1
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Ximenes G, Saha SK, Guterres H, Vieira A, Harris L, Mahony M, Dos Santos A, Toto L, Amaral E, Spargo JC, Tay SY, Amaral S, Champlin K, Draper ADK, Francis JR, Yan J, Lynar SA. Antimicrobial prescribing in referral hospitals in Timor-Leste: results of the first two national point prevalence surveys, 2020-21. JAC Antimicrob Resist 2024; 6:dlae123. [PMID: 39091690 PMCID: PMC11293431 DOI: 10.1093/jacamr/dlae123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/08/2024] [Indexed: 08/04/2024] Open
Abstract
Objectives To describe antimicrobial use (AMU) in patients admitted to hospitals in Timor-Leste. Methods In 2020 and 2021, we undertook antimicrobial prescribing point prevalence surveys across all six hospitals in Timor-Leste (one national and five municipal) to describe AMU and appropriateness in admitted patients. Results In 2020, 291/394 (73.9%) surveyed patients had been prescribed antimicrobials, compared with 260/403 (64.5%) in 2021 (P = 0.004). Most (309/551; 56.1%) were prescribed one antimicrobial, and 179/551 (32.5%) were prescribed two. The most commonly prescribed antibiotics were ceftriaxone (38.5% in 2020, 41.5% in 2021) and ampicillin (35.7% in 2020, 32.3% in 2021), followed by gentamicin, metronidazole and cloxacillin. Reserve antibiotics like meropenem and vancomycin were minimally used. Of all antimicrobial prescriptions, 70.8% were deemed appropriate in 2020 and 69.1% in 2021. Antimicrobial prescriptions for surgical and post-partum prophylaxis were frequently deemed inappropriate [37/50 (74.0%) and 39/44 (88.6%) prescriptions, respectively]. Conclusions Most patients admitted to hospital in Timor-Leste are prescribed antimicrobials, and approximately one-third of these prescriptions are inappropriate. However, this was in the context of limited local guideline availability at the time of surveys and limited microbiological culture capacity outside of the capital, Dili. Improved microbiological guidance, iterative guideline revisions based on local antimicrobial resistance (AMR) surveillance data, and enhanced stewardship activities including further point prevalence studies, could improve antimicrobial use, optimize patient outcomes and reduce AMR in Timor-Leste.
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Affiliation(s)
- Guilherme Ximenes
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
- Pharmacy Department, Hospital Nacional Guido Valadares, Dili, Timor-Leste
| | - Sajal K Saha
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
- Department of Infectious Diseases, Melbourne Medical School, National Centre for Antimicrobial Stewardship (NCAS), University of Melbourne, Melbourne, 3010 Victoria, Australia
- Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), IMPACT, Deakin University, Geelong 3220, VIC, Australia
| | - Helio Guterres
- Department of Internal Medicine, Hospital Nacional Guido Valadares, Dili, Timor-Leste
| | - Adriano Vieira
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Lisa Harris
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Michelle Mahony
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
- Department of Paediatrics, Royal Darwin Hospital, Darwin 0810, Northern Territory, Australia
| | - Agata Dos Santos
- Pharmacy Department, Hospital Nacional Guido Valadares, Dili, Timor-Leste
| | - Lucia Toto
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
- Department of Internal Medicine, Hospital Nacional Guido Valadares, Dili, Timor-Leste
| | - Elfiana Amaral
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
- Department of Internal Medicine, Hospital Nacional Guido Valadares, Dili, Timor-Leste
| | - Jessie C Spargo
- Department of Paediatrics, Royal Darwin Hospital, Darwin 0810, Northern Territory, Australia
| | - Sze Yen Tay
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
- Department of Infectious Diseases, Royal Darwin Hospital, Darwin 0810, Northern Territory, Australia
| | - Salvador Amaral
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Karen Champlin
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Anthony D K Draper
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
- Northern Territory Centre for Disease Control, Darwin 0810, Northern Territory, Australia
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra 0200, Australian Capital Territory, Australia
| | - Joshua R Francis
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
- Department of Paediatrics, Royal Darwin Hospital, Darwin 0810, Northern Territory, Australia
| | - Jennifer Yan
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
- Department of Paediatrics, Royal Darwin Hospital, Darwin 0810, Northern Territory, Australia
| | - Sarah A Lynar
- Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
- Department of Infectious Diseases, Royal Darwin Hospital, Darwin 0810, Northern Territory, Australia
- Northern Territory Centre for Disease Control, Darwin 0810, Northern Territory, Australia
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2
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Pereira A, Sidjabat HE, Davis S, Vong da Silva PG, Alves A, Dos Santos C, Jong JBDC, da Conceição F, Felipe NDJ, Ximenes A, Nunes J, Fária IDR, Lopes I, Barnes TS, McKenzie J, Oakley T, Francis JR, Yan J, Ting S. Prevalence of Antimicrobial Resistance in Escherichia coli and Salmonella Species Isolates from Chickens in Live Bird Markets and Boot Swabs from Layer Farms in Timor-Leste. Antibiotics (Basel) 2024; 13:120. [PMID: 38391506 PMCID: PMC10885974 DOI: 10.3390/antibiotics13020120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
The rapid emergence of antimicrobial resistance is a global concern, and high levels of resistance have been detected in chicken populations worldwide. The purpose of this study was to determine the prevalence of antimicrobial resistance in Escherichia coli and Salmonella spp. isolated from healthy chickens in Timor-Leste. Through a cross-sectional study, cloacal swabs and boot swabs were collected from 25 live bird markets and two layer farms respectively. E. coli and Salmonella spp. from these samples were tested for susceptibility to six antimicrobials using a disk diffusion test, and a subset was tested for susceptibility to 27 antimicrobials using broth-based microdilution. E. coli and Salmonella spp. isolates showed the highest resistance towards either tetracycline or ampicillin on the disk diffusion test. E. coli from layer farms (odds ratio:5.2; 95%CI 2.0-13.1) and broilers (odds ratio:18.1; 95%CI 5.3-61.2) were more likely to be multi-drug resistant than those from local chickens. Based on the broth-based microdilution test, resistance to antimicrobials in the Timor-Leste Antimicrobial Guidelines for humans were low, except for resistance to ciprofloxacin in Salmonella spp. (47.1%). Colistin resistance in E. coli was 6.6%. Although this study shows that antimicrobial resistance in chickens was generally low in Timor-Leste, there should be ongoing monitoring in commercial chickens as industry growth might be accompanied with increased antimicrobial use.
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Affiliation(s)
- Abrao Pereira
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Hanna E Sidjabat
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Steven Davis
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Paulo Gabriel Vong da Silva
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Amalia Alves
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Cristibela Dos Santos
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Joanita Bendita da Costa Jong
- Ministry of Agriculture, Livestock, Fisheries and Forestry, Government of Timor-Leste, Av. Nicolao Lobato, Comoro, Dili, Timor-Leste
| | - Felisiano da Conceição
- Ministry of Agriculture, Livestock, Fisheries and Forestry, Government of Timor-Leste, Av. Nicolao Lobato, Comoro, Dili, Timor-Leste
| | - Natalino de Jesus Felipe
- Ministry of Agriculture, Livestock, Fisheries and Forestry, Government of Timor-Leste, Av. Nicolao Lobato, Comoro, Dili, Timor-Leste
| | - Augusta Ximenes
- Ministry of Agriculture, Livestock, Fisheries and Forestry, Government of Timor-Leste, Av. Nicolao Lobato, Comoro, Dili, Timor-Leste
| | - Junilia Nunes
- Ministry of Agriculture, Livestock, Fisheries and Forestry, Government of Timor-Leste, Av. Nicolao Lobato, Comoro, Dili, Timor-Leste
| | - Isménia do Rosário Fária
- Ministry of Agriculture, Livestock, Fisheries and Forestry, Government of Timor-Leste, Av. Nicolao Lobato, Comoro, Dili, Timor-Leste
| | - Isabel Lopes
- Ministry of Agriculture, Livestock, Fisheries and Forestry, Government of Timor-Leste, Av. Nicolao Lobato, Comoro, Dili, Timor-Leste
| | | | - Joanna McKenzie
- School of Veterinary Science, Massey University, Palmerston North 4442, New Zealand
| | - Tessa Oakley
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Joshua R Francis
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Jennifer Yan
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
| | - Shawn Ting
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Dili, Timor-Leste
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3
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Gastrointestinal Carriage of Antimicrobial Resistance in School-Aged Children in Three Municipalities of Timor-Leste. Antibiotics (Basel) 2022; 11:antibiotics11091262. [PMID: 36140041 PMCID: PMC9495830 DOI: 10.3390/antibiotics11091262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/17/2022] Open
Abstract
Invasive bacterial infections are a leading cause of death in children, primarily in low- and middle-income countries (LMIC). Links between carriage of antimicrobial-resistant organisms and more resistant infections have been established; however, little has been reported regarding community carriage of antibiotic-resistant organisms such as extended-spectrum β-lactamase (ESBL)-producing Enterobacterales in LMIC. The aim of this study was to determine colonic carriage of ESBL-producing fluoroquinolone- and aminoglycoside-resistant Enterobacterales in healthy children in three municipalities of Timor-Leste. In November 2020, 621 stool samples were collected from school-aged children and underwent screening for the presence of Enterobacterales species and antimicrobial resistance (AMR). Ciprofloxacin-resistant Gram-negative organisms were cultured from 16.5% (95% CI 6.2−26.9), and gentamicin resistance was identified in 6.8% (95% CI 2.8−10.7). Compared to the prevalence of ciprofloxacin resistance in Dili (36.1%), there was significantly lower prevalence in the rural municipalities of Ermera (12.9%; AOR 0.38, 95% CI 0.24−0.60, p < 0.001) and Manufahi (4.5%; AOR 0.07, 95% CI 0.01−0.51, p = 0.009). The overall cluster-adjusted prevalence of ESBL-producing bacteria was 8.3%, with no significant differences between municipalities. This study demonstrates high rates of carriage of AMR among school-aged children in Timor-Leste, with higher rates observed in Dili compared to rural municipalities. Empiric antibiotic guidelines should include recommendations for treating community-acquired infections that account for the possibility of antimicrobial resistance.
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4
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Estimates of Antibacterial Consumption in Timor-Leste Using Distribution Data and Variation in Municipality Usage Patterns. Antibiotics (Basel) 2021; 10:antibiotics10121468. [PMID: 34943680 PMCID: PMC8698407 DOI: 10.3390/antibiotics10121468] [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: 09/28/2021] [Revised: 11/19/2021] [Accepted: 11/24/2021] [Indexed: 12/19/2022] Open
Abstract
The association between antimicrobial resistance and antimicrobial usage has become a growing global concern. Many lower-middle income countries including Timor-Leste (TL) have limited information on antimicrobial usage, although recent research suggests increasing resistance rates among human pathogens there. The aim of this study was to use distribution data to estimate antibiotic consumption at both the national and sub-national level in Timor-Leste, stratifying into resistance class and adherence to the national essential medicines list (EML) and WHO AWaRe guidelines. A retrospective review of distribution data from Timor-Leste central medical store (SAMES) was undertaken to give a defined daily dose (DDD)/1000 inhabitants/day using WHO methodology. National antibiotic distribution in the TL EML in 2019 was estimated at 11.1 DDD/1000 inhabitants/day, comparable to consumption rates observed in other lower-middle-income countries using similar methodology. Differences in distribution quantities were noted between municipalities, with 4 of the 13 municipalities notably above the national average and around 32% of listed restricted antimicrobials distributed incongruent with the EML. This study provides insights into estimated antimicrobial consumption in Timor-Leste that has previously been poorly defined. Estimates of consumption can be used to understand emerging resistance in this small island nation, add to the body of knowledge on antimicrobial use to advise policy and guideline development, and help with stewardship activities.
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5
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VanOeffelen M, Nguyen M, Aytan-Aktug D, Brettin T, Dietrich EM, Kenyon RW, Machi D, Mao C, Olson R, Pusch GD, Shukla M, Stevens R, Vonstein V, Warren AS, Wattam AR, Yoo H, Davis JJ. A genomic data resource for predicting antimicrobial resistance from laboratory-derived antimicrobial susceptibility phenotypes. Brief Bioinform 2021; 22:bbab313. [PMID: 34379107 PMCID: PMC8575023 DOI: 10.1093/bib/bbab313] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/18/2021] [Accepted: 07/20/2021] [Indexed: 11/14/2022] Open
Abstract
Antimicrobial resistance (AMR) is a major global health threat that affects millions of people each year. Funding agencies worldwide and the global research community have expended considerable capital and effort tracking the evolution and spread of AMR by isolating and sequencing bacterial strains and performing antimicrobial susceptibility testing (AST). For the last several years, we have been capturing these efforts by curating data from the literature and data resources and building a set of assembled bacterial genome sequences that are paired with laboratory-derived AST data. This collection currently contains AST data for over 67 000 genomes encompassing approximately 40 genera and over 100 species. In this paper, we describe the characteristics of this collection, highlighting areas where sampling is comparatively deep or shallow, and showing areas where attention is needed from the research community to improve sampling and tracking efforts. In addition to using the data to track the evolution and spread of AMR, it also serves as a useful starting point for building machine learning models for predicting AMR phenotypes. We demonstrate this by describing two machine learning models that are built from the entire dataset to show where the predictive power is comparatively high or low. This AMR metadata collection is freely available and maintained on the Bacterial and Viral Bioinformatics Center (BV-BRC) FTP site ftp://ftp.bvbrc.org/RELEASE_NOTES/PATRIC_genomes_AMR.txt.
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Affiliation(s)
| | - Marcus Nguyen
- University of Chicago Consortium for Advanced Science and Engineering, University of Chicago, Chicago, IL, USA
- Data Science and Learning Division, Argonne National Laboratory, Argonne, IL, USA
| | - Derya Aytan-Aktug
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Thomas Brettin
- University of Chicago Consortium for Advanced Science and Engineering, University of Chicago, Chicago, IL, USA
- Computing Environment and Life Sciences, Argonne National Laboratory, Argonne, IL, USA
| | - Emily M Dietrich
- University of Chicago Consortium for Advanced Science and Engineering, University of Chicago, Chicago, IL, USA
- Computing Environment and Life Sciences, Argonne National Laboratory, Argonne, IL, USA
| | - Ronald W Kenyon
- Biocomplexity Institute and Initiative, University of Virginia, Virginia, USA
| | - Dustin Machi
- Biocomplexity Institute and Initiative, University of Virginia, Virginia, USA
| | - Chunhong Mao
- Biocomplexity Institute and Initiative, University of Virginia, Virginia, USA
| | - Robert Olson
- University of Chicago Consortium for Advanced Science and Engineering, University of Chicago, Chicago, IL, USA
- Data Science and Learning Division, Argonne National Laboratory, Argonne, IL, USA
| | - Gordon D Pusch
- Fellowship for Interpretation of Genomes, Burr Ridge, IL, USA
| | - Maulik Shukla
- University of Chicago Consortium for Advanced Science and Engineering, University of Chicago, Chicago, IL, USA
- Data Science and Learning Division, Argonne National Laboratory, Argonne, IL, USA
| | - Rick Stevens
- Computing Environment and Life Sciences, Argonne National Laboratory, Argonne, IL, USA
- Department of Computer Science, University of Chicago, Chicago, IL, USA
| | | | - Andrew S Warren
- Biocomplexity Institute and Initiative, University of Virginia, Virginia, USA
| | - Alice R Wattam
- Data Science and Learning Division, Argonne National Laboratory, Argonne, IL, USA
- Biocomplexity Institute and Initiative, University of Virginia, Virginia, USA
| | - Hyunseung Yoo
- University of Chicago Consortium for Advanced Science and Engineering, University of Chicago, Chicago, IL, USA
- Data Science and Learning Division, Argonne National Laboratory, Argonne, IL, USA
| | - James J Davis
- University of Chicago Consortium for Advanced Science and Engineering, University of Chicago, Chicago, IL, USA
- Data Science and Learning Division, Argonne National Laboratory, Argonne, IL, USA
- Northwestern Argonne Institute for Science and Engineering, Evanston, IL, USA
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6
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Quality microbiological diagnostics and antimicrobial susceptibility testing, an essential component of antimicrobial resistance surveillance and control efforts in Pacific island nations. Western Pac Surveill Response J 2020; 11:41-46. [PMID: 32963890 PMCID: PMC7485514 DOI: 10.5365/wpsar.2018.9.3.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Problem Emerging bacterial antimicrobial (antibiotic) resistance (AMR) is a global threat to human health. However, most lower income countries do not have microbiological diagnostic testing for prompt, reliable confirmation of bloodstream infection and identification of AMR. Context Clinicians in Pacific island nations are increasingly challenged by patients who have infection due to antimicrobial-resistant bacteria. Treatment of infection remains empirical because of a lack of diagnostic testing capacity and may follow guidelines that were formulated without reference to local measures of AMR prevalence. There is limited understanding among clinicians of microbiology testing and test interpretation. Action Examine the lessons learnt from pilot laboratory development programmes in two Pacific island nations that focused on establishing standard procedures for micrological diagnostics and antimicrobial susceptibility testing (AST) and on improving the training of clinicians to increase their use of laboratory services. Outcome The pilot programmes addressed a range of logistical difficulties and evaluated two blood culture systems. They also examined and improved internal QC implementation and evaluated the prevalence of AMR. Discussion Continued development of microbiological diagnostic capability in the Pacific region is paramount. Pacific Island nations need to develop the capability of at least one central laboratory to culture AMR pathogens and subject them to quality-controlled AST or arrange for suitable referral to a nearby country. Discussion This study demonstrated a persistently high prevalence of three major bacterial STIs across four countries in WHO’s Western Pacific Region during nearly two decades. Further strengthening of strategies to control and prevent STIs is warranted.
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7
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Pauter K, Szultka-Młyńska M, Buszewski B. Determination and Identification of Antibiotic Drugs and Bacterial Strains in Biological Samples. Molecules 2020; 25:E2556. [PMID: 32486359 PMCID: PMC7321139 DOI: 10.3390/molecules25112556] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/27/2020] [Accepted: 05/29/2020] [Indexed: 12/22/2022] Open
Abstract
Antibiotics were initially natural substances. However, nowadays, they also include synthetic drugs, which show their activity against bacteria, killing or inhibiting their growth and division. Thanks to these properties, many antibiotics have quickly found practical application in the fight against infectious diseases such as tuberculosis, syphilis, gastrointestinal infections, pneumonia, bronchitis, meningitis and septicemia. Antibiotic resistance is currently a detrimental problem; therefore, in addition to the improvement of antibiotic therapy, attention should also be paid to active metabolites in the body, which may play an important role in exacerbating the existing problem. Taking into account the clinical, cognitive and diagnostic purposes of drug monitoring, it is important to select an appropriate analytical method that meets all the requirements. The detection and identification of the microorganism responsible for the infection is also an essential factor in the implementation of appropriate antibiotic therapy. In recent years, clinical microbiology laboratories have experienced revolutionary changes in the way microorganisms are identified. The MALDI-TOF MS technique may be interesting, especially in some areas where a quick analysis is required, as is the case with clinical microbiology. This method is not targeted, which means that no prior knowledge of the infectious agent is required, since identification is based on a database match.
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Affiliation(s)
- Katarzyna Pauter
- Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University, Gagarin 7, 87-100 Torun, Poland; (K.P.); (B.B.)
- Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Wilenska 4, 87-100 Torun, Poland
| | - Małgorzata Szultka-Młyńska
- Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University, Gagarin 7, 87-100 Torun, Poland; (K.P.); (B.B.)
| | - Bogusław Buszewski
- Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University, Gagarin 7, 87-100 Torun, Poland; (K.P.); (B.B.)
- Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Wilenska 4, 87-100 Torun, Poland
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8
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Francis JR, Sarmento N, Draper ADK, Marr I, Ting S, Fancourt N, Alves L, Champlin K, Bongers A, Yan J. Antimicrobial resistance and antibiotic use in Timor-Leste: building surveillance capacity with a One Health approach. ACTA ACUST UNITED AC 2020; 44. [PMID: 31940450 DOI: 10.33321/cdi.2020.44.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Joshua R Francis
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia; Department of Paediatrics, Royal Darwin Hospital, Darwin, Australia
| | - Nevio Sarmento
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
| | - Anthony D K Draper
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia; Centre for Disease Control, Top End Health Service, Darwin, Australia
| | - Ian Marr
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
| | - Shawn Ting
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
| | - Nicholas Fancourt
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia; Department of Paediatrics, Royal Darwin Hospital, Darwin, Australia
| | - Lucsendar Alves
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
| | - Karen Champlin
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
| | - Alexander Bongers
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
| | - Jennifer Yan
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia; Department of Paediatrics, Royal Darwin Hospital, Darwin, Australia
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9
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Yam ELY, Hsu LY, Yap EPH, Yeo TW, Lee V, Schlundt J, Lwin MO, Limmathurotsakul D, Jit M, Dedon P, Turner P, Wilder-Smith A. Antimicrobial Resistance in the Asia Pacific region: a meeting report. Antimicrob Resist Infect Control 2019; 8:202. [PMID: 31890158 PMCID: PMC6921568 DOI: 10.1186/s13756-019-0654-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 11/14/2019] [Indexed: 01/01/2023] Open
Abstract
The Asia Pacific region, home to two-thirds of the world's population and ten of the least developed countries, is considered a regional hot-spot for the emergence and spread of antimicrobial resistance (AMR). Despite this, there is a dearth of high-quality regional data on the extent of AMR. Recognising the urgency to close this gap, Singapore organised a meeting to discuss the problems in the region and frame a call for action. Representatives from across the region and beyond attended the meeting on the "Antimicrobial Resistance in the Asia Pacific & its impact on Singapore" held in November 2018. This meeting report is a summary of the discussions on the challenges and progress in surveillance, drivers and levers of AMR emergence, and the promising innovations and technologies that could be used to combat the increasing threat of AMR in the region. Enhanced surveillance and research to provide improved evidence-based strategies and policies are needed. The major themes that emerged for an action plan are working towards a tailored solution for the region by harnessing the One Health approach, enhancing inter-country collaborations, and collaboratively leverage upon new emerging technologies. A regionally coordinated effort that is target-driven, sustainable and builds on a framework facilitating communication and governance will strengthen the fight against AMR in the Asia Pacific region.
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Affiliation(s)
- Esabelle Lo Yan Yam
- 1Centre for Global Health, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Li Yang Hsu
- 2Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Eric Peng-Huat Yap
- 1Centre for Global Health, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Tsin Wen Yeo
- 1Centre for Global Health, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Vernon Lee
- 2Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,3Public Health Group, Ministry of Health, Singapore, Singapore
| | - Joergen Schlundt
- 4Nanyang Technological University Food Technology Centre and School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore
| | - May O Lwin
- 5Wee Kim Wee School of Communication and Information and Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Direk Limmathurotsakul
- 6Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,7Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mark Jit
- 8Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,9Modelling and Economics Unit, Public Health England, London, UK.,10School of Public Health, University of Hong Kong, Hong Kong, SAR China
| | - Peter Dedon
- 11Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore, Singapore.,12Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA USA
| | - Paul Turner
- 13Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia.,14Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Annelies Wilder-Smith
- 1Centre for Global Health, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232 Singapore.,15Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.,16Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
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Malchione MD, Torres LM, Hartley DM, Koch M, Goodman JL. Carbapenem and colistin resistance in Enterobacteriaceae in Southeast Asia: Review and mapping of emerging and overlapping challenges. Int J Antimicrob Agents 2019; 54:381-399. [DOI: 10.1016/j.ijantimicag.2019.07.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/16/2019] [Accepted: 07/21/2019] [Indexed: 01/21/2023]
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Tebano G, la Martire G, Sarmento N, Francis JR. Antibiotic resistance in Timor-Leste: a systematic review of evidence. J Antimicrob Chemother 2019; 73:1110-1111. [PMID: 29365120 DOI: 10.1093/jac/dkx518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Gianpiero Tebano
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-PH, Paris, France.,Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Giulia la Martire
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-PH, Paris, France.,Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Nevio Sarmento
- Departamento Laboratorio e Banco de Sangue, Hospital Nacional Guido Valadares, Dili, Timor-Leste
| | - Joshua R Francis
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
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