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Yang B, Xin X, Cao X, Nasifu L, Nie Z, He B. Phenotypic and genotypic perspectives on detection methods for bacterial antimicrobial resistance in a One Health context: research progress and prospects. Arch Microbiol 2024; 206:409. [PMID: 39302440 DOI: 10.1007/s00203-024-04131-z] [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: 07/29/2024] [Revised: 09/03/2024] [Accepted: 09/04/2024] [Indexed: 09/22/2024]
Abstract
The widespread spread of bacterial antimicrobial resistance (AMR) and multidrug-resistant bacteria poses a significant threat to global public health. Traditional methods for detecting bacterial AMR are simple, reproducible, and intuitive, requiring long time incubation and high labor intensity. To quickly identify and detect bacterial AMR is urgent for clinical treatment to reduce mortality rate, and many new methods and technologies were required to be developed. This review summarizes the current phenotypic and genotypic detection methods for bacterial AMR. Phenotypic detection methods mainly include antimicrobial susceptibility tests, while genotypic detection methods have higher sensitivity and specificity and can detect known or even unknown drug resistance genes. However, most of the current tests are either genotypic or phenotypic and rarely combined. Combining the advantages of phenotypic and genotypic methods, combined with the joint application of multiple rapid detection methods may be the trend for future AMR testing. Driven by rapid diagnostic technology, big data analysis, and artificial intelligence, detection methods of bacterial AMR are expected to constantly develop and innovate. Adopting rational detection methods and scientific data analysis can better address the challenges of bacterial AMR and ensure human health and social well-being.
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Affiliation(s)
- Bingbing Yang
- Department of Laboratory Medicine, Nanjing First Hospital, China Pharmaceutical University, Nanjing, 210006, China
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, Pharmaceutical University, Nanjing, 211198, China
| | - Xiaoqi Xin
- Department of Laboratory Medicine, Nanjing First Hospital, China Pharmaceutical University, Nanjing, 210006, China
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, Pharmaceutical University, Nanjing, 211198, China
| | - Xiaoqing Cao
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Lubanga Nasifu
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
- Department of Biology, Muni University, Arua, Uganda
| | - Zhenlin Nie
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
| | - Bangshun He
- Department of Laboratory Medicine, Nanjing First Hospital, China Pharmaceutical University, Nanjing, 210006, China.
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
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Alotaibi G. Prevalence, pandemic, preventions and policies to overcome antimicrobial resistance. Saudi J Biol Sci 2024; 31:104032. [PMID: 38854892 PMCID: PMC11157277 DOI: 10.1016/j.sjbs.2024.104032] [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: 02/25/2024] [Revised: 05/22/2024] [Accepted: 05/25/2024] [Indexed: 06/11/2024] Open
Abstract
Antimicrobial resistance (AMR) is a growing concern in Asia, and it is essential to understand the prevalence, pandemic, prevention, and policies to overcome it. According to the World Health Organization (WHO), AMR is one of the main causes of death; in 2019, it was linked to 4.95 million fatalities and caused about 1.27 million deaths. A core package of actions has been provided by WHO to help countries prioritize their needs when creating, carrying out, and overseeing national action plans on antimicrobial resistance. Using a people-cantered approach to AMR, the interventions address the needs and obstacles that individuals and patients encounter when trying to obtain healthcare. The people-cantered core package of AMR treatments seeks to improve public and policymakers; awareness and comprehension of AMR by changing the narrative of AMR to emphasize the needs of people and systemic impairments. Additionally, it backs a more comprehensive and programmatic national response to AMR, which emphasizes the value of fair and inexpensive access to high-quality healthcare services for the avoidance, identification, and management of drug-resistant diseases. The report signals increasing resistance to antibiotics in bacterial infections in humans and the need for better data. In conclusion, the prevalence of AMR in Asia is a significant public health concern, and it is crucial to implement policies and interventions to overcome it.
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Affiliation(s)
- Ghallab Alotaibi
- Department of Pharmacology, College of Pharmacy, Shaqra University, Riyadh 11961, Saudi Arabia
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Nhung NT, Phu DH, Carrique-Mas JJ, Padungtod P. A review and meta-analysis of non-typhoidal Salmonella in Vietnam: Challenges to the control and antimicrobial resistance traits of a neglected zoonotic pathogen. One Health 2024; 18:100698. [PMID: 38468610 PMCID: PMC10926303 DOI: 10.1016/j.onehlt.2024.100698] [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: 08/28/2023] [Revised: 12/18/2023] [Accepted: 02/29/2024] [Indexed: 03/13/2024] Open
Abstract
Non-typhoidal Salmonella (NTS) is a food-borne zoonotic pathogen with important implications for human health. Despite its importance, the burden of NTS infections in Vietnam is unknown. We conducted a systematic review and a meta-analysis to describe the prevalence and phenotypic antimicrobial resistance (AMR) for NTS over time in Vietnam. Following PRISMA guidelines, we identified 72 studies from PubMed and Google Scholar containing data relevant to 'Salmonella', 'Salmonellosis', and 'Vietnam', or 'Viet Nam'. Of those, forty-two papers reporting prevalence of NTS, and twenty-six including data on phenotypic resistance were selected for meta-analysis. The prevalence of NTS ranged from 2% to 5% in humans and from 30% to 41% in samples from animals and the farm/slaughterhouse environment. Between 2000 and 2020 we observed a 27.3% (p = 0.044) increase in absolute terms in prevalence among individuals with enteric diseases and a 12.0% (p = 0.047) increase in aquaculture/seafood samples. The most commonly serovars identified across studies included S. Weltevreden (12.0%), followed by S. Typhimurium (10.1%), S. Derby (6.4%), S. London (5.8%), S. Anatum (4.4%), S. Rissen (3.9%), S. Enteritidis (3.7%), S. Albany (3.3%) and S. 4,[5],12:i:- (3.0%). Over the same period, there was an increasing trend in the pooled AMR prevalence for quinolones (15.6% relative increase), 3rd-, 4th-, and 5th-generation cephalosporins (23.7%), penicillins (16.1%), tetracyclines (12.9%), sulfonamides (8.8%), amphenicol (17.8%), and multidrug resistance (11.4%) (all p ≤ 0.014). A broad range of AMR genes (ARGs) were detected in both human and animal populations. The observed prevalence and AMR trends in Vietnam underscore the need of adopting a One Health strategy encompassing surveillance systems, research initiatives, and awareness campaigns to effectively address the challenges posed by NTS.
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Affiliation(s)
- Nguyen Thi Nhung
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
| | - Doan Hoang Phu
- Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh City, Viet Nam
- Doctoral Program in Health Sciences, College of Graduate Studies, Walailak University, Nakhon Si Thammarat, Thailand
| | | | - Pawin Padungtod
- Food and Agriculture Organization of the United Nations (FAO), Hanoi, Viet Nam
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Nohrborg S, Nguyen-Thi T, Xuan HN, Lindahl J, Boqvist S, Järhult JD, Magnusson U. Understanding Vietnamese chicken farmers' knowledge and practices related to antimicrobial resistance using an item response theory approach. Front Vet Sci 2024; 11:1319933. [PMID: 38645642 PMCID: PMC11027563 DOI: 10.3389/fvets.2024.1319933] [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: 10/11/2023] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Antimicrobial resistance (AMR) poses a threat to animal and human health, as well as food security and nutrition. Development of AMR is accelerated by over- and misuse of antimicrobials as seen in many livestock systems, including poultry production. In Vietnam, high AMR levels have been reported previously within poultry production, a sector which is dominated by small-scale farming, even though it is intensifying. This study focuses on understanding small- and medium-scale chicken farmers' knowledge and practices related to AMR by applying an item response theory (IRT) approach, which has several advantages over simpler statistical methods. Methods Farmers representing 305 farms in Thai Nguyen province were interviewed from November 2021 to January 2022, using a structured questionnaire. Results generated with IRT were used in regression models to find associations between farm characteristics, and knowledge and practice levels. Results Descriptive results showed that almost all farmers could buy veterinary drugs without prescription in the local community, that only one third of the farmers received veterinary professional advice or services, and that the majority of farmers gave antibiotics as a disease preventive measure. Regression analysis showed that multiple farm characteristics were significantly associated to farmers' knowledge and practice scores. Conclusion The study highlights the complexity when tailoring interventions to move towards more medically rational antibiotic use at farms in a setting with high access to over-the-counter veterinary drugs and low access to veterinary services, since many on-farm factors relevant for the specific context need to be considered.
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Affiliation(s)
- Sandra Nohrborg
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Thinh Nguyen-Thi
- International Livestock Research Institute, Regional Office for East and Southeast Asia, Hanoi, Vietnam
| | - Huyen Nguyen Xuan
- Department of Bacteriology, National Institute of Veterinary Research, Hanoi, Vietnam
| | - Johanna Lindahl
- Department of Animal Health and Antimicrobial Strategies, National Veterinary Institute, Uppsala, Sweden
| | - Sofia Boqvist
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Josef D. Järhult
- Department of Medical Sciences, Zoonosis Science Center, Uppsala University, Uppsala, Sweden
| | - Ulf Magnusson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Zarske M, Luu HQ, Deneke C, Knüver MT, Thieck M, Hoang HTT, Bretschneider N, Pham NT, Huber I, Stingl K. Identification of knowledge gaps in whole-genome sequence analysis of multi-resistant thermotolerant Campylobacter spp. BMC Genomics 2024; 25:156. [PMID: 38331708 PMCID: PMC10851486 DOI: 10.1186/s12864-024-10014-w] [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: 10/19/2023] [Accepted: 01/14/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Campylobacter spp. is the most frequent cause of bacterial food-borne gastroenteritis and a high priority antibiotic resistant bacterium according to the World Health Organization (WHO). European monitoring of thermotolerant Campylobacter spp. does not reflect the global burden of resistances already circulating within the bacterial population worldwide. METHODS We systematically compared whole genome sequencing with comprehensive phenotypic antimicrobial susceptibility, analyzing 494 thermotolerant Campylobacter poultry isolates from Vietnam and Germany. Any discrepancy was checked by repeating the wet lab and improving the dry lab part. Selected isolates were additionally analyzed via long-read Oxford Nanopore technology, leading to closed chromosomes and plasmids. RESULTS Overall, 22 different resistance genes and gene variants (e. g. erm(B), aph(3')-IIIa, aph(2'')-If, catA, lnu(C), blaOXA, sat4) and point mutations in three distinct genes (gyrA, 23S rRNA, rpsL) associated with AMR were present in the Campylobacter isolates. Two AMR genes were missing in the database and one falsely associated with resistance. Bioinformatic analysis based on short-read data partly failed to identify tet(O) and aadE, when the genes were present as duplicate or homologous gene variants. Intriguingly, isolates also contained different determinants, redundantly conferring resistance to chloramphenicol, gentamicin, kanamycin, lincomycin and streptomycin. We found a novel tet(W) in tetracycline sensitive strains, harboring point mutations. Furthermore, analysis based on assemblies from short-read data was impaired to identify full length phase variable aad9, due to variations of the poly-C tract within the gene. The genetic determinant responsible for gentamicin resistance of one isolate from Germany could not be identified. GyrT86I, presenting the main determinant for (fluoro-)quinolone resistance led to a rare atypical phenotype of ciprofloxacin resistance but nalidixic acid sensitivity. Long-read sequencing predicted AMR genes were mainly located on the chromosome, and rarely on plasmids. Predictions from long- and short-read sequencing, respectively, often differed. AMR genes were often organized in multidrug resistance islands (MDRI) and partially located in proximity to transposase genes, suggesting main mobilization of resistance determinants is via natural transformation and transposition in Campylobacter. CONCLUSIONS The results of this study suggest that there is frequent resistance gene duplication, mosaicism, and mutation leading to gene variation and truncation in Campylobacter strains that have not been reported in previous studies and are missing from databases. Furthermore, there is a need for deciphering yet unknown resistance mechanisms and resistance spread in thermotolerant Campylobacter spp. that may pose a challenge to global food safety.
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Affiliation(s)
- Michael Zarske
- Department of Biological Safety, Federal Institute for Risk Assessment (BfR), Diedersdorfer Weg 1, Berlin, D-12277, Germany
| | - Huong Quynh Luu
- National Institute of Veterinary Research (NIVR), 86 Truong Chinh Street, Hanoi, Dong Da District, Vietnam
| | - Carlus Deneke
- Department of Biological Safety, Federal Institute for Risk Assessment (BfR), Diedersdorfer Weg 1, Berlin, D-12277, Germany
| | - Marie-Theres Knüver
- Department of Biological Safety, Federal Institute for Risk Assessment (BfR), Diedersdorfer Weg 1, Berlin, D-12277, Germany
| | - Maja Thieck
- Department of Biological Safety, Federal Institute for Risk Assessment (BfR), Diedersdorfer Weg 1, Berlin, D-12277, Germany
| | - Ha Thi Thu Hoang
- Department of Bacteriology, National Institute of Hygiene and Epidemiology (NIHE), 1 Yersin Street, Hanoi, Trung District, Vietnam
| | - Nancy Bretschneider
- Department of Molecular Biology and Gene Technology, Bavarian Health and Food Safety Authority, Oberschleissheim, D-85764, Germany
| | - Ngoc Thi Pham
- National Institute of Veterinary Research (NIVR), 86 Truong Chinh Street, Hanoi, Dong Da District, Vietnam
| | - Ingrid Huber
- Department of Molecular Biology and Gene Technology, Bavarian Health and Food Safety Authority, Oberschleissheim, D-85764, Germany
| | - Kerstin Stingl
- Department of Biological Safety, Federal Institute for Risk Assessment (BfR), Diedersdorfer Weg 1, Berlin, D-12277, Germany.
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Sanders P, van Geijlswijk I, Bonten M, Mughini-Gras L, van Hout J, Heederik D. Comparing human and animal antimicrobial usage: a critical appraisal of the indicators used is needed. JAC Antimicrob Resist 2024; 6:dlae005. [PMID: 38268966 PMCID: PMC10807996 DOI: 10.1093/jacamr/dlae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
Comparisons between antimicrobial usage (AMU) in humans and food-producing animals are regularly made. The accuracy of such comparisons depends on the indicators used to quantify AMU. Indicators for AMU quantitatively relate use data (the numerator) to population data (the denominator). The denominator should be a proxy for the population at risk in a certain period when comparing the exposure of different populations to antimicrobials. Denominators based on numbers of animals slaughtered, such as the commonly used population correction unit, do not consider the time at risk of antimicrobial treatment. Production-based indicators underestimate animal AMU. Additionally, production-based indicators are fundamentally different from indicators used to quantify human AMU. Using such indicators to compare human and animal AMU therefore leads to biased results. More caution should be taken in selecting the indicator to quantify AMU when comparing AMU in food-producing animals and humans.
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Affiliation(s)
- Pim Sanders
- The Netherlands Veterinary Medicines Institute (SDa), Utrecht, The Netherlands
| | - Ingeborg van Geijlswijk
- The Netherlands Veterinary Medicines Institute (SDa), Utrecht, The Netherlands
- Pharmacy Department, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Marc Bonten
- The Netherlands Veterinary Medicines Institute (SDa), Utrecht, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lapo Mughini-Gras
- The Netherlands Veterinary Medicines Institute (SDa), Utrecht, The Netherlands
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jobke van Hout
- The Netherlands Veterinary Medicines Institute (SDa), Utrecht, The Netherlands
- Royal GD, Deventer, The Netherlands
| | - Dick Heederik
- The Netherlands Veterinary Medicines Institute (SDa), Utrecht, The Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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Bâtie C, Tran Minh H, Thi Vu VA, Thuy Luong D, Thi Pham T, Fortané N, Pham Duc P, Goutard FL. Reducing antimicrobial use in chicken production in Vietnam: Exploring the systemic dimension of change. PLoS One 2023; 18:e0290296. [PMID: 37683022 PMCID: PMC10490891 DOI: 10.1371/journal.pone.0290296] [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: 01/18/2023] [Accepted: 08/03/2023] [Indexed: 09/10/2023] Open
Abstract
Antibiotic use in livestock production is one of the drivers of antibiotic resistance and a shift towards better and reduced antibiotic usage is urgently required. In Vietnam, where there are frequent reports of the misuse and overuse of antibiotics, little attention has been paid to farmers who have successfully changed their practices. This qualitative study aims to understand the transition process of Vietnamese chicken farmers toward reduced antibiotic usage. We conducted semi-structured interviews with 18 chicken farmers, 13 drug sellers, and 5 traders using participatory tools and a socio-anthropological approach. We explored the farmers' histories, current and past antibiotic usage, methods used to reduce antibiotic use, and motivations and barriers to changing practices. Through the thematic analysis of the farmers' transcripts, we identified technical, economic, and social factors that influence change. Out of eighteen farmers, we identified ten farmers who had already reduced antibiotic usage. The main motivations included producing quality chickens (tasty and safe) while reducing farm expenditures. Barriers were related to poor biosecurity in the area, market failures, and the farmers' lack of knowledge. Innovation led to overcome these obstacles included the local development of handmade probiotics and the organization of farmer cooperatives to overcome economic difficulties and guarantee product outlets. Knowledge was increased by workshops organized at the communal level and the influence of competent veterinarians in the area. We showed that the transition process was influenced by several components of the system rather than by any individual alone. Our study demonstrated that local initiatives to reduce antibiotic use in Vietnamese chicken production do exist. As changes depend on the system in which stakeholders are embedded, systemic lock-ins must be removed to allow practices to change. The promotion of locally-developed solutions should be further encouraged.
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Affiliation(s)
- Chloé Bâtie
- ASTRE, CIRAD, INRAE, Univ Montpellier, Montpellier, France
| | - Hang Tran Minh
- Institute of Anthropology, Vietnam Academy of Social Sciences, Hanoi, Vietnam
| | - Van Anh Thi Vu
- USAID Learns, United States Agency for International Development/Vietnam, Hanoi, Vietnam
| | - Duong Thuy Luong
- Institute of Regional Sustainable Development, Vietnam Academy of Social, Hanoi, Vietnam
| | - Trang Thi Pham
- Faculty of Animal Science and Veterinary Medicine, Thai Nguyen University of Agriculture and Forestry, Thai Nguyen, Vietnam
| | - Nicolas Fortané
- UMR IRISSO, CNRS, INRAE, Université Paris Dauphine, PSL, Paris, France
| | - Phuc Pham Duc
- Center for Public Health and Ecosystem Research (CENPHER), Hanoi University of Public Health, Hanoi, Vietnam
- Institute of Environmental Health and Sustainable Development, Hanoi, Vietnam
| | - Flavie Luce Goutard
- ASTRE, CIRAD, INRAE, Univ Montpellier, Montpellier, France
- ASTRE, CIRAD, Hanoi, Vietnam
- National Institute of Animal Science, Hanoi, Vietnam
- National Institute of Veterinary Research, Hanoi, Vietnam
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Nhung NT, Dutta A, Higginson E, Kermack L, Yen NTP, Phu DH, Kiet BT, Choisy M, Geskus RB, Baker S, Carrique-Mas J. Impact of antimicrobial use on abundance of antimicrobial resistance genes in chicken flocks in Vietnam. JAC Antimicrob Resist 2023; 5:dlad090. [PMID: 37484028 PMCID: PMC10362913 DOI: 10.1093/jacamr/dlad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/09/2023] [Indexed: 07/25/2023] Open
Abstract
Objectives We investigated longitudinally Vietnamese small-scale chicken flocks in order to characterize changes in antimicrobial resistance gene (ARG) content over their life cycle, and the impact of antimicrobial use (AMU) on an intervention consisting of veterinary advice provision. Methods AMU data and faecal samples were collected from 83 flocks (25 farms) at day-old, mid- and late-production (∼4 month cycle). Using high-throughput real-time PCR, samples were investigated for 94 ARGs. ARG copies were related to 16S rRNA and ng of DNA (ngDNA). Impact of AMU and ARGs in day-olds was investigated by mixed-effects models. Results Flocks received a mean (standard error, SE) animal daily dose (ADD) of 736.7 (83.0) and 52.1 (9.9) kg in early and late production, respectively. Overall, ARGs/16S rRNA increased from day-old (mean 1.47; SE 0.10) to mid-production (1.61; SE 0.16), further decreasing in end-production (1.60; SE 0.1) (all P > 0.05). In mid-production, ARGs/16S rRNA increased for aminoglycosides, phenicols, sulphonamides and tetracyclines, decreasing for polymyxins β-lactams and genes that confer resistance to mutiple classes (multi-drug resistance) (MDR). At end-production, aminoglycoside resistance decreased and polymyxin and quinolone resistance increased (all P < 0.05). Results in relation to ngDNA gave contradictory results. Neither AMU nor ARGs in day-olds had an impact on subsequent ARG abundance. The intervention resulted in 74.2% AMU reduction; its impact on ARGs depended on whether ARGs/ngDNA (+14.8%) or ARGs/16S rRNA metrics (-10.7%) (P > 0.05) were computed. Conclusions The flocks' environment (contaminated water, feed and residual contamination) is likely to play a more important role in transmission of ARGs to flocks than previously thought. Results highlight intriguing differences in the quantification of ARGs depending on the metric chosen.
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Affiliation(s)
- Nguyen Thi Nhung
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Avijit Dutta
- Cambridge Institute of Therapeutic Immunology & Infectious Disease, University of Cambridge, Cambridge, UK
- Chattogram Veterinary and Animal Sciences University, Chattogram 4225, Bangladesh
| | - Ellen Higginson
- Cambridge Institute of Therapeutic Immunology & Infectious Disease, University of Cambridge, Cambridge, UK
| | - Leanne Kermack
- Cambridge Institute of Therapeutic Immunology & Infectious Disease, University of Cambridge, Cambridge, UK
| | | | - Doan Hoang Phu
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh City, Vietnam
| | - Bach Tuan Kiet
- Sub-Department of Animal Health and Production, Dong Thap Province, Cao Lanh, Vietnam
| | - Marc Choisy
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Ronald B Geskus
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Stephen Baker
- Cambridge Institute of Therapeutic Immunology & Infectious Disease, University of Cambridge, Cambridge, UK
| | - Juan Carrique-Mas
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Food and Agriculture Organization of the United Nations (FAO), Hanoi, Vietnam
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Nguyen QH, Le TTH, Nguyen ST, Nguyen KOT, Quyen DV, Hayer J, Bañuls AL, Tran TTT. Large-scale analysis of putative plasmids in clinical multidrug-resistant Escherichia coli isolates from Vietnamese patients. Front Microbiol 2023; 14:1094119. [PMID: 37323902 PMCID: PMC10265513 DOI: 10.3389/fmicb.2023.1094119] [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: 11/09/2022] [Accepted: 05/09/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction In the past decades, extended-spectrum beta-lactamase (ESBL)-producing and carbapenem-resistant (CR) Escherichia coli isolates have been detected in Vietnamese hospitals. The transfer of antimicrobial resistance (AMR) genes carried on plasmids is mainly responsible for the emergence of multidrug-resistant E. coli strains and the spread of AMR genes through horizontal gene transfer. Therefore, it is important to thoroughly study the characteristics of AMR gene-harboring plasmids in clinical multidrug-resistant bacterial isolates. Methods The profiles of plasmid assemblies were determined by analyzing previously published whole-genome sequencing data of 751 multidrug-resistant E. coli isolates from Vietnamese hospitals in order to identify the risk of AMR gene horizontal transfer and dissemination. Results The number of putative plasmids in isolates was independent of the sequencing coverage. These putative plasmids originated from various bacterial species, but mostly from the Escherichia genus, particularly E. coli species. Many different AMR genes were detected in plasmid contigs of the studied isolates, and their number was higher in CR isolates than in ESBL-producing isolates. Similarly, the blaKPC-2, blaNDM-5, blaOXA-1, blaOXA-48, and blaOXA-181 β-lactamase genes, associated with resistance to carbapenems, were more frequent in CR strains. Sequence similarity network and genome annotation analyses revealed high conservation of the β-lactamase gene clusters in plasmid contigs that carried the same AMR genes. Discussion Our study provides evidence of horizontal gene transfer in multidrug-resistant E. coli isolates via conjugative plasmids, thus rapidly accelerating the emergence of resistant bacteria. Besides reducing antibiotic misuse, prevention of plasmid transmission also is essential to limit antibiotic resistance.
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Affiliation(s)
- Quang Huy Nguyen
- University of Science and Technology of Hanoi, Vietnam Academy of Science and Technology, Hanoi, Vietnam
- LMI DRISA, IRD-USTH, Hanoi, Vietnam
- Institute of Biotechnology, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Thi Thu Hang Le
- University of Science and Technology of Hanoi, Vietnam Academy of Science and Technology, Hanoi, Vietnam
- LMI DRISA, IRD-USTH, Hanoi, Vietnam
| | - Son Thai Nguyen
- University of Science and Technology of Hanoi, Vietnam Academy of Science and Technology, Hanoi, Vietnam
- LMI DRISA, IRD-USTH, Hanoi, Vietnam
| | - Kieu-Oanh Thi Nguyen
- University of Science and Technology of Hanoi, Vietnam Academy of Science and Technology, Hanoi, Vietnam
- LMI DRISA, IRD-USTH, Hanoi, Vietnam
| | - Dong Van Quyen
- University of Science and Technology of Hanoi, Vietnam Academy of Science and Technology, Hanoi, Vietnam
- Institute of Biotechnology, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Juliette Hayer
- LMI DRISA, IRD-USTH, Hanoi, Vietnam
- UMR MIVEGEC, University of Montpellier-IRD-CNRS, Montpellier, France
| | - Anne-Laure Bañuls
- LMI DRISA, IRD-USTH, Hanoi, Vietnam
- UMR MIVEGEC, University of Montpellier-IRD-CNRS, Montpellier, France
| | - Tam Thi Thanh Tran
- University of Science and Technology of Hanoi, Vietnam Academy of Science and Technology, Hanoi, Vietnam
- LMI DRISA, IRD-USTH, Hanoi, Vietnam
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Camara N, Moremi N, Mghamba J, Eliakimu E, Shumba E, Ondoa P, Egyir B. Surveillance of antimicrobial resistance in human health in Tanzania: 2016-2021. Afr J Lab Med 2023; 12:2053. [PMID: 37293314 PMCID: PMC10244825 DOI: 10.4102/ajlm.v12i1.2053] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/09/2023] [Indexed: 06/10/2023] Open
Abstract
Background Antimicrobial resistance (AMR) surveillance plays an important role in early detection of resistant strains of pathogens and informs treatments decisions at local, regional and national levels. In 2017, Tanzania developed a One Health AMR Surveillance Framework to guide establishment of AMR surveillance systems in the human and animal sectors. Aim We reviewed AMR surveillance studies in Tanzania to document progress towards establishing an AMR surveillance system and determine effective strengthening strategies. Methods We conducted a literature review on AMR studies conducted in Tanzania by searching Google Scholar, PubMed, and the websites of the Tanzania Ministry of Health and the World Health Organization for articles written in English and published from January 2012 to March 2021 using relevant search terms. Additionally, we reviewed applicable guidelines, plans, and reports from the Tanzanian Ministry of Health. Results We reviewed 10 articles on AMR in Tanzania, where studies were conducted at hospitals in seven of Tanzania's 26 regions between 2012 and 2019. Nine AMR sentinel sites had been established, and there was suitable and clear coordination under 'One Health'. However, sharing of surveillance data between sectors had yet to be strengthened. Most studies documented high resistance rates of Gram-negative bacteria to third-generation cephalosporins. There were few laboratory staff who were well trained on AMR. Conclusion Important progress has been made in establishing a useful, reliable AMR surveillance system. Challenges include a need to develop, implement and build investment case studies for the sustainability of AMR surveillance in Tanzania and ensure proper use of third-generation cephalosporins. What this study adds This article adds to the knowledge base of AMR trends in Tanzania and progress made in the implementation of AMR surveillance in human health sector as a contribution to the global AMR initiatives to reduce AMR burden worldwide. It has highlighted key gaps that need policy and implementation level attention.
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Affiliation(s)
- Neema Camara
- Epidemiology and Disease Control Section, Ministry of Health, Dodoma, United Republic of Tanzania
| | - Nyambura Moremi
- Department of Bacteriology, National Public Health Laboratory, Dar es Salaam, United Republic of Tanzania
| | - Janneth Mghamba
- Epidemiology and Disease Control Section, Ministry of Health, Dodoma, United Republic of Tanzania
| | - Eliudi Eliakimu
- Health Quality Assurance Unit, Ministry of Health, Dodoma, United Republic of Tanzania
| | - Edwin Shumba
- African Society for Laboratory Medicine, Addis Ababa, Ethiopia
| | - Pascale Ondoa
- African Society for Laboratory Medicine, Addis Ababa, Ethiopia
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
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11
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Long Y, Song L, Shu Y, Li B, Peijnenburg W, Zheng C. Evaluating the spatial and temporal distribution of emerging contaminants in the Pearl River Basin for regulating purposes. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 257:114918. [PMID: 37086620 DOI: 10.1016/j.ecoenv.2023.114918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 05/03/2023]
Abstract
Little information is available on how the types, concentrations, and distribution of chemicals have evolved over the years. The objective of the present study is therefore to review the spatial and temporal distribution profile of emerging contaminants with limited toxicology data in the pearl river basin over the years to build up the emerging contaminants database in this region for risk assessment and regulatory purposes. The result revealed that seven groups of emerging contaminants were abundant in this region, and many emerging contaminants had been detected at much higher concentrations before 2011. Specifically, antibiotics, phenolic compounds, and acidic pharmaceuticals were the most abundant emerging contaminants detected in the aquatic compartment, while phenolic compounds were of the most profound concern in soil. Flame retardants and plastics were the most frequently studied chemicals in organisms. The abundance of the field concentrations and frequencies varied considerably over the years, and currently available data can hardly be used for regulation purposes. It is suggested that watershed management should establish a regular monitoring scheme and comprehensive database to monitor the distribution of emerging contaminants considering the highly condensed population in this region. The priority monitoring list should be formed in consideration of historical abundance, potential toxic effects of emerging contaminants as well as the distribution of heavily polluting industries in the region.
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Affiliation(s)
- Ying Long
- Shenzhen Institute of Sustainable Development, Southern University of Science and Technology, Shenzhen 518055, China; School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China
| | - Lan Song
- Shenzhen Institute of Sustainable Development, Southern University of Science and Technology, Shenzhen 518055, China; School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China.
| | - Yaqing Shu
- School of Navigation, Wuhan University of Technology, Wuhan 430063, China
| | - Bing Li
- Water Research Center, Tsinghua Shenzhen International Graduate School, Tsinghua, Shenzhen 518055, China
| | - Willie Peijnenburg
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Institute of Environmental Sciences (CML), Leiden University, Leiden RA 2300, the Netherlands
| | - Chunmiao Zheng
- Shenzhen Institute of Sustainable Development, Southern University of Science and Technology, Shenzhen 518055, China; School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China
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12
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Carrique-Mas JJ, Hue LT, Dung LT, Thuy NT, Padungtod P. Restrictions on antimicrobial use in aquaculture and livestock, Viet Nam. Bull World Health Organ 2023; 101:223-225. [PMID: 36865604 PMCID: PMC9948497 DOI: 10.2471/blt.22.289187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/17/2022] [Accepted: 11/24/2022] [Indexed: 03/04/2023] Open
Affiliation(s)
- Juan J Carrique-Mas
- Food and Agriculture Organization of the United Nations, Emergency Center for Transboundary Animal Diseases, Room 402, B3 Building, Van Phuc Diplomatic Compound 298, Kim Ma, 100000Hanoi, Viet Nam
| | - Le Thi Hue
- Department of Animal Health, Ministry of Agriculture and Rural Development, Hanoi, Viet Nam
| | - Le Thi Dung
- Food and Agriculture Organization of the United Nations, Emergency Center for Transboundary Animal Diseases, Room 402, B3 Building, Van Phuc Diplomatic Compound 298, Kim Ma, 100000Hanoi, Viet Nam
| | - Nguyen Thu Thuy
- Department of Animal Health, Ministry of Agriculture and Rural Development, Hanoi, Viet Nam
| | - Pawin Padungtod
- Food and Agriculture Organization of the United Nations, Emergency Center for Transboundary Animal Diseases, Room 402, B3 Building, Van Phuc Diplomatic Compound 298, Kim Ma, 100000Hanoi, Viet Nam
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13
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Li T, Wang Z, Guo J, de la Fuente-Nunez C, Wang J, Han B, Tao H, Liu J, Wang X. Bacterial resistance to antibacterial agents: Mechanisms, control strategies, and implications for global health. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 860:160461. [PMID: 36435256 DOI: 10.1016/j.scitotenv.2022.160461] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 06/16/2023]
Abstract
The spread of bacterial drug resistance has posed a severe threat to public health globally. Here, we cover bacterial resistance to current antibacterial drugs, including traditional herbal medicines, conventional antibiotics, and antimicrobial peptides. We summarize the influence of bacterial drug resistance on global health and its economic burden while highlighting the resistance mechanisms developed by bacteria. Based on the One Health concept, we propose 4A strategies to combat bacterial resistance, including prudent Application of antibacterial agents, Administration, Assays, and Alternatives to antibiotics. Finally, we identify several opportunities and unsolved questions warranting future exploration for combating bacterial resistance, such as predicting genetic bacterial resistance through the use of more effective techniques, surveying both genetic determinants of bacterial resistance and the transmission dynamics of antibiotic resistance genes (ARGs).
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Affiliation(s)
- Ting Li
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, PR China; Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, PR China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Biotechnology, No. 20, Dongda Street, Fengtai District, Beijing 100071, PR China
| | - Zhenlong Wang
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, PR China; Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, PR China
| | - Jianhua Guo
- Australian Centre for Water and Environmental Biotechnology (ACWEB, formerly AWMC), The University of Queensland, St Lucia, Queensland 4072, Australia.
| | - Cesar de la Fuente-Nunez
- Machine Biology Group, Departments of Psychiatry and Microbiology, Institute for Biomedical Informatics, Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America; Departments of Bioengineering and Chemical and Biomolecular Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, United States of America; Penn Institute for Computational Science, University of Pennsylvania, Philadelphia, PA, United States of America.
| | - Jinquan Wang
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, PR China; Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, PR China
| | - Bing Han
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, PR China; Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, PR China
| | - Hui Tao
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, PR China; Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, PR China
| | - Jie Liu
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, PR China; Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, PR China
| | - Xiumin Wang
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, PR China; Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, PR China.
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14
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Phu DH, Wongtawan T, Truong DB, Van Cuong N, Carrique-Mas J, Thomrongsuwannakij T. A systematic review and meta-analysis of integrated studies on antimicrobial resistance in Vietnam, with a focus on Enterobacteriaceae, from a One Health perspective. One Health 2022; 15:100465. [PMID: 36561710 PMCID: PMC9767812 DOI: 10.1016/j.onehlt.2022.100465] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 11/21/2022] Open
Abstract
Vietnam is a low- and middle-income country (LMIC), a primary food producer, and an antimicrobial resistance (AMR) hotspot. AMR is recognized as a One Health challenge since it may transfer between humans, animals and the environment. This study aimed to apply systematic review and meta-analysis to investigate the phenotypic profiles and correlations of antimicrobial-resistant Enterobacteriaceae across three compartments: humans, animals and the environment in Vietnam. A total of 89 articles found in PubMed, Science Direct, and Google Scholar databases were retrieved for qualitative synthesis. E. coli and non-typhoidal Salmonella (NTS) were the most common bacterial species in studies of all compartments (60/89 studies). Among antimicrobials classified as critically important, the resistance levels were observed to be highest to quinolones, 3rd generation of cephalosporins, penicillins, and aminoglycosides. Of 89 studies, 55 articles reported the resistance prevalence of E. coli and NTS in healthy humans, animals and the environment against ciprofloxacin, ceftazidime, ampicillin, gentamicin, sulfamethoxazole-trimethoprim, chloramphenicol was used for meta-analysis. The pooled prevalence was found highest in E. coli against ampicillin 84.0% (95% CI 73.0-91.0%) and sulfamethoxazole-trimethoprim 66.0% (95% CI 56.0-75.0%) while in NTS they were 34.0% (95% CI 24.0-46.0%), 33.0% (95% CI 25.0-42.0%), respectively. There were no significant differences in the pooled prevalence of E. coli and NTS to these antimicrobials across healthy humans, animals and the environment, except for ceftazidime-resistant E. coli (χ2 = 8.29, p = 0.02), chloramphenicol-resistant E.coli (χ2 = 9.65, p < 0.01) and chloramphenicol-resistant NTS (χ2 = 7.51, p = 0.02). Findings from the multiple meta-regression models indicated that the AMR levels in E. coli (β = 1.887, p < 0.001) and the North (β = 0.798, p = 0.047) had a higher fraction of AMR than NTS and other regions of Vietnam. The outcomes of this study play an important role as the baseline information for further investigation and follow-up intervention strategies to tackle AMR in Vietnam, and more generally, can be adapted to other LMICs.
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Affiliation(s)
- Doan Hoang Phu
- Akkhraratchakumari Veterinary College, Walailak University, Nakhon Si Thammarat 80160, Thailand,College of Graduate Studies, Walailak University, Nakhon Si Thammarat 80160, Thailand,Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh City 70000, Viet Nam
| | - Tuempong Wongtawan
- Akkhraratchakumari Veterinary College, Walailak University, Nakhon Si Thammarat 80160, Thailand,Centre for One Health, Walailak University, Nakhon Si Thammarat 80160, Thailand,Centre of Excellence Research for Melioidosis and other Microorganism, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Dinh Bao Truong
- Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh City 70000, Viet Nam
| | - Nguyen Van Cuong
- Oxford University Clinical Research Unit, Ho Chi Minh City 70000, Viet Nam,Ausvet PTY LTD, Bruce ACT 2617, Canberra, Australia
| | - Juan Carrique-Mas
- Food and Agriculture Organization of the United Nations, Ha Noi 10000, Viet Nam
| | - Thotsapol Thomrongsuwannakij
- Akkhraratchakumari Veterinary College, Walailak University, Nakhon Si Thammarat 80160, Thailand,Centre for One Health, Walailak University, Nakhon Si Thammarat 80160, Thailand,Corresponding author at: Akkhraratchakumari Veterinary College, Walailak University, Nakhon Si Thammarat 80160, Thailand.
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15
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Genomic characterisation of multidrug-resistant Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii in two intensive care units in Hanoi, Viet Nam: a prospective observational cohort study. THE LANCET. MICROBE 2022; 3:e857-e866. [PMID: 36206776 DOI: 10.1016/s2666-5247(22)00181-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Viet Nam has high rates of antimicrobial resistance (AMR) but little capacity for genomic surveillance. This study used whole genome sequencing to examine the prevalence and transmission of three key AMR pathogens in two intensive care units (ICUs) in Hanoi, Viet Nam. METHODS A prospective surveillance study of all adults admitted to ICUs at the National Hospital for Tropical Diseases and Bach Mai Hospital was done between June 19, 2017, and Jan 16, 2018. Clinical and environmental samples were cultured on selective media, characterised with MALDI TOF mass spectrometry, and sequenced with Illumina. Phylogenies based on the de-novo assemblies (SPAdes) were constructed with MAFFT (PARsnp), Gubbins, and RAxML. Resistance genes were detected with Abricate against the US National Center for Biotechnology Information database. FINDINGS 3153 Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii isolates from 369 patients were analysed. Phylogenetic analysis revealed predominant lineages within A baumannii (global clone 2, sequence types ST2 and ST571) and K pneumoniae (ST15, ST16, ST656, ST11, and ST147) isolates. Isolation from stool was most common with E coli (87·0%) followed by K pneumoniae (62·5%). Of the E coli, 85·0% carried a blaCTX-M variant, while 81·8% of K pneumoniae isolates carried blaNDM (54·4%), or blaKPC (45·1%), or both. Transmission analysis with single nucleotide polymorphisms identified 167 clusters involving 251 (68%) of 369 patients, in some cases involving patients from both ICUs. There were no clear differences between the lineages or AMR genes recovered between the two ICUs. INTERPRETATION This study represents the largest prospective surveillance study of key AMR pathogens in Vietnamese ICUs. Clusters of closely related isolates in patients across both ICUs suggests recent transmission before ICU admission in other health-care settings or in the community. FUNDING UK Medical Research Council Newton Fund, Viet Nam Ministry of Science and Technology, Wellcome Trust, Academy of Medical Sciences, Health Foundation, and UK National Institute for Health and Care Research Cambridge Biomedical Research Centre.
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16
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Torumkuney D, Kundu S, Vu GV, Nguyen HA, Pham HV, Kamble P, Truong Ha Lan N, Keles N. Country data on AMR in Vietnam in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicines and clinical outcome. J Antimicrob Chemother 2022; 77:i26-i34. [PMID: 36065731 PMCID: PMC9445855 DOI: 10.1093/jac/dkac214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is one of the biggest threats to global public health. Selection of resistant bacteria is driven by inappropriate use of antibiotics, amongst other factors. COVID-19 may have exacerbated AMR due to unnecessary antibiotic prescribing. Country-level knowledge is needed to understand options for action. OBJECTIVES To review the current situation with respect to AMR in Vietnam and initiatives addressing it. Identifying areas where more information is required will provide a call to action to minimize any further rises in AMR within Vietnam and improve patient outcomes. METHODS National initiatives to address AMR in Vietnam, antibiotic use and prescribing, and availability of susceptibility data, in particular for the key community-acquired respiratory tract infection (CA-RTI) pathogens Streptococcus pneumoniae and Haemophilus influenzae, were identified. National and international antibiotic prescribing guidelines for CA-RTIs (community-acquired pneumonia, acute otitis media and acute bacterial rhinosinusitis) commonly used locally were also reviewed, plus local antibiotic availability. Insights from clinicians in Vietnam were sought to contextualize this information. CONCLUSIONS In Vietnam there have been some initiatives addressing AMR; Vietnam was the first country in the Western Pacific Region to develop a national action plan to combat AMR, which according to the WHO is being implemented. Vietnam also has one of the highest rates of AMR in Asia due, in part, to the overuse of antimicrobial drugs, both in the animal health sector and in humans in both hospitals and the community. In addition, despite a 2005 law requiring antibiotic prescription, there is unrestricted access to over-the-counter antibiotics. Several global surveillance studies provide antibiotic susceptibility data for CA-RTI pathogens in Vietnam including Survey of Antibiotic Resistance (SOAR) and SENTRY (small isolate numbers only). For management of the common CA-RTIs in Vietnam there are several country-specific local antibiotic prescribing guidelines and in addition, there is a range of international guidelines referred to, but these may have been created based on pathogen resistance patterns that might be very different to those in Vietnam. Expert clinician opinion confirms the high resistance rates among common respiratory pathogens. A more standardized inclusive approach in developing local guidelines, using up-to-date surveillance data of isolates from community-acquired infections in Vietnam, could make management guideline use more locally relevant for clinicians. This would pave the way for a higher level of appropriate antibiotic prescribing and improved adherence. This would, in turn, potentially limit AMR development and improve clinical outcomes for patients.
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Affiliation(s)
- Didem Torumkuney
- GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
| | | | - Giap Van Vu
- Respiratory Center, Bach Mai Hospital, Hanoi 100000, Vietnam
| | - Hoang Anh Nguyen
- The National Centre for Drug Information and Adverse Drug Reactions Monitoring, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Hung Van Pham
- University of Medicine and Pharmacy, 217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, Vietnam
| | - Praveen Kamble
- GlaxoSmithKline, 252, Dr Annie Besant Road, Worli, 400030 Mumbai, India
| | - Ngoc Truong Ha Lan
- GlaxoSmithKline Vietnam, Unit 701, 235 Dong Khoi, District 1, Ho Chi Minh City, Vietnam
| | - Nergis Keles
- GlaxoSmithKline, Büyükdere Cad. No: 173, 1. Levent Plaza B Blok 34394 Levent, Istanbul, Türkiye
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Cai HTN, Tran HT, Nguyen YHT, Vu GQT, Tran TP, Bui PB, Nguyen HTT, Pham TQ, Lai AT, Van Nuil JI, Lewycka S. Challenges and Lessons Learned in the Development of a Participatory Learning and Action Intervention to Tackle Antibiotic Resistance: Experiences From Northern Vietnam. Front Public Health 2022; 10:822873. [PMID: 35958847 PMCID: PMC9362799 DOI: 10.3389/fpubh.2022.822873] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/22/2022] [Indexed: 12/02/2022] Open
Abstract
Antibiotic use in the community for humans and animals is high in Vietnam, driven by easy access to over-the counter medicines and poor understanding of the role of antibiotics. This has contributed to antibiotic resistance levels that are amongst the highest in the world. To address this problem, we developed a participatory learning and action (PLA) intervention. Here we describe challenges and lessons learned while developing and testing this intervention in preparation for a large-scale One Health trial in northern Vietnam. We tested the PLA approach using community-led photography, and then reflected on how this approach worked in practice. We reviewed and discussed implementation documentation and developed and refined themes. Five main themes were identified related to challenges and lessons learned: understanding the local context, stakeholder relationship development, participant recruitment, building trust and motivation, and engagement with the topic of antibiotics and antimicrobial resistance (AMR). Partnerships with national and local authorities provided an important foundation for building relationships with communities, and enhanced visibility and credibility of activities. Partnership development required managing relationships, clarifying roles, and accommodating different management styles. When recruiting participants, we had to balance preferences for top-down and bottom-up approaches. Building trust and motivation took time and was challenged by limited study team presence in the community. Open discussions around expectations and appropriate incentives were re-visited throughout the process. Financial incentives provided initial motivation to participate, while less tangible benefits like collective knowledge, social connections, desire to help the community, and new skills, sustained longer-term motivation. Lack of awareness and perceived importance of the problem of AMR, affected initial motivation. Developing mutual understanding through use of common and simplified language helped when discussing the complexities of this topic. A sense of ownership emerged as the study progressed and participants understood more about AMR, how it related to their own concerns, and incorporated their own ideas into activities. PLA can be a powerful way of stimulating community action and bringing people together to tackle a common problem. Understanding the nuances of local power structures, and allowing time for stakeholder relationship development and consensus-building are important considerations when designing engagement projects.
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Affiliation(s)
| | - Hang Thi Tran
- Oxford University Clinical Research Unit, Hanoi, Vietnam
| | | | | | | | | | - Huong Thi Thu Nguyen
- Communicable Disease Control and Prevention, National Institute for Hygiene and Epidemiology, Hanoi, Vietnam
| | - Thai Quang Pham
- Communicable Disease Control and Prevention, National Institute for Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Jennifer Ilo Van Nuil
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Sonia Lewycka
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- *Correspondence: Sonia Lewycka
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18
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Characterisation of chicken farms in Vietnam: a typology of antimicrobial use among different production systems. Prev Vet Med 2022; 208:105731. [DOI: 10.1016/j.prevetmed.2022.105731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/08/2022] [Accepted: 07/26/2022] [Indexed: 11/22/2022]
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19
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Mouiche MMM, Wouembe FDK, Mpouam SE, Moffo F, Djuntu M, Toukam CMW, Kameni JMF, Okah-Nnane NH, Awah-Ndukum J. Cross-Sectional Survey of Prophylactic and Metaphylactic Antimicrobial Use in Layer Poultry Farming in Cameroon: A Quantitative Pilot Study. Front Vet Sci 2022; 9:646484. [PMID: 35518638 PMCID: PMC9063002 DOI: 10.3389/fvets.2022.646484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 01/14/2022] [Indexed: 11/21/2022] Open
Abstract
An evaluation of the patterns of antimicrobial use in livestock can help understand the increasing level of antimicrobial resistance worldwide. This study aimed at evaluating antimicrobial usage in modern layer poultry farms in the West Region of Cameroon. In this light, 70 layer poultry farms and 4 veterinary pharmacies were surveyed. Data on antimicrobial use were collected through interviews using a quantitative-frequency questionnaire and consultation of medical records. The four veterinary pharmacies sold a total of 2.8 tons of antimicrobials (active ingredients) during 2011. At the level of farms, 297 kg of antimicrobials (active ingredients) were used in the 50 layer poultry farms surveyed. Tetracycline, sulfonamides, quinolones, and β-lactams (aminopenicillins) were the most sold and used drugs in layer farms. As for treatment indication, metaphylactic (58.1%) and prophylactic (41.9%) treatments were the most observed practices, and nearly all (99%) treatments were administered per os as remedies to respiratory (33.4%) and digestive (24.7%) tract symptoms. Overall, 78.2% of antimicrobials sold in pharmacies and 67.3% used in the farms belonged to the class of critically important antimicrobials of the WHO categorization of antimicrobials according to their importance to human medicine. Doxycycline, sulfonamide, ampicillin, and streptomycin, which have been banned for layer poultry in the production of eggs for human consumption, were still used in Cameroon. The treatment incidences based on the used daily dose (TIUDD) and animal daily dose (TIADD) were 11.59 and 10.45, respectively. In regard to dosage correctness based on the UDD/ADD ratio, aminoglycosides (100%), macrolides (90.6%), and tetracyclines (74.5%) were the most underdosed, while trimethoprim sulfonamides (45.8%) and β-lactams (35.7%) were overdosed. This study highlights an irrational antimicrobial usage in layer poultry farms. Regulation of the use of antimicrobials and the education of farmers on adequate antimicrobial use are essential to preserve the effectiveness of drugs in both humans and animals.
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Affiliation(s)
- Mohamed Moctar Mouliom Mouiche
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | | | - Serge Eugene Mpouam
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Frédéric Moffo
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Michael Djuntu
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | | | - Jean Marc Feussom Kameni
- Ministry of Livestock, Fisheries and Animal Industries (MINEPIA), Yaoundé, Cameroon.,Epidemiology-Public Health-Veterinary Association (ESPV), Yaoundé, Cameroon
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20
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Quynh NTN, Dat VQ. Purchase of carbapenems in Vietnam, a low- to middle-income pharmaceutical market with a high burden of antimicrobial drug resistance. WHO South East Asia J Public Health 2022; 10:12-17. [PMID: 35046152 DOI: 10.4103/who-seajph.who-seajph_76_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction Carbapenems are the last-resort antibiotics used for the treatment of multidrug-resistant bacterial infections. We reported the expenditure and prices of carbapenems in public healthcare institutions in Vietnam. Materials and Methods Data on carbapenem procurement were obtained from tender-winning bids from provincial health authorities and public hospitals from 2013 to 2018. We use the anatomical therapeutic chemical index 2019 and the defined daily doses (DDDs) to describe the purchase (in number of DDD) and the price of carbapenem (presented in US dollar per DDD). Results There are four available carbapenems in Vietnam between 2013 and 2018. Imipenem/cilastatin was the most common purchased antibiotic, accounting for 50.7% of total carbapenem consumption. The vast majority of carbapenem purchase (in DDD) was imported (79.1%). By 2018, among available carbapenems, the average price of doripenem was the highest (US $85.25/DDD), followed by meropenem (US $39.4/DDD), imipenem/cilastatin (US $36.5/DDD), and ertapenem (US $24.5 per DDD). The average carbapenem price decreased by 6.3% annually. The price of doripenem (P = -0.8518, r = 0.0313) and meropenem (P = 0.8875, r = 0.0183) had a significant correlation with the number of manufacturers in the market. The price variability and the number of manufacturers of doripenem (P = 0.8173, r = 0.047) and meropenem (P = -0.8116, r = 0.499) also had a strong positive correlation. Conclusion The price of carbapenems in the Vietnam pharmaceutical market was high. Monitoring the price and consumption of last-resort antibiotic are needed to ensure availability of antibiotics in the setting with high burden of antibiotic drug resistance.
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Affiliation(s)
- Ninh Thi Nhu Quynh
- Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam
| | - Vu Quoc Dat
- Department of Infectious Diseases, Hanoi Medical University; Tropical Diseases and Harm Reduction, Hanoi Medical University Hospital, Hanoi, Vietnam
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21
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Ha LTT, Rueanghiran C, Giang NTH, Thuy DP, Phu DH, Tuan Kiet B, Hien VB, Hue LT, Padungtod P, Truong BD, Carrique-Mas JJ. Antimicrobial Usage Surveillance Through Sales at Veterinary Drug Shops Intended for Livestock in Vietnam. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2021. [DOI: 10.3389/fsufs.2021.784500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There is a pressing need to establish surveillance systems for antimicrobial use (AMU) intended for animal production particularly in many low- and middle-income countries. This is an extremely challenging task, notably due to the wide range of animal species, production types and antimicrobials available in the market. In Vietnam, farmers commonly buy antimicrobials from veterinary drug shops. Therefore, veterinary drug shops are a potential target for data collection on AMU. We collected antimicrobial sales data at veterinary drug shops and estimated the amount of AMU in different animal species by antimicrobial active ingredient (AAI) class using different measurement metrics. We compiled information on all antimicrobials licensed in Vietnam and used this information to develop a mobile application to capture sales of antimicrobials intended for use in poultry, pig, and ruminant. We provided tablets with this application to 60 veterinary drug shops in two provinces of the country (Bac Giang in the north, Dong Thap in the south; three districts and 30 shops per province) for data collection over 3 weeks. Total sales of antimicrobials were extrapolated to 1 year, and these amounts were related to three different denominator estimates in each province including standing animal body weight, animal biomass, and Population Correction Unit (PCU). A total of 3,960 transactions [2,577 (median 75.5 per shop) in Bac Giang; 1,383 (median 28.5 per shop) in Dong Thap] of 831 different antimicrobial-containing products were recorded in the 3-week period. Sales of 57 AAIs belonging to 17 classes were recorded. In the three Bac Giang districts, we estimated that 242.0 kg of AAI were hypothetically sold over 1 year. Of those, 202.2 kg (83.6%) were intended for poultry, 19.8 kg (8.1%) for pigs, and 20.0 kg (8.3%) for ruminants. In Dong Thap, an estimated 48.4 kg of antimicrobials were sold, including 28.9 kg (59.7%) for poultry, 16.0 kg (33.1%) for pigs, and 3.5 kg (7.2%) for ruminants. After standardized by different animal population denominators, AMU in Bac Giang amounted to 1129.2 mg/kg standing animal body weight, 480.2 mg/kg biomass, and 636.1 mg/kg PCU. In Dong Thap, AMU figures were 1211.0 mg/kg standing animal body weight, 595.8 mg/kg biomass and 818.5 mg/kg PCU. We discuss the observed differences between species, location and metrics, as well as the potential advantages and limitations (including potential sources of bias) of this methodology and its applicability at country level. Retail level data collection can effectively be integrated into AMU surveillance systems that help identify priority AMU management areas (species, regions, and antimicrobial classes), establish national benchmarks and reduction targets.
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Van DA, Ngo TH, Huynh TH, Nakada N, Ballesteros F, Tanaka H. Distribution of pharmaceutical and personal care products (PPCPs) in aquatic environment in Hanoi and Metro Manila. ENVIRONMENTAL MONITORING AND ASSESSMENT 2021; 193:847. [PMID: 34839394 DOI: 10.1007/s10661-021-09622-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/12/2021] [Indexed: 06/13/2023]
Abstract
Pharmaceutical and personal care products (PPCPs) recently defined as emerging pollutants that widespread in surface water all around the world. This study investigated the distribution, and ecological risk of PPCPs in urban rivers of Hanoi, Vietnam, and Metro Manila, the Philippines. Of the 56 investigated PPCPs, 48 and 33 compounds were detected in the river water in Hanoi and in Metro Manila, respectively. The individual PPCP concentrations ranged from a few ng L-1 to thousands of ng L-1. The total concentration of PPCPs detected in water samples ranged from 7.5 to 20,789 ng L-1 in Hanoi and 118 to 3,394 ng L-1 in Manila. The predominant antibiotics was sulfamethoxazole detected in 27/28 samples with a maximum concentration up to 2,778 ng L-1 in Hanoi and presented in all samples with a maximum concentration up to 261 ng L-1 in Metro Manila. In Hanoi, the level of PPCPs in urban canals of Kim Nguu and To Lich Rivers was as high as that detected in domestic wastewater. The PPCP concentrations in tributaries and mainstream were lower than those found in urban canals. In rivers of both sites, PPCPs tended to increase along the stream. The concentration ratio of the labile marker caffeine to recalcitrant marker carbamazepine indicated that untreated domestic wastewater is the significant source of PPCPs in river water in Hanoi and Metro Manila. The ecological risk estimated by the risk quotient of the obtained maximum residue of PPCPs in investigated river water predicted a high risk of PPCPs to the aquatic organism in both Hanoi and Manila.
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Affiliation(s)
- Dieu-Anh Van
- School of Environmental Science and Technology, Hanoi University of Science and Technology, 1 Dai Co Viet Road, Hanoi, Vietnam
| | - Thanh Huy Ngo
- School of Environmental Science and Technology, Hanoi University of Science and Technology, 1 Dai Co Viet Road, Hanoi, Vietnam
| | - Trung Hai Huynh
- School of Environmental Science and Technology, Hanoi University of Science and Technology, 1 Dai Co Viet Road, Hanoi, Vietnam.
| | - Norihide Nakada
- Research Center for Environmental Quality Management, Graduate School of Engineering, Kyoto University, 1-2 Yumihama, Otsu, Shiga, 520-0811, Japan
| | - Florencio Ballesteros
- Department of Chemical Engineering, University of the Philippines, Diliman, Quezon City, 1100, Metro Manila, The Philippines
| | - Hiroaki Tanaka
- Research Center for Environmental Quality Management, Graduate School of Engineering, Kyoto University, 1-2 Yumihama, Otsu, Shiga, 520-0811, Japan
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23
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Truong DTQ, Hounmanou YMG, Dang STT, Olsen JE, Truong GTH, Tran NT, Scheutz F, Dalsgaard A. Genetic Comparison of ESBL-Producing Escherichia coli from Workers and Pigs at Vietnamese Pig Farms. Antibiotics (Basel) 2021; 10:1165. [PMID: 34680746 PMCID: PMC8532784 DOI: 10.3390/antibiotics10101165] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022] Open
Abstract
We analyzed and compared genomes of Extended Spectrum Beta-Lactamase (ESBL)-producing Escherichia coli from pigs and pig farm workers at 116 farms in Vietnam. Analyses revealed the presence of blaCTX-M-55, blaCTX-M-27, blaCTX-M-15, blaCTX-M-14, blaCTX-M-3, blaCTX-M-65, blaCTX-M-24, blaDHA-1, and blaCMY2 in both hosts. Most strains from pigs contained quinolones (qnr) and colistin resistance genes (mcr-1 and mcr-3). Isolates predominantly harbored more than one plasmid replicon and some harbored plasmid replicons on the same contigs as the ESBL genes. Five strains from farm workers of ST38 (2), ST69 (1), and ST1722 (2) were classified as either uropathogenic E. coli (UPECHM)/extraintestinal pathogenic E. coli (ExPECJJ) or UPECHM, and the remaining were genetically distinct commensals. A high heterogeneity was found among the ESBL-producing E. coli from pigs and workers, with most isolates belonging to unrelated phylogroups, serogroups, and sequence types with >4046 Single-Nucleotide Polymorphisms-(SNPs). In comparing the genomes of pig isolates to those from humans, it appeared that ESBL-producing E. coli in workers did not predominantly originate from pigs but were rather host-specific. Nevertheless, the occurrence of ESBL-producing E. coli carrying plasmid-mediated colistin and quinolone resistance genes in pigs could represent a potential source for horizontal transmission to humans through food rather than direct contact.
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Affiliation(s)
- Duong Thi Quy Truong
- National Institute of Veterinary Research, Hanoi 10000, Vietnam; (D.T.Q.T.); (S.T.T.D.); (G.T.H.T.); (N.T.T.)
| | | | - Son Thi Thanh Dang
- National Institute of Veterinary Research, Hanoi 10000, Vietnam; (D.T.Q.T.); (S.T.T.D.); (G.T.H.T.); (N.T.T.)
| | - John Elmerdahl Olsen
- Department of Veterinary and Animal Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark;
| | - Giang Thi Huong Truong
- National Institute of Veterinary Research, Hanoi 10000, Vietnam; (D.T.Q.T.); (S.T.T.D.); (G.T.H.T.); (N.T.T.)
| | - Nhat Thi Tran
- National Institute of Veterinary Research, Hanoi 10000, Vietnam; (D.T.Q.T.); (S.T.T.D.); (G.T.H.T.); (N.T.T.)
| | - Flemming Scheutz
- Department of Bacteria, Parasites and Fungi, Statens Serum Institute, 2300 Copenhagen S, Denmark;
| | - Anders Dalsgaard
- Department of Veterinary and Animal Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark;
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24
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Hadjirin NF, Miller EL, Murray GGR, Yen PLK, Phuc HD, Wileman TM, Hernandez-Garcia J, Williamson SM, Parkhill J, Maskell DJ, Zhou R, Fittipaldi N, Gottschalk M, Tucker AW(D, Hoa NT, Welch JJ, Weinert LA. Large-scale genomic analysis of antimicrobial resistance in the zoonotic pathogen Streptococcus suis. BMC Biol 2021; 19:191. [PMID: 34493269 PMCID: PMC8422772 DOI: 10.1186/s12915-021-01094-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/13/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is among the gravest threats to human health and food security worldwide. The use of antimicrobials in livestock production can lead to emergence of AMR, which can have direct effects on humans through spread of zoonotic disease. Pigs pose a particular risk as they are a source of zoonotic diseases and receive more antimicrobials than most other livestock. Here we use a large-scale genomic approach to characterise AMR in Streptococcus suis, a commensal found in most pigs, but which can also cause serious disease in both pigs and humans. RESULTS We obtained replicated measures of Minimum Inhibitory Concentration (MIC) for 16 antibiotics, across a panel of 678 isolates, from the major pig-producing regions of the world. For several drugs, there was no natural separation into 'resistant' and 'susceptible', highlighting the need to treat MIC as a quantitative trait. We found differences in MICs between countries, consistent with their patterns of antimicrobial usage. AMR levels were high even for drugs not used to treat S. suis, with many multidrug-resistant isolates. Similar levels of resistance were found in pigs and humans from regions associated with zoonotic transmission. We next used whole genome sequences for each isolate to identify 43 candidate resistance determinants, 22 of which were novel in S. suis. The presence of these determinants explained most of the variation in MIC. But there were also interesting complications, including epistatic interactions, where known resistance alleles had no effect in some genetic backgrounds. Beta-lactam resistance involved many core genome variants of small effect, appearing in a characteristic order. CONCLUSIONS We present a large dataset allowing the analysis of the multiple contributing factors to AMR in S. suis. The high levels of AMR in S. suis that we observe are reflected by antibiotic usage patterns but our results confirm the potential for genomic data to aid in the fight against AMR.
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Affiliation(s)
- Nazreen F. Hadjirin
- grid.5335.00000000121885934Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Eric L. Miller
- grid.256868.70000 0001 2215 7365Microbial Ecology and Evolution Laboratory, Haverford College, Haverford, USA
| | - Gemma G. R. Murray
- grid.5335.00000000121885934Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Phung L. K. Yen
- grid.412433.30000 0004 0429 6814Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Ho D. Phuc
- grid.412433.30000 0004 0429 6814Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Thomas M. Wileman
- grid.5335.00000000121885934Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Juan Hernandez-Garcia
- grid.5335.00000000121885934Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Susanna M. Williamson
- grid.13689.350000 0004 0426 1697Department for Environment, Food and Rural Affairs (Defra), London, UK
| | - Julian Parkhill
- grid.5335.00000000121885934Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Duncan J. Maskell
- grid.1008.90000 0001 2179 088XChancellery, University of Melbourne, Melbourne, Australia
| | - Rui Zhou
- grid.35155.370000 0004 1790 4137College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Nahuel Fittipaldi
- grid.14848.310000 0001 2292 3357Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Canada
| | - Marcelo Gottschalk
- grid.14848.310000 0001 2292 3357Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Canada
| | - A. W. ( Dan) Tucker
- grid.5335.00000000121885934Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Ngo Thi Hoa
- grid.412433.30000 0004 0429 6814Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - John J. Welch
- grid.5335.00000000121885934Department of Genetics, University of Cambridge, Cambridge, UK
| | - Lucy A. Weinert
- grid.5335.00000000121885934Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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25
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Cuong NV, Ly NPC, Van NTB, Phu DH, Kiet BT, Hien VB, Padungtod P, Thwaites G, Choisy M, Carrique-Mas J. Feasibility study of a field survey to measure antimicrobial usage in humans and animals in the Mekong Delta region of Vietnam. JAC Antimicrob Resist 2021; 3:dlab107. [PMID: 34396120 PMCID: PMC8360299 DOI: 10.1093/jacamr/dlab107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/30/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Development of antimicrobial use (AMU) surveillance systems in humans and animals is a priority for many low- and middle-income countries; however accurate estimations are hampered by a diversity of animal production systems and metrics. The Mekong Delta region of Vietnam is a 'hotspot' of antimicrobial resistance and is home to a high density of humans and animal populations. OBJECTIVES To measure and compare AMU using different metrics (standing population, biomass and population correction unit) in the Mekong Delta, and to explore the potential of field-based data collection methods in the design of AMU surveillance systems. METHODS We collected AMU data from humans and animals (chickens, ducks, Muscovy ducks, pigs) from 101 small-scale farms in the Mekong Delta over a fixed period (90 days in humans, 7 days in animals). RESULTS Humans used 7.1 DDDkg, or 175.9 mg of antimicrobial active ingredients (AAIs) per kg of standing body mass annually; animals consumed 60.9 ADDkg or 1324 mg. In the Mekong Delta humans represented 79.3% of the total body mass but consumed 29.6% of AAIs by weight. AAIs regarded of critical importance by WHO represented 56.9% and 50.2% of doses consumed by animals and humans, respectively. CONCLUSIONS Using a One Health approach, we show that AMU can potentially be estimated from cross-sectional surveys, although results are hypothetical due to small sample size and are sensitive to the chosen population denominator. The methodology proposed here can potentially be scaled up be applied to design AMU surveillance in low-resource settings, allowing AMU reduction efforts to be focused on particular animal species.
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Affiliation(s)
- Nguyen Van Cuong
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | - Doan Hoang Phu
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Faculty of Animal Science and Veterinary Medicine, University of Agriculture and Forestry, Ho Chi Minh City, Vietnam
| | - Bach Tuan Kiet
- Sub-Department of Animal Health and Production (SDAHP), Cao Lanh, Dong Thap, Vietnam
| | - Vo Be Hien
- Sub-Department of Animal Health and Production (SDAHP), Cao Lanh, Dong Thap, Vietnam
| | - Pawin Padungtod
- Food and Agriculture Organization of the United Nations, Hanoi, Vietnam
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, UK
| | - Marc Choisy
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Food and Agriculture Organization of the United Nations, Hanoi, Vietnam
- MIVEGEC, IRD, CNRS, University of Montpellier, Montpellier, France
| | - Juan Carrique-Mas
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, UK
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Hickman RA, Leangapichart T, Lunha K, Jiwakanon J, Angkititrakul S, Magnusson U, Sunde M, Järhult JD. Exploring the Antibiotic Resistance Burden in Livestock, Livestock Handlers and Their Non-Livestock Handling Contacts: A One Health Perspective. Front Microbiol 2021; 12:651461. [PMID: 33959112 PMCID: PMC8093850 DOI: 10.3389/fmicb.2021.651461] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 03/16/2021] [Indexed: 01/14/2023] Open
Abstract
Antibiotics are freqeuently used in the livestock sector in low- and middle-income countries for treatment, prophylaxis, and growth promotion. However, there is limited information into the zoonotic prevalence and dissemination patterns of antimicrobial resistance (AMR) within these environments. In this study we used pig farming in Thailand as a model to explore AMR; 156 pig farms were included, comprising of small-sized (<50 sows) and medium-sized (≥100 sows) farms, where bacterial isolates were selectively cultured from animal rectal and human fecal samples. Bacterial isolates were subjected to antimicrobial susceptibility testing (AST), and whole-genome sequencing. Our results indicate extensive zoonotic sharing of antibiotic resistance genes (ARGs) by horizontal gene transfer. Resistance to multiple antibiotics was observed with higher prevalence in medium-scale farms. Zoonotic transmission of colistin resistance in small-scale farms had a dissemination gradient from pigs to handlers to non-livestock contacts. We highly recommend reducing the antimicrobial use in animals’ feeds and medications, especially the last resort drug colistin.
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Affiliation(s)
- Rachel A Hickman
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center, Uppsala University, Uppsala, Sweden
| | | | - Kamonwan Lunha
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Jatesada Jiwakanon
- Research Group for Animal Health Technology, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sunpetch Angkititrakul
- Research Group for Animal Health Technology, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ulf Magnusson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Marianne Sunde
- Section for Animal Health and Food Safety, Norwegian Veterinary Institute, Oslo, Norway
| | - Josef D Järhult
- Department of Medical Sciences, Zoonosis Science Center, Uppsala University, Uppsala, Sweden
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Anh HQ, Le TPQ, Da Le N, Lu XX, Duong TT, Garnier J, Rochelle-Newall E, Zhang S, Oh NH, Oeurng C, Ekkawatpanit C, Nguyen TD, Nguyen QT, Nguyen TD, Nguyen TN, Tran TL, Kunisue T, Tanoue R, Takahashi S, Minh TB, Le HT, Pham TNM, Nguyen TAH. Antibiotics in surface water of East and Southeast Asian countries: A focused review on contamination status, pollution sources, potential risks, and future perspectives. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 764:142865. [PMID: 33097262 DOI: 10.1016/j.scitotenv.2020.142865] [Citation(s) in RCA: 142] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/26/2020] [Accepted: 10/03/2020] [Indexed: 05/11/2023]
Abstract
This review provides focused insights into the contamination status, sources, and ecological risks associated with multiple classes of antibiotics in surface water from the East and Southeast Asia based on publications over the period 2007 to 2020. Antibiotics are ubiquitous in surface water of these countries with concentrations ranging from <1 ng/L to hundreds μg/L and median values from 10 to 100 ng/L. Wider ranges and higher maximum concentrations of certain antibiotics were found in surface water of the East Asian countries like China and South Korea than in the Southeast Asian nations. Environmental behavior and fate of antibiotics in surface water is discussed. The reviewed occurrence of antibiotics in their sources suggests that effluent from wastewater treatment plants, wastewater from aquaculture and livestock production activities, and untreated urban sewage are principal sources of antibiotics in surface water. Ecological risks associated with antibiotic residues were estimated for aquatic organisms and the prevalence of antibiotic resistance genes and antibiotic-resistant bacteria were reviewed. Such findings underline the need for synergistic efforts from scientists, engineers, policy makers, government managers, entrepreneurs, and communities to manage and reduce the burden of antibiotics and antibiotic resistance in water bodies of East and Southeast Asian countries.
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Affiliation(s)
- Hoang Quoc Anh
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam; Center of Advanced Technology for the Environment (CATE), Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama 790-8566, Japan.
| | - Thi Phuong Quynh Le
- Laboratory of Environmental Chemistry, Institute of Natural Products Chemistry, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam; Graduate University of Science and Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam.
| | - Nhu Da Le
- Laboratory of Environmental Chemistry, Institute of Natural Products Chemistry, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Xi Xi Lu
- Department of Geography, National University of Singapore, Arts Link 1, Singapore 117570, Singapore
| | - Thi Thuy Duong
- Institute of Environmental Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Josette Garnier
- Sorbonne University, UMR Metis 7619, 4th floor, Tour 56, 4 Place Jussieu, Paris 75005, France
| | - Emma Rochelle-Newall
- Institute of Ecology and Environmental Sciences of Paris (iEES-Paris), Sorbonne Université, Université Paris-Est Créteil, IRD, CNRS, INRA, Paris, France
| | - Shurong Zhang
- College of Water Sciences, Beijing Normal University, 19 Xinjiekouwai St., Beijing 100875, China
| | - Neung-Hwan Oh
- Graduate School of Environmental Studies, Seoul National University, Seoul 08826, Republic of Korea
| | - Chantha Oeurng
- Institute of Technology of Cambodia, Russian Conference Blvd., Phnom Penh, Cambodia
| | - Chaiwat Ekkawatpanit
- Civil Engineering Department, King Mongkut's University of Technology Thonburi (KMUTT), 126 Pracha Uthit Rd., Thon Buri, Bangkok 10140, Thailand
| | - Tien Dat Nguyen
- Center for Research and Technology Transfer, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Quang Trung Nguyen
- Center for Research and Technology Transfer, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Tran Dung Nguyen
- Institute of Environmental Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Trong Nghia Nguyen
- Faculty of Chemical Technology and Environment, Hung Yen University of Technology and Education, Khoai Chau, Hung Yen 17000, Viet Nam
| | - Thi Lieu Tran
- Viet Nam National Institute of Occupational Safety and Health (VNNIOSH), 99 Tran Quoc Toan, Hoan Kiem, Hanoi 10000, Viet Nam
| | - Tatsuya Kunisue
- Center for Marine Environmental Studies (CMES), Ehime University, 2-5 Bunkyo-cho, Matsuyama 790-8577, Japan
| | - Rumi Tanoue
- Center for Marine Environmental Studies (CMES), Ehime University, 2-5 Bunkyo-cho, Matsuyama 790-8577, Japan
| | - Shin Takahashi
- Center of Advanced Technology for the Environment (CATE), Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama 790-8566, Japan; Center for Marine Environmental Studies (CMES), Ehime University, 2-5 Bunkyo-cho, Matsuyama 790-8577, Japan
| | - Tu Binh Minh
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam
| | - Huu Tuyen Le
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam
| | - Thi Ngoc Mai Pham
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam
| | - Thi Anh Huong Nguyen
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam
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Haulisah NA, Hassan L, Bejo SK, Jajere SM, Ahmad NI. High Levels of Antibiotic Resistance in Isolates From Diseased Livestock. Front Vet Sci 2021; 8:652351. [PMID: 33869326 PMCID: PMC8047425 DOI: 10.3389/fvets.2021.652351] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/09/2021] [Indexed: 12/20/2022] Open
Abstract
Overuse of antimicrobials in livestock health and production beyond therapeutic needs has been highlighted in recent years as one of the major risk factors for the acceleration of antimicrobial resistance (AMR) of bacteria in both humans and animals. While there is an abundance of reports on AMR in clinical isolates from humans, information regarding the patterns of resistance in clinical isolates from animals is scarce. Hence, a situational analysis of AMR based on clinical isolates from a veterinary diagnostic laboratory was performed to examine the extent and patterns of resistance demonstrated by isolates from diseased food animals. Between 2015 and 2017, 241 cases of diseased livestock were received. Clinical specimens from ruminants (cattle, goats and sheep), and non-ruminants (pigs and chicken) were received for culture and sensitivity testing. A total of 701 isolates were recovered from these specimens. From ruminants, Escherichia coli (n = 77, 19.3%) predominated, followed by Staphylococcus aureus (n = 73, 18.3%). Antibiotic sensitivity testing (AST) revealed that E. coli resistance was highest for penicillin, streptomycin, and neomycin (77-93%). In addition, S. aureus was highly resistant to neomycin, followed by streptomycin and ampicillin (68-82%). More than 67% of E. coli isolates were multi-drug resistant (MDR) and only 2.6% were susceptible to all the tested antibiotics. Similarly, 65.6% of S. aureus isolates were MDR and only 5.5% were susceptible to all tested antibiotics. From non-ruminants, a total of 301 isolates were recovered. Escherichia coli (n = 108, 35.9%) and Staphylococcus spp. (n = 27, 9%) were the most frequent isolates obtained. For E. coli, the highest resistance was against amoxicillin, erythromycin, tetracycline, and neomycin (95-100%). Staphylococcus spp. had a high level of resistance to streptomycin, trimethoprim/sulfamethoxazole, tetracycline and gentamicin (80-100%). The MDR levels of E. coli and Staphylococcus spp. isolates from non-ruminants were 72.2 and 74.1%, respectively. Significantly higher resistance level were observed among isolates from non-ruminants compared to ruminants for tetracycline, amoxicillin, enrofloxacin, and trimethoprim/sulfamethoxazole.
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Affiliation(s)
| | - Latiffah Hassan
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | - Siti Khairani Bejo
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Nur Indah Ahmad
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Malaysia
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Luu QH, Nguyen TLA, Pham TN, Vo NG, Padungtod P. Antimicrobial use in household, semi-industrialized, and industrialized pig and poultry farms in Viet Nam. Prev Vet Med 2021; 189:105292. [PMID: 33621709 DOI: 10.1016/j.prevetmed.2021.105292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/27/2021] [Accepted: 01/30/2021] [Indexed: 11/28/2022]
Abstract
The use and misuse of antimicrobials in livestock production contributes to increasing antimicrobial resistance (AMR). Antimicrobial use (AMU), has been identified as a problem in Viet Nam. There were many identified drivers of AMU in Viet Nam such as lack of access to veterinary services, easy access to cheap over-the-counter antimicrobials, and insufficient farm biosecurity. This study included chicken farmers (n = 540) and pig farmers (n = 540) from household, semi-industrialized, and industrialized farms in the North, Central, and South of Viet Nam. The objective of this study was to determine farmers rationale behind AMU on their farms and their usage patterns. On pig farms, 98.1% of the farmers reported use of antimicrobials in their production. On chicken farms, 87.9% reported use of antimicrobials in their production. The results of the survey showed that the three main purposes of AMU were treatment of sick animals, disease prevention, and weight gain. Treatment accounted for 81.3% in pig farming and 62.1% in chicken farming. The main reason to start antimicrobial therapy in pig and chicken production was observation of the first clinical signs of disease (73.9% of the pig farmers and 74.9% of chicken farmers). The proportion of industrial pig farms performing diagnostic tests before using antimicrobials was singnificantly (p < 0.05) higher than household farms (OR = 45.3). The proportion of chicken farmers who used diagnostic tests before using antimicrobials on semi-industrial (OR = 4.1) and industrial farms (OR = 26.7) were significantly higher compared with household farms. Through encouraging the prudent use of antimicrobials in animal husbandry we can reduce the use of antimicrobials at the primary production level and thereby lowering the risk of AMR.
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Affiliation(s)
- Quynh Huong Luu
- National Institute of Veterinary Research, No. 86, Truong Chinh road, Phuong Mai ward, Dong Da district, Ha Noi, Viet Nam.
| | - Thi Lan Anh Nguyen
- National Institute of Veterinary Research, No. 86, Truong Chinh road, Phuong Mai ward, Dong Da district, Ha Noi, Viet Nam.
| | - Thi Ngoc Pham
- National Institute of Veterinary Research, No. 86, Truong Chinh road, Phuong Mai ward, Dong Da district, Ha Noi, Viet Nam.
| | - Ngan Giang Vo
- Food and Agriculture Organization of the United Nations Country Office for Viet Nam Green One UN House Building, No. 304, Kim Ma Street, Hanoi, Viet Nam.
| | - Pawin Padungtod
- Food and Agriculture Organization of the United Nations Country Office for Viet Nam Green One UN House Building, No. 304, Kim Ma Street, Hanoi, Viet Nam.
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Phu DH, Cuong NV, Truong DB, Kiet BT, Hien VB, Thu HTV, Yen LK, Minh NTT, Padungtod P, Setyawan E, Thwaites G, Rushton J, Carrique-Mas J. Reducing Antimicrobial Usage in Small-Scale Chicken Farms in Vietnam: A 3-Year Intervention Study. Front Vet Sci 2021; 7:612993. [PMID: 33585602 PMCID: PMC7876082 DOI: 10.3389/fvets.2020.612993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/29/2020] [Indexed: 12/20/2022] Open
Abstract
Indiscriminate antimicrobial use (AMU) in animal production is a driver of antimicrobial resistance globally. There is a need to define sustainable interventions to reduce AMU in small-scale production systems, which currently represent the most widespread farming systems in South East Asia and many low- and middle-income countries. We conducted a before-and-after intervention study on a random sample of small-scale chicken farms in the Mekong Delta of Vietnam from 2016 to 2019. The study included a baseline followed by an intervention phase where farmers were provided with regular veterinary advice on flock health and husbandry, as well as antimicrobial replacement products. Of 102 recruited farms (raising >100 chickens per flock cycle), thirty-five (34.2%) entered the intervention phase, whilst the rest stopped raising chickens, mainly due to suboptimal flock performance. Through the implementation of our intervention, chicken flocks reduced levels of AMU by 66% [adjusted hazard ratio (HR) = 0.34; p = 0.002) from a baseline of 343.4 Animal Daily Doses per 1,000 chicken-days and decreased weekly mortality by 40% (adjusted HR = 0.60; p = 0.005) from a baseline mortality of 1.60 per 100 birds. Chicken bodyweight increased by 100 g (p = 0.002) in intervention flocks. Our findings demonstrate that the provision of veterinary advice can achieve substantial reductions in AMU in small-scale production systems without compromising flock health and productivity.
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Affiliation(s)
- Doan Hoang Phu
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh City, Vietnam
| | - Nguyen Van Cuong
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Dinh Bao Truong
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh City, Vietnam
| | - Bach Tuan Kiet
- Sub-Department of Animal Health and Production, Cao Lãnh City, Vietnam
| | - Vo Be Hien
- Sub-Department of Animal Health and Production, Cao Lãnh City, Vietnam
| | - Ho Thi Viet Thu
- Department of Veterinary Medicine, Can Tho University, Can Tho, Vietnam
| | - Lam Kim Yen
- Faculty of Agriculture and Aquaculture, Dong Thap Community College, Cao Lãnh City, Vietnam
| | | | - Pawin Padungtod
- Food and Agriculture Organization of the United Nations, Hanoi, Vietnam
| | - Erry Setyawan
- Food and Agriculture Organization of the United Nations, Jakarta, Indonesia
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Jonathan Rushton
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Juan Carrique-Mas
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
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Nguyen MN, Hoang HTT, Xavier BB, Lammens C, Le HT, Hoang NTB, Nguyen ST, Pham NT, Goossens H, Dang AD, Malhotra-Kumar S. Prospective One Health genetic surveillance in Vietnam identifies distinct bla CTX-M-harbouring Escherichia coli in food-chain and human-derived samples. Clin Microbiol Infect 2021; 27:1515.e1-1515.e8. [PMID: 33476808 DOI: 10.1016/j.cmi.2021.01.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES We performed a One Health surveillance in Hanoi-a region with a high-density human population and livestock production, and a recognized hotspot of animal-associated antimicrobial resistance (AMR)-to study the contribution of blaCTX-M-carrying Escherichia coli and plasmids from food-animal sources in causing human community-acquired urinary tract infections (CA-UTIs). METHODS During 2014-2015, 9090 samples were collected from CA-UTI patients (urine, n = 8564), pigs/chickens from farms and slaughterhouses (faeces, carcasses, n = 448), and from the slaughterhouse environment (surface swabs, water, n = 78). E. coli was identified in 2084 samples. Extended-spectrum β-lactamase (ESBL) production was confirmed in 235 and blaCTX-M in 198 strains by PCR with short-read plasmid sequencing. Fourteen strains were long-read sequenced to enable plasmid reconstruction. RESULTS The majority of the ESBL-producing E. coli strains harboured blaCTX-M (n = 198/235, 84%). High clonal diversity (48 sequence types, STs) and distinct, dominant STs in human sources (ST1193, n = 38/137; ST131, n = 30/137) and non-human sources (ST155, n = 25/61) indicated lack of clonal transmission between habitats. Eight blaCTX-M variants were identified; five were present in at least two sample sources. Human and food-animal strains did not show similar plasmids carrying shared blaCTX-M genes. However, IS6 elements flanking ISEcp1-blaCTX-M-orf477/IS903B structures were common across habitats. CONCLUSIONS In this study, animal-associated blaCTX-ME. coli strains or blaCTX-M plasmids were not direct sources of CA-UTIs or ESBL resistance in humans, respectively, suggesting evolutionary bottlenecks to their adaptation to a new host species. Presence of common IS6 elements flanking blaCTX-M variants in different plasmid backbones, however, highlighted the potential of these transposable elements for AMR transmission either within or across habitats.
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Affiliation(s)
- Minh Ngoc Nguyen
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | | | - Basil Britto Xavier
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Christine Lammens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Hai Thanh Le
- Vietnam National Children's Hospital, Hanoi, Viet Nam
| | | | | | - Ngoc Thi Pham
- National Institute of Veterinary Research, Hanoi, Viet Nam
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Anh Duc Dang
- Vietnam National Children's Hospital, Hanoi, Viet Nam
| | - Surbhi Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
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Pavez-Muñoz E, González C, Fernández-Sanhueza B, Sánchez F, Escobar B, Ramos R, Fuenzalida V, Galarce N, Arriagada G, Neira V, Muñoz-Aguayo J, Flores-Figueroa C, Johnson TJ, Alegría-Morán R. Antimicrobial Usage Factors and Resistance Profiles of Shiga Toxin-Producing Escherichia coli in Backyard Production Systems From Central Chile. Front Vet Sci 2021; 7:595149. [PMID: 33521079 PMCID: PMC7844202 DOI: 10.3389/fvets.2020.595149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 12/17/2020] [Indexed: 12/28/2022] Open
Abstract
Shiga toxin-producing Escherichia coli (STEC) is a zoonotic pathogen and important cause of foodborne disease worldwide. Many animal species in backyard production systems (BPS) harbor STEC, systems characterized by low biosecurity and technification. No information is reported on STEC circulation, antimicrobial resistance (AMR) and potential drivers of antimicrobial usage in Chilean BPS, increasing the risk of maintenance and transmission of zoonotic pathogens and AMR generation. Thus, the aim of this study was to characterize phenotypic and genotypic AMR and to study the epidemiology of STEC isolated in BPS from Metropolitana region, Chile. A total of 85 BPS were sampled. Minimal inhibitory concentration and whole genome sequencing was assessed in 10 STEC strain isolated from BPS. All strains were cephalexin-resistant (100%, n = 10), and five strains were resistant to chloramphenicol (50%). The most frequent serotype was O113:H21 (40%), followed by O76:H19 (40%), O91:H14 (10%), and O130:H11 (10%). The stx1 type was detected in all isolated strains, while stx2 was only detected in two strains. The Stx subtype most frequently detected was stx1c (80%), followed by stx1a (20%), stx2b (10%), and stx2d (10%). All strains harbored chromosomal blaAmpC. Principal component analysis shows that BPS size, number of cattle, pet and horse, and elevation act as driver of antimicrobial usage. Logistic multivariable regression shows that recognition of diseases in animals (p = 0.038; OR = 9.382; 95% CI: 1.138–77.345), neighboring poultry and/or swine BPS (p = 0.006; OR = 10.564; 95% CI: 1.996–55.894), visit of Veterinary Officials (p = 0.010; OR = 76.178; 95% CI: 2.860–2029.315) and close contact between animal species in the BPS (p = 0.021; OR = 9.030; 95% CI: 1.385–58.888) increase significantly the risk of antimicrobial use in BPS. This is the first evidence of STEC strains circulating in BPS in Chile, exhibiting phenotypic AMR, representing a threat for animal and public health. Additionally, we identified factors acting as drivers for antimicrobial usage in BPS, highlighting the importance of integration of these populations into surveillance and education programs to tackle the potential development of antimicrobial resistance and therefore the risk for ecosystemic health.
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Affiliation(s)
- Erika Pavez-Muñoz
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Camilo González
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Bastián Fernández-Sanhueza
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Fernando Sánchez
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Beatriz Escobar
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Romina Ramos
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Verónica Fuenzalida
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Nicolás Galarce
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Gabriel Arriagada
- Instituto de Ciencias Agroalimentarias, Animales y Ambientales-ICA3, Universidad de O'Higgins, Rancagua, Chile
| | - Víctor Neira
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Jeannette Muñoz-Aguayo
- Mid-Central Research and Outreach Center, University of Minnesota, Saint Paul, MN, United States
| | - Cristian Flores-Figueroa
- Mid-Central Research and Outreach Center, University of Minnesota, Saint Paul, MN, United States
| | - Timothy J Johnson
- Department of Veterinary and Biomedical Sciences, University of Minnesota, Saint Paul, MN, United States
| | - Raúl Alegría-Morán
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile.,Facultad de Ciencias Agropecuarias y Ambientales, Universidad Pedro de Valdivia, Santiago, Chile
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Umair M, Abdullah RM, Aslam B, Nawaz MH, Ali Q, Fatima F, Ali J, Zahoor MA, Mohsin M. First Case Report on Quantification of Antimicrobial Use in Corporate Dairy Farms in Pakistan. Front Vet Sci 2020; 7:575848. [PMID: 33324699 PMCID: PMC7725763 DOI: 10.3389/fvets.2020.575848] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/26/2020] [Indexed: 12/31/2022] Open
Abstract
Intensive livestock farming has become indispensable to meet the rapidly increasing demand for animal-based nutrition in low- and middle-income countries (LMICs) where antimicrobials are frequently used for treatment and prophylactic or metaphylactic purposes. However, very little is known about the trends of antimicrobial use (AMU) in dairy animals in LMICs. The objective of this study was to quantify AMU in two large commercial dairy farms in Pakistan. A retrospective study was conducted at two large corporate commercial dairy farms located in Punjab province for the year 2018. AMU was calculated using three metrics: active ingredient (AI; kg) and milligrams per population unit (mg/PU; mg/kg), which quantifies the amount of AI used, and antimicrobial treatment incidence (ATI; DDDA/1,000 cow-days), which estimates the per-day number of treatments to 1,000 cows. Total on-farm AMU was found to be 138.34 kg, 65.88 mg/kg, and 47.71 DDDA/1,000 cow-days. Measured in ATI, aminoglycosides (11.05 DDDA/1,000 cow-days), penicillins (8.29 DDDA/1,000 cow-days), and tetracyclines (8.1 DDDA/1,000 cow-days) were the most frequently used antimicrobial classes. A total of 42.46% of all the antimicrobials used belonged to the critically important antimicrobials for human medicine as defined by the World Health Organization. Considerably high AMU was found compared to other farm-level studies across the world. This was the first study to quantify AMU in the dairy industry in Pakistan. Our results showed that corporate commercial dairy management practices are associated with increased antimicrobial consumption and highlight the need for antimicrobial stewardship programs to encourage prudent use of antimicrobials in commercial dairy.
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Affiliation(s)
- Muhammad Umair
- Institute of Microbiology, University of Agriculture, Faisalabad, Pakistan
| | | | - Bilal Aslam
- Institute of Pharmacy, Physiology and Pharmacology, University of Agriculture, Faisalabad, Pakistan
| | - Muhammad Hassan Nawaz
- Department of Theriogenology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, Pakistan
| | - Qasim Ali
- Institute of Microbiology, University of Agriculture, Faisalabad, Pakistan
| | - Fariha Fatima
- Institute of Microbiology, University of Agriculture, Faisalabad, Pakistan
| | - Jabir Ali
- Institute of Microbiology, University of Agriculture, Faisalabad, Pakistan
| | - Muhammad Asif Zahoor
- Department of Microbiology, Faculty of Life Sciences, Government College University Faisalabad, Faisalabad, Pakistan
| | - Mashkoor Mohsin
- Institute of Microbiology, University of Agriculture, Faisalabad, Pakistan
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Pokharel S, Shrestha P, Adhikari B. Antimicrobial use in food animals and human health: time to implement 'One Health' approach. Antimicrob Resist Infect Control 2020; 9:181. [PMID: 33160396 PMCID: PMC7648983 DOI: 10.1186/s13756-020-00847-x] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/29/2020] [Indexed: 01/21/2023] Open
Abstract
The use of antimicrobials in animals for growth promotion and infection prevention significantly contributes to the development of antimicrobial resistance (AMR), a growing public health threat. While the World Health Organization (WHO), the United Nations (UN) and the European Union (EU) have taken steps towards reducing and restricting the use of antimicrobials in animals, initiatives are insufficient in developing countries where the demands for food animals continue to rise over the years. The inter-sectoral acknowledgment of inextricable link between animal health, human health and the environment (One Health approach) is critical. Concerted and collaborative efforts among all the stakeholders are essential to deal with this complex problem of resistance.
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Affiliation(s)
- Sunil Pokharel
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Priyanka Shrestha
- International Diagnostics Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Bipin Adhikari
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
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35
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Mouiche MMM, Moffo F, Betsama JDB, Mapiefou NP, Mbah CK, Mpouam SE, Penda RE, Ciake SAC, Feussom JMK, Kamnga ZF, Awah-Ndukum J. Challenges of antimicrobial consumption surveillance in food-producing animals in sub-Saharan African countries: Patterns of antimicrobials imported in Cameroon from 2014 to 2019. J Glob Antimicrob Resist 2020; 22:771-778. [PMID: 32645443 DOI: 10.1016/j.jgar.2020.06.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 06/08/2020] [Accepted: 06/17/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Antimicrobial consumption surveillance is a useful tool for planning antimicrobial resistance control strategies and risk analysis. The present study was carried out to evaluate the consumption trends of antimicrobials for veterinary use in food-producing animals in Cameroon from 2014 to 2019. METHODS Data on quantities of classes of active substances were collected from the records of the technical authorization to import veterinary drugs of suppliers' invoices at the Ministry of Livestock (MINEPIA); animal population data were collected from the FAO-Stat database. RESULTS The study revealed that 217.67tonnes of antimicrobials (by weight of active substance) were imported during the 6-year period, with an average of 36.28±10.11tonnes per year. Tetracyclines (31.71%), sulfonamides (23.84%), quinolones (11.11%) and β-lactams (10.17%) were the most commonly imported classes of antimicrobials. With regard to the importance of veterinary antimicrobials to human medicine, critically important antimicrobial (34.3%), reserve (4.6%) and watch (25.5%) groups as classified by the WHO AWaRe categorization were recorded. Overall, a mean of 5.24±1.40mg/PCU (population correction unit) was used in all food-producing animals during the 6-year period. However, the mean quantity of antimicrobials adjusted by animal biomass was highest in poultry (213.32±50.26mg/kg), followed by pigs (63.04±18.87mg/kg), cattle (4.11±2.20mg/kg), sheep (0.83±0.43mg/kg) and goats (0.47±0.24mg/kg). CONCLUSION Strict surveillance systems of antimicrobial consumption in the country are vital to optimize control strategies. Monitoring importation data of veterinary antimicrobial products could be useful for sub-Saharan African countries to quantify consumption and estimate trends for antimicrobial usage effectively.
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Affiliation(s)
- Mohamed Moctar Mouliom Mouiche
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Yaounde, Cameroon.
| | - Frédéric Moffo
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Yaounde, Cameroon; Laboratory of Animal Physiology and Health, Department of Zootechnics, Faculty of Agronomy and Agricultural Sciences, University of Dschang, Dschang, Cameroon
| | - Jean Daniel Betsama Betsama
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Yaounde, Cameroon
| | - Nabilah Pemi Mapiefou
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Yaounde, Cameroon
| | - Cleophas Kahtita Mbah
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Yaounde, Cameroon
| | - Serge Eugene Mpouam
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Yaounde, Cameroon
| | - Rose Eliane Penda
- Ministry of Livestock, Fisheries and Animal Industries (MINEPIA), Yaounde, Cameroon
| | | | - Jean Marc Kameni Feussom
- Ministry of Livestock, Fisheries and Animal Industries (MINEPIA), Yaounde, Cameroon; Epidemiology-Public Health-Veterinary Association (ESPV), Yaounde, Cameroon
| | | | - Julius Awah-Ndukum
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Yaounde, Cameroon; Laboratory of Animal Physiology and Health, Department of Zootechnics, Faculty of Agronomy and Agricultural Sciences, University of Dschang, Dschang, Cameroon; College of Technology, University of Bamenda, Bambili, Cameroon
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