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Aboushady AT, Manigart O, Sow A, Fuller W, Ouedraogo AS, Ebruke C, Babin FX, Gahimbare L, Sombié I, Stelling J. Surveillance of Antimicrobial Resistance in the ECOWAS Region: Setting the Scene for Critical Interventions Needed. Antibiotics (Basel) 2024; 13:627. [PMID: 39061309 PMCID: PMC11273779 DOI: 10.3390/antibiotics13070627] [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: 06/11/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open
Abstract
Antimicrobial resistance poses a significant challenge to public health globally, leading to increased morbidity and mortality. AMR surveillance involves the systematic collection, analysis, and interpretation of data on the occurrence and distribution of AMR in humans, animals, and the environment for action. The West African Health Organization, part of the Economic Community of West African States (ECOWAS), is committed to addressing AMR in the region. This paper examines the status of AMR surveillance in ECOWAS countries using available WHO data from the TrACSS survey and GLASS enrollments. The analysis reveals that while progress has been made, significant challenges remain. Twelve of the fifteen ECOWAS countries are enrolled in GLASS, and ten have developed national action plans (NAPs) for AMR. However, there is a need to ensure all countries fully implement their NAPs, continue reporting to GLASS, and use the data for evidence-based actions and decision making. Surveillance systems for AMR and antimicrobial consumption/use vary across countries with some demonstrating limited capacity. All countries, except Cabo Verde, reported having a reference laboratory for AMR testing. Strengthening laboratory capabilities, data management and use, and multisectoral coordination are crucial for effective AMR surveillance and response. Based on the findings and the regional context, it is essential to prioritize capacity building, data utilization, and the adoption of standardized guidelines for AMR surveillance. Collaboration among ECOWAS countries, the WAHO, and international partners is essential to address AMR comprehensively. Ensuring a consistent supply of essential antimicrobial medications and reagents is vital.
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Affiliation(s)
| | - Olivier Manigart
- West African Health Organization, Bobo-Dioulasso 01 BP 153, Burkina Faso (A.S.); (C.E.); (I.S.)
- GFA Consulting Group, 22359 Hamburg, Germany
- Ecole de Santé Publique, Université Libre de Bruxelles, 1050 Brussels, Belgium
| | - Abdourahmane Sow
- West African Health Organization, Bobo-Dioulasso 01 BP 153, Burkina Faso (A.S.); (C.E.); (I.S.)
- Institut Pasteur de Dakar, Dakar 220, Senegal
- Department de Santé Public, Faculté de Médecine, de Pharmacie et D’Odontostomatologie, Université Cheikh Anta Diop, Dakar 5005, Senegal
| | - Walter Fuller
- World Health Organization Regional Office for Africa, Brazzaville P.O. Box 06, Congo; (W.F.); (L.G.)
| | - Abdoul-Salam Ouedraogo
- Centre Muraz, Institut National de Santé Publique, Bobo-Dioulasso 01 BP 390, Burkina Faso;
| | - Chinelo Ebruke
- West African Health Organization, Bobo-Dioulasso 01 BP 153, Burkina Faso (A.S.); (C.E.); (I.S.)
- GFA Consulting Group, 22359 Hamburg, Germany
| | | | - Laetitia Gahimbare
- World Health Organization Regional Office for Africa, Brazzaville P.O. Box 06, Congo; (W.F.); (L.G.)
| | - Issiaka Sombié
- West African Health Organization, Bobo-Dioulasso 01 BP 153, Burkina Faso (A.S.); (C.E.); (I.S.)
| | - John Stelling
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
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Aldholmi M, Ahmad R, Shaikh MH, Salem AM, Alqurashi M, Alturki M. Anti-Infective Activity of Momordica charantia Extract with Molecular Docking of Its Triterpenoid Glycosides. Antibiotics (Basel) 2024; 13:544. [PMID: 38927210 PMCID: PMC11200997 DOI: 10.3390/antibiotics13060544] [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: 05/06/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
Momordica charantia, commonly known as bitter melon, is a fruiting plant that has been used for several diseases including infectious diseases. In this study, we report the antibacterial, antifungal, and antiviral activity of different bitter melon fruit parts originating from India and Saudi Arabia. The in vitro experiments are supported by the molecular docking of karavilosides to verify their role in the bioactivity. The antimicrobial assays revealed activity against Candida albicans, Escherichia coli, and Staphylococcus aureus. The extracts exhibited the potent inhibition of HIV-I reverse transcriptase, with an IC50 of 0.125 mg/mL observed for the pith extract originating from Saudi Arabia and the standard drug doxorubicin. The molecular docking of karavilosides exhibited a significant affinity to reverse transcriptase comparable to Rilpivirine and higher than that of doxorubicin. These outcomes encourage the precious bioactive components of the seed and pith of the Saudi bitter melon fruits to be further studied for isolation and structure elucidation.
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Affiliation(s)
- Mohammed Aldholmi
- Department of Natural Products, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Rizwan Ahmad
- Department of Natural Products, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Mohammad Habeeb Shaikh
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34224, Saudi Arabia
| | - Ayad Mohammed Salem
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34224, Saudi Arabia
| | - Maher Alqurashi
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Mansour Alturki
- Department of Pharmaceutical Chemistry, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
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Guo YX, Guo XR, Chen XY. Design of Ratio-Fluorescence Nanohybrid Based on Radix Hedysari Green-Synthesized CDs and GSH-AuNCs for Sensitive Detection of Cefodizime Sodium in Urine Sample. Int J Mol Sci 2024; 25:5971. [PMID: 38892157 PMCID: PMC11172498 DOI: 10.3390/ijms25115971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/24/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
A dual-emission ratio-fluorescent sensing nanohybrid based on Radix Hedysari green-synthesized carbon quantum dots (CDs) and glutathione-functionalized gold nanoclusters (GSH-AuNCs) had been developed for the determination of cefodizime sodium (CDZM). The designed fluorescence nanohybrid had two significant fluorescence emission peaks at 458 nm and 569 nm when excited at 360 nm, which was attributed to the CDs and GSH-AuNCs. With the addition of CDZM, the fluorescence at 458 nm was slightly weakened while the fluorescence at 569 nm was enhanced obviously. Based on the relationship between the I569/I458 fluorescence intensity ratio and the concentration of CDZM, the designed nanohybrid exhibited a good linearity range of 1.0-1000.0 μM and the limit of detection (LOD) was 0.19 μM. The method was finally applied in the detection of CDZM in urine, showing the potential applications in complicated biological samples.
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Affiliation(s)
| | | | - Xin-Yue Chen
- Institute of Pharmaceutical Analysis, School of Pharmacy, Lanzhou University, Lanzhou 730030, China; (Y.-X.G.); (X.-R.G.)
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Hamadalneel YB, Ahmed HO, Alamin MF, Almahy WM, Almustafa ZM, Yousif YM, Taha MA. Prevalence and Antimicrobial Sensitivity Patterns of Uropathogens in Wad Medani, Sudan: A Three Years, Cross-Sectional Study. Infect Drug Resist 2024; 17:2131-2140. [PMID: 38828377 PMCID: PMC11143980 DOI: 10.2147/idr.s464501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/22/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose Urinary tract infections exert a significant negative impact on an individual's quality of life and cause significant economic and public health burdens. Therefore, this study was conducted to identify the common bacterial uropathogens associated with urinary tract infections in Wad Medani patients and their susceptibility to antibiotics. Patients and Methods This was a cross-sectional study. All urine samples were collected from patients at Wad Medani and investigated at the Pathology Center for Diagnosis and Research, Faculty of Medicine, University of Gezira, Sudan, from the 1st of January 2021 to the 15th of October 2023. Results A total of 2698 urine samples were analyzed during the three years study period, with a mean age of 45.29 ± 18.9 years. Among these patients, 1108 (41.8%) were positive for bacterial growth, and 888 (80.14%) were female. A total of 522 (47.1%) were gram positive bacteria (GPB), and 586 (52.9%) were gram negative bacteria (GNB). The most frequently isolated bacteria were S. aureus 42% (465/1108) and E. coli 38.5% (427/1108), while P. aeruginosa was less detected 3.4% (38/1108). Amikacin 91.5% was the most sensitive drug to isolated GPB, while cotrimoxazole 20.9% was the least sensitive drug. In particular, amikacin 94.1% (144/153) was the most sensitive drug to S. aureus, while cotrimoxazole 20.7% (80/386) was the least sensitive drug. Moreover, amikacin 91.5% was the most sensitive drug to the isolated GNB, while ampicillin 5.7% was the least sensitive drug. Notably, amikacin was the most sensitive drug to all the isolated GNB, and ampicillin was the least sensitive drug to all the isolated GNB. Conclusion This study reported a moderate uropathogen isolation rate of 41.8%. S. aureus and E. coli were the most frequently isolated bacteria, most of which were from female patients. Remarkably, amikacin was the most sensitive drug to isolated GNB and GPB.
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Affiliation(s)
- Yousif B Hamadalneel
- Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, University of Gezira, Wad Medani, Sudan
| | - Hifa O Ahmed
- Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, University of Gezira, Wad Medani, Sudan
| | - Marwa F Alamin
- Department of Molecular Biology, Institute of Endemic Disease, Khartoum University, Khartoum, Sudan
| | - Walaa M Almahy
- Clinical Pharmacy & Pharmacy Practice, Pharmacy Program, Wad Medani College for Science and Technology, Wad Medani, Gezira State, Sudan
| | - Zainab M Almustafa
- Clinical Pharmacy & Pharmacy Practice, Pharmacy Program, Wad Medani College for Science and Technology, Wad Medani, Gezira State, Sudan
| | - Yousif M Yousif
- Clinical Pharmacy & Pharmacy Practice, Pharmacy Program, Wad Medani College for Science and Technology, Wad Medani, Gezira State, Sudan
| | - Mohammed A Taha
- Pathology Center for Diagnosis and Research, Faculty of Medicine, University of Gezira, Wad Medani, Sudan
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Bhatti S, Chaurasia B, Yaqoob E, Ameer J, Shehzad Y, Shahzad K, Mahmood A, Scalia G, Umana GE, Javed S. Assessing bacterial prevalence and resistance in paediatric meningitis: safeguarding the central nervous system. Ann Med Surg (Lond) 2024; 86:2671-2676. [PMID: 38694313 PMCID: PMC11060287 DOI: 10.1097/ms9.0000000000001953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/29/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction Paediatric bacterial meningitis (PBM) represents a major contributor to childhood morbidity and mortality globally, with heightened susceptibility in low- and middle-income nations where antimicrobial resistance (AMR) is highly prevalent. Pakistan exemplifies this setting, with widespread antibiotic overuse driving AMR expansion. Thus, expediting PBM diagnosis and targeted antibiotic therapy is imperative yet challenged by the dynamic local epidemiology. This study aimed to delineate the recent bacterial etiologies and AMR profiles of PBM from a major Pakistani diagnostics laboratory to inform empirical treatment. Materials and methods This prospective observational investigation evaluated PBM epidemiology in patients under 18 years old admitted to the study hospital. Standard cerebrospinal fluid analysis identified bacterial pathogens and antibiotic susceptibility patterns. Results Among 171 PBM cases, 152 (88.9%) had bacterial isolates confirmed via culture. The cohort was 42.7% male with a mean age of 3 months. The most prevalent pathogens among infants younger than 3 months were Escherichia coli, Enterococcus faecium, and Staphylococcus epidermidis, contrasting with S. epidermidis, Streptococcus pneumoniae, and Staphylococcus hominis predominating in older children. Staphylococcal isolates exhibited considerable penicillin and erythromycin resistance but maintained vancomycin and linezolid susceptibility. Other resistance patterns varied. Conclusion These findings highlight the pressing threat of paediatric AMR in Pakistan, underscoring the need for vigilant AMR surveillance and judicious antimicrobial use. This study provides a reference to current PBM epidemiology to guide context-specific empirical therapy.
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Affiliation(s)
- Sania Bhatti
- Department of Neurosurgery, Holy Family Hospital, Rawalpindi Medical University, Rawalpindi
| | - Bipin Chaurasia
- Violence, Injury Prevention & Disability Unit, Department of Public Health, Health Services Academy, Ministry of National Health Services Regulations and Coordination, Government of Pakistan
- Neurosurgery Clinic, Birgunj, Nepal
| | - Eesha Yaqoob
- Violence, Injury Prevention & Disability Unit, Department of Public Health, Health Services Academy, Ministry of National Health Services Regulations and Coordination, Government of Pakistan
- Health Services Academy, Ministry of National Health Services Regulations and Coordination, Government of Pakistan
| | - Jannat Ameer
- Health Services Academy, Ministry of National Health Services Regulations and Coordination, Government of Pakistan
- Rawal Institute of Health Sciences, Islamabad
| | - Yasir Shehzad
- Rawal Institute of Health Sciences, Islamabad
- District Headquarter Hospital, Jhelum, Pakistan
| | - Khuram Shahzad
- District Headquarter Hospital, Jhelum, Pakistan
- Neurosurgery Clinic, Birgunj, Nepal
| | - Ashraf Mahmood
- Department of Neurosurgery, Holy Family Hospital, Rawalpindi, Pakistan
| | | | | | - Saad Javed
- Department of Neurosurgery, Holy Family Hospital, Rawalpindi Medical University, Rawalpindi
- Violence, Injury Prevention & Disability Unit, Department of Public Health, Health Services Academy, Ministry of National Health Services Regulations and Coordination, Government of Pakistan
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Sharma V, Das R, Mehta DK, Sharma D, Aman S, Khan MU. Quinolone scaffolds as potential drug candidates against infectious microbes: a review. Mol Divers 2024:10.1007/s11030-024-10862-4. [PMID: 38683488 DOI: 10.1007/s11030-024-10862-4] [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: 02/16/2024] [Accepted: 03/26/2024] [Indexed: 05/01/2024]
Abstract
Prevalence of microbial infections and new rising pathogens are signified as causative agent for variety of serious and lethal health crisis in past years. Despite medical advances, bacterial and fungal infections continue to be a rising problem in the health care system. As more bacteria develop resistance to antibiotics used in therapy, and as more invasive microbial species develop resistance to conventional antimicrobial drugs. Relevant published publications from the last two decades, up to 2024, were systematically retrieved from the MEDLINE/PubMed, SCOPUS, EMBASE, and WOS databases using keywords such as quinolones, anti-infective, antibacterial, antimicrobial resistance and patents on quinolone derivatives. With an approach of considerable interest towards novel heterocyclic derivatives as novel anti-infective agents, researchers have explored these as essential tools in vistas of drug design and development. Among heterocycles, quinolones have been regarded extremely essential for the development of novel derivatives, even able to tackle the associated resistance issues. The quinolone scaffold with its bicyclic structure and specific functional groups such as the carbonyl and acidic groups, is indeed considered a valuable functionalities for further lead generation and optimization in drug discovery. Besides, the substitution at N-1, C-3 and C-7 positions also subjected to be having a significant role in anti-infective potential. In this article, we intend to highlight recent quinolone derivatives based on the SAR approach and anti-infective potential such as antibacterial, antifungal, antimalarial, antitubercular, antitrypanosomal and antiviral activities. Moreover, some recent patents granted on quinolone-containing derivatives as anti-infective agents have also been highlighted in tabular form. Due consideration of this, future research in this scaffold is expected to be useful for aspiring scientists to get pharmacologically significant leads.
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Affiliation(s)
- Vishal Sharma
- Department of Pharmaceutical Chemistry, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, 133207, India
| | - Rina Das
- Department of Pharmaceutical Chemistry, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, 133207, India
| | - Dinesh Kumar Mehta
- Department of Pharmaceutical Chemistry, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, 133207, India.
| | - Diksha Sharma
- Swami Devidyal College of Pharmacy, Barwala, 134118, India
| | - Shahbaz Aman
- Department of Microbiology, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, 133207, India
| | - M U Khan
- Department of pharmaceutical Chemistry & Pharmacognosy, Unaizah College of Pharmacy, Qassim University, Uniazah, Al Qassim, Saudi Arabia
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Nashwan AJ, Barakat M, Niaz F, Tariq S, Ahmed SK. Antimicrobial Resistance: Stewardship and One Health in the Eastern Mediterranean Region. Cureus 2024; 16:e58478. [PMID: 38765382 PMCID: PMC11101134 DOI: 10.7759/cureus.58478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
Antimicrobial resistance (AMR) is a major threat in the Eastern Mediterranean region (EMR) due to factors such as the high prevalence of infectious diseases, weak health systems, and the misuse of antimicrobials. This paper aims to discuss how interdisciplinary action and collaboration, specifically through antimicrobial stewardship (AMS) and the One Health approach, can effectively address AMR in the EMR. The review focuses on successful AMS initiatives and the adoption of the One Health approach in countries within the EMR, including the Gulf Cooperation Countries (GCC), Egypt, Iran, Jordan, and Pakistan. The goal is to highlight the potential for progress in combating AMR and identify challenges and opportunities for strengthening interdisciplinary collaboration. The results showcase successful AMS programs and One Health initiatives in various EMR countries, demonstrating their potential to address AMR challenges. The paper also discusses the challenges faced by these nations, such as limited resources, fragmented health systems, and knowledge gaps. Additionally, opportunities for enhancing interdisciplinary action through regional cooperation, international partnerships, and research and innovation are outlined. In conclusion, this paper emphasizes the importance of a comprehensive and collaborative response to combat AMR in the EMR. It advocates for the One Health approach as a crucial framework to guide these efforts, promoting coordinated action, improved surveillance, responsible antimicrobial use, and enhanced interdisciplinary collaboration to effectively mitigate the threat of AMR.
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Affiliation(s)
- Abdulqadir J Nashwan
- Department of Nursing Education and Research, Hamad Medical Corporation, Doha, QAT
| | - Muna Barakat
- School of Pharmacy, Applied Science Private University, Amman, JOR
| | - Faizan Niaz
- Department of Clinical Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, PAK
| | - Samiuddin Tariq
- Department of Clinical Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, PAK
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Asad A, Jahan I, Munni MA, Begum R, Mukta MA, Saif K, Faruque SN, Hayat S, Islam Z. Multidrug-resistant conjugative plasmid carrying mphA confers increased antimicrobial resistance in Shigella. Sci Rep 2024; 14:6947. [PMID: 38521802 PMCID: PMC10960829 DOI: 10.1038/s41598-024-57423-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 03/18/2024] [Indexed: 03/25/2024] Open
Abstract
Shigellosis remains a common gastrointestinal disease mostly in children < 5 years of age in developing countries. Azithromycin (AZM), a macrolide, is currently the first-line treatment for shigellosis in Bangladesh; ciprofloxacin (CIP) and ceftriaxone (CRO) are also used frequently. We aimed to evaluate the current epidemiology of antimicrobial resistance (AMR) and mechanism(s) of increasing macrolide resistance in Shigella in Bangladesh. A total of 2407 clinical isolates of Shigella from 2009 to 2016 were studied. Over the study period, Shigella sonnei was gradually increasing and become predominant (55%) over Shigella flexneri (36%) by 2016. We used CLSI-guided epidemiological cut-off value (ECV) for AZM in Shigella to set resistance breakpoints (zone-diameter ≤ 15 mm for S. flexneri and ≤ 11 mm for S. sonnei). Between 2009 and 2016, AZM resistance increased from 22% to approximately 60%, CIP resistance increased by 40%, and CRO resistance increased from zero to 15%. The mphA gene was the key macrolide resistance factor in Shigella; a 63MDa conjugative middle-range plasmid was harboring AZM and CRO resistance factors. Our findings show that, especially after 2014, there has been a rapid increase in resistance to the three most effective antibiotics. The rapid spread of macrolide (AZM) resistance genes among Shigella are driven by horizontal gene transfer rather than direct lineage.
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Affiliation(s)
- Asaduzzaman Asad
- Laboratory of Gut-Brain Axis, Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmad Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Israt Jahan
- Laboratory of Gut-Brain Axis, Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmad Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Moriam Akter Munni
- Laboratory of Gut-Brain Axis, Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmad Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Ruma Begum
- Laboratory of Gut-Brain Axis, Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmad Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Morium Akter Mukta
- Laboratory of Gut-Brain Axis, Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmad Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Kazi Saif
- Laboratory of Gut-Brain Axis, Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmad Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Shah Nayeem Faruque
- Laboratory of Gut-Brain Axis, Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmad Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Shoma Hayat
- Laboratory of Gut-Brain Axis, Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmad Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Zhahirul Islam
- Laboratory of Gut-Brain Axis, Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmad Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
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Ajulo S, Awosile B. Global antimicrobial resistance and use surveillance system (GLASS 2022): Investigating the relationship between antimicrobial resistance and antimicrobial consumption data across the participating countries. PLoS One 2024; 19:e0297921. [PMID: 38315668 PMCID: PMC10843100 DOI: 10.1371/journal.pone.0297921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/14/2024] [Indexed: 02/07/2024] Open
Abstract
For the first time since 2015, the World Health Organization's (WHO) global Antimicrobial Resistance and Use Surveillance (GLASS) featured both global reports for antimicrobial resistance (AMR) and antimicrobial consumption (AMC) data in its annual reports. In this study we investigated the relationship of AMR with AMC within participating countries reported in the GLASS 2022 report. Our analysis found a statistically significant correlation between beta-lactam/cephalosporin and fluoroquinolones consumption and AMR to these antimicrobials associated with bloodstream E. coli and Klebsiella pneumoniae among the participating countries (P<0.05). We observed that for every 1 unit increase in defined daily dose DDD of beta-lactam/cephalosporins and quinolone consumptions among the countries, increased the recoveries of bloodstream-associated beta-lactam/cephalosporins-resistant E. coli/Klebsiella spp. by 11-22% and quinolone-resistant E. coli/Klebsiella spp. by 31-40%. When we compared the antimicrobial consumptions between the antimicrobial ATC (Alphanumeric codes developed by WHO) groups and countries, we observed a statistically significant higher daily consumption of beta-lactam-penicillins (J01C, DDD difference range: 5.23-8.13) and cephalosporins (J01D, DDD difference range: 2.57-5.13) compared to other antimicrobial groups among the countries (adjusted for multiple comparisons using Tukey's method). Between the participating countries, we observed a statistically significant higher daily consumption of antimicrobial groups in Iran (DDD difference range: 3.63-4.84) and Uganda (DDD difference range: 3.79-5.01) compared to other participating countries (adjusted for multiple comparisons using Tukey's method). Understanding AMC and how it relates to AMR at the global scale is critical in the global AMR policy development and implementation of global antimicrobial stewardship.
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Affiliation(s)
- Samuel Ajulo
- School of Veterinary Medicine, Texas Tech University, Amarillo, Texas, United States of America
| | - Babafela Awosile
- School of Veterinary Medicine, Texas Tech University, Amarillo, Texas, United States of America
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Acharya R, Panthi S, Khatiwada P, Bhattarai B, Singh S, Bhattarai K, Aryal R, Neupane D, Thapa A, Karki K, Basnet LB, Khanal VK, Ghimire A. Antibiotics use among residents in Eastern Nepal: a community-based mixed method study. Ann Med Surg (Lond) 2024; 86:748-755. [PMID: 38333289 PMCID: PMC10849382 DOI: 10.1097/ms9.0000000000001611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/03/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction According to the WHO, more than two-thirds of all antibiotics are used in the community, of which about 30% are used inappropriately. The antimicrobial resistance (AMR) problem is a growing threat to Nepal because of indiscriminate and inappropriate use. However, exact data on the extent of inappropriate use of antibiotics in the community is scarce in Nepal. Objectives To know the extent of inappropriate use of antibiotics among the community and their knowledge and practice towards the usage of antibiotics. Methods A community-based cross-sectional study was conducted from 20 December 2017 to 20 March 2018 using a purposive sampling technique. A semi-structured questionnaire was used while conducting face-to-face interviews with 336 respondents to find out the knowledge and practice regarding antibiotic use. Investigators took different antibiotics (in all dosage forms) with them to show participants whether they knew and/or used the antibiotics in the last year. Results The mean age of respondents with standard deviation was 39.87±13.67 years ranging from 18 to 84 years. Around 35.42% of respondents were farmers and 34.52% were homemakers. 28.87% of respondents were illiterate, 32.44% had primary education and 33.33% had secondary education. Almost half of them (48.51%) think that antibiotics are safe and can be commonly used. So, 43.15% of them preferred taking antibiotics when they had a common cold. The majority of the participants (81.84%) did not have any idea about antibiotic resistance. 94.6% of the respondents used antibiotics inappropriately. Conclusion The results of the present study revealed that inappropriate use of antibiotics is high and associated with low earning wages in both males and females in the age group 18-39 years.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Anish Thapa
- Department of Medicine, Universal College of Medical Sciences, Bhairahawa, Lumbini Province
| | | | - Lila Bahadur Basnet
- School of Public Health and community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Province 1
| | - Vijay Kumar Khanal
- School of Public Health and community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Province 1
| | - Anup Ghimire
- School of Public Health and community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Province 1
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Ango TS, Gelaw NB, Zegene GM, Teshome T, Getahun T. Prevalence and antimicrobial susceptibility profile of bacteria isolated from the hands of housemaids in Jimma City, Ethiopia. Front Public Health 2024; 11:1301685. [PMID: 38348381 PMCID: PMC10859430 DOI: 10.3389/fpubh.2023.1301685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/27/2023] [Indexed: 02/15/2024] Open
Abstract
Introduction Bacterial pathogens continue to be a major cause of foodborne gastroenteritis in humans and remain a public health problem. Housemaids operating inside a kitchen could be the source of infection and may transmit disease-inflicting pathogens through contaminated hands. Objective This study aimed to assess the prevalence and antimicrobial susceptibility profile of bacteria isolated from the hands of housemaids in Jimma City, Ethiopia. Methods A laboratory-based cross-sectional study was employed among 234 housemaids. Hand swab samples from the dominant hand of the study participants were collected under sterile conditions following standard operating procedures. Then, in the laboratory, the swabs were inoculated aseptically using streak-plating methods on the growth media, such as mannitol salt agar [Staphylococcus aureus and coagulase-negative staphylococci], MacConkey agar [Klebsiella species and Proteus species], salmonella-shigella agar [Salmonella species and Shigella species], and eosin methylene blue agar [Escherichia coli (E. coli)]. In addition, a set of biochemical tests was applied to examine bacterial species. Data were double-entered into EpiData version 3.1 and then exported to the Statistical Package for Social Science (SPSS) version 26 for further analysis. Descriptive analyses were summarized using frequency and percentage. Results The proportion of housemaids' hands containing one or more positive bacterial isolates was 72% (95% CI: 66.2, 77.8). The dominant bacterial isolates were Staphylococcus aureus (31.6%), Escherichia coli (21.3%), Salmonella species (1.3%), Shigella species (6.7%), Klebsiella species (23.1%) and Proteus species (14.7%). Fingernail status (AOR =15.31, 95% CI: 10.372, 22.595) and the removal of a watch, ring, and bracelet during hand washing (AOR = 20.844, 95% CI: 2.190, 9.842) were significantly associated with the prevalence of bacterial isolation. Most Staphylococcus aureus isolates were susceptible to chloramphenicol (98.6%). Escherichia coli isolates were susceptible to tetracycline (75%), ceftriaxone (79.2%), chloramphenicol (87.5%), and ceftazidime (77.1%). Eighty percent of isolated Shigella species were susceptible to chloramphenicol and gentamicin respectively. In addition, Klebsiella and Proteus species exhibited high susceptibility to chloramphenicol. However, their isolates showed resistance against a number of the tested antimicrobials. Staphylococcus aureus isolates (28.2%) were resistance to tetracycline. Moreover, One-quarter of Escherichia coli isolates were resistance to tetracycline, ceftriaxone, chloramphenicol, and ceftazidime. Whereas 46.7% and 48.5% of isolated Shigella species and Proteus species were resistance to tetracycline and ceftriaxone. Conclusion The hands of housemaids are important potential sources of pathogenic bacteria that would result in the potential risk of foodborne diseases. Most bacteria isolates were resistant to tetracycline, ceftriaxone, and ceftazidime. Therefore, practicing good hand hygiene helps to prevent and control the spread of antimicrobial-resistant microbes.
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Affiliation(s)
- Tadele Shiwito Ango
- Department of Public Health, Mizan Aman Health Science College, Mizan Aman, Southwest Ethiopia People Regional State, Ethiopia
| | - Negalgn Byadgie Gelaw
- Department of Public Health, Mizan Aman Health Science College, Mizan Aman, Southwest Ethiopia People Regional State, Ethiopia
| | - Girma Mamo Zegene
- Department of Public Health, Mizan Aman Health Science College, Mizan Aman, Southwest Ethiopia People Regional State, Ethiopia
| | - Tizita Teshome
- Department of Environmental Health Sciences and Technology, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tesfalem Getahun
- Department of Environmental Health Sciences and Technology, Institute of Health, Jimma University, Jimma, Ethiopia
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Precha N, Sukmai S, Hengbaru M, Chekoh M, Laohaprapanon S, Makkaew P, Dom NC. Knowledge, attitudes, and practices regarding antibiotic use and resistance among health science and non-health science university students in Thailand. PLoS One 2024; 19:e0296822. [PMID: 38180959 PMCID: PMC10769033 DOI: 10.1371/journal.pone.0296822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/19/2023] [Indexed: 01/07/2024] Open
Abstract
Antibiotic-resistant bacteria (ARB) have been recognized as one of the global health issues affecting humans, animals, and the environment. A lack of knowledge, negative attitudes, and irrational drug use can make significant contributions to the spread of ARB. This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding antibiotic use and resistance among health science (HS) and non-health science (NHS) students and to determine the factors that influence their KAP concerning antibiotic use and resistance. A cross-sectional study was conducted among 404 HS and NHS students in Southern Thailand from December 2021 to March 2022. The students who fulfilled the study inclusion criteria responded to a questionnaire that had five dimensions. Descriptive statistics were used to analyze the qualitative variables, and Fisher's exact test was applied to compare the demographic variables, KAP responses between the HS and NHS students. The KAP regarding antibiotic use and resistance for each variable were compared using the Mann-Whitney U test and Kruskal-Wallis H test. Spearman's correlation test was used to estimate the correlation between the variables and KAP. A total of 404 (HS,162; NHS,242) students completed the self-administered questionnaire. The students' highest score was for attitude, followed by practice and knowledge. Our findings revealed that the HS students had higher levels of KAP correlated with antibiotic use and resistance than the NHS students (P < 0.001). The higher KAP scores were among the more senior students, which indicates that instruction on antibiotics was effective in their curriculum. Antibiotic use and resistance knowledge and attitudes should be conveyed to all university students via academic curriculum. Such interventions could set the standard for rational antibiotic use as well as long-term prevention and control of antibiotic-resistant bacteria.
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Affiliation(s)
- Nopadol Precha
- Department of Environmental Health and Technology, School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
- Excellent Center for Dengue and Community Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Suppachai Sukmai
- Department of Environmental Health and Technology, School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Muhammadsarif Hengbaru
- Department of Environmental Health and Technology, School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Muhammadkaddfee Chekoh
- Department of Environmental Health and Technology, School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Sawanya Laohaprapanon
- Department of Environmental Health and Technology, School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Prasert Makkaew
- Department of Environmental Health and Technology, School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
- Excellent Center for Dengue and Community Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Nazri Che Dom
- Centre of Environmental Health and Safety Studies, Facultyof Health Sciences, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
- Integrated Mosquito Research Group (I-MeRGe), Universiti Teknologi MARA (UiTM), Selangor, Malaysia
- Institute for Biodiversity and Sustainable Development (IBSD), Universiti Teknologi MARA (UiTM), Selangor, Malaysia
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13
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Parambil AM, Prasad A, Tomar AK, Ghosh I, Rajamani P. Biogenic carbon dots: a novel mechanistic approach to combat multidrug-resistant critical pathogens on the global priority list. J Mater Chem B 2023; 12:202-221. [PMID: 38073612 DOI: 10.1039/d3tb02374e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
This study delves into investigating alternative methodologies for anti-microbial therapy by focusing on the mechanistic assessment of carbon dots (CDs) synthesized from F. benghalensis L. extracts. These biogenic CDs have shown remarkable broad-spectrum anti-bacterial activity even against multi-drug resistant (MDR) bacterial strains, prompting a deeper examination of their potential as novel anti-microbial agents. The study highlights the significant detrimental impact of CDs on bacterial cells through oxidative damage, which disrupts the delicate balance of ROS control within the cells. Notably, even at low doses, the anti-bacterial activity of CDs against MDR strains of P. aeruginosa and E. cloacae is highly effective, demonstrating their promise as potent antimicrobial agents. The research sheds light on the capacity of CDs to generate ROS, leading to membrane lipid peroxidation, loss of membrane potential, and rupture of bacterial cell membranes, resulting in cytoplasmic leakage. SEM and TEM analysis revealed time-dependent cell surface, morphological, and ultrastructural changes such as elongation of the cells, irregular surface protrusion, cell wall and cell membrane disintegration, internalization, and aggregations of CDs. These mechanisms offer a comprehensive explanation of how CDs exert their anti-bacterial effects. We also determined the status of plasma membrane integrity and evaluated live (viable) and dead cells upon CD exposure by flow cytometry. Furthermore, comet assay, biochemical assays, and SDS PAGE identify DNA damage, carbohydrate and protein leakage, and distinct differences in protein expression, adding another layer of understanding to the mechanisms behind CDs' anti-bacterial activity. These findings pave the way for future research on managing ROS levels and developing CDs with enhanced anti-bacterial properties, presenting a breakthrough in anti-microbial therapy.
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Affiliation(s)
- Ajith Manayil Parambil
- School of Environmental Sciences, Jawaharlal Nehru University (JNU), New Delhi 110067, India.
| | - Abhinav Prasad
- School of Environmental Sciences, Jawaharlal Nehru University (JNU), New Delhi 110067, India.
| | - Anuj Kumar Tomar
- School of Environmental Sciences, Jawaharlal Nehru University (JNU), New Delhi 110067, India.
| | - Ilora Ghosh
- School of Environmental Sciences, Jawaharlal Nehru University (JNU), New Delhi 110067, India.
| | - Paulraj Rajamani
- School of Environmental Sciences, Jawaharlal Nehru University (JNU), New Delhi 110067, India.
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Aboushady AT, Sujan MJ, Pham K, Clark A, Marks F, Holm M, Joh HS, Poudyal N, Stelling J. Key Recommendations for Antimicrobial Resistance Surveillance: Takeaways From the CAPTURA Project. Clin Infect Dis 2023; 77:S581-S587. [PMID: 38118016 PMCID: PMC10732552 DOI: 10.1093/cid/ciad487] [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] [Indexed: 12/22/2023] Open
Abstract
Antimicrobial resistance (AMR) is a growing global public health challenge associated with 4.95 million deaths in 2019 and an estimated 10 million deaths per year by 2050 in the absence of coordinated action. A robust AMR surveillance system is therefore required to avert such a scenario. Based on an analysis of country-level AMR data in 8 Capturing Data on Antimicrobial Resistance Patterns and Trends in Use in Regions of Asia (CAPTURA) countries, we present a list of key recommendations to strengthen AMR surveillance. We propose 10 primary considerations under 3 broad categories, including recommendations on (1) laboratory and testing practices, (2) data management and analysis, and (3) data use.
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Affiliation(s)
- Ahmed Taha Aboushady
- Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - Kien Pham
- International Vaccine Institute, Seoul, Republic of Korea
| | - Adam Clark
- Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Florian Marks
- International Vaccine Institute, Seoul, Republic of Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar
| | - Marianne Holm
- International Vaccine Institute, Seoul, Republic of Korea
| | - Hea Sun Joh
- International Vaccine Institute, Seoul, Republic of Korea
| | - Nimesh Poudyal
- International Vaccine Institute, Seoul, Republic of Korea
| | - John Stelling
- Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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15
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Attram N, Dela H, Behene E, Kyei NNA, Ocansey K, Yanney JN, Nyarko EO, Addo KK, Koram KA, Fox A, Letizia A, Sanders T. Antimicrobial use of patients with sexually transmitted infection symptoms prior to presentation at five health facilities in Southern Ghana. Antimicrob Resist Infect Control 2023; 12:146. [PMID: 38093385 PMCID: PMC10720218 DOI: 10.1186/s13756-023-01351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Unregulated and inappropriate antimicrobial use are major contributors to the evolution of antimicrobial resistance worldwide. It is important to monitor and collect data on the use of antibiotics at health facilities and in the general population in order to support antimicrobial stewardship programs. METHODS As part of a gonorrhea surveillance study that was conducted from June 2012 to Jan 2018, we administered a questionnaire to elicit information on the types of antimicrobials used by individuals to treat symptoms of a gonorrhea infection prior to presenting at five health facilities in Southern Ghana. RESULTS Almost one-third (383/1,349; 28%) of study participants admitted taking one or more antimicrobial types before hospital presentation, while 138/383 (36%) of those who took antimicrobials could not remember what they ingested. A greater percentage of individuals who reported prior antimicrobial use before presentation at a health facility tested positive for gonorrhea by NAAT (30%), in contrast to 24% for those without prior treatment (p = 0.004). Penicillin and its derivatives, as well as ciprofloxacin and doxycycline, were the most used, while a few individuals reported taking drugs such as kanamycin and rifampin. Males were more likely than females to take an antimicrobial prior to attending a health center. CONCLUSION In order to curb excessive and inappropriate antimicrobial use, antibiotics used by patients before presenting at hospitals ought to be investigated by healthcare providers. It is recommended that health professionals receive continuing education on the consequences of unregulated antimicrobial use.
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Affiliation(s)
- Naiki Attram
- Naval Medical Research Unit-EURAFCENT, Accra, Ghana.
| | - Helena Dela
- Naval Medical Research Unit-EURAFCENT, Accra, Ghana
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Eric Behene
- Naval Medical Research Unit-EURAFCENT, Accra, Ghana
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Nicholas N A Kyei
- Ghana Armed Forces Health Directorate, 37 Military Hospital, Accra, Ghana
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Heidelberg Institute of Global Health, Heidelberg University, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Karen Ocansey
- Naval Medical Research Unit-EURAFCENT, Accra, Ghana
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Jennifer N Yanney
- Naval Medical Research Unit-EURAFCENT, Accra, Ghana
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Edward O Nyarko
- Ghana Armed Forces Health Directorate, 37 Military Hospital, Accra, Ghana
| | - Kennedy K Addo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Kwadwo A Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Anne Fox
- Naval Medical Research Unit-EURAFCENT, Accra, Ghana
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El-Demerdash AS, Orady RM, Matter AA, Ebrahem AF. An Alternative Approach Using Nano-garlic Emulsion and its Synergy with Antibiotics for Controlling Biofilm-Producing Multidrug-Resistant Salmonella in Chicken. Indian J Microbiol 2023; 63:632-644. [PMID: 38034905 PMCID: PMC10682320 DOI: 10.1007/s12088-023-01124-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 10/18/2023] [Indexed: 12/02/2023] Open
Abstract
Surface-growing antibiotic-resistant pathogenic Salmonella is emerging as a global health challenge due to its high economic loss in the poultry industry. Their pathogenesis, increasing antimicrobial resistance, and biofilm formation make them challenging to treat with traditional therapy. The identification of antimicrobial herbal ingredients may provide valuable solutions to solve this problem. Therefore, our aim is to evaluate the potency of nano garlic as the alternative of choice against multidrug-resistant (MDR) Salmonella isolates using disc diffusion and microdilution assays. Then, checkerboard titration in trays was applied, and FIC was measured to identify the type of interaction between the two antimicrobials. A disc diffusion assay revealed that neomycin was the drug of choice. The range of nano garlic MIC was 12.5-25 μg/ml, while the neomycin MIC range was 32-64 μg/ml. The FIC index established a synergistic association between the two tested drugs in 85% of isolates. An experimental model was used including nano garlic and neomycin alone and in combination against Salmonella infection. The combination therapy significantly improved body productivity and inhibited biofilm formation by more than 50% down regulating the CsgBAD, motB, and sipA operons, which are responsible for curli fimbriae production and biofilm formation in Salmonella serotypes.
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Affiliation(s)
- Azza S. El-Demerdash
- Laboratory of Biotechnology, Department of Microbiology, Agriculture Research Center (ARC), Animal Health Research Institute (AHRI), Zagazig, 44516 Egypt
| | - Rania M. Orady
- Reference Laboratory for Veterinary Quality Control on Poultry Production, Agricultural Research Center, Animal Health Research Institute, Gamasa, Egypt
| | - Ahmed A. Matter
- Reference Laboratory for Veterinary Quality Control on Poultry Production, Agricultural Research Center, Animal Health Research Institute, Gamasa, Egypt
| | - Amera F. Ebrahem
- Reference Laboratory for Veterinary Quality Control on Poultry Production, Agricultural Research Center, Animal Health Research Institute, Gamasa, Egypt
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17
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Denyer Willis L, Kayendeke M, Chandler CIR. The politics of irrationality. Med Anthropol Q 2023; 37:382-395. [PMID: 37703403 PMCID: PMC10947286 DOI: 10.1111/maq.12809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 07/16/2023] [Indexed: 09/15/2023]
Abstract
In siloed discussions of antimicrobial resistance, antibiotic use on farms in the Global South has emerged as a key site for intervention. The antibiotic consumption targeted is not all consumption, but "irrational" consumption. This concept of irrationality is neither new, nor true, but rather is a long-standing form of maintenance work within global health systems. Via an attention to chickens and the antibiotics farmers use to raise them in the suburbs of Kampala, we suggest that claims of irrationality are a central part of constituting what Tania Li has called the 'deficient subject'. In other words, irrationality, like the chicken and the antibiotic, is itself a humanitarian device that maintains a certain condition of governance where 'Africans' are imagined as being in deficit of rationality and good behavior. Claims of irrationality justify (and mask the political nature of) intervention.
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Affiliation(s)
| | | | - Clare IR Chandler
- Department of Global Health and DevelopmentLondon School of Hygiene and Tropical MedicineLondonUK
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Erkihun M, Chanie DN, Siraj YA. Antimicrobial-Resistance Profile of Helicobacter pylori, Obtained from Endoscopic Patients in Bahir Dar, North West Ethiopia. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:7326288. [PMID: 38023659 PMCID: PMC10661867 DOI: 10.1155/2023/7326288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023]
Abstract
Background Antimicrobial resistance for Helicobacter pylori infection is a highly emerging problem throughout the world to treat gastric-associated diseases. People living in developing countries are more likely to acquire a Helicobacter pylori infection and less likely to gate treatment after infection due to poverty. Therefore, the current study was aimed at determining the magnitude and antibiotic-resistance profile of Helicobacter pylori isolated from patients who underwent endoscopic examination. Methods A cross-sectional study was conducted from January to May 2019 at endoscopy service-providing health facilities that are found in Bahir Dar, Ethiopia (Gamby teaching general hospital, Kidane Mihret specialty higher clinic, and Eyasta specialty higher clinic). Data were collected using a pretested, structured questionnaire. Antibiotic susceptibility of Helicobacter pylori isolates from gastric biopsies was determined. Data were analyzed using SPSS version 23. Results The 17.8% proportion of Helicobacter pylori was isolated from 135 endoscopy-examined patients (24/135). The majority of isolates (71% of 17/24) were from males, while only 29% of 7/24) were from females. Antimicrobial-resistance of Helicobacter pylori was high to all commonly prescribed antibiotics: amoxicillin and metronidazole (91.7%), clarithromycin and ciprofloxacin (66.7% each), and tetracycline (37.5%). Conclusion Helicobacter pylori isolates from the current study participants were rather low in number. But the highest antibiotic-resistance profile of Helicobacter pylori was observed. Therefore, these findings alarmingly indicate that routine antimicrobial susceptibility testing against Helicobacter pylori isolates is crucial for better patient management.
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Affiliation(s)
- Mulat Erkihun
- Department of Medical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, Debre Tabor University, P.O. Box 272, Debre Tabor, Ethiopia
| | - Desalegn Nigatu Chanie
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
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Shahi MK, Gompo TR, Sharma S, Pokhrel B, Manandhar S, Jeamsripong S. Situational Analysis and Knowledge, Attitudes, and Practices of Antimicrobial Use and Resistance among Broiler Poultry Farmers in Nepal. Animals (Basel) 2023; 13:3135. [PMID: 37835741 PMCID: PMC10571899 DOI: 10.3390/ani13193135] [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: 09/04/2023] [Revised: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023] Open
Abstract
The purpose of this study was twofold: first, to conduct a situational analysis, and second, to assess the knowledge, attitudes, and practices (KAP) of broiler poultry farmers (BPF) regarding antimicrobial use (AMU) and antimicrobial resistance (AMR). Data were collected from 500 BPF across 40 districts, representing 88.1% of Nepal's broiler poultry population. Among these farmers, 81.0% were male, 59.6% had up to 4 years of experience in poultry farming, and 50.8% had completed at least a high school education. The most used antimicrobials on the farms were doxycycline (23.5%), neomycin (17.1%), and colistin sulfate (9.6%) out of 27 reported antimicrobials. While the BPF exhibited limited knowledge (62.6%) and practice (55.5%) related to AMU and AMR, their overall attitude toward these issues was positive (91.6%). This study also identified significant factors influencing farmers' attitudes toward AMU and AMR. Farmers aged 31-40 showed a stronger inclination compared to other age groups (OR = 4.2, p = 0.02), and those using antimicrobials for preventive purposes had a more favorable attitude compared to those using them for other purposes (OR = 5.9, p = 0.02). In light of these findings, this study recommends the implementation of effective regulatory measures for drug usage, along with awareness programs addressing AMU and AMR to address the issue of AMR in poultry production.
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Affiliation(s)
- Manoj Kumar Shahi
- Nepal Veterinary Council, Tripureshwor, Kathmandu 4600, Nepal; (M.K.S.); (S.M.)
| | - Tulsi Ram Gompo
- Central Veterinary Laboratory, Tripureshwar, Kathmandu 44600, Nepal
| | - Sumit Sharma
- Nepal Veterinary Council, Tripureshwor, Kathmandu 4600, Nepal; (M.K.S.); (S.M.)
| | - Bishal Pokhrel
- Nepal Veterinary Council, Tripureshwor, Kathmandu 4600, Nepal; (M.K.S.); (S.M.)
| | - Srijana Manandhar
- Nepal Veterinary Council, Tripureshwor, Kathmandu 4600, Nepal; (M.K.S.); (S.M.)
| | - Saharuetai Jeamsripong
- Department of Veterinary Public Health, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Rd., Pathumwan, Bangkok 10330, Thailand
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Ramkisson T, Rip D. Carbapenem resistance in Enterobacterales from agricultural, environmental and clinical origins: South Africa in a global context. AIMS Microbiol 2023; 9:668-691. [PMID: 38173973 PMCID: PMC10758576 DOI: 10.3934/microbiol.2023034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/05/2023] [Accepted: 09/15/2023] [Indexed: 01/05/2024] Open
Abstract
Carbapenem agents are regarded as last-resort antibiotics, however, bacterial resistance towards carbapenems has been reported in both clinical and agricultural settings worldwide. Carbapenem resistance, defined as the resistance of a bacteria towards one or more carbapenem drugs, can be mediated in either of, or a combination of, three mechanisms-although, the mechanism mediated through the production of carbapenemases (β-lactamases that are able to enzymatically degrade carbapenems) is of most significance. Of particular concern is the occurrence of carbapenemase producing Enterobacterales (CPE), with literature describing a dramatic increase in resistance globally. In South Africa, increases of carbapenemase activity occurring in Enterobacter species, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa have recently been reported. CPE can also be found in agricultural environments, as global studies have documented numerous instances of CPE presence in various animals such as pigs, cattle, seafood, horses and dogs. However, most reports of CPE occurrence in agricultural settings come from Northern America, Europe and some parts of Asia, where more extensive research has been conducted to understand the CPE phenomenon. In comparison to clinical data, there are limited studies investigating the spread of CPE in agricultural settings in Africa, highlighting the importance of monitoring CPE in livestock environments and the food chain. Further research is necessary to uncover the true extent of CPE dissemination in South Africa. This review will discuss the phenomenon of bacterial antibiotic resistance (ABR), the applications of the carbapenem drug and the occurrence of carbapenem resistance globally.
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Affiliation(s)
- Taish Ramkisson
- Department of Food Science, Stellenbosch University, Stellenbosch, 7600, South Africa
| | - Diane Rip
- Department of Food Science, Stellenbosch University, Stellenbosch, 7600, South Africa
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Graziano G, Notarbartolo V, Priano W, Maida CM, Insinga V, Rinaudo G, Russo A, Palermo R, Vitale F, Giuffrè M. Surveillance of Multidrug-Resistant Pathogens in Neonatal Intensive Care Units of Palermo, Italy, during SARS-CoV-2 Pandemic. Antibiotics (Basel) 2023; 12:1457. [PMID: 37760753 PMCID: PMC10525448 DOI: 10.3390/antibiotics12091457] [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: 08/04/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is a topic of concern, especially in high-level care departments like neonatal intensive care units (NICUs). The systematic use of an "active" epidemiological surveillance system allows us to observe and analyze any changes in microbial distribution, limiting the risk of healthcare-associated infection (HAI) development. METHODS We have conducted a longitudinal observational study in the five NICUs of Palermo, comparing the "pre-pandemic period" (March 2014-February 2020) with the "pandemic" one (March 2020-February 2022). The primary aim of the study was to evaluate the cumulative prevalence of carriage from multi-drug resistant (MDR) bacteria in the cumulative NICUs (NICU C). RESULTS During the "pre-pandemic period", 9407 swabs were collected (4707 rectal, 4700 nasal); on the contrary, during the "pandemic period", a total of 2687 swabs were collected (1345 rectal, 1342 nasal). A statistically significant decrease in MDR-Gram-negative bacteria (GNB) carriage prevalence was detected during the pandemic. At the same time, there was a general worsening of the carriage of carbapenemase-forming MDR-GNB (CARBA-R+) and methicillin-resistant Staphylococcus aureus (MRSA) during the pandemic period. A significant reduction in methicillin-susceptible Staphylococcus aureus (MSSA) carriage was detected too. CONCLUSIONS The surveillance of MDRO carriage in NICUs is fundamental for limiting the social and economic burden of HAIs.
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Affiliation(s)
- Giorgio Graziano
- Clinical Epidemiology Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy; (G.G.); (C.M.M.); (A.R.); (F.V.)
| | - Veronica Notarbartolo
- Neonatology and Neonatal Intensive Care Unit, Ingrassia Hospital, 90132 Palermo, Italy;
| | - Walter Priano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (W.P.); (R.P.)
| | - Carmelo Massimo Maida
- Clinical Epidemiology Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy; (G.G.); (C.M.M.); (A.R.); (F.V.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (W.P.); (R.P.)
| | - Vincenzo Insinga
- Neonatology and Neonatal Intensive Care Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy;
| | - Grazia Rinaudo
- Neonatology and Neonatal Intensive Care Unit, Villa Sofia Cervello Hospitals, 90146 Palermo, Italy;
| | - Arianna Russo
- Clinical Epidemiology Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy; (G.G.); (C.M.M.); (A.R.); (F.V.)
| | - Roberta Palermo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (W.P.); (R.P.)
| | - Francesco Vitale
- Clinical Epidemiology Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy; (G.G.); (C.M.M.); (A.R.); (F.V.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (W.P.); (R.P.)
| | - Mario Giuffrè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (W.P.); (R.P.)
- Neonatology and Neonatal Intensive Care Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy;
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Elgriw N, Métayer V, Drapeau A, François P, Azaiez S, Mastouri M, Rhim H, Elzagheid A, Soufiyah N, Madec JY, Chaouch C, Mansour W, Haenni M. Clonal, Plasmidic and Genetic Diversity of Multi-Drug-Resistant Enterobacterales from Hospitalized Patients in Tripoli, Libya. Antibiotics (Basel) 2023; 12:1430. [PMID: 37760726 PMCID: PMC10525897 DOI: 10.3390/antibiotics12091430] [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: 07/29/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Resistance to extended-spectrum cephalosporins (ESC) and carbapenems in Enterobacterales is a major issue in public health. Carbapenem resistance in particular is associated with increased morbidity and mortality. Moreover, such resistance is often co-harbored with resistance to non-beta-lactam antibiotics, and pathogens quickly become multi-drug-resistant (MDR). Only a few studies have been published on AMR in Libyan hospitals, but all reported worrisome results. Here, we studied 54 MDR isolates that were collected from 49 patients at the Tripoli University Hospital between 2019 and 2021. They were characterized using phenotypic methods, PCR and PFGE, and a sub-set of isolates were short- and long-read whole-genome sequenced. The results showed the frequent occurrence of Klebsiella pneumoniae (49/54), among which several high-risk clones were responsible for the spread of resistance, namely, ST11, ST17, ST101 and ST147. ESC and carbapenem resistance was due to a wide variety of enzymes (CTX-M, OXA-48, NDM, KPC), with their corresponding genes carried by different plasmids, including IncF-IncHI2 and IncF-IncR hybrids. This study highlights that implementation of infection prevention, control and surveillance measures are needed in Libya to fight against AMR.
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Affiliation(s)
- Nada Elgriw
- Department of Microbiology, Libyan Biotechnology Reseaerch Center, Tripoli P.O. Box 30313, Libya;
- Faculty of pharmacy Monastir, Doctoral commission in Pharmaceutical Sciences, University of Monastir, Monastir 5000, Tunisia; (M.M.); (H.R.); (C.C.)
- Laboratory of Transmissible Diseases and Biologically Active Substances LR99ES27, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Véronique Métayer
- Unité Antibiorésistance et Virulence Bactériennes, ANSES—Université de Lyon, 69007 Lyon, France; (V.M.); (A.D.); (P.F.); (J.-Y.M.)
| | - Antoine Drapeau
- Unité Antibiorésistance et Virulence Bactériennes, ANSES—Université de Lyon, 69007 Lyon, France; (V.M.); (A.D.); (P.F.); (J.-Y.M.)
| | - Pauline François
- Unité Antibiorésistance et Virulence Bactériennes, ANSES—Université de Lyon, 69007 Lyon, France; (V.M.); (A.D.); (P.F.); (J.-Y.M.)
| | - Sana Azaiez
- Laboratoire de Recherche Biophysique Métabolique et Pharmacologie Appliquée, Faculté de Médecine Ibn Al Jazzar Sousse, Université de Sousse, LR12ES02, Sousse 4002, Tunisia; (S.A.); (W.M.)
| | - Maha Mastouri
- Faculty of pharmacy Monastir, Doctoral commission in Pharmaceutical Sciences, University of Monastir, Monastir 5000, Tunisia; (M.M.); (H.R.); (C.C.)
- Laboratory of Transmissible Diseases and Biologically Active Substances LR99ES27, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Hajer Rhim
- Faculty of pharmacy Monastir, Doctoral commission in Pharmaceutical Sciences, University of Monastir, Monastir 5000, Tunisia; (M.M.); (H.R.); (C.C.)
- Laboratory of Transmissible Diseases and Biologically Active Substances LR99ES27, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Adam Elzagheid
- Department of Genetic Engineering, Libyan Biotechnology Reseaerch Center, Tripoli P.O. Box 30313, Libya;
| | - Najeeb Soufiyah
- Medical Microbiology and Immunology Department, Faculty of Pharmacy, University of Tripoli, Tripoli P.O. Box 13275, Libya;
| | - Jean-Yves Madec
- Unité Antibiorésistance et Virulence Bactériennes, ANSES—Université de Lyon, 69007 Lyon, France; (V.M.); (A.D.); (P.F.); (J.-Y.M.)
| | - Cherifa Chaouch
- Faculty of pharmacy Monastir, Doctoral commission in Pharmaceutical Sciences, University of Monastir, Monastir 5000, Tunisia; (M.M.); (H.R.); (C.C.)
- Laboratory of Transmissible Diseases and Biologically Active Substances LR99ES27, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Wejdene Mansour
- Laboratoire de Recherche Biophysique Métabolique et Pharmacologie Appliquée, Faculté de Médecine Ibn Al Jazzar Sousse, Université de Sousse, LR12ES02, Sousse 4002, Tunisia; (S.A.); (W.M.)
| | - Marisa Haenni
- Unité Antibiorésistance et Virulence Bactériennes, ANSES—Université de Lyon, 69007 Lyon, France; (V.M.); (A.D.); (P.F.); (J.-Y.M.)
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El-Saadony MT, Saad AM, Yang T, Salem HM, Korma SA, Ahmed AE, Mosa WFA, Abd El-Mageed TA, Selim S, Al Jaouni SK, Zaghloul RA, Abd El-Hack ME, El-Tarabily KA, Ibrahim SA. Avian campylobacteriosis, prevalence, sources, hazards, antibiotic resistance, poultry meat contamination, and control measures: a comprehensive review. Poult Sci 2023; 102:102786. [PMID: 37454641 PMCID: PMC10371856 DOI: 10.1016/j.psj.2023.102786] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/05/2023] [Accepted: 05/13/2023] [Indexed: 07/18/2023] Open
Abstract
Avian campylobacteriosis is a vandal infection that poses human health hazards. Campylobacter is usually colonized in the avian gut revealing mild signs in the infected birds, but retail chicken carcasses have high contamination levels of Campylobacter spp. Consequently, the contaminated avian products constitute the main source of human infection with campylobacteriosis and result in severe clinical symptoms such as diarrhea, abdominal pain, spasm, and deaths in sensitive cases. Thus, the current review aims to shed light on the prevalence of Campylobacter in broiler chickens, Campylobacter colonization, bird immunity against Campylobacter, sources of poultry infection, antibiotic resistance, poultry meat contamination, human health hazard, and the use of standard antimicrobial technology during the chicken processing of possible control strategies to overcome such problems.
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Affiliation(s)
- Mohamed T El-Saadony
- Department of Agricultural Microbiology, Faculty of Agriculture, Zagazig University, Zagazig, 44511, Egypt
| | - Ahmed M Saad
- Department of Biochemistry, Faculty of Agriculture, Zagazig University, Zagazig, 44511, Egypt
| | - Tao Yang
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Pharmacy, Hainan Medical University, Haikou, 571199, China
| | - Heba M Salem
- Department of Poultry Diseases, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Sameh A Korma
- Department of Food Science, Faculty of Agriculture, Zagazig University, Zagazig, 44511, Egypt
| | - Ahmed Ezzat Ahmed
- Biology Department, College of Science, King Khalid University, Abha, 61413, Saudi Arabia; Research Center for Advanced Materials Science (RCAMS), King Khalid University, Abha, 61413, Saudi Arabia
| | - Walid F A Mosa
- Plant Production Department (Horticulture-Pomology), Faculty of Agriculture, Saba Basha, Alexandria University, Alexandria, 21531, Egypt
| | - Taia A Abd El-Mageed
- Department of Soils and Water, Faculty of Agriculture, Fayoum University, Fayoum, 63514, Egypt
| | - Samy Selim
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, 72388, Saudi Arabia
| | - Soad K Al Jaouni
- Department of Hematology/Oncology, Yousef Abdulatif Jameel Scientific Chair of Prophetic Medicine Application, Faculty of Medicine, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Rashed A Zaghloul
- Department Agricultural Microbiology, Faculty of Agriculture, Benha University, Moshtohor, Qaluybia, 13736, Egypt
| | - Mohamed E Abd El-Hack
- Poultry Department, Faculty of Agriculture, Zagazig University, Zagazig, 44511, Egypt
| | - Khaled A El-Tarabily
- Department of Biology, College of Science, United Arab Emirates University, Al Ain, 15551, United Arab Emirates.
| | - Salam A Ibrahim
- Food Microbiology and Biotechnology Laboratory, Carver Hall, College of Agriculture and Environmental Sciences, North Carolina A & T State University, Greensboro, NC, 27411-1064
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24
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Kandeel SA, Megahed AA. Editorial: Infectious diseases, microbial ecology, and antimicrobial resistance dynamics in food animals. Front Vet Sci 2023; 10:1266980. [PMID: 37614461 PMCID: PMC10443096 DOI: 10.3389/fvets.2023.1266980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/25/2023] Open
Affiliation(s)
- Sahar A. Kandeel
- Department of Animal Medicine (Infectious Diseases), College of Veterinary Medicine, Benha University, Kalyobiya, Egypt
| | - Ameer A. Megahed
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
- Department of Animal Medicine (Internal Medicine), College of Veterinary Medicine, Benha University, Kalyobiya, Egypt
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25
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Garbern SC, Islam MT, Islam K, Ahmed SM, Brintz BJ, Khan AI, Taniuchi M, Platts-Mills JA, Qadri F, Leung DT. Derivation and External Validation of a Clinical Prediction Model for Viral Diarrhea Etiology in Bangladesh. Open Forum Infect Dis 2023; 10:ofad295. [PMID: 37404954 PMCID: PMC10316693 DOI: 10.1093/ofid/ofad295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 05/26/2023] [Indexed: 07/06/2023] Open
Abstract
Background Antibiotics are commonly overused for diarrheal illness in many low- and middle-income countries, partly due to a lack of diagnostics to identify viral cases, in which antibiotics are not beneficial. This study aimed to develop clinical prediction models to predict risk of viral-only diarrhea across all ages, using routinely collected demographic and clinical variables. Methods We used a derivation dataset from 10 hospitals across Bangladesh and a separate validation dataset from the icddr,b Dhaka Hospital. The primary outcome was viral-only etiology determined by stool quantitative polymerase chain reaction. Multivariable logistic regression models were fit and externally validated; discrimination was quantified using area under the receiver operating characteristic curve (AUC) and calibration assessed using calibration plots. Results Viral-only diarrhea was common in all age groups (<1 year, 41.4%; 18-55 years, 17.7%). A forward stepwise model had AUC of 0.82 (95% confidence interval [CI], .80-.84) while a simplified model with age, abdominal pain, and bloody stool had AUC of 0.81 (95% CI, .78-.82). In external validation, the models performed adequately although less robustly (AUC, 0.72 [95% CI, .70-.74]). Conclusions Prediction models consisting of 3 routinely collected variables can accurately predict viral-only diarrhea in patients of all ages in Bangladesh and may help support efforts to reduce inappropriate antibiotic use.
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Affiliation(s)
- Stephanie Chow Garbern
- Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | | | - Kamrul Islam
- Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Sharia M Ahmed
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Ben J Brintz
- Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | - Mami Taniuchi
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
| | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
| | - Firdausi Qadri
- Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Daniel T Leung
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah, USA
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26
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Asad A, Jahan I, Munni MA, Begum R, Mukta MA, Saif K, Faruque SN, Hayat S, Islam Z. Increasing trend of antibiotic resistance in Shigella in Bangladesh: a plasmid-mediated transfer of mphA macrolide resistance gene. RESEARCH SQUARE 2023:rs.3.rs-3080386. [PMID: 37461575 PMCID: PMC10350201 DOI: 10.21203/rs.3.rs-3080386/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
Shigellosis remains a common gastrointestinal disease mostly in children <5 years of age in developing countries. Azithromycin (AZM), a macrolide, is currently the first-line treatment for shigellosis in Bangladesh; ciprofloxacin (CIP) and ceftriaxone (CRO) are also used frequently. We aimed to evaluate the current epidemiology of antimicrobial resistance (AMR) and mechanism(s) of increasing macrolide resistance in Shigella in Bangladesh. A total of 2407 clinical isolates of Shigella from 2009 to 2016 were studied. Over the study period, Shigella sonnei was gradually increasing and become predominant (55%) over Shigella flexneri (36%) by 2016. We used CLSI-guided epidemiological cut-off value (ECV) for AZM in Shigella to set resistance breakpoints (zone-diameter ≤ 15 mm for S. flexneri and ≤ 11 mm for S. sonnei). Between 2009 and 2016, AZM resistance increased from 22% to approximately 60%, CIP resistance increased by 40%, and CRO resistance increased from zero to 15%. The mphA gene was the key macrolide resistance factor in Shigella; a 63MDa conjugative middle-range plasmid was harboring AZM and CRO resistance factors. Our findings show that, especially after 2014, there has been a rapid increase in resistance to the three most effective antibiotics. The rapid spread of macrolide (AZM) resistance genes among Shigella are driven by horizontal gene transfer rather than direct lineage.
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Affiliation(s)
| | - Israt Jahan
- International Centre for Diarrhoeal Disease Research
| | | | - Ruma Begum
- International Centre for Diarrhoeal Disease Research
| | | | - Kazi Saif
- International Centre for Diarrhoeal Disease Research
| | | | - Shoma Hayat
- International Centre for Diarrhoeal Disease Research
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27
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Sheng J, Cave R, Ter-Stepanyan MM, Kotsinyan N, Chen J, Zhang L, Jiang T, Mkrtchyan HV. Whole-Genome Sequencing and Comparative Genomics Analysis of a Newly Emerged Multidrug-Resistant Klebsiella pneumoniae Isolate of ST967. Microbiol Spectr 2023; 11:e0401122. [PMID: 37022188 PMCID: PMC10269624 DOI: 10.1128/spectrum.04011-22] [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: 10/02/2022] [Accepted: 03/16/2023] [Indexed: 04/07/2023] Open
Abstract
Klebsiella pneumoniae is a common cause of hospital- and community-acquired infections globally, yet its population structure remains unknown for many regions, particularly in low- and middle-income countries (LMICs). Here, we report for the first-time whole-genome sequencing (WGS) of a multidrug-resistant K. pneumoniae isolate, ARM01, recovered from a patient in Armenia. Antibiotic susceptibility testing revealed that ARM01 was resistant to ampicillin, amoxicillin-clavulanic acid, ceftazidime, cefepime, norfloxacin, levofloxacin, and chloramphenicol. Genome sequencing analysis revealed that ARM01 belonged to sequence type 967 (ST967), capsule type K18, and antigen type O1. ARM01 carried 13 antimicrobial resistance (AMR) genes, including blaSHV-27, dfrA12, tet(A), sul1, sul2, catII.2, mphA, qnrS1, aadA2, aph3-Ia, strA, and strB and the extended-spectrum β-lactamase (ESBL) gene blaCTX-M-15, but only one known virulence factor gene, yagZ/ecpA, and one plasmid replicon, IncFIB(K)(pCAV1099-114), were detected. The plasmid profile, AMR genes, virulence factors, accessory gene profile, and evolutionary analyses of ARM01 showed high similarity to isolates recovered from Qatar (SRR11267909 and SRR11267906). The date of the most recent common ancestor (MRCA) of ARM01 was estimated to be around 2017 (95% confidence interval [CI], 2017 to 2018). Although in this study, we report the comparative genomics analysis of only one isolate, it emphasizes the importance of genomic surveillance for emerging pathogens, urging the need for implementation of more effective infection prevention and control practices. IMPORTANCE Whole-genome sequencing and population genetics analysis of K. pneumoniae are scarce from LMICs, and none has been reported for Armenia. Multilevel comparative analysis revealed that ARM01 (an isolate belonging to a newly emerged K. pneumoniae ST967 lineage) was genetically similar to two isolates recovered from Qatar. ARM01 was resistant to a wide range of antibiotics, reflecting the unregulated usage of antibiotics (in most LMICs, antibiotic use is typically unregulated.) Understanding the genetic makeup of these newly emerging lineages will aid in optimizing antibiotic use for patient treatment and contribute to the worldwide efforts of pathogen and AMR surveillance and implementation of more effective infection prevention and control strategies.
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Affiliation(s)
- Jie Sheng
- Institute of Systems Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- Suzhou Institute of Systems Medicine, Suzhou, China
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Rory Cave
- School of Biomedical Sciences, University of West London, London, United Kingdom
| | - Mary M. Ter-Stepanyan
- Yerevan State Medical University after Mkhitar Heratsi, Faculty of Public Health, Department of Epidemiology, Yerevan, Republic of Armenia
- Research Center of Maternal and Child Health Protection, Yerevan, Armenia
| | - Nune Kotsinyan
- National Centre for Disease Control and Prevention, Yerevan, Armenia
| | - Jiazhen Chen
- Department of Infectious Disease, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Zhang
- Institute of Systems Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- Suzhou Institute of Systems Medicine, Suzhou, China
| | - Taijiao Jiang
- Institute of Systems Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- Suzhou Institute of Systems Medicine, Suzhou, China
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- Guangzhou Laboratory, Guangzhou, China
| | - Hermine V. Mkrtchyan
- School of Biomedical Sciences, University of West London, London, United Kingdom
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28
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Tenzin J, Tshomo KP, Wangda S, Gyeltshen W, Tshering G. Knowledge, attitude and practice on antimicrobial use and antimicrobial resistance among competent persons in the community pharmacies in Bhutan. Front Public Health 2023; 11:1113239. [PMID: 37397770 PMCID: PMC10308045 DOI: 10.3389/fpubh.2023.1113239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/11/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Since the discovery, antimicrobials have been used to treat variety of infections both in humans and animals caused by microbes. However, with the increasing use, microbes developed resistance to the antimicrobials and many of the antimicrobials became ineffective against certain microbes. Many factors are reported to contribute to the resistance of microbes to antimicrobials. One contributing factor is the misuse and overuse of antibiotics which mainly occur due to the lack of knowledge, careless attitudes, and incorrect practices about use of antibiotics. Methods This cross-sectional survey study was conducted among the competent persons (CP) in the community pharmacies in Bhutan, with the aim to assess their knowledge, attitude and practice (KAP) on antimicrobial use (AMU) and antimicrobial resistance (AMR). Results Results from the survey revealed that the competent persons had good level of knowledge about antimicrobial use and antimicrobial resistance. They also had favourable attitude towards antimicrobial resistance and rational use of antimicrobials. Their knowledge and attitude had led to good practices while dispensing antimicrobials from their pharmacies. However, almost all of them had never had any opportunity to take part in activities related to antimicrobial use and antimicrobial resistance that were organized by the public sector. Many of them did not even hear or know about the existence of the policies on use of antimicrobials or on curbing antimicrobial resistance in the country. Conclusion Involvement of the community pharmacies through trainings and participations in policy making processes is seen as a vital mechanism that can eventually help achieve the goals in the national drive towards reducing antimicrobial resistance.
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Shohag MH, Kuddus SA, Brishty EMS, Chowdhury SS, Hossain MT, Hasan M, Khan SI, Hossain M, Reza HM. Post-market quality assessment of 22 ciprofloxacin brands by HPLC available in Bangladesh market. Heliyon 2023; 9:e17180. [PMID: 37342574 PMCID: PMC10277576 DOI: 10.1016/j.heliyon.2023.e17180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023] Open
Abstract
Antibiotic resistance has been recognized as a public health threat in recent years, and mortality due to resistance is increasing alarmingly every year. Antibiotic resistance, among many factors, may arise due to the consumption of substandard antibiotic brands that provide subnormal levels of the drug in the blood. Post-market evaluation can provide important information in assessing pharmaceutical products in terms of quality, purity, and therapeutic aspects. Ciprofloxacin, a broad-spectrum antibiotic, has been used against a wide range of infectious diseases in Bangladesh. The present study aimed to determine the quality attributes of twenty-two commonly prescribed brands of ciprofloxacin 500 mg tablet collected from Dhaka city and the rural regions of Jessore. RP-HPLC coupled with UV-visible spectrophotometry was used to determine the potency of ciprofloxacin in tablets, and the zone of inhibition was determined using Kirby-Bauer's disc diffusion method to assess the antimicrobial efficacy against different strains of microorganisms. We found that 95.45% of brands (21 out of 22 brands) of ciprofloxacin tablets met United States Pharmacopoeia (USP) and British Pharmacopoeia (BP) specified potency, whereas one brand failed. From dissolution studies, we observed that 68.2% of brands (15 out of 22 brands) followed USP/NF dissolution test specifications, whereas 31.8% (7 out of 22 brands) failed to release 80% of the labeled amount of drug within 30 min. Drug release kinetics data showed that most brands followed the Weibull drug release kinetic model. Fit factor analysis exhibited that 8 brands out of 22 (36.4%) failed to comply similar dissolution profiles with the reference product. Minimum inhibitory concentrations, assessed against five bacterial strains, further showed good antimicrobial sensitivity by all brands.
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30
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Zia S, Alkheraije KA. Recent trends in the use of bacteriophages as replacement of antimicrobials against food-animal pathogens. Front Vet Sci 2023; 10:1162465. [PMID: 37303721 PMCID: PMC10247982 DOI: 10.3389/fvets.2023.1162465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/06/2023] [Indexed: 06/13/2023] Open
Abstract
A major public health impact is associated with foodborne illnesses around the globe. Additionally, bacteria are becoming more resistant to antibiotics, which pose a global threat. Currently, many scientific efforts have been made to develop and implement new technologies to combat bacteria considering the increasing emergence of multidrug-resistant bacteria. In recent years, there has been considerable interest in using phages as biocontrol agents for foodborne pathogens in animals used for food production and in food products themselves. Foodborne outbreaks persist, globally, in many foods, some of which lack adequate methods to control any pathogenic contamination (like fresh produce). This interest may be attributed both to consumers' desire for more natural food and to the fact that foodborne outbreaks continue to occur in many foods. Poultry is the most common animal to be treated with phage therapy to control foodborne pathogens. A large number of foodborne illnesses worldwide are caused by Salmonella spp. and Campylobacter, which are found in poultry and egg products. Conventional bacteriophage-based therapy can prevent and control humans and animals from various infectious diseases. In this context, describing bacteriophage therapy based on bacterial cells may offer a breakthrough for treating bacterial infections. Large-scale production of pheasants may be economically challenging to meet the needs of the poultry market. It is also possible to produce bacteriophage therapy on a large scale at a reduced cost. Recently, they have provided an ideal platform for designing and producing immune-inducing phages. Emerging foodborne pathogens will likely be targeted by new phage products in the future. In this review article, we will mainly focus on the Bacteriophages (phages) that have been proposed as an alternative strategy to antibiotics for food animal pathogens and their use for public health and food safety.
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Affiliation(s)
- Sana Zia
- Department of Zoology, Government Sadiq College Women University Bahawalpur, Bahawalpur, Pakistan
| | - Khalid A. Alkheraije
- Department of Veterinary Medicine College of Agriculture and Veterinary Medicine, Qassim University, Buraidah, Saudi Arabia
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31
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Shankar K, Agarwal S, Mishra S, Bhatnagar P, Siddiqui S, Abrar I. A review on antimicrobial mechanism and applications of graphene-based materials. BIOMATERIALS ADVANCES 2023; 150:213440. [PMID: 37119697 DOI: 10.1016/j.bioadv.2023.213440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/01/2023]
Abstract
In recent years, graphene and its derivatives, owing to their phenomenal surface, and mechanical, electrical, and chemical properties, have emerged as advantageous materials, especially in terms of their potential for antimicrobial applications. Particularly important among graphene's derivatives is graphene oxide (GO) due to the ease with which its surface can be modified, as well as the oxidative and membrane stress that it exerts on microbes. This review encapsulates all aspects regarding the functionalization of graphene-based materials (GBMs) into composites that are highly potent against bacterial, viral, and fungal activities. Governing factors, such as lateral size (LS), number of graphene layers, solvent and GBMs' concentration, microbial shape and size, aggregation ability of GBMs, and especially the mechanisms of interaction between composites and microbes are discussed in detail. The current and potential applications of these antimicrobial materials, especially in dentistry, osseointegration, and food packaging, have been described. This knowledge can further drive research that aims to look for the most suitable components for antimicrobial composites. The need for antimicrobial materials has seldom been more felt than during the COVID-19 pandemic, which has also been highlighted here. Possible future research areas include the exploration of GBMs' ability against algae.
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Affiliation(s)
- Krishna Shankar
- Department of Chemical Engineering, Birla Institute of Technology and Science, Pilani - Hyderabad Campus, Shameerpet, Hyderabad, Telangana 500078, India
| | - Satakshi Agarwal
- Department of Chemical Engineering, Birla Institute of Technology and Science, Pilani - Hyderabad Campus, Shameerpet, Hyderabad, Telangana 500078, India
| | - Subham Mishra
- Department of Chemical Engineering, Birla Institute of Technology and Science, Pilani - Hyderabad Campus, Shameerpet, Hyderabad, Telangana 500078, India
| | - Pranshul Bhatnagar
- Department of Chemical Engineering, Birla Institute of Technology and Science, Pilani - Hyderabad Campus, Shameerpet, Hyderabad, Telangana 500078, India
| | - Sufiyan Siddiqui
- Department of Chemical Engineering, Birla Institute of Technology and Science, Pilani - Hyderabad Campus, Shameerpet, Hyderabad, Telangana 500078, India
| | - Iyman Abrar
- Department of Chemical Engineering, Birla Institute of Technology and Science, Pilani - Hyderabad Campus, Shameerpet, Hyderabad, Telangana 500078, India.
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Thal DA, Mettenleiter TC. One Health—Key to Adequate Intervention Measures against Zoonotic Risks. Pathogens 2023; 12:pathogens12030415. [PMID: 36986337 PMCID: PMC10057313 DOI: 10.3390/pathogens12030415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/25/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Zoonotic diseases are a heterogenous group of infections transmittable between humans and vertebrate animal species. Globally, endemic and emerging zoonoses are responsible for high social and economic costs. Due to the particular positioning of zoonoses at the human-animal-environment interface, zoonotic disease control is an integral part of One Health, which recognizes the close link between human, animal and ecosystem health. During recent years, the validity of the One Health approach has been recognized by academia and policy makers. However, gaps are still evident, particularly in the implementation of the concept as a unifying, integrated approach for different sectors and disciplines for the control of zoonoses. For example, while cooperation between human and veterinary medicine has made significant progress, networking with environmental sciences leaves room for improvement. Examination of individual intervention measures can help to gain valuable insights for future projects, and help to identify existing gaps. This is also a task for the One Health High-Level Expert Panel, which was established by WHO, OIE, FAO and UNEP to give science-based strategic advice on One Health measures. Overall, we should aim to learn from current situations, and to identify the best practice examples available, to continuously develop and improve One Health concepts for the control of zoonoses.
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Rahbi FA, Salmi IA, Khamis F, Balushi ZA, Pandak N, Petersen E, Hannawi S. Physicians' attitudes, knowledge, and practices regarding antibiotic prescriptions. J Glob Antimicrob Resist 2023; 32:58-65. [PMID: 36584969 DOI: 10.1016/j.jgar.2022.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 12/06/2022] [Accepted: 12/17/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Inappropriate and overuse of antimicrobials, incorrect dosing, and extended duration are some of the leading causes of antibiotic-resistance that have led to the development of antimicrobial resistance (AMR). We aimed to evaluate knowledge, attitudes, and practices regarding rational antibiotic prescribing among physicians in a teaching hospital in Oman, with the goal of identifying knowledge gaps and interventions that could lead to judicious use of antimicrobials and reduce the emergence of resistant organisms METHODS: A cross-sectional study assessing physicians' knowledge of and attitudes towards prescribing antibiotics was conducted at the Royal Hospital from 15 January to 31 March 2020. Likert scales were used to evaluate physicians' awareness and perception of personal performance regarding the care of patients with infections and rational use of antibiotics. RESULTS Inadequate hand washing was regarded as the most important factor contributing to AMR (51.6%), followed by widespread use of antibiotics (49%), prescribing broad-spectrum antibiotics (47.3%), lack of effective narrow-spectrum antibiotics (47.3%), inappropriate duration of antibiotic therapy (46.2%), inappropriate empirical choice of antibiotics (45.1%), poor access to information on local antibiotic resistance patterns (40.8%), and inadequate restrictions on antibiotic prescribing (34.4%). Other factors contributing to AMR such as lack of local hospital guidelines on antibiotic usage, random mutations in microbes, patient demands and expectations for antibiotics, and the role of pharmaceutical companies in advertising and promoting use of antibiotics were deemed important by 33.3%, 26.8%, 22.5% and 20.4%, respectively. CONCLUSIONS AMR is a global health threat with significant effect on the health system and the economy. Misuse and overuse of antimicrobials remain the main drivers for the development of drug-resistant pathogens. Identifying knowledge gaps and planning interventions that could lead to judicious use of antimicrobials including establishing an Antimicrobial Stewardship Program are of paramount importance in reducing AMR in the twenty-first century and beyond.
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Affiliation(s)
| | - Issa Al Salmi
- Renal Medicine, The Royal Hospital, Muscat, Oman; Internal Medicine, Oman Medical Specialty Board, Muscat, Oman.
| | - Faryal Khamis
- Infectious Disease Unit, Department of Medicine , The Royal Hospital, Muscat, Oman
| | - Zakaria Al Balushi
- Infectious Disease Unit, Department of Medicine , The Royal Hospital, Muscat, Oman
| | - Nenad Pandak
- Infectious Disease Unit, Department of Medicine , The Royal Hospital, Muscat, Oman
| | - Eskild Petersen
- European Society for Clinical Microbiology and Infectious Diseases, Basel, Switzerland; Department of Molecular Medicine, The University of Pavia, Pavia, Italy; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Suad Hannawi
- Internal Medicine Department, Ministry of Health and Prevention, Dubai, UAE
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Alhaji NB, Odetokun IA, Adamu AM, Hassan A, Lawan MK, Fasina FO. Antimicrobial usage and associated residues and resistance emergence in smallholder beef cattle production systems in Nigeria: A One Health challenge. Vet Res Commun 2023; 47:233-245. [PMID: 35641718 DOI: 10.1007/s11259-022-09944-1] [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: 11/14/2021] [Accepted: 05/20/2022] [Indexed: 01/27/2023]
Abstract
Livestock intensification has facilitated antimicrobial use (AMU) with consequent antimicrobial resistance (AMR) development. We assessed AMU in beef farms, pathways for residues and resistance dissemination to humans, risk status, residues identification, and drivers for antimicrobial residues and resistance emergence in beef cattle production systems. A cross-sectional survey was conducted in randomly selected beef farms of Northern Nigeria, between 2018 and 2019. Traffic Light model and Disc Diffusion Test were used to assess risk status and determined residues, respectively. Data was analyzed using descriptive statistics and logistic regression models at 95% confidence level. About 92% (n = 608) farmers participated. The majority of farmers managing intensive (78.9%) and semi-intensive (76.6%) farms did not follow antimicrobial dosage instructions. Also, 72.4% and 83.9% of the farmers on intensive and semi-intensive systems, respectively, did not observed withdrawal periods after AMU. Furthermore, 71.5% farmers in intensive and 53.2% in semi-intensive farms used antimicrobials as growth promoters. Antimicrobials frequently used include tetracyclines, sulfonamides and penicillin. Antimicrobial residues and resistance dissemination pathways from beef herds were: consumption of contaminated meat with residues (p = 0.007); contacts with contaminated cattle and fomites (p < 0.001); and contaminated manure and aerosols in farm environment (p = 0.003). Significant drivers of residues and resistance emergence were antimicrobial misuse and overuse (OR = 2.72; 95% CI:1.93-3.83), non-enforcement of laws (OR = 2.98; 95% CI:2.11-4.21), poor education and expertise (OR = 1.52; 95% CI:1.09-2.12), and husbandry management system (OR = 10.24; 95% CI:6.75-15.54). The majority of intensive (63.6%) and semi-intensive (57.63%) farm systems belonged to Class 3 (Red risk) status. Antimicrobial residues were detected in 48.4% intensively and 34.4% semi-intensively managed farms. The study revealed poor practices of AMU in beef cattle production. Many factors were found to influenced antimicrobial residues and resistance occurrence and dissemination. A 'One Health' approach mitigation with adequate sanitation, hygiene, and good biosecurity measures will assure food safety, public and environmental health.
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Affiliation(s)
- Nma Bida Alhaji
- Department of Public Health and Epidemiology, Niger State Ministry of Livestock and Fisheries, Minna, Nigeria. .,Department of Veterinary Public Health and Preventive Medicine, University of Abuja, Abuja, Nigeria.
| | - Ismail Ayoade Odetokun
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Ilorin, Nigeria
| | - Andrew Musa Adamu
- Department of Veterinary Public Health and Preventive Medicine, University of Abuja, Abuja, Nigeria
| | - Abubakar Hassan
- Department of Veterinary Pathology, University of Ibadan, Ibadan, Nigeria
| | - Mohammed Kabiru Lawan
- Department of Veterinary Public Health and Preventive Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Folorunso Oludayo Fasina
- Emergency Centre for Transboundary Animal Diseases-Food and Agriculture Organization of the United Nations (ECTAD-FAO), Dar es Salaam, Tanzania
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Firissa YB, Shelton D, Azazh A, Engida H, Kifle F, Debebe F. Prevalence and Antimicrobial Sensitivity Patterns of Uropathogens, in Tikur Anbessa Specialized Hospital Emergency Medicine Department Addis Ababa, Ethiopia. Infect Drug Resist 2023; 16:1649-1656. [PMID: 36992968 PMCID: PMC10041979 DOI: 10.2147/idr.s402472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/16/2023] [Indexed: 03/31/2023] Open
Abstract
Background Empirical treatment of infections remains a major contributing factor to the emergence of pathogens that are resistant to antibiotics. The study aimed to assess the prevalence and anti-microbial sensitivity patterns of uropathogens in the Emergency Medicine Department of Tikur Anbessa Hospital, Ethiopia. Methods Urine sample data collected over two years from January 2015 to January 2016 at Tikur Anbessa Hospital's laboratory were retrospectively analyzed for bacterial pathogens, and their antimicrobial susceptibility. Antimicrobial sensitivity tests were done using the disc diffusion technique as per the standard of the Kirby-Bauer method. Results Of the total 220 samples that were collected, 50 (22.7%) were culture-positive. Male to female data ratio was 1:1.1. Escherichia coli was the dominant isolate (50%) followed by Enterococcus species (12%), Enterobacter species (12%), and Klebsiella species (8%). Overall resistance rates to Cotrimoxazole, Ampicillin, Augmentin, and Ceftriaxone were 90.4%, 88.8%, 82.5%, and 79.3%, respectively. The sensitivity rates for Chloramphenicol, Amikacin, Vancomycin, Meropenem, Cefoxitin, and Nitrofurantoin ranged from 72% to 100%. The antibiogram of isolates showed that 43 (86%) isolates were resistant to two or more antimicrobials, and 49 (98%) were resistant to at least one antibiotic. Conclusion and Recommendation Urinary tract infections are mostly caused by Gram-negative bacteria predominantly in females and Escherichia coli are the most common isolates. Resistance rates to Cotrimoxazole, Ampicillin, Augmentin, and Ceftriaxone were high. Chloramphenicol, Amikacin, Vancomycin, Meropenem, Cefoxitin, and Nitrofurantoin are considered appropriate antimicrobials for the empirical treatment of complicated urinary tract infections in the emergency department. Yet, using antibiotics indiscriminately for patients with complicated UTIs may increase the resistance rate and also lead to treatment failure, hence the prescriptions should be revised following the culture and sensitivity results.
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Affiliation(s)
- Yared Boru Firissa
- Emergency Medicine and Critical Care Department, ALERT Hospital, Addis Ababa, Ethiopia
- Correspondence: Yared Boru Firissa, Department of Emergency Medicine and Critical Care, ALERT Hospital, Addis Ababa, 165, Ethiopia, Email
| | - Dominick Shelton
- Emergency Medicine Department, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Aklilu Azazh
- Emergency Medicine and Critical Care Department, Tikur Anbessa Hospital, Addis Ababa, Ethiopia
| | - Hywet Engida
- Emergency Medicine and Critical Care Department, Tikur Anbessa Hospital, Addis Ababa, Ethiopia
| | - Fitsum Kifle
- Network for Perioperative and Critical Care, Addis Ababa, Ethiopia
| | - Finot Debebe
- Emergency Medicine and Critical Care Department, Tikur Anbessa Hospital, Addis Ababa, Ethiopia
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Dougnon V, Legba BB, Gbaguidi B, Agbodjento E, Agbankpe AJ, Rocha D, Ayi I, Azonbakin S, Diallo A, Bonkoungou IJ, Klotoe JR, Agbangla C, Alitonou GA. A review of some medicinal plants with the potential to defeat antimicrobial resistance: Cases of Benin, Togo, Ghana, Burkina Faso, and Cape Verde. INTERNATIONAL JOURNAL OF ONE HEALTH 2022. [DOI: 10.14202/ijoh.2022.124-160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Antimicrobial resistance (AMR) is a global public health problem. In the alternatives being explored for developing new antimicrobials, medicinal plants occupy an important place, particularly in Africa, where they are widely used. This review aims to analyze the potential of medicinal plants from Benin, Togo, Ghana, Burkina-Faso, and Cape Verde in the fight against AMR. A bibliographic search was conducted to explore scientific databases such as PubMed and Google Scholar. During this search, particular attention was given to epidemiological data related to AMR in these countries, medicinal plants traditionally used to treat microbial infections and medicinal plants that have been shown to be active on multidrug-resistant microbial strains. In total, 94 manuscripts were investigated. Epidemiological data showed that the problem of AMR is worsening in each target country. In addition, several medicinal plants have been demonstrated to be effective against microbial strains resistant to conventional antibiotics. A total of 532 medicinal plants were identified according to their ethnomedical uses for the treatment of microbial infections. Scientific evidence was collected on the antimicrobial potential of 91 plants. This study showed the potential of medicinal plants in the fight against AMR. Their documented traditional use, coupled with the evidence of efficacy provided, make them interesting sources for developing new antimicrobials.
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Affiliation(s)
- Victorien Dougnon
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Boris Brice Legba
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Bertin Gbaguidi
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Eric Agbodjento
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Alidehou Jerrold Agbankpe
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Diara Rocha
- Department of Biology, University of Cape Verde, Cape Verde
| | - Irene Ayi
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Ghana
| | - Simon Azonbakin
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | | | - Isidore Juste Bonkoungou
- Department of Biochemistry - Microbiology, University of University Joseph KI ZERBO, Burkina-Faso
| | - Jean Robert Klotoe
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Clément Agbangla
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Guy Alain Alitonou
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
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Hospital-Based Air-Borne and Surface-Borne Bacterial Pathogens and Their Antimicrobial Profiles in Wolaita Sodo, Southern Ethiopia. Int J Microbiol 2022; 2022:5718341. [DOI: 10.1155/2022/5718341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/30/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Background. It is well documented that hospital environments are the niche/reservoir of many clinically important microorganisms, including multidrug-resistant air-borne and surface-borne pathogens. This problem is the most pressing public health concern, particularly in developing countries like Ethiopia, due to its poor infection management system. This study was planned to detect air-borne and surface-borne bacterial pathogens and their antimicrobial resistance patterns in Wolaita Sodo University Comprehensive Hospital, Southern Ethiopia. Method. A laboratory-based cross-sectional study was conducted from May to July 2021. Swabbing and open-plate sample collection methods were used to collect specimens. Standard bacteriological techniques were used to isolate and identify bacterial pathogens. The Mueller-Hinton agar was used to detect the drug susceptibility pattern of bacteria by using the Kirby-Bauer disc diffusion method. Result. From a total of 323 samples tested, 118 (36.5%) showed the growth of bacteria. The detection rate of bacterial pathogens in the intensive care unit (35.4%) was higher than in operation theater. From the total of 118 bacterial isolates, 39.8%, 27.9%, 20.3%, and 11.5% of S. aureus, P. aeruginosa, Klebsiella pneumoniae, and E. coli, respectively, were surface-borne. Whereas 37%, 25%, 20.83, and 16.6% of S. aureus, P. aeruginosa, Klebsiella species, and E. coli, respectively, were air-borne. S. aureus showed a 19.04 to 80.9% range of antimicrobial resistance to different classes of antibiotics from surface specimens. A 12.5–100% range of antibiotic resistance levels was detected for all Gram-negative surface-borne bacterial pathogens. P. aeruginosa was 66.7%, 73.3%, and 73.3% resistant to gentamicin, chloramphenicol, and ceftriaxone, respectively. K. pneumoniae showed 75% and 87.5% resistance to ceftriaxone and ciprofloxacin, respectively, and a completely ampicillin-resistant E. coli was detected. From a total of 48 bacterial pathogens identified from surfaces in the intensive care unit, 34 (70.8%) developed multidrug resistance. Conclusion. A significant prevalence of surface-borne bacterial pathogens was detected. This study revealed that S. aureus, P. aeruginosa, K. pneumoniae, and E. coli were nosocomial infection concerns of the hospital, and this could be the reason for different types of hospital acquired infections in the study area. A high prevalence of MDR was detected in the most surface-borne bacterial isolates.
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38
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Harun MGD, Anwar MMU, Sumon SA, Hassan MZ, Mohona TM, Rahman A, Abdullah SAHM, Islam MS, Kaydos-Daniels SC, Styczynski AR. Rationale and guidance for strengthening infection prevention and control measures and antimicrobial stewardship programs in Bangladesh: a study protocol. BMC Health Serv Res 2022; 22:1239. [PMID: 36207710 PMCID: PMC9540083 DOI: 10.1186/s12913-022-08603-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/26/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Hospital-acquired infections (HAIs) and antimicrobial resistance (AMR) are major global health challenges. Drug-resistant infectious diseases continue to rise in developing countries, driven by shortfalls in infection control measures, antibiotic misuse, and scarcity of reliable diagnostics. These escalating global challenges have highlighted the importance of strengthening fundamental infection prevention and control (IPC) measures and implementing effective antimicrobial stewardship programs (ASP). This study aims to present a framework for enhancing IPC measures and ASP efforts to reduce the HAI and AMR burden in Bangladesh. METHODS This implementation approach will employ a mixed-methods strategy, combining both quantitative and qualitative data from 12 tertiary hospitals in Bangladesh. A baseline assessment will be conducted using the Infection Prevention and Control Assessment Framework (IPCAF) developed by the WHO. We will record IPC practices through direct observations of hand hygiene, personal protective equipment (PPE) utilization, and hospital ward IPC infrastructure. Additionally, data on healthcare providers' knowledge, attitudes, and practices regarding IPC and antibiotic prescribing will be collected using both structured questionnaires and qualitative interviews. We will also assist the hospital leadership with establishing and/or strengthening IPC and ASP committees. Based on baseline assessments of each healthcare facility, tailored interventions and quality improvement projects will be designed and implemented. An end-line assessment will also be conducted after 12 months of intervention using the same assessment tools. The findings will be compared with the baseline to determine changes in IPC and antibiotic stewardship practices. DISCUSSION Comprehensive assessments of healthcare facilities in low-resource settings are crucial for strengthening IPC measures and ASP activities,. This approach to assessing existing IPC and ASP activities will provide policy-relevant data for addressing current shortfalls. Moreover, this framework proposes identifying institutionally-tailored solutions, which will ensure that response activities are appropriately contextualized, aligned with stakeholder priorities, and offer sustainable solutions. CONCLUSION Findings from this study can guide the design and implementation of feasible and sustainable interventions in resource-constrained healthcare settings to address gaps in existing IPC and ASP activities. Therefore, this protocol will be applicable across a broad range of settings to improve IPC and ASP and reduce the burden of hospital-acquired infections and AMR.
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Affiliation(s)
- Md Golam Dostogir Harun
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
| | - Md Mahabub Ul Anwar
- Centers for Disease Control and Prevention (CDC), Bangladesh Country Office, Dhaka, Bangladesh
| | - Shariful Amin Sumon
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Md Zakiul Hassan
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Tahrima Mohsin Mohona
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Aninda Rahman
- Communicable Disease Control, Directorate General of Health Services, Dhaka, Bangladesh
| | | | | | | | - Ashley R Styczynski
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, USA
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39
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Sachdev C, Anjankar A, Agrawal J. Self-Medication With Antibiotics: An Element Increasing Resistance. Cureus 2022; 14:e30844. [PMID: 36451647 PMCID: PMC9704507 DOI: 10.7759/cureus.30844] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/29/2022] [Indexed: 04/04/2023] Open
Abstract
Self-medication refers to the consumption of drugs such as antibiotics by individuals based on their own experience and knowledge, without consulting a doctor either for diagnosis or prescription. The inappropriate use of antibiotics is the primary source of antibiotic resistance (AR) development in microorganisms. As a result, some specific types of microorganisms that are naturally resistant to antibiotics have become considerably more common. Self-medication poses a danger to the advantages of antibiotics since it results in financial burdens on low and middle-income countries (LMICs), management failures, the evolution of antibiotic-resistant bacterial serotypes, and a higher risk of contamination of the general population by such tensions. Antibiotic misuse puts patients at risk for adverse drug reactions, false symptom relief, and the rise of drug-resistant microorganisms. It carries many health risks, chiefly in LMICs. These risks are linked to various factors, including a shortage of medical experts, low-level healthcare facilities, unregulated medication delivery, and negative public perceptions of doctors. The primary issue with self-medication is that majority of the population is uninformed of the harmful consequences of antibiotic resistance and how they might donate to it by self-diagnosing and self-treating with antibiotics. Antibiotic self-medication remains a common practice in society, and educational attainment significantly affects the frequency of this behavior. The article aims to educate the people by showing the development and plausible future to decrease antibiotic misuse. It also tells about the various challenges and prevention of this preceding problem.
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Affiliation(s)
- Chetna Sachdev
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Ashish Anjankar
- Biochemistry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Jayesh Agrawal
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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40
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Anyanwu MU, Ugwu IC, Okorie-Kanu OJ, Ngwu MI, Kwabugge YA, Aneke CI, Chah KF. Sorbitol non-fermenting Escherichia coli and E. coli O157: prevalence and antimicrobial resistance profile of strains in slaughtered food animals in Southeast Nigeria. Access Microbiol 2022. [DOI: 10.1099/acmi.0.000433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Antimicrobial resistance (AMR) is one of the greatest global health challenges. Reliable monitoring of AMR in bacteria in food animals is critical in order to devise mitigation strategies and empiric treatment of infections associated with the organisms. The aim of this study was to isolate sorbitol non-fermenting (SN-F)
Escherichia coli
from food animals (broiler chickens, cattle and pigs) slaughtered at Ikpa Market, Nsukka, Enugu State, Southeast Nigeria, detect
E. coli
O157 and determine the in vitro antimicrobial resistance profile of the
E. coli
strains. A total of 388 faecal samples were collected from randomly selected broiler chickens (n=155), cattle (n=129) and pigs (n=104). Isolation of SN-F
E. coli
was done using tryptic soy broth and cefixime- and potassium tellurite-supplemented sorbitol MacConkey agar (CT-SMAC). SN-F
E. coli
strains were confirmed biochemically and
E. coli
O157 detected serologically using specific
E. coli
O157 latex agglutination test kit. The antimicrobial resistance profile of all strains was established using the disc diffusion method. Overall, 52 (13.4 %) SN-F
E. coli
strains were recovered from the broiler chickens (n=31), cattle (n=12) and pigs (n=9). A significant association (χ2=9.70; P <0.05) was observed between the prevalence of SN-F
E. coli
and animal species.
E. coli
O157 was detected in two of the samples, representing 0.51% of the 388 samples processed. All the
E. coli
strains were resistant to at least one antimicrobial agent tested and 76% were multidrug resistant (MDR). The mean multiple antibiotic resistance indices (MARI) for isolates from chickens, cattle and pig were 0.32, 0.18 and 0.23, respectively. This study showed that a considerable percentage of food animals slaughtered in Nsukka Southeastern Nigeria are potential reservoirs of multiple-drug-resistant SN-F E. coli, including
E. coli
O157 that could spread to humans and the environment.
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Affiliation(s)
- Madubuike U. Anyanwu
- Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Ifeoma C. Ugwu
- Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Onyinye J. Okorie-Kanu
- Department of Veterinary Public Health and Preventive Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Maria I. Ngwu
- Department of Pharmaceutics, University of Nigeria, Nsukka, Nsukka, Enugu, Nigeria
| | - Yakubu A. Kwabugge
- Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Chioma I. Aneke
- Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Kennedy F. Chah
- Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, Enugu, Nigeria
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Waage J, Grace D, Fèvre EM, McDermott J, Lines J, Wieland B, Naylor NR, Hassell JM, Chan K. Changing food systems and infectious disease risks in low-income and middle-income countries. Lancet Planet Health 2022; 6:e760-e768. [PMID: 36087606 PMCID: PMC9451496 DOI: 10.1016/s2542-5196(22)00116-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 06/15/2023]
Abstract
The emergence of COVID-19 has drawn the attention of health researchers sharply back to the role that food systems can play in generating human disease burden. But emerging pandemic threats are just one dimension of the complex relationship between agriculture and infectious disease, which is evolving rapidly, particularly in low-income and middle-income countries (LMICs) that are undergoing rapid food system transformation. We examine this changing relationship through four current disease issues. The first is that greater investment in irrigation to improve national food security raises risks of vector-borne disease, which we illustrate with the case of malaria and rice in Africa. The second is that the intensification of livestock production in LMICs brings risks of zoonotic diseases like cysticercosis, which need to be managed as consumer demand grows. The third is that the nutritional benefits of increasing supply of fresh vegetables, fruit, and animal-sourced foods in markets in LMICs pose new food-borne disease risks, which might undermine supply. The fourth issue is that the potential human health risks of antimicrobial resistance from agriculture are intensified by changing livestock production. For each disease issue, we explore how food system transition is creating unintentional infectious disease risks, and what solutions might exist for these problems. We show that successfully addressing all of these challenges requires a coordinated approach between public health and agricultural sectors, recognising the costs and benefits of disease-reducing interventions to both, and seeking win-win solutions that are most likely to attract broad policy support and uptake by food systems.
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Affiliation(s)
- Jeff Waage
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK.
| | - Delia Grace
- International Livestock Research Institute, Nairobi, Kenya; Natural Resources Institute, University of Greenwich, London, UK
| | - Eric M Fèvre
- International Livestock Research Institute, Nairobi, Kenya; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - John McDermott
- International Food Policy Research Institute, Washington, DC, USA
| | - Jo Lines
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Barbara Wieland
- International Livestock Research Institute, Nairobi, Kenya; Institute of Virology and Immunology, Mittelhäusern, Switzerland; Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Nichola R Naylor
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - James M Hassell
- International Livestock Research Institute, Nairobi, Kenya; Smithsonian National Zoo and Conservation Biology Institute, Washington, DC, USA
| | - Kallista Chan
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
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Singh S, Wilksch JJ, Dunstan RA, Mularski A, Wang N, Hocking D, Jebeli L, Cao H, Clements A, Jenney AWJ, Lithgow T, Strugnell RA. LPS O Antigen Plays a Key Role in Klebsiella pneumoniae Capsule Retention. Microbiol Spectr 2022; 10:e0151721. [PMID: 35913154 PMCID: PMC9431683 DOI: 10.1128/spectrum.01517-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 06/14/2022] [Indexed: 11/24/2022] Open
Abstract
Despite the importance of encapsulation in bacterial pathogenesis, the biochemical mechanisms and forces that underpin retention of capsule by encapsulated bacteria are poorly understood. In Gram-negative bacteria, there may be interactions between lipopolysaccharide (LPS) core and capsule polymers, between capsule polymers with retained acyl carriers and the outer membrane, and in some bacteria, between the capsule polymers and Wzi, an outer membrane protein lectin. Our transposon studies in Klebsiella pneumoniae B5055 identified additional genes that, when insertionally inactivated, resulted in reduced encapsulation. Inactivation of the gene waaL, which encodes the ligase responsible for attaching the repeated O antigen of LPS to the LPS core, resulted in a significant reduction in capsule retention, measured by atomic force microscopy. This reduction in encapsulation was associated with increased sensitivity to human serum and decreased virulence in a murine model of respiratory infection and, paradoxically, with increased biofilm formation. The capsule in the WaaL mutant was physically smaller than that of the Wzi mutant of K. pneumoniae B5055. These results suggest that interactions between surface carbohydrate polymers may enhance encapsulation, a key phenotype in bacterial virulence, and provide another target for the development of antimicrobials that may avoid resistance issues associated with growth inhibition. IMPORTANCE Bacterial capsules, typically comprised of complex sugars, enable pathogens to avoid key host responses to infection, including phagocytosis. These capsules are synthesized within the bacteria, exported through the outer envelope, and then secured to the external surface of the organism by a force or forces that are incompletely described. This study shows that in the important hospital pathogen Klebsiella pneumoniae, the polysaccharide capsule is retained by interactions with other surface sugars, especially the repeated sugar molecule of the LPS molecule in Gram-negative bacteria known as "O antigen." This O antigen is joined to the LPS molecule by ligation, and loss of the enzyme responsible for ligation, a protein called WaaL, results in reduced encapsulation. Since capsules are essential to the virulence of many pathogens, WaaL might provide a target for new antimicrobial development, critical to the control of pathogens like K. pneumoniae that have become highly drug resistant.
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Affiliation(s)
- Shweta Singh
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Jonathan J. Wilksch
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Infection and Immunity Program, Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, Victoria, Australia
| | - Rhys A. Dunstan
- Infection and Immunity Program, Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, Victoria, Australia
| | - Anna Mularski
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Nancy Wang
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Dianna Hocking
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Leila Jebeli
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Hanwei Cao
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Abigail Clements
- Department of Life Sciences, Imperial College London, London, United Kingdom
| | - Adam W. J. Jenney
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Trevor Lithgow
- Infection and Immunity Program, Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, Victoria, Australia
| | - Richard A. Strugnell
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
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Prevalence and Antimicrobial Resistance of Escherichia coli in Chicken Meat and Edible Poultry Organs Collected from Retail Shops and Supermarkets of North Western Province in Sri Lanka. J FOOD QUALITY 2022. [DOI: 10.1155/2022/8962698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Escherichia coli is a commensal bacterium that lives in human and animal intestines. Shiga toxin-producing strains of E. coli STECs are responsible for most food-related E. coli infections. Pathogenic E. coli transmits to human bodies due to the consumption of contaminated, raw, or undercooked food. This study was conducted to identify the prevalence of E. coli contamination in edible poultry meat and meat organs in the North Western Province of Sri Lanka. A total of 250 samples consisting of chicken meat (n = 144) and edible organs (n = 106) were collected from retail shops (n = 181) and supermarkets (n = 69), in both Kurunegala and Puttlam districts. The prevalence of E. coli from 250 chicken meat samples was 66.80% (167/250); E. coli prevalence at retail shops (66.85%) was higher than that at supermarkets (66.67%) and was not statistically significant. E. coli prevalence in chicken meat and edible organs was 65.73% and 69.16%, respectively. Molecular confirmation for the positive samples was done through polymerase chain reaction (PCR) using previously designed primers. An antibiotic susceptibility test was performed according to CLSI using nine antibiotics: ampicillin, amoxicillin, chloramphenicol, ceftazidime, ciprofloxacin, cephalexin, erythromycin, gentamicin, and tetracycline. Most isolates were resistant to erythromycin (80.84%) and amoxicillin (76.05%), while the least resistance was observed for gentamicin (4.79%). This study indicates the potential public health risk associated with chicken sold at retail and supermarket levels in the North Western Province of Sri Lanka.
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Tyasningsih W, Ramandinianto SC, Ansharieta R, Witaningrum AM, Permatasari DA, Wardhana DK, Effendi MH, Ugbo EN. Prevalence and antibiotic resistance of Staphylococcus aureus and Escherichia coli isolated from raw milk in East Java, Indonesia. Vet World 2022; 15:2021-2028. [PMID: 36313841 PMCID: PMC9615504 DOI: 10.14202/vetworld.2022.2021-2028] [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: 04/13/2022] [Accepted: 07/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Raw milk can be a source of food-borne disease transmission and a medium for spreading antibiotic-resistant bacteria. Staphylococcus aureus and Escherichia coli are bacteria that have the pathogenic ability to attack host cells and are capable of harboring antibiotic-resistant genes. This study estimated the prevalence and antibiotic resistance of S. aureus and E. coli isolated from raw milk in East Java, Indonesia. Materials and Methods: Two hundred and fifty raw milk samples were collected from five dairy farms in East Java. S. aureus and E. coli were isolated using their respective selective media, whereas antibiotic susceptibility testing was performed using the Kirby–Bauer disk diffusion method. The methicillin-resistant S. aureus (MRSA) was confirmed using the oxacillin resistance screen agar test, and extended-spectrum beta-lactamase (ESBL)-producing E. coli was determined using the double-disk synergy test. The presence of mecA and blaTEM genes were screened by the polymerase chain reaction method. Results: Results indicated that the prevalence of S. aureus was 138 (55.2%) and that E. coli was 176 (70.4%). Of the 138 S. aureus isolated, 27 (19.6%) were MRSA, and among the 176 E. coli isolates identified, 3 (1.7%) were ESBL producers. The mecA gene was observed in 2 (7.4%) MRSA and all 3 (100%) ESBL-producing E. coli isolated harbored blaTEM genes. Conclusion: The presence of MRSA and ESBL-producing E. coli in raw milk is a serious public health threat, and public awareness should be raised about the dangers posed by these pathogenic organisms.
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Affiliation(s)
- Wiwiek Tyasningsih
- Division of Veterinary Microbiology, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Ribby Ansharieta
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Adiana Mutamsari Witaningrum
- Division of Veterinary Public Health, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Dian Ayu Permatasari
- Division of Veterinary Public Health, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Dhandy Koesoemo Wardhana
- Division of Veterinary Public Health, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Mustofa Helmi Effendi
- Division of Veterinary Public Health, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Emmanuel Nnabuike Ugbo
- Department of Applied Microbiology, Faculty of Science, Ebonyi State University, Abakaliki, Nigeria
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Amponsah OKO, Nagaraja SB, Ayisi-Boateng NK, Nair D, Muradyan K, Asense PS, Wusu-Ansah OK, Terry RF, Khogali M, Buabeng KO. High Levels of Outpatient Antibiotic Prescription at a District Hospital in Ghana: Results of a Cross Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10286. [PMID: 36011917 PMCID: PMC9407799 DOI: 10.3390/ijerph191610286] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/13/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Monitoring of antibiotic prescription practices in hospitals is essential to assess and facilitate appropriate use. This is relevant to halt the progression of antimicrobial resistance. METHODS Assessment of antibiotic prescribing patterns and completeness of antibiotic prescriptions among out-patients in 2021 was conducted at the University Hospital of Kwame Nkrumah University of Science and Technology in the Ashanti region of Ghana. We reviewed electronic medical records (EMR) of 49,660 patients who had 110,280 encounters in the year. RESULTS The patient encounters yielded 350,149 prescriptions. Every month, 33-36% of patient encounters resulted in antibiotic prescription, higher than the World Health Organization's (WHO) recommended optimum of 27%. Almost half of the antibiotics prescribed belonged to WHO's Watch group. Amoxicillin-clavulanic acid (50%), azithromycin (29%), ciprofloxacin (28%), metronidazole (21%), and cefuroxime (20%) were the most prescribed antibiotics. Antibiotic prescribing parameters (indication, name of drug, duration, dose, route, and frequency) were documented in almost all prescriptions. CONCLUSIONS Extending antimicrobial stewardship to the out-patient settings by developing standard treatment guidelines, an out-patient specific drug formulary, and antibiograms can promote rational antibiotic use at the hospital. The EMR system of the hospital is a valuable tool for monitoring prescriptions that can be leveraged for future audits.
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Affiliation(s)
- Obed Kwabena Offe Amponsah
- Department of Pharmacy Practice, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | | | - Nana Kwame Ayisi-Boateng
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | - Divya Nair
- International Union against TB and Lung Disease (The Union), 75006 Paris, France
| | - Karlos Muradyan
- Tuberculosis Research and Prevention Center, Yerevan 0014, Armenia
| | - Phanuel Seli Asense
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | - Osei Kwaku Wusu-Ansah
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | - Robert Fraser Terry
- Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organisation, 1211 Geneva, Switzerland
| | - Mohammed Khogali
- Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organisation, 1211 Geneva, Switzerland
| | - Kwame Ohene Buabeng
- Department of Pharmacy Practice, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
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Ohemu GP. Starved of ACTION: A Critical Look at the Antimicrobial Resistance Action Plans of African Countries. ACS Infect Dis 2022; 8:1377-1380. [PMID: 35916786 DOI: 10.1021/acsinfecdis.2c00303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The urgent need for Africa, as a continent, to start galvanizing resources and strengthening its capacity to win the fight against the looming threat of antimicrobial resistance (AMR) was once again brought to the limelight by the recent study on the "Global Burden of Bacterial Antimicrobial Resistance" (The Lancet 2022, 399, 629). According to the study, western sub-Saharan Africa is a super-region for AMR, with overall mortality rates due to and associated with AMR standing at 27.3 and 114.8 per 100 000 people, respectively. Putting this in perspective, if the leaders of this region do not take effective action, Africa will indeed be one of the two worst-affected regions, along with Asia, with the possibility of over 4.1 million people dying annually from AMR by 2050. The development of a National Action Plan, as directed by the World Health Organization, provides an important framework for addressing the complex and multi-faceted nature of the rise and spread of drug-resistant bacteria. This paper reviews the AMR National Action Plans of African countries and calls on the leaders of this region to move from paper to action and to look beyond just the reduction of antibiotic consumption and, as a more comprehensive response to the threat of AMR, focus also on expanding access to safe drinking water, bettering sanitary conditions, maintaining effective leadership at all levels of governance, increasing government spending on healthcare services, and strengthening regulatory oversight.
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Affiliation(s)
- Godwin Pius Ohemu
- Microbiology Technology, School of Science Laboratory Technology, University of Port Harcourt, Choba, East-West Road, Port Harcourt 500102, Nigeria
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47
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de Lauzanne A, Sreng N, Foucaud E, Sok T, Chon T, Yem C, Hak V, Heng S, Soda M, Gouali M, Nadimpalli M, Inghammar M, Rabenandrasana MAN, Collard JM, Vray M, Hello SL, Kerleguer A, Piola P, Delarocque-Astagneau E, Guillemot D, Huynh BT, Borand L. Prevalence and factors associated with faecal carriage of extended-spectrum β-lactamase-producing Enterobacterales among peripartum women in the community in Cambodia. J Antimicrob Chemother 2022; 77:2658-2666. [PMID: 35794710 PMCID: PMC9525094 DOI: 10.1093/jac/dkac224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/09/2022] [Indexed: 11/21/2022] Open
Abstract
Background In Southeast-Asia, where many conditions associated with dissemination of ESBL-producing Enterobacterales (ESBL-E) in the community are met, data from the community are scarce but show high ESBL-E carriage prevalence. Maternal ESBL-E colonization is considered a risk factor for neonatal colonization, which is the first step towards developing neonatal sepsis. Despite this, ESBL-E carriage prevalence and its risk factors during pregnancy or postpartum remain undefined in Southeast-Asia. Objectives To estimate the prevalence of ESBL-E faecal colonization among peripartum women in the community of an urban and a rural area in Cambodia, to investigate ESBL-E genomic characteristics and to identify associated risk factors. Methods Epidemiological data and faecal samples from 423 peripartum women were collected in an urban and rural areas in Cambodia (2015–16). Bacterial cultures, antibiotic susceptibility tests and ESBL gene sequencing were performed. Risk factor analysis was conducted using logistic regression. Results The prevalence of ESBL-E faecal carriage was 79.2% (95% CI 75.0%–82.8%) among which Escherichia coli (n = 315/335, 94.0%) were most frequent. All isolates were multidrug resistant. Among 318 ESBL-E, the genes most frequently detected were blaCTX-M-15 (41.5%), blaCTX-M-55 (24.8%), and blaCTX-M-27 (15.1%). Low income, undernutrition, multiparity, regular consumption of pork, dried meat, and raw vegetables, were associated with ESBL-E faecal carriage. Conclusions The high prevalence of ESBL-E carriage observed among peripartum women in Southeast-Asia and the identified associated factors underline the urgent need for public health measures to address antimicrobial resistance, including a ‘One Health’ approach.
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Affiliation(s)
| | - Navin Sreng
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Elsa Foucaud
- Assistance Publique/Hôpitaux de Paris, Hôpital Jean Verdier, Paris, France
| | - Touch Sok
- Cambodian Communicable Disease Control Department, Phnom Penh, Cambodia
| | - Thida Chon
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Chhaily Yem
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Veasna Hak
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Sothada Heng
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Meng Soda
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | | | | | - Malin Inghammar
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia.,Lund University, Department of Clinical Sciences Lund, Section for Infection Medicine, Lund, Sweden
| | | | | | - Muriel Vray
- Institut Pasteur, Paris, France.,Institut Pasteur, Dakar, Senegal
| | | | | | | | - Elisabeth Delarocque-Astagneau
- Institut National de la Santé et de la Recherche Médicale, Université de Versailles Saint-Quentin-en-Yvelines and Université Paris-Saclay, Paris, France.,Assistance Publique/Hôpitaux de Paris, Hôpital Raymond-Poincaré, Garches, France
| | - Didier Guillemot
- Institut Pasteur, Paris, France.,Institut National de la Santé et de la Recherche Médicale, Université de Versailles Saint-Quentin-en-Yvelines and Université Paris-Saclay, Paris, France.,Assistance Publique/Hôpitaux de Paris, Hôpital Raymond-Poincaré, Garches, France
| | - Bich Tram Huynh
- Institut Pasteur, Paris, France.,Institut National de la Santé et de la Recherche Médicale, Université de Versailles Saint-Quentin-en-Yvelines and Université Paris-Saclay, Paris, France
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Yang Q, Yuan F, Li L, Jin J, He J. Effects of monthly evaluations on the rates of irrational antimicrobial prescription in the outpatient and emergency departments at Ningbo No. 6 Hospital, Ningbo, China. Eur J Med Res 2022; 27:98. [PMID: 35733215 PMCID: PMC9214680 DOI: 10.1186/s40001-022-00728-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Antibiotic resistance is a major global public health problem. The primary cause of antibiotic resistance is inappropriate antibiotic use. In this study, we aimed to verify whether the monthly evaluation of antibiotic prescription improves clinical antibiotic use in outpatient and emergency departments. METHODS A minimum of 25% of the prescriptions for antibacterial drugs were randomly selected at the outpatient and emergency departments to enter the monthly evaluation system from July 2016 to June 2019. We analysed the rate of irrational prescription of antibiotics, proportion of the use of antibiotics, and consistency between the evaluation and expert groups after implementing the monthly assessment to validate the role of monthly evaluations. RESULTS After 3 years of monthly evaluations of antibiotic prescriptions, the utilisation rate of single antibiotics in the outpatient and emergency departments was found to increase each year. Each year, a decreasing trend was observed for the irrational use of antibiotics, whereas the proportion of antibiotics to the total drugs prescribed gradually decreased in the same period. In addition, the consistency of prescription evaluation results between the evaluation and expert groups increased continuously. CONCLUSIONS Monthly evaluation of antibiotic prescriptions is an effective management tool for the rational use of antibiotics in clinical practice. This practice could help reduce the combinative use of antibiotics, rate of irrational antibiotic prescription, and antibiotic use ratio, and play an important role in safe clinical drug use.
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Affiliation(s)
- Qiong Yang
- Department of Pharmacy, Ningbo No. 6 Hospital, Ningbo, China
| | - Fangfang Yuan
- Department of Rheumatism and Immunology, Ningbo No. 6 Hospital, Ningbo, China
| | - Li Li
- Department of Pharmacy, Ningbo No. 6 Hospital, Ningbo, China
| | - Jianfeng Jin
- Department of Pharmacy, Ningbo No. 6 Hospital, Ningbo, China
| | - Junhong He
- Department of Pharmacy, Ningbo No. 6 Hospital, Ningbo, China.
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49
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Hein W, Aglanu LM, Mensah-Sekyere M, Harant A, Brinkel J, Lamshöft M, Lorenz E, Eibach D, Amuasi J. Fighting Antimicrobial Resistance: Development and Implementation of the Ghanaian National Action Plan (2017–2021). Antibiotics (Basel) 2022; 11:antibiotics11050613. [PMID: 35625257 PMCID: PMC9137880 DOI: 10.3390/antibiotics11050613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/25/2022] [Accepted: 04/29/2022] [Indexed: 11/16/2022] Open
Abstract
In recent years, Ghana has been recognised as a leading player in addressing antimicrobial resistance (AMR) in Africa. However, based on our literature review, we could not ascertain whether the core elements of the national action plan (NAP) were implemented in practice. In this paper, we present a qualitative analysis of the development of AMR-related policies in Ghana, including the NAP. We conducted 13 semi-structured expert interviews to obtain at a more thorough understanding of the implementation process for the AMR NAP and to highlight its accomplishments and shortcomings. The results show that AMR policies, as embodied in the NAP, have led to an extended network of cooperation between stakeholders in many political fields. Broadly, limited allocation of financial resources from the government and from international cooperation have been deplored. Furthermore, the opportunity for using the NAP in mainstreaming the response to the threat of AMR has not been seized. To the general public, this remained hidden behind a number of other relevant health topics such as infection prevention, veterinary services and pharmaceutical regulation. As a One Health (OH) challenge, developing countries could integrate AMR NAPs into other health and environmental programmes to improve its implementation in practice.
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Affiliation(s)
- Wolfgang Hein
- German Institute of Global and Area Studies (GIGA), 20354 Hamburg, Germany
- Faculty of Business, Economics and Social Sciences, University of Hamburg, 20146 Hamburg, Germany;
- Correspondence:
| | - Leslie Mawuli Aglanu
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), PMB UPO, Kumasi, Ghana; (L.M.A.); (J.A.)
- University Medical Centre Groningen (UMCG), University of Groningen, 9713 GZ Groningen, The Netherlands
| | | | - Anne Harant
- Faculty of Business, Economics and Social Sciences, University of Hamburg, 20146 Hamburg, Germany;
| | - Johanna Brinkel
- Bernhard Nocht Institute for Tropical Medicine (BNITM), 20359 Hamburg, Germany; (J.B.); (M.L.); (E.L.)
- German Centre for Infection Research (DZIF), 20354 Hamburg, Germany
| | - Maike Lamshöft
- Bernhard Nocht Institute for Tropical Medicine (BNITM), 20359 Hamburg, Germany; (J.B.); (M.L.); (E.L.)
- German Centre for Infection Research (DZIF), 20354 Hamburg, Germany
| | - Eva Lorenz
- Bernhard Nocht Institute for Tropical Medicine (BNITM), 20359 Hamburg, Germany; (J.B.); (M.L.); (E.L.)
- German Centre for Infection Research (DZIF), 20354 Hamburg, Germany
| | - Daniel Eibach
- Federal Ministry for Economic Cooperation and Development (Germany), 53113 Bonn, Germany;
| | - John Amuasi
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), PMB UPO, Kumasi, Ghana; (L.M.A.); (J.A.)
- Kwame Nkrumah University of Science and Technology (KNUST), PMB UPO, Kumasi, Ghana;
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50
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Ahmadzai MA, Shinwari Q, Al-Rasheed AA, Garba B. Armed conflict and the proliferation of antimicrobial resistance: The situation in war-ravaged Afghanistan. INTERNATIONAL JOURNAL OF ONE HEALTH 2022. [DOI: 10.14202/ijoh.2022.43-47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial resistance (AMR) constitutes a serious impediment to the attainment of the World Health Organization's Sustainable Development Goals, which seek to ensure and promote healthy living among humans and animals. Studies have identified the vulnerability of conflict-affected populations to exposure to antimicrobial-resistant pathogens. Resource-limited countries like Afghanistan have suffered for long periods from armed conflicts, and this situation is exacerbated by the already poor or dilapidated healthcare delivery services. The country has suffered human and economic losses due to antimicrobial-resistant bacterial infections driven by the prolonged war, as well as a limited number of antimicrobials and frequent under dosage. Most reports point to the overuse of broad-spectrum antibiotics as the main reason for building up resistant strains. There is a need for more efforts toward identifying the major contributors and enlightening the public on the importance of AMR. This review aimed to provide a critical appraisal regarding the current situation of AMR in Afghanistan.
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Affiliation(s)
- Mohammad Aman Ahmadzai
- Department of Clinic, Faculty of Veterinary Science, Helmand University, 3902 Peace Watt, Lashkar Gah, Helmand, Afghanistan
| | - Qiamudin Shinwari
- Department of Para Clinic, Faculty of Veterinary Science, Helmand University, 3902 Peace Watt, Lashkar Gah, Helmand, Afghanistan
| | | | - Bashiru Garba
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Usmanu Danfodiyo University Sokoto, 840212, Sultan Abubakar Road, City Campus Complex, Sokoto State, Nigeria
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