01) and the correlation between saliva and tracheal secretion was 33% (r = 0.33447) with p < 0.0001. In conclusion, saliva can be an excellent discriminator of systemic infections, and can be considered a useful culture in clinical practice.
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Affiliation(s)
- Leonardo Moura Brasil da Rocha Santos
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
- Instituto Policlin de Ensino e Pesquisas-IPEP, Av. Nove de Julho, 430-Vila Ady'Anna, São José dos Campos, SP, 12243-001, Brazil
| | - Lucas de Paula Ramos
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
- Laboratory "Systemic Health Care", EA4129, University of Lyon, Lyon, France
- UFR de Médicine, Université Lyon 1, Lyon, France
| | - Carlos Eduardo Rocha Santos
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
- Instituto Policlin de Ensino e Pesquisas-IPEP, Av. Nove de Julho, 430-Vila Ady'Anna, São José dos Campos, SP, 12243-001, Brazil
| | - Diego Garcia Miranda
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
- UFR de Médicine, Université Lyon 1, Lyon, France
- Laboratoire des Multimatériaux et Interfaces CNRS (UMR 5615), Université Lyon 1, Villeurbanne, France
| | - Mariana Gadelho Gimenez
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Av. Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
| | - Vanessa Marques Meccatti
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Av. Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil.
| | - Marcela Dos Santos Oliveira
- Anhembi Morumbi University, Benedito Matarazzo, 6070-Jardim Aquarius, São José dos Campos, SP, 12230-002, Brazil
| | - Morun Bernardino Neto
- Departamento de Ciências Básicas e Ambientais-LOB, Escola de Engenharia de Lorena-EEL/USP, Estrada Municipal do Campinho, s/no, Lorena, SP, 12602-810, Brazil
| | - Luciane Dias de Oliveira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
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Loftus MJ, Everts RJ, Cheng AC, Eti P, Fakasiieiki T, Isaia L, Isopo E, Jenney AW, Lameko V, Leaupepe H, Leavai F, Lee SJ, Moungaevalu M, Stewardson AJ, Tekoaua R, Tou D, Wuatai G, Peleg AY. Antimicrobial susceptibility of bacterial isolates from clinical specimens in four Pacific Island countries, 2017-2021. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 32:100677. [PMID: 36798514 PMCID: PMC9926303 DOI: 10.1016/j.lanwpc.2022.100677] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 02/05/2023]
Abstract
Background There are limited antimicrobial resistance (AMR) surveillance data from low- and middle-income countries, especially from the Pacific Islands region. AMR surveillance data is essential to inform strategies for AMR pathogen control. Methods We performed a retrospective analysis of antimicrobial susceptibility results from the national microbiology laboratories of four Pacific Island countries - the Cook Islands, Kiribati, Samoa and Tonga - between 2017 and 2021. We focused on four bacteria that have been identified as 'Priority Pathogens' by the World Health Organization: Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Findings Following deduplication, a total of 20,902 bacterial isolates was included in the analysis. The most common organism was E. coli (n = 8455) followed by S. aureus (n = 7830), K. pneumoniae (n = 2689) and P. aeruginosa (n = 1928). The prevalence of methicillin resistance among S. aureus isolates varied between countries, ranging from 8% to 26% in the Cook Islands and Kiribati, to 43% in both Samoa and Tonga. Ceftriaxone susceptibility remained high to moderate among E. coli (87%-94%) and K. pneumoniae (72%-90%), whereas amoxicillin + clavulanate susceptibility was low against these two organisms (50%-54% and 43%-61%, respectively). High susceptibility was observed for all anti-pseudomonal agents (83%-99%). Interpretation Despite challenges, these Pacific Island laboratories were able to conduct AMR surveillance. These data provide valuable contemporary estimates of AMR prevalence, which will inform local antibiotic formularies, treatment guidelines, and national priorities for AMR policy. Funding Supported by the National Health and Medical Research Council.
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Affiliation(s)
- Michael J. Loftus
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia
| | - Richard J. Everts
- Nelson Bays Primary Health, Nelson, New Zealand,Corresponding author. Nelson Bays Primary Health, PO Box 1776, Nelson 7040, New Zealand.
| | - Allen C. Cheng
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | | | | | | | - Adam W.J. Jenney
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia,College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | | | | | | | - Sue J. Lee
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia
| | | | - Andrew J. Stewardson
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia
| | | | | | | | - Anton Y. Peleg
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia,Infection and Immunity Program, Monash Biomedicine Discovery Institute, Department of Microbiology, Monash University, Clayton, Australia,Corresponding author. Department of Infectious Diseases, The Alfred Hospital and Monash University, Level 2, 85 Commercial Road, Melbourne, 3004, Australia.
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Zhang Y, Yang Y, Meng X, Zhou X, Guo B. Efficient Kilogram-Scale Synthesis of a Novel Oxazolidinone Antibacterial Candidate YG-056SP. Org Process Res Dev 2023. [DOI: 10.1021/acs.oprd.2c00350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Yinyong Zhang
- Sichuan Engineering Research Center for Biomimetic Synthesis of Natural Drugs, School of Life Science and Engineering, Southwest Jiaotong University, Chengdu610031, P. R. China
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai201203, P. R. China
- School of Pharmacy, University of Chinese Academy of Sciences, Beijing100049, P. R. China
| | - Yushe Yang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai201203, P. R. China
- School of Pharmacy, University of Chinese Academy of Sciences, Beijing100049, P. R. China
| | - Xin Meng
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai201203, P. R. China
- School of Pharmacy, University of Chinese Academy of Sciences, Beijing100049, P. R. China
| | - Xianli Zhou
- Sichuan Engineering Research Center for Biomimetic Synthesis of Natural Drugs, School of Life Science and Engineering, Southwest Jiaotong University, Chengdu610031, P. R. China
- Affiliated Hospital, The Third People’s Hospital of Chengdu, Southwest Jiaotong University, Chengdu610000, P. R. China
| | - Bin Guo
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai201203, P. R. China
- School of Pharmacy, University of Chinese Academy of Sciences, Beijing100049, P. R. China
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Antimicrobial resistance in Escherichia coli and Pseudomonas aeruginosa before and after the coronavirus disease 2019 (COVID-19) pandemic in the Dominican Republic. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e191. [PMID: 36505946 PMCID: PMC9726630 DOI: 10.1017/ash.2022.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022]
Abstract
Objective To describe antimicrobial resistance before and after the COVID-19 pandemic in the Dominican Republic. Design Retrospective study. Setting The study included 49 outpatient laboratory sites located in 13 cities nationwide. Participants Patients seeking ambulatory microbiology testing for urine and bodily fluids. Methods We reviewed antimicrobial susceptibility reports for Escherichia coli isolates from urine and Pseudomonas aeruginosa (PSAR) from bodily fluids between January 1, 2018, to December 31, 2021, from deidentified susceptibility data extracted from final culture results. Results In total, 27,718 urine cultures with E. coli and 2,111 bodily fluid cultures with PSAR were included in the analysis. On average, resistance to ceftriaxone was present in 25.19% of E. coli isolated from urine each year. The carbapenem resistance rates were 0.15% for E. coli and 3.08% for PSAR annually. The average rates of E. coli with phenotypic resistance consistent with possible extended-spectrum β-lactamase (ESBL) in urine were 25.63% and 24.75%, respectively, before and after the COVID-19 pandemic. The carbapenem resistance rates in urine were 0.11% and 0.20%, respectively, a 200% increase. The average rates of PSAR with carbapenem resistance in bodily fluid were 2.33% and 3.84% before and after the COVID-19 pandemic, respectively, a 130% percent increase. Conclusions Resistance to carbapenems in PSAR and E. coli after the COVID-19 pandemic is rising. These resistance patterns suggest that ESBL is common in the Dominican Republic. Carbapenem resistance was uncommon but increased after the COVID-19 pandemic.
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Mena Lora AJ, Rojas-Fermin R, Bisono B, Almonte M, Bleasdale SC. A nationwide survey of antimicrobial dispensation practices in pharmacies and bodegas in the Dominican Republic. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e173. [PMID: 36483416 PMCID: PMC9726472 DOI: 10.1017/ash.2022.314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 06/17/2023]
Abstract
In many developing countries, antimicrobials are available without prescriptions in pharmacies and stores. We performed a survey to describe antimicrobial availability, training, and use recommendations for common symptoms in the Dominican Republic. Pharmacy recommendations varied, whereas aminopenicillins are routinely recommended at bodegas. Frontline staff are gatekeepers and potential targets for stewardship education.
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Affiliation(s)
| | - Rita Rojas-Fermin
- Hospital General Plaza de la Salud, Santo Domingo, Dominican Republic
| | | | - Marcos Almonte
- Baptist Medical Center, Trenton, New Jersey, United States
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Hayes JF. Fighting Back against Antimicrobial Resistance with Comprehensive Policy and Education: A Narrative Review. Antibiotics (Basel) 2022; 11:antibiotics11050644. [PMID: 35625288 PMCID: PMC9137785 DOI: 10.3390/antibiotics11050644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 12/15/2022] Open
Abstract
Globally, antimicrobial resistance has emerged as a significant threat. A comprehensive plan is required to combat antimicrobial resistance. There have been national and international efforts to address this global health problem, but much work remains. Enhanced funding and regulations to support antimicrobial stewardship policy and program development, reforms to incentivize drug development to treat resistant pathogens, and efforts to strengthen One Health programs are areas for collaboration and innovation. Finally, implementation of educational interventions for trainees encompassing these key areas along with training on policy and leadership development is critical to enable sustainability of these efforts to fight back against antimicrobial resistance.
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Affiliation(s)
- Justin F Hayes
- Department of Medicine, Division of Infectious Diseases, Banner University Medical Center-Tucson and South, University of Arizona College of Medicine, 1501 N. Campbell Avenue, Tucson, AZ 85724, USA
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Vardanega J, Smith LK, Smith S, Hanson J. Animal bite wounds and their management in tropical Australia. Int J Infect Dis 2022; 118:1-9. [DOI: 10.1016/j.ijid.2022.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/24/2022] [Accepted: 02/14/2022] [Indexed: 10/19/2022] Open
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High Prevalence of Carbapenemase-Producing Acinetobacter baumannii in Wound Infections, Ghana, 2017/2018. Microorganisms 2021; 9:microorganisms9030537. [PMID: 33807838 PMCID: PMC7998214 DOI: 10.3390/microorganisms9030537] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/24/2021] [Accepted: 02/27/2021] [Indexed: 01/01/2023] Open
Abstract
Three years after a prospective study on wound infections in a rural hospital in Ghana revealed no emergence of carbapenem-resistant bacteria we initiated a new study to assess the prevalence of multidrug-resistant pathogens. Three hundred and one samples of patients with wound infections were analysed for the presence of resistant bacteria in the period August 2017 till March 2018. Carbapenem-resistant Acinetobacter (A.) baumannii were further characterized by resistance gene sequencing, PCR-based bacterial strain typing, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST “Oxford scheme”). A. baumanni was detected in wound infections of 45 patients (15%); 22 isolates were carbapenem-resistant. Carbapenemases NDM-1 and/or OXA-23 were detected in all isolates; two isolates harboured additionally OXA-420. PFGE and MLST analyses confirmed the presence of one A. baumannii strain in 17 patients that was assigned to the worldwide spread sequence type ST231 and carried NDM-1 and OXA-23. Furthermore, two new A. baumannii STs (ST2145 and ST2146) were detected in two and three patients, respectively. Within three years the prevalence of carbapenem-resistant A. baumannii increased dramatically in the hospital. The early detection of multidrug-resistant bacteria and prevention of their further spread are only possible if continuous surveillance and molecular typing will be implemented.
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Babatola AO, Fadare JO, Olatunya OS, Obiako R, Enwere O, Kalungia A, Ojo TO, Sunmonu TA, Desalu O, Godman B. Addressing antimicrobial resistance in Nigerian hospitals: exploring physicians prescribing behavior, knowledge, and perception of antimicrobial resistance and stewardship programs. Expert Rev Anti Infect Ther 2020; 19:537-546. [PMID: 32990480 DOI: 10.1080/14787210.2021.1829474] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION We assessed the knowledge of, attitude toward antimicrobial resistance (AMR) and practice of antimicrobial stewardship (AMS) among physicians in Nigeria to provide future guidance to the Nigerian National Action Plan for AMR. METHODS A descriptive cross-sectional questionnaire-based study explored the physicians' self-reported practice of antibiotic prescribing, knowledge, attitude, and practice of AMR and components of ASPs. RESULTS The majority (217; 67.2%) of respondents prescribed antibiotics daily in their clinical practice AMR was recognized as a global and local problem by 308 (95.4%) and 262 (81.1%) respondents, respectively. Only 91 (28.2%) of respondents have ever heard of antibiotic stewardship. The median AMR knowledge score was 40 (19-45)out of 45while that for ASP was 46.0(32-57) out of 60. There was significant statistical difference between the ASP median scores among the medical specialties category (P value <0.0001) More respondents had good knowledge of AMR than ASPs (82.7% versus 36.5%; p < 0.0001). CONCLUSION Respondents in this study were more knowledgeable about AMR than AMS and its core components.
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Affiliation(s)
- Adefunke O Babatola
- Department of Paediatrics, Ekiti State University, Ado-Ekiti, Nigeria.,Department of Paediatrics, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Joseph O Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ado-Ekiti, Nigeria.,Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Oladele S Olatunya
- Department of Paediatrics, Ekiti State University, Ado-Ekiti, Nigeria.,Department of Paediatrics, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Reginald Obiako
- Department of Clinical Pharmacology, Ahmadu Bello University, Zaria, Nigeria.,Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Okezie Enwere
- Department of Medicine, Imo State University, Orlu, Nigeria
| | - Aubrey Kalungia
- Department of Pharmacy, University of Zambia, Lusaka, Zambia
| | - Temitope O Ojo
- Department of Community Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Olufemi Desalu
- Department of Medicine, University of Ilorin, Ilorin, Nigeria
| | - Brian Godman
- Department of Pharmacy, Faculty of Health Sciences, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.,Health Economics Centre, University of Liverpool Management School, Liverpool, UK.,Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
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10
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Sandrock C, Aziz SR. Travel/Tropical Medicine and Pandemic Considerations for the Global Surgeon. Oral Maxillofac Surg Clin North Am 2020; 32:407-425. [PMID: 32473858 PMCID: PMC7205681 DOI: 10.1016/j.coms.2020.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
International travel goes hand in hand with medical delivery to underserved communities. The global health care worker can be exposed to a wide range of infectious diseases during their global experiences. A pretravel risk assessment visit and all appropriate vaccinations and education must be performed. Universal practices of water safety, food safety, and insect avoidance will prevent most travel-related infections and complications. Region-specific vaccinations will further reduce illness risk. An understanding of common travel-related illness signs and symptoms is helpful. Emerging pathogens that can cause a pandemic should be understood to avoid health care worker infection and spread.
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Affiliation(s)
- Christian Sandrock
- UC Davis School of Medicine, 4150 V street, Suite 3400, Sacramento, CA 95817, USA.
| | - Shahid R Aziz
- Rutgers School of Dental Medicine, 110 Bergen Street, Room B854, Newark, NJ 07103, USA
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11
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Loftus M, Stewardson A, Naidu R, Coghlan B, Jenney A, Kepas J, Lavu E, Munamua A, Peel T, Sahai V, Tekoaua R, Tudravu L, Zinihite J, Cheng A, Rafai E, Peleg A. Antimicrobial resistance in the Pacific Island countries and territories. BMJ Glob Health 2020; 5:e002418. [PMID: 32349993 PMCID: PMC7213808 DOI: 10.1136/bmjgh-2020-002418] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 12/19/2022] Open
Abstract
Antimicrobial resistance (AMR) is a critical global health threat with a disproportionate impact on low-income and middle-income countries (LMICs) due to their higher burden of infections, reduced laboratory surveillance infrastructure and fewer regulations governing antimicrobial use among humans or animals. While there have been increasing descriptions of AMR within many LMICs in WHO's Western Pacific and South East Asian regions, there remains a paucity of data from Pacific Island countries and territories (PICTs). The PICTs represent 22 predominantly middle-income countries and territories with a combined population of 12 million people and 20 official languages, spread over hundreds of separate islands spanning an area corresponding to more than 15% of the earth's surface. Our paper outlines the present state of the evidence regarding AMR in PICTs-discussing the present estimates of AMR and their accompanying limitations, important drivers of AMR, as well as outlining key priorities and potential solutions for tackling AMR in this region. Significant areas for action include developing National Action Plans, strengthening laboratory surveillance systems and educational activities targeted at both healthcare workers and the wider community. Ensuring adequate funding for AMR activities in PICTs is challenging given competing health and environmental priorities, in this context global or regional funding initiatives such as the Fleming Fund can play a key role.
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Affiliation(s)
- Michael Loftus
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Andrew Stewardson
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Ravi Naidu
- Colonial War Memorial Hospital, Suva, Fiji
| | - Ben Coghlan
- Health Security Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Adam Jenney
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
- College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Jonila Kepas
- Medical Standards Division, Government of Papua New Guinea National Department of Health, Port Moresby, National Capital District, Papua New Guinea
| | - Evelyn Lavu
- Central Public Health Laboratory, Government of Papua New Guinea National Department of Health, Port Moresby, National Capital District, Papua New Guinea
| | - Alex Munamua
- National Referral Hospital, Honiara, Solomon Islands
| | - Trisha Peel
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | | | - Rosemary Tekoaua
- Laboratory Services, Government of the Republic of Kiribati Ministry of Health and Medical Services, Tarawa, Kiribati
| | | | - Julie Zinihite
- National Pharmacy Division, Solomon Islands Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Allen Cheng
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Eric Rafai
- Fiji Ministry of Health and Medical Services, Suva, Fiji
| | - Anton Peleg
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Infection and Immunity Program, Monash Biomedicine Discovery Institute, Department of Microbiology, Monash University, Clayton, Victoria, Australia
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12
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Fernandes MR, Sellera FP, Moura Q, Esposito F, Sabino CP, Lincopan N. Identification and genomic features of halotolerant extended-spectrum-β-lactamase (CTX-M)-producing Escherichia coli in urban-impacted coastal waters, Southeast Brazil. MARINE POLLUTION BULLETIN 2020; 150:110689. [PMID: 31733900 DOI: 10.1016/j.marpolbul.2019.110689] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 10/17/2019] [Accepted: 10/23/2019] [Indexed: 06/10/2023]
Abstract
We report the occurrence and genomic analysis of extended-spectrum β-lactamase (CTX-M)-producing Escherichia coli in anthropogenically polluted coastal waters of Southeast Brazil. E. coli strains belonging to sequence types (STs) ST10, ST38, ST155 and ST1284 exhibited a wide resistome, with genes conferring resistance to medically relevant antimicrobials and heavy metals, and a halophilic behavior (tolerance to 9-10% NaCl). These findings suggest a heavy contamination in this area by critical priority bacteria adapted to marine environments, which might have negative impacts on human and ocean health.
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Affiliation(s)
- Miriam R Fernandes
- Department of Clinical Analysis, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Fábio P Sellera
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Quézia Moura
- Faculty of Health Sciences, Federal University of Grande Dourados, Mato Grosso do Sul, Brazil
| | - Fernanda Esposito
- Department of Clinical Analysis, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Caetano P Sabino
- Department of Clinical Analysis, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Nilton Lincopan
- Department of Clinical Analysis, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil; Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
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