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Lynch I, Fluks L, Manderson L, Isaacs N, Essop R, Praphasawat R, Middleton L, Naemiratch B. Gender and equity considerations in AMR research: a systematic scoping review. Monash Bioeth Rev 2024:10.1007/s40592-024-00194-2. [PMID: 38676854 DOI: 10.1007/s40592-024-00194-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/29/2024]
Abstract
Research on gender and antimicrobial resistance (AMR) beyond women's biological susceptibility is limited. A gender and equity lens in AMR research is necessary to promote gender equality and support the effectiveness, uptake, and sustainability of real-world AMR solutions. We argue that it is an ethical and social justice imperative to include gender and related intersectional issues in AMR research and implementation. An intersectional exploration of the interplay between people's diverse identities and experiences, including their gender, socio-economic status, race, disability, age, and sexuality, may help us understand how these factors reinforce AMR risk and vulnerability and ensure that interventions to reduce the risk of AMR do not impact unevenly. This paper reports on the findings of a systematic scoping review on the interlinkages between AMR, gender and other socio-behavioural characteristics to identify priority knowledge gaps in human and animal health in LMICs. The review focused on peer-reviewed and grey literature published between 2017 and 2022. Three overarching themes were gendered division of caregiving roles and responsibilities, gender power relations in decision-making, and interactions between gender norms and health-seeking behaviours. Research that fails to account for gender and its intersections with other lines of disadvantage, such as race, class and ability, risks being irrelevant and will have little impact on the continued and dangerous spread of AMR. We provide recommendations for integrating an intersectional gender lens in AMR research, policy and practice.
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Affiliation(s)
- Ingrid Lynch
- Human Sciences Research Council, Cape Town, South Africa
| | - Lorenza Fluks
- Human Sciences Research Council, Cape Town, South Africa
| | | | - Nazeema Isaacs
- Human Sciences Research Council, Cape Town, South Africa
| | - Roshin Essop
- Human Sciences Research Council, Cape Town, South Africa
| | - Ravikanya Praphasawat
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Lyn Middleton
- University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Bhensri Naemiratch
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
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Menezes KV, Duarte CEDS, Moreira MG, Moreno TDJC, Pereira VJDS, Ucella-Filho JGM, Otenio MH, Ignacchiti MDC, Resende JA. Enterobacteria in anaerobic digestion of dairy cattle wastewater: Assessing virulence and resistance for one health security. WATER RESEARCH 2024; 252:121192. [PMID: 38309066 DOI: 10.1016/j.watres.2024.121192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/26/2023] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
Samples from a dairy cattle waste-fed anaerobic digester were collected across seasons to assess sanitary safety for biofertilizer use. Isolated enterobacteria (suggestive of Escherichia coli) were tested for susceptibility to biocides, antimicrobials, and biofilm-forming capability. Results revealed a decrease in total bacteria, coliforms, and enterobacteria in biofertilizer compared to the effluent. Among 488 isolates, 98.12 % exhibited high biofilm formation. Biofertilizer isolates exhibited a similar biofilm formation capability as effluent isolates in summer, but greater propensity in winter. Resistance to biocides and antimicrobials varied, with tetracycline resistance reaching 19 %. Of the isolates, 25 were multidrug-resistant (MDR), with 64 % resistant to three drugs. Positive correlations were observed between MDR and increased biofilm formation capacity in both samples, while there was negative correlation between MDR and increased biocide resistance. A higher number of MDR bacteria were found in biofertilizer compared to the effluent, revealing the persistence of E. coli resistance, posing challenges to food safety and public health.
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Affiliation(s)
- Kássia Vidal Menezes
- Graduate Program in Veterinary Sciences, Center for Agricultural Sciences and Engineering - CCAE, Federal University of Espírito Santo - UFES, Alto Universitário, no number, Guararema, Alegre, ES 29500-000, Brazil
| | | | - Myleny Goularte Moreira
- Department of Pharmacy and Nutrition, Federal University of Espírito Santo - UFES, Alegre, ES 29500-000, Brazil
| | | | - Vitor José da Silva Pereira
- Department of Pharmacy and Nutrition, Federal University of Espírito Santo - UFES, Alegre, ES 29500-000, Brazil
| | - João Gilberto Meza Ucella-Filho
- Department of Forestry and Wood Sciences, Federal University of Espírito Santo - UFES, Jerônimo Monteiro, ES 29550-000, Brazil
| | | | | | - Juliana Alves Resende
- Graduate Program in Veterinary Sciences, Center for Agricultural Sciences and Engineering - CCAE, Federal University of Espírito Santo - UFES, Alto Universitário, no number, Guararema, Alegre, ES 29500-000, Brazil; Department of Pharmacy and Nutrition, Federal University of Espírito Santo - UFES, Alegre, ES 29500-000, Brazil.
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Smit CCH, Lambert M, Rogers K, Djordjevic SP, Van Oijen AM, Keighley C, Taxis K, Robertson H, Pont LG. One Health Determinants of Escherichia coli Antimicrobial Resistance in Humans in the Community: An Umbrella Review. Int J Mol Sci 2023; 24:17204. [PMID: 38139033 PMCID: PMC10743193 DOI: 10.3390/ijms242417204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
To date, the scientific literature on health variables for Escherichia coli antimicrobial resistance (AMR) has been investigated throughout several systematic reviews, often with a focus on only one aspect of the One Health variables: human, animal, or environment. The aim of this umbrella review is to conduct a systematic synthesis of existing evidence on Escherichia coli AMR in humans in the community from a One Health perspective. PubMed, EMBASE, and CINAHL were searched on "antibiotic resistance" and "systematic review" from inception until 25 March 2022 (PROSPERO: CRD42022316431). The methodological quality was assessed, and the importance of identified variables was tabulated across all included reviews. Twenty-three reviews were included in this study, covering 860 primary studies. All reviews were of (critically) low quality. Most reviews focused on humans (20), 3 on animals, and 1 on both human and environmental variables. Antibiotic use, urinary tract infections, diabetes, and international travel were identified as the most important human variables. Poultry farms and swimming in freshwater were identified as potential sources for AMR transmission from the animal and environmental perspectives. This umbrella review highlights a gap in high-quality literature investigating the time between variable exposure, AMR testing, and animal and environmental AMR variables.
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Affiliation(s)
- Chloé C. H. Smit
- Graduate School of Health, University of Technology Sydney, Sydney, NSW 2008, Australia; (C.C.H.S.); (K.R.)
| | - Maarten Lambert
- Department of PharmacoTherapy, -Epidemiology and -Economics, Faculty of Science and Engineering, University of Groningen, 9713 AV Groningen, The Netherlands; (M.L.); (K.T.)
| | - Kris Rogers
- Graduate School of Health, University of Technology Sydney, Sydney, NSW 2008, Australia; (C.C.H.S.); (K.R.)
| | - Steven P. Djordjevic
- The Australian Institute for Microbiology & Infection, University of Technology Sydney, Sydney, NSW 2007, Australia;
| | - Antoine M. Van Oijen
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia;
| | - Caitlin Keighley
- Southern.IML Pathology, Sonic Healthcare, 3 Bridge St, Wollongong, NSW 2500, Australia
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Katja Taxis
- Department of PharmacoTherapy, -Epidemiology and -Economics, Faculty of Science and Engineering, University of Groningen, 9713 AV Groningen, The Netherlands; (M.L.); (K.T.)
| | - Hamish Robertson
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD 4059, Australia;
| | - Lisa G. Pont
- Graduate School of Health, University of Technology Sydney, Sydney, NSW 2008, Australia; (C.C.H.S.); (K.R.)
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Mondragón-Quiguanas A, Villaquirán-Muriel MÁ, Rivera SP, Rosero-García D, Aranaga C, Correa A, Falco A. Beta-Lactam-Resistant Enterobacterales Isolated from Landfill Leachates. Pathogens 2022; 11:1077. [PMID: 36297134 PMCID: PMC9609224 DOI: 10.3390/pathogens11101077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 11/25/2023] Open
Abstract
Antibiotic resistance is one of the main challenges worldwide due to the high morbidity and mortality caused by infections produced by resistant bacteria. In Colombia, this problem has been studied mainly from the clinical perspective; however, it is scarcely studied in the leachates produced in landfills. The objective of this study was to detect, identify and determine the antibiotic sensitivity profile of Enterobacterales isolated from a leachate treatment plant located in Cali, Colombia. Detection was performed using selective culture media, bacterial identification using Matrix-Assisted Laser Desorption/Ionization-Time-Of-Flight (MALDI-TOF, bioMérieux) and by sequencing the gene coding for the 16S ribosomal RNA subunit when discrepancies were observed between phenotypic characteristics and MALDI-TOF. Antibiotic sensitivity profiling was determined using the automated VITEK®2 system (bioMérieux). Twenty-one isolates were obtained, of which Klebsiella pneumoniae was the most frequent (23.8%), and 34% of the isolates showed decreased sensitivity to beta-lactam antibiotics such as cefoxitin, ampicillin/sulbactam and piperacillin/tazobactam. These findings suggest that leachates from landfills could be a reservoir of pathogenic bacteria carrying antibiotic resistance determinants, so periodic microbiological characterization of these effluents should be performed, promoting the One Health approach.
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Affiliation(s)
- Alejandra Mondragón-Quiguanas
- Universidad Santiago de Cali, Grupo de Investigación en Microbiología, Industria y Ambiente (GIMIA), Facultad de Ciencias Básicas, Cali 760035, Colombia
| | - Miguel Ángel Villaquirán-Muriel
- Universidad Santiago de Cali, Grupo de Investigación en Microbiología, Industria y Ambiente (GIMIA), Facultad de Ciencias Básicas, Cali 760035, Colombia
| | - Sandra Patricia Rivera
- Universidad Santiago de Cali, Grupo de Investigación en Microbiología, Industria y Ambiente (GIMIA), Facultad de Ciencias Básicas, Cali 760035, Colombia
- Laboratorio de Salud Pública Departamental, Secretaria Departamental de Salud del Valle del Cauca, Gobernación del Valle del Cauca, Cali 760045, Colombia
| | - Doris Rosero-García
- Universidad Santiago de Cali, Grupo de Investigación en Microbiología, Industria y Ambiente (GIMIA), Facultad de Ciencias Básicas, Cali 760035, Colombia
| | - Carlos Aranaga
- Universidad Santiago de Cali, Grupo de Investigación en Química y Biotecnología (QUIBIO), Facultad de Ciencias Básicas, Cali 760035, Colombia
| | - Adriana Correa
- Universidad Santiago de Cali, Grupo de Investigación en Microbiología, Industria y Ambiente (GIMIA), Facultad de Ciencias Básicas, Cali 760035, Colombia
- Clínica Imbanaco, Cali 760042, Colombia
| | - Aura Falco
- Universidad Santiago de Cali, Grupo de Investigación en Microbiología, Industria y Ambiente (GIMIA), Facultad de Ciencias Básicas, Cali 760035, Colombia
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Whole-Genome Characterisation of ESBL-Producing E. coli Isolated from Drinking Water and Dog Faeces from Rural Andean Households in Peru. Antibiotics (Basel) 2022; 11:antibiotics11050692. [DOI: 10.3390/antibiotics11050692] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 02/04/2023] Open
Abstract
E. coli that produce extended-spectrum β-lactamases (ESBLs) are major multidrug-resistant bacteria. In Peru, only a few reports have characterised the whole genome of ESBL enterobacteria. We aimed to confirm the identity and antimicrobial resistance (AMR) profile of two ESBL isolates from dog faeces and drinking water of rural Andean households and determine serotype, phylogroup, sequence type (ST)/clonal complex (CC), pathogenicity, virulence genes, ESBL genes, and their plasmids. To confirm the identity and AMR profiles, we used the VITEK®2 system. Whole-genome sequencing (WGS) and bioinformatics analysis were performed subsequently. Both isolates were identified as E. coli, with serotypes -:H46 and O9:H10, phylogroups E and A, and ST/CC 5259/- and 227/10, respectively. The isolates were ESBL-producing, carbapenem-resistant, and not harbouring carbapenemase-encoding genes. Isolate 1143 ST5259 harboured the astA gene, encoding the EAST1 heat-stable toxin. Both genomes carried ESBL genes (blaEC-15, blaCTX-M-8, and blaCTX-M-55). Nine plasmids were detected, namely IncR, IncFIC(FII), IncI, IncFIB(AP001918), Col(pHAD28), IncFII, IncFII(pHN7A8), IncI1, and IncFIB(AP001918). Finding these potentially pathogenic bacteria is worrisome given their sources and highlights the importance of One-Health research efforts in remote Andean communities.
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