Antimicrobial Resistance

Efforts to Identify and Combat Antimicrobial Resistance in Uganda: A Systematic Review

The global burden of antimicrobial resistance is on the rise, resulting in higher morbidity and mortality in our communities. The spread of antimicrobial resistance in the environment and development of resistant microbes is a challenge to the control of antimicrobial resistance. Approaches, such as antimicrobial stewardship programmes and enhanced surveillance, have been devised to curb its spread. However, particularly in lower- and middle-income countries, the overall extent of antimicrobial resistance and knowledge on ongoing surveillance, stewardship or investigation efforts, are often poorly understood. This study aimed to look at the efforts that have been undertaken to detect and combat antimicrobial resistance in Uganda as a means of establishing an overview of the situation, to help inform future decisions. We conducted a systematic literature review of the PubMed database to assess these efforts. A search combining keywords associated with antimicrobial resistance were used to find relevant studies between 1995 and 2020 on surveillance of antimicrobial resistance in Uganda, and susceptibility of microbes to different drugs. The search yielded 430 records, 163 of which met the inclusion criteria for analysis. The studies were categorized according to country and region, the type of antimicrobial resistance, context of the study, study design and outcome of the study. We observed that antibacterial resistance and antimalarial resistance had the most published studies while antiviral and antifungal resistance were represented by very few studies each. Most studies were conducted in humans and hospital settings, with few in veterinary and One Health contexts, and only one that included environmental sampling. The majority of studies have focused on surveillance, susceptibility testing or resistance genes; none of our included papers had a policy or stewardship focus. The results from our work can inform public health policy on antimicrobial stewardship as it contributes to understanding the status of antimicrobial resistance surveillance in Uganda, and can also help to guide future research efforts. Notably, a One Health approach needs to be followed with respect to surveillance of antimicrobial resistance to better understand the mechanisms of resistance transfer across the human-animal–environment interface, including additional investigation in antiviral and antifungal resistance.

Emergence of multidrug-resistant bacteria isolated from surgical site infection in dogs and cats

ABSTRACT Surgical site infections (SSIs) and antimicrobial resistance among pathogens causing SSI are a growing concern in veterinary hospitals. One major reason, the widespread use of antimicrobials, has led to increased incidence of SSIs. This study identified bacteria and resistance profiles to antimicrobials in the SSI cases diagnosed at the Surgical Clinic of Small Animals in the Veterinary Hospital, Federal University of Viçosa, Brazil. The main genus identified was Staphylococcus, followed by Escherichia, Enterococcus, Bacillus, Shigella, Citrobacter, Proteus, Morganella, Serratia, Enterobacter, Pseudomonas and Klebsiella were also found, but in small number. The results indicated the predominance of Gram-negative bacteria among the collected samples. Most of isolates identified were resistant to more than one of the following antimicrobials: ampicillin, tetracycline, enrofloxacin, amoxicillin/clavulanic acid and cephalotin. Of the 17 Staphylococcus sp. isolates, two (11.8%) were methicillin-resistant Staphylococcus aureus (MRSA) and 11 (64.7%) of them were methicillin-resistant Staphylococcus pseudintermedius (MRSP). There were bacterial genera identified with resistance to all tested antimicrobials in different proportions. This should alert veterinary hospitals to the emergence of multidrug-resistant bacteria and to the requirement for the revision of surgical protocols with regard to antimicrobial prophylaxis and therapy.

Antibiotic susceptibility of bacterial isolates from 502 dogs with respiratory signs

The aim of this study was to investigate the prevalence of bacterial species isolated from bronchoalveolar lavage fluid (BALF) samples taken from dogs with respiratory signs and to determine their antibiotic susceptibility. Clinical cases were included in the study if they showed signs of respiratory disease and data relating to bacterial culture and susceptibility of BALF samples were available. The medical records of 493 privately owned dogs that were presented between January 1989 and December 2011 were evaluated retrospectively. In 35 per cent of samples, no bacteria were cultured. Bacteria isolated from culture-positive samples included Streptococcus species (31 per cent of positive cultures), Enterobacteriaceae (30 per cent, including Escherichia coli (15 per cent)), Staphylococcus species (19 per cent), Pasteurella species (16 per cent) and Pseudomonas species (14 per cent). Bordetella bronchiseptica as a primary respiratory pathogen was isolated in 8 per cent of cases. Enrofloxacin showed the best susceptibility pattern; 86 per cent of all isolates and 87 per cent of Gram-negative bacteria were susceptible to this antibiotic. Amoxicillin/clavulanic acid yielded the best susceptibility pattern in Gram-positive bacteria (92 per cent). Therefore, these antibiotics can be recommended for empirical or first-line treatment in dogs with bacterial lower respiratory tract infections.

Review: Chinese herbs as alternatives to antibiotics in feed for swine and poultry production: Potential and challenges in application

Gong, J., Yin, F., Hou, Y. and Yin, Y. 2014. Chinese herbs as alternatives to antibiotics in feed for swine and poultry production: Potential and challenges in application. Can. J. Anim. Sci. 94: 223–241. Traditional Chinese medicine (TCM) has a long history of clinical practice, and its own theoretical framework focused on functions at the whole-body level. However, due to cultural differences, TCM has not been fully recognized in Western countries. With the recent development of the theory of whole-body systems biology and “-omics”, there is a new opportunity to study TCM and to close the gap between TCM and Western medicine, because of the similarity in the theoretical foundations between TCM and whole-body systems biology. The uniqueness of TCM theory and practice is the approach to maintain and restore the body balance as a whole with no or little unfavourable side effects. Recent studies have also shown that Chinese herbs used as feed additives can modulate nutritional metabolism, immune responses, and intestinal health of food-producing animals, demonstrating good potential as substitutes for dietary antibiotics. Nonetheless, some issues need to be addressed before Chinese herbs can reach their full application. This article has critically reviewed recent progresses in scientific research of Chinese herbs as feed additives and their potential to replace dietary antibiotics. Possible challenges in future application for swine and poultry production are also discussed.

Resistência de bactérias isoladas de cães e gatos no Hospital Veterinário da Universidade Estadual de Londrina (2008-2009)

Foi determinado o perfil de resistência de bactérias isoladas de diversas afecções em cães e gatos atendidos no Setor de Clinica Cirúrgica de Animais de Companhia do Hospital Veterinário da Universidade Estadual de Londrina. Houve maior frequência de Staphylococcus spp. (27,6%), seguido por Pseudomonas spp. (22,7%) e Escherichia coli (16,6%). Na prova de sensibilidade antimicrobiana pelo método de difusão em ágar houve alta porcentagem de resistência das bactérias isoladas aos principais antibióticos usados no tratamento das infecções do trato urinário, principalmente das bactérias Gram negativas que apresentaram resistência superior a 66% aos antibióticos testados, com exceção da norfloxacina. Nas bactérias isoladas de feridas, apenas a gentamicina e a amicacina demonstraram índices de resistência inferior a 50,0%. Nas bactérias isoladas das afecções otológicas observou-se menor resistência à norfloxacina e maior à neomicina, sendo os menores índices de resistência observados nas bactérias Gram positivas. As bactérias Gram positivas apresentaram maior resistência à ciprofloxacina nos casos ortopédicos, e nas bactérias isoladas das peritonites houve 100% de resistência a diversos antibióticos. Este trabalho ressalta a importância da identificação bacteriana e a realização de antibiogramas para a escolha do agente antimicrobiano apropriado no tratamento das principais afecções atendidas na área de animais de companhia em medicina veterinária.

Feline pyothorax - new insights into an old problem: part 2. Treatment recommendations and prophylaxis

Until recently, pyothorax in the cat has been generally considered to have a poor prognosis. However, it has become clear that most cats that survive the first 48 h following presentation can be successfully treated with aggressive medical management. In this second part of a two-part review, logical guidelines for the management of the disease are discussed, with particular emphasis on antimicrobial selection. Patient stabilisation and supportive care, techniques for pleural space drainage and lavage and indications for surgery are reviewed.