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Ožegić O, Bedenić B, Sternak SL, Sviben M, Talapko J, Pažur I, Škrlec I, Segedi I, Meštrović T. Antimicrobial Resistance and Sports: The Scope of the Problem, Implications for Athletes' Health and Avenues for Collaborative Public Health Action. Antibiotics (Basel) 2024; 13:232. [PMID: 38534667 DOI: 10.3390/antibiotics13030232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Antimicrobial resistance (AMR) poses a global threat, leading to increased mortality and necessitating urgent action-however, its impact on athletes and the world of sports has hitherto been neglected. Sports environments (including athletic and aquatic) exhibit high levels of microbial contamination, potentially contributing to the spread of resistant microorganisms during physical activities. Moreover, the literature suggests that travel for sports events may lead to changes in athletes' gut microbiomes and potentially impact their antibiotic resistance profiles, raising questions about the broader implications for individual and public/global health. The prevalence of Staphylococcus aureus (S. aureus) among athletes (particularly those engaged in contact or collision sports) ranges between 22.4% and 68.6%, with MRSA strains being isolated in up to 34.9% of tested individuals. Factors such as training frequency, equipment sharing, delayed post-training showers, and a history of certain medical conditions are linked to higher colonization rates. Moreover, MRSA outbreaks have been documented in sports teams previously, highlighting the importance of implementing preventive measures and hygiene protocols in athletic settings. In light of the growing threat of AMR, there is a critical need for evidence-based treatment guidelines tailored to athletes' unique physiological demands to ensure responsible antibiotic use and mitigate potential health risks. While various initiatives-such as incorporating AMR awareness into major sporting events-aim to leverage the broad audience of sports to communicate the importance of addressing AMR, proactive measures (including improved AMR surveillance during large sporting events) will be indispensable for enhancing preparedness and safeguarding both athletes' and the general public's health. This narrative review thoroughly assesses the existing literature on AMR and antibiotic usage in the context of sports, aiming to illuminate areas where information may be lacking and underscoring the significance of promoting global awareness about AMR through sports.
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Affiliation(s)
- Ognjen Ožegić
- Department of Anaesthesiology, Intensive Medicine and Pain Management, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia
| | - Branka Bedenić
- Medical Microbiology Department, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- BIMIS-Biomedical Research Center Šalata, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Sunčanica Ljubin Sternak
- Medical Microbiology Department, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Clinical Microbiology Department, Teaching Institute of Public Health "Dr Andrija Štampar", 10000 Zagreb, Croatia
| | - Mario Sviben
- Medical Microbiology Department, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Parasitology Department, Microbiology Service, Croatian National Institute of Public Health, 10000 Zagreb, Croatia
| | - Jasminka Talapko
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Iva Pažur
- Department of Anaesthesiology, Intensive Medicine and Pain Management, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
| | - Ivana Škrlec
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Ivan Segedi
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia
| | - Tomislav Meštrović
- University Centre Varaždin, University North, 42000 Varaždin, Croatia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USA
- Department for Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA 98195, USA
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Sharma A. Raising awareness and mitigating risk of transmission of antimicrobial resistance during the upcoming 2024 Gangasagar religious mass gathering. New Microbes New Infect 2024; 56:101213. [PMID: 38223847 PMCID: PMC10784787 DOI: 10.1016/j.nmni.2023.101213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 01/16/2024] Open
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Sharma A, Gupta B, Petersen E, Lee SS, Zumla A. Enhancing preparedness for reducing transmission and globalisation of Antimicrobial Resistance at the Ardh Kumbh Mela 2025, the world's largest recurring religious mass gathering. Int J Infect Dis 2023; 137:79-81. [PMID: 37852598 DOI: 10.1016/j.ijid.2023.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Affiliation(s)
- Avinash Sharma
- DBT-National Centre for Cell Science, Pune, 411007, India.
| | - Bhavuk Gupta
- DBT-National Centre for Cell Science, Pune, 411007, India
| | - Eskild Petersen
- Institute for Clinical Medicine, Faculty of Health Sciences, University of Aarhus, Denmark; European Society for Clinical Microbiology and Infectious Diseases Task Force for Emerging Infections, Basel, Switzerland; International Society for Infectious Diseases
| | - Shui Shan Lee
- International Society for Infectious Diseases; International Society for Infectious Diseases; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong; S.H. Ho Research Centre for Infectious Diseases
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, University College London; NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
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Gupta A, Dutt V, Sharma N, Kajale S, Bhatt A, Shafi S, Azhar E, Zumla A, Sharma A. Examining the microbial composition of natural springs in Bhaderwah, Jammu and Kashmir, India. ENVIRONMENTAL MONITORING AND ASSESSMENT 2023; 195:949. [PMID: 37450062 DOI: 10.1007/s10661-023-11507-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/10/2023] [Indexed: 07/18/2023]
Abstract
Natural springs are the main source of water supply for domestic and agricultural use for humans living in the mountainous regions of Asia. Increasing anthropogenic activities with associated waste load, coupled with inadequate sanitation, and contamination of natural water resources and the environment are emerging as important public health issues. We performed a prospective microbiological and physicochemical investigation of water samples from seven distinct natural springs situated at an altitude of 1615 m in the Bhaderwah region of Jammu and Kashmir, India. Bacterial groups belonging to opportunistic pathogens such as members of Moraxellaceae (Acinetobacter), Arcobacteraceae (Pseudoarcobacter), Pseudomonadaceae (Pseudomonas), Oxalobacteraceae (Massilia), and Flavobacteriaceae (Flavobacterium) were observed. The total coliform test indicated an intermediate level of risk of fecal contamination of the springs, except for one site. Through a questionnaire-based survey of the local population, we discovered that around 40% of participants had suffered from waterborne diseases including typhoid (~14%) and diarrhea (~11%). Our data suggests that increased surveillance of fecal contamination and heterotrophic opportunistic pathogens is needed to enhance water quality and reduce health risks for people living in mountainous regions.
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Affiliation(s)
- Abhishek Gupta
- National Centre for Microbial Resource, National Centre for Cell Science, Pune, India
| | - Vandana Dutt
- Institute of Mountain Environment, University of Jammu, Bhaderwah Campus, Jammu and Kashmir, India
| | - Neeraj Sharma
- Institute of Mountain Environment, University of Jammu, Bhaderwah Campus, Jammu and Kashmir, India.
| | - Swapnil Kajale
- National Centre for Microbial Resource, National Centre for Cell Science, Pune, India
| | - Arun Bhatt
- GB Pant Institute of Engineering and Technology, Garhwal, Uttarakhand, India
| | - Shuja Shafi
- Mass Gatherings and Global Health Network, London, UK
| | - Esam Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Center, and Medical Laboratory Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alimuddin Zumla
- Division of Infection and Immunity, NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, University College London, London, UK
| | - Avinash Sharma
- National Centre for Microbial Resource, National Centre for Cell Science, Pune, India.
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Sharma A, Karande M, Zumla A. Advancing sewage surveillance at mass gathering events for reducing transmission of antimicrobial resistant bacterial pathogens. Travel Med Infect Dis 2023; 54:102619. [PMID: 37453675 DOI: 10.1016/j.tmaid.2023.102619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Avinash Sharma
- DBT-National Centre for Cell Science, NCCS Complex, Ganeshkhind, Pune, 411007, India.
| | - Mrunal Karande
- DBT-National Centre for Cell Science, NCCS Complex, Ganeshkhind, Pune, 411007, India.
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, University College London, UK; NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK.
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Sharma A, McCloskey B, Hui DS, Rambia A, Zumla A, Traore T, Shafi S, El-Kafrawy SA, Azhar EI, Zumla A, Rodriguez-Morales AJ. Global mass gathering events and deaths due to crowd surge, stampedes, crush and physical injuries - Lessons from the Seoul Halloween and other disasters. Travel Med Infect Dis 2022; 52:102524. [PMID: 36516965 DOI: 10.1016/j.tmaid.2022.102524] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022]
Affiliation(s)
| | - Brian McCloskey
- Global Health Program, Chatham House, Royal Institute of International Affairs, London, UK
| | - David S Hui
- Department of Medicine & Therapeutics and Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China
| | | | - Adam Zumla
- Accident and Emergency Department, Royal Albert Edward Infirmary, Wigan and Leigh NHS Foundation Trust, Wigan, United Kingdom
| | - Tieble Traore
- Emergency Preparedness and Response Programme, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal
| | - Shuja Shafi
- Mass Gatherings and Global Health Network, London, UK
| | - Sherif A El-Kafrawy
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, and Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Esam I Azhar
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, and Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, University College London; and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - Alfonso J Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de Las Américas - Institución Universitaria Vision de Las Americas, Pereira, Risaralda, Colombia; Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru; Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, P.O. Box 36, Lebanon.
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