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Factors influencing epidemiology of dermatomycoses at Gdansk, Poland and Grodno, Belarus. Postepy Dermatol Alergol 2022; 39:788-792. [PMID: 36090716 PMCID: PMC9454370 DOI: 10.5114/ada.2022.118922] [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: 03/21/2021] [Accepted: 04/30/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction An increase in numbers of cutaneous fungal infections is being observed around the world. Dermatomycoses occur in every age group and can significantly decrease quality of life. Examining the prevalence and epidemiological trends of cutaneous fungal infections is necessary for developing new effective preventive, diagnostic and therapeutic methods. Many factors can influence the growth and patterns of global spread of the different species of fungi. Aim To investigate the differences between the prevalence of dermatophytes and cutaneous fungal infections observed at two mycological laboratories and their plausible causes. Material and methods Mycological examination was performed in 7324 patients in Gdansk, Poland and in 4729 patients in Grodno, Belarus who exhibited clinical signs and symptoms of cutaneous fungal infections. Direct preparations was made in 20% KOH with 40% DMSO. Additionally cultures were prepared on modified Sabouraud dextrose agar. Results Dermatophytes were cultured in 642 (53.58%) cases in Gdansk. The most common species of dermatophytes were Trichophyton rubrum (306 cases), Trichophyton mentagrophytes var. granulosum (193 cases) and Microsporum canis (127 cases). Yeasts were isolated in 531 (44.40%) cases out of which Candida albicans was the most frequently identified in 323 cases. Similarly, dermatophytes were the most common in 1158 (68.72%) cases in Grodno. Candida were isolated in 527 (31.28%) cases. Analysing the localization of dermatomycoses onychomycosis was observed in majority of the infected patients in Gdansk. In Grodno the most common location of superficial cutaneous infection was tinea corporis In the Gdansk region dermatomycoses were observed in 688 female patients and in 508 male patients. In Grodno the prevalence is inverted with the majority of cases observed in 921 males and 764 females. Conclusions The prevalence of superficial fungal infections is higher in Grodno, Belarus when compared to Gdansk, Poland. Similarly, dermatophytes were most commonly observed in both Laboratories.
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Polianciuc SI, Gurzău AE, Kiss B, Ştefan MG, Loghin F. Antibiotics in the environment: causes and consequences. Med Pharm Rep 2020; 93:231-240. [PMID: 32832887 PMCID: PMC7418837 DOI: 10.15386/mpr-1742] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/04/2020] [Indexed: 12/21/2022] Open
Abstract
Antibiotics represent one of the main discoveries of the last century that changed the treatment of a large array of infections in a significant way. However, increased consumption has led to an exposure of bacterial communities and ecosystems to a large amount of antibiotic residues. This paper aims to provide a brief overview of the primary drivers associated with antibiotic occurrence in the environment. Furthermore, we attempted to summarize the behavior of antibiotic residues in the environment and the necessity of their detection and quantification. Also, we provide updated scientific and regulatory facts about environmental antibiotic discharge and environmental and human antibiotics risk assessment. We propose that environmental antibiotic contamination should be diminished beginning from regulating the causes of occurrence in the environment (such as antibiotic consumption) and ending with regulating antibiotic discharge and risk assessment. Some important intermediate steps are represented by the detection and quantification of the antibiotics and the characterization of their behavior in the environment, which could come to support future regulatory decisions.
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Affiliation(s)
- Svetlana Iuliana Polianciuc
- Toxicology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Faculty of Pharmacy, Cluj-Napoca, Romania
| | | | - Bela Kiss
- Toxicology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Faculty of Pharmacy, Cluj-Napoca, Romania
| | - Maria Georgia Ştefan
- Toxicology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Faculty of Pharmacy, Cluj-Napoca, Romania
| | - Felicia Loghin
- Toxicology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Faculty of Pharmacy, Cluj-Napoca, Romania
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Mustonen N, Siljander H, Peet A, Tillmann V, Härkönen T, Ilonen J, Hyöty H, Knip M, Koski K, Koski M, Ryhänen S, Hämäläinen A, Ormisson A, Ulich V, Kuzmicheva E, Mokurov S, Markova S, Pylova S, Isakova M, Shakurova E, Petrov V, Dorshakova NV, Karapetyan T, Varlamova T, Kiviniemi M, Alnek K, Janson H, Uibo R, von Mutius E, Weber J, Ahlfors H, Kallionpää H, Laajala E, Lähdesmäki H, Lahesmaa R, Moulder R, Nieminen J, Ruohtula T, Vaarala O, Honkanen H, Kondrashova A, Oikarinen S, Harmsen HJ, De Goffau MC, Welling G, Alahuhta K, Virtanen SM. Early childhood infections and the use of antibiotics and antipyretic-analgesics in Finland, Estonia and Russian Karelia. Acta Paediatr 2019; 108:2075-2082. [PMID: 31132164 DOI: 10.1111/apa.14874] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/14/2019] [Accepted: 05/22/2019] [Indexed: 12/13/2022]
Abstract
AIM Infections in early childhood are common reasons to seek medical attention. This study compares the prevalence of infections, and the use of antibiotics and antipyretic-analgesics, in children from Finland, Estonia and Russian Karelia. METHODS Children with a genetically increased risk for type 1 diabetes (N = 797) were observed from birth up to 3 years of age. Illnesses and medications were reported by parents continuously. All reported infections, antibiotics and antipyretic-analgesics were compared between Finland and Estonia, and to a lesser extent with Russian Karelia, due to poor study compliance. RESULTS Compared with Estonians, Finns reported more infections during the first and second years of life. During the follow-up, Finnish children had 10 infections while Estonians only had 8 (p < 0.001). Finns also used more antibiotics and antipyretic-analgesics in each year during the follow-up. Russian Karelians reported the lowest frequency of infections and the most infrequent use of antibiotics and antipyretic-analgesics in the first two years of life. CONCLUSION Infections and the use of antibiotics and antipyretic-analgesics in early childhood were most frequent in Finland, where socio-economic conditions are the most developed and microbial encounters are sparse. This may reflect on the hygiene hypothesis, a less effective immune system that allows normally harmless microbes to attack and cause clinical infections.
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Affiliation(s)
- Neea Mustonen
- Pediatric Research Center, Children’s Hospital Helsinki University Hospital University of Helsinki Helsinki Finland
- Research Programs Unit, Diabetes and Obesity University of Helsinki Helsinki Finland
| | - Heli Siljander
- Pediatric Research Center, Children’s Hospital Helsinki University Hospital University of Helsinki Helsinki Finland
- Research Programs Unit, Diabetes and Obesity University of Helsinki Helsinki Finland
| | - Aleksandr Peet
- Department of Pediatrics, Tartu University Hospital University of Tartu Tartu Estonia
| | - Vallo Tillmann
- Department of Pediatrics, Tartu University Hospital University of Tartu Tartu Estonia
| | - Taina Härkönen
- Pediatric Research Center, Children’s Hospital Helsinki University Hospital University of Helsinki Helsinki Finland
- Research Programs Unit, Diabetes and Obesity University of Helsinki Helsinki Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, Institute of Biomedicine University of Turku Turku Finland
- Clinical Microbiology Turku University Hospital Turku Finland
| | - Heikki Hyöty
- Department of Virology, School of Medicine University of Tampere Tampere Finland
- Fimlab Laboratories Pirkanmaa Hospital District Tampere Finland
| | - Mikael Knip
- Pediatric Research Center, Children’s Hospital Helsinki University Hospital University of Helsinki Helsinki Finland
- Research Programs Unit, Diabetes and Obesity University of Helsinki Helsinki Finland
- Folkhälsan Research Center Helsinki Finland
- Tampere Center for Child Health Research Tampere University Hospital Tampere Finland
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Robertson J, Iwamoto K, Hoxha I, Ghazaryan L, Abilova V, Cvijanovic A, Pyshnik H, Darakhvelidze M, Makalkina L, Jakupi A, Dzhakubekova A, Carp A, Cizmovic L, Rachina S, Radonjic V, Yusufi S, Aksoy M, Ibragimova M, Godman B, Kluge H, Pedersen HB. Antimicrobial Medicines Consumption in Eastern Europeand Central Asia - An Updated Cross-National Study and Assessment of QuantitativeMetrics for Policy Action. Front Pharmacol 2019; 9:1156. [PMID: 30890943 PMCID: PMC6411709 DOI: 10.3389/fphar.2018.01156] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 09/24/2018] [Indexed: 12/16/2022] Open
Abstract
Introduction: Surveillance of antimicrobial medicines consumption is central to improving their use and reducing resistance rates. There are few published data on antibiotic consumption in Eastern Europe and Central Asia. To address this, 18 non-European Union (EU) countries and territories contribute to the WHO Regional Office for Europe (WHO Europe) Antimicrobial Medicines Consumption (AMC) Network. Objectives: (i) Analyze 2015 consumption of J01 class antibacterials for systemic use from 16 AMC Network members; (ii) compare results with 2011 data and 2015 ESAC-Net estimates; (iii) assess consumption against suggested indicators; (iv) evaluate the impact of planned changes to defined daily doses (DDDs) in 2019 for some commonly used antibiotics; and (v) consider the utility of quantitative metrics of consumption for policy action. Methods: Analysis methods are similar to ESAC-Net for EU countries. The Anatomical Therapeutic Chemical (ATC) classification and DDD methodology were used to calculate total consumption (DDD/1000 inhabitants/day [DID]), relative use measures (percentages), extent of use of WHO Watch and Reserve group antibiotics and impact of DDD changes. Findings: Total J01 consumption in 2015 ranged 8.0-41.5 DID (mean 21.2 DID), generally lower than in 2011 (6.4-42.3 DID, mean 23.6 DID). Beta-lactam penicillins, cephalosporins, and quinolones represented 16.2-56.6, 9.4-28.8, and 7.5-24.6% of total J01 consumption, respectively. Third-generation cephalosporins comprised up to 90% of total cephalosporin consumption in some countries. Consumption of WHO Reserve antibiotics was very low; Watch antibiotics comprised 17.3-49.5% of total consumption (mean 30.9%). Variability was similar to 2015 ESAC-Net data (11.7-38.3 DID; mean 22.6 DID). DDD changes in 2019 impact both total and relative consumption estimates: total DIDs reduced on average by 12.0% (7.3-35.5 DID), mostly due to reduced total DDDs for commonly used penicillins; impact on rankings and relative use estimates were modest. Discussion: Quantitative metrics of antibiotic consumption have value. Improvements over time reflect national activities, however, changes in total volumes may conceal shifts to less desirable choices. Relative use measures targeting antibiotics of concern may be more informative. Some, including WHO Watch and Reserve classifications, lend themselves to prescribing targets supported by guidelines and treatment protocols.
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Affiliation(s)
- Jane Robertson
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
- Department of Clinical Pharmacology, The University of Newcastle, Callaghan, NSW, Australia
| | - Kotoji Iwamoto
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Iris Hoxha
- Department of Pharmacy, University of Medicine, Tirana, Tirana, Albania
| | - Lilit Ghazaryan
- Scientific Centre of Drug and Medical Technology Expertise, Ministry of Health, Yerevan, Armenia
| | - Vafa Abilova
- Department of Import Medicines and Medical Devices, Analytical Expertise Center, Ministry of Health, Baku, Azerbaijan
| | - Ana Cvijanovic
- Sector for Providing Information on Drugs and Medical Products, Agency for Medicinal Products and Medical Devices of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Halina Pyshnik
- Department of Pharmaceutical Inspection and Organization of Medicinal Supply, Ministry of Health of the Republic of Belarus, Minsk, Belarus
| | - Marina Darakhvelidze
- Health Care Department, Ministry of IDPs, Labour, Health and Social Affairs of Georgia, Tbilisi, Georgia
| | - Larissa Makalkina
- Department of Cardiology and Internal Medicine with a Course of Clinical Pharmacology and Pharmacy Astana Medical University, Astana, Kazakhstan
| | - Arianit Jakupi
- A2 – Pharmaceutical Consulting and UBT – Higher Education Institution, Pristina, Kosovo†
| | - Aigul Dzhakubekova
- Specialized Expertise of Medicines Unit, Department of Drug Provision and Medical Devices, Ministry of Health, Bishkek, Kyrgyzstan
| | - Angela Carp
- P.I. Coordination, Implementation and Monitoring Unit of the Health System Projects, Chişinãu, Moldova
| | - Lidija Cizmovic
- Department for Establishing Maximum Prices and Monitoring Consumption of Medicines, Agency for Medicines and Medical Devices, Podgorica, Montenegro
| | - Svetlana Rachina
- Internal Medicine Department with Cardiology and Functional Diagnostics Course, Russian Friendship University, Moscow, Russia
| | - Vesela Radonjic
- National Centre for Information on Medicines and Medical Device, Medicines and Medical Devices Agency of Serbia, Belgrade, Serbia
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Salomudin Yusufi
- Vice-Rector for Science, Avicenna Tajik State Medical University, Dushanbe, Tajikistan
| | - Mesil Aksoy
- Turkish Medicines and Medical Devices Agency, Department of Rational Use of Medicines, Ministry of Health, Ankara, Turkey
| | - Muhabbat Ibragimova
- Head of the Information and Analytical Department, The State Center for Expertise and Standardization of Medicines, Medical Devices and Medical Equipment of the Agency for the Development of the Pharmaceutical Industry under the Ministry of Health of the Republic of Uzbekistan, Tashkent, Uzbekistan
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
- Liverpool Health Economics, University of Liverpool, Liverpool, United Kingdom
- Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Hans Kluge
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Hanne Bak Pedersen
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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Lobova TI, Yemelyanova E, Andreeva IS, Puchkova LI, Repin VY. Antimicrobial Resistance and Plasmid Profile of Bacterial Strains Isolated from the Urbanized Eltsovka-1 River (Russia). Microb Drug Resist 2015; 21:477-90. [DOI: 10.1089/mdr.2014.0203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tatiana I. Lobova
- Krasnoyarsk Scientific Centre of Siberian Branch of the Russian Academy of Sciences, Krasnoyarsk, Russia
| | - Elena Yemelyanova
- Novosibirsk State Medical University, Novosibirsk, Russia
- State Research Center of Virology and Biotechnology VECTOR of the Federal Service for Surveillance in Consumer Rights Protection and Human Well-Being, Novosibirsk, Russia
| | - Irina S. Andreeva
- State Research Center of Virology and Biotechnology VECTOR of the Federal Service for Surveillance in Consumer Rights Protection and Human Well-Being, Novosibirsk, Russia
| | - Larisa I. Puchkova
- State Research Center of Virology and Biotechnology VECTOR of the Federal Service for Surveillance in Consumer Rights Protection and Human Well-Being, Novosibirsk, Russia
| | - Vladimir Ye Repin
- State Research Center of Virology and Biotechnology VECTOR of the Federal Service for Surveillance in Consumer Rights Protection and Human Well-Being, Novosibirsk, Russia
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Bush PJ, Cebotarenco N. It's time children learned about medicines. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2010. [DOI: 10.1211/jphsr.01.01.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Vorobieva V, Bazhukova T, Hanssen AM, Caugant DA, Semenova N, Haldorsen BC, Simonsen GS, Sundsfjord A. Clinical isolates of Staphylococcus aureus from the Arkhangelsk region, Russia: antimicrobial susceptibility, molecular epidemiology, and distribution of Panton-Valentine leukocidin genes. APMIS 2009; 116:877-87. [PMID: 19132981 DOI: 10.1111/j.1600-0463.2008.01092.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A total of 91 consecutive clinical isolates of Staphylococcus aureus were collected at the Regional Hospital of Arkhangelsk, Russia, from May to December 2004, and examined for antimicrobial susceptibility, methicillin resistance and presence of Panton-Valentine leucocidin (PVL) genes. Epidemiological typing was performed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Methicillin-resistant S. aureus (MRSA) isolates were examined by staphylococcal cassette chromosome mec (SCCmec) typing. High-to-moderate rates of resistance to penicillin (beta-lactamase production; 93%), tetracycline (40%), erythromycin and clindamycin (32%) were observed. Forty out of ninety-one (44%) isolates were positive for PVL genes. Thirty-six (40%) PVL-positive methicillin-susceptible S. aureus (MSSA) strains were shown by PFGE and MLST typing (ST121, ST681, ST837) to be part of a nosocomial outbreak caused by clonal complex (CC) 121. PFGE, MLST and SCCmec typing revealed three MRSA clones. Sequence type (ST) 239-III (n=11), ST1097-III (n=1) and ST8-IV (n=3) belong to CC8 of epidemic multiresistant MRSA, whereas ST426-MRSA-IV/CC395 (n=1) has not been reported previously. All MRSA strains were PVL negative. The overall results underline the necessity of microbiological sampling, antimicrobial susceptibility testing, and epidemiological typing as a rational basis for antimicrobial treatment of S. aureus infections, and infection control measures to limit the spread of multiresistant MRSA and epidemic MSSA clones.
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Affiliation(s)
- V Vorobieva
- Department of Microbiology and Virology, Faculty of Medicine, Institute of Medical Biology, University of Tromsø, Norway
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Goryachkina K, Babak S, Burbello A, Wettemark B, Bergman U. Quality use of medicines: a new method of combining antibiotic consumption and sensitivity data—application in a Russian hospital. Pharmacoepidemiol Drug Saf 2008; 17:636-44. [DOI: 10.1002/pds.1543] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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9
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Katz A, Leibovitz E, Timchenko VN, Greenberg D, Porat N, Peled N, Dagan R, Ossipov IB. Antibiotic susceptibility, serotype distribution and vaccine coverage of nasopharyngeal and oropharyngeal Streptococcus pneumoniae in a day-care centre in St. Petersburg, Russia. ACTA ACUST UNITED AC 2007; 39:293-8. [PMID: 17454891 DOI: 10.1080/00365540600987741] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
UNLABELLED The objectives were to study serotypes and antibiotic susceptibility of Streptococcus pneumoniae carried by healthy children attending a day-care centre in St. Petersburg. S. pneumoniae colonization was investigated in 125 children aged 16-70 months. Antibiotic susceptibility was determined by E-test and disk diffusion. 83 S. pneumoniae cases were isolated in 75/125 (60%) children: 36/75 (48%) in the nasopharynx, 12/75 (16%) in the oropharynx and 27/75 (36%) in both. Carriage rates were 100%, 68%, 72%, 46% and 54% in children aged 12-23, 24-35, 36-47, 48-59 and >or=60 months, respectively. 97.6% of isolates were susceptible to penicillin. 61.4%, 32.5%, 19.3%, 16.7% and 6% isolates were non-susceptible to trimethoprim/sulfamethoxazole, tetracycline, clindamycin, erythromycin and chloramphenicol, respectively. 20.5% of isolates were multidrug resistant (MDR). 45% of isolates were of serotypes included in the 7-valent pneumococcal conjugate vaccine (7V-PCV); 64.9%, 56.8%, 32.4% and 27% of 7V-PCV serotypes were resistant to trimethoprim/sulfamethoxazole, tetracycline, clindamycin and erythromycin, respectively. The respective figures for MDR isolates were 100%, 94.1%, 70.6% and 76.5%; 76.5% of all MDR isolates were covered by 7V-PCV. IN CONCLUSION 1) resistance to trimethoprim/sulfamethoxazole and tetracycline was high; 2) resistance to macrolides was higher than in other Russian regions; 3) 7V-PCV coverage was modest, but the vaccine may potentially reduce MDR-S. pneumoniae.
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Affiliation(s)
- Anna Katz
- Paediatric Infectious Disease Unit, Soroka University Medical Centre, Ben-Gurion University, Beer-Sheva, Israel
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10
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Grude N, Potaturkina-Nesterova NI, Jenkins A, Strand L, Nowrouzian FL, Nyhus J, Kristiansen BE. A comparison of phylogenetic group, virulence factors and antibiotic resistance in Russian and Norwegian isolates of Escherichia coli from urinary tract infection. Clin Microbiol Infect 2007; 13:208-211. [PMID: 17328737 DOI: 10.1111/j.1469-0691.2006.01584.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Isolates of Escherichia coli from 31 Norwegian and 31 Russian females with significant bacteruria who presented with clinical signs of urinary tract infection (UTI) were tested for antimicrobial sensitivity, the presence of virulence genes, phylogroup distribution and clonal affinity. Twenty isolates, representing the full clonal diversity of a collection of 138 intestinal isolates of E. coli from healthy Norwegian females, served as a reference group. Russian UTI isolates belonged more often to phylogroup A and possessed fewer virulence genes than did Norwegian isolates. UTI isolates of E. coli were genetically heterogeneous and had a high degree of antimicrobial sensitivity.
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Affiliation(s)
- N Grude
- Department of Microbiology, Telemark Biomedical Centre, Skien; Telemark University College, Bø; Department of Microbiology and Virology, University of Tromsø, Tromsø, Norway.
| | | | - A Jenkins
- Department of Microbiology, Telemark Biomedical Centre, Skien; Telemark University College, Bø
| | - L Strand
- Department of Microbiology, Telemark Biomedical Centre, Skien; Telemark University College, Bø
| | - F L Nowrouzian
- Department of Microbiology, University of Gothenburg, Gothenburg, Sweden
| | - J Nyhus
- Bionor Immuno AS, Skien, Norway
| | - B-E Kristiansen
- Department of Microbiology, Telemark Biomedical Centre, Skien; Department of Microbiology and Virology, University of Tromsø, Tromsø, Norway
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Matuz M, Benko R, Doro P, Hajdu E, Nagy G, Nagy E, Monnet DL, Soos G. Regional variations in community consumption of antibiotics in Hungary, 1996-2003. Br J Clin Pharmacol 2006; 61:96-100. [PMID: 16390356 PMCID: PMC1884983 DOI: 10.1111/j.1365-2125.2005.02525.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIMS To study regional differences and identify determinants of antibiotic consumption in ambulatory care in Hungary. METHODS Regional distribution-based antibiotic sales data were converted into a number of defined daily doses (DDD) per 1000 inhabitant-days. Correlations were assessed with the Spearman rank test. RESULTS There were large and stable interregional differences in antibiotic consumption. They were associated with socio-economic determinants, e.g. the population receiving free access to medicines and receiving regular social assistance. CONCLUSIONS More detailed studies are needed to better understand the determinants of antibiotic use in these specific patient populations and to identify additional determinants at regional level.
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Affiliation(s)
- Maria Matuz
- Department of Clinical Pharmacy, University of Szeged, Budapest, Hungary.
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12
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Gu Y, Wang G, Sun J. Simultaneous determination of erythromycin ethylsuccinate and its metabolite erythromycin in human plasma using liquid chromatography–electrospray ionization mass spectrometry for clinical study. J Pharm Biomed Anal 2006; 40:737-43. [PMID: 16376051 DOI: 10.1016/j.jpba.2005.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2005] [Revised: 11/01/2005] [Accepted: 11/04/2005] [Indexed: 11/23/2022]
Abstract
A sensitive and selective liquid chromatography-electrospray ionization mass spectrometry (LC-ESI-MS) method was developed for simultaneous identification and quantification of erythromycin ethylsuccinate and erythromycin in human plasma, which can be well applied to clinical study. The method was based on liquid-liquid extraction, followed by a LC procedure with an ODS C18 column, and mixture of acetonitrile and 1.67 mmol/l acetic acid as mobile phase. MS detection was performed using a single quadrupole mass spectrometer in positive selected ion monitoring (SIM) mode. The method was validated to be linear, precise and accurate. The lower limit of quantification of erythromycin ethylsuccinate and erythromycin were both 0.5 ng/ml. The proposed method enables the unambiguous identification and quantification of erythromycin ethylsuccinate and erythromycin for clinical drug monitoring.
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Affiliation(s)
- Yi Gu
- Key Laboratory of Pharmacokinetics and Drug Metabolism, China Pharmaceutical University, 1 Shennong Road, Nanjing City 210038, China
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Väänänen MH, Pietilä K, Airaksinen M. Self-medication with antibiotics--does it really happen in Europe? Health Policy 2005; 77:166-71. [PMID: 16095749 DOI: 10.1016/j.healthpol.2005.07.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2005] [Accepted: 07/04/2005] [Indexed: 10/25/2022]
Abstract
AIMS AND METHODS The aim of this study was to determine whether antibiotics are used for self-medication in southern Spain, a region belonging to European Union. The data were collected by a survey in the Costa del Sol region, Spain during 2002 by using a convenience sample of 1000 Finns living permanently in the area (response rate 53%, n=530). RESULTS Antibiotics were used by 28% of the respondents during the previous 6 months before the query. Of the antibiotic users, 41% had bought their antibiotics without a prescription. Clearly the most common indication for antibiotic use was common cold, with almost half (45%) of the antibiotic users reporting it as purpose of medication, followed by sore throat (17%). The number of courses did not differ between prescription and non-prescription antibiotic users, most (64%) of the users having used one course. Neither did the groups differ according to background variables used, including the frequency of experiencing adverse reactions. CONCLUSIONS Unnecessary and unrational self-medication with antibiotics seems to be common in southern Spain among Finnish immigrants. This may indicate that Spanish health care system, including community pharmacies are failing their task in enhancing rational use of medicines. It is important that all the member countries within EU will take their responsibility in promoting public health goals in their national policy, e.g., in minimising the antibiotic resistance for expanding.
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Affiliation(s)
- Minna Heleena Väänänen
- Division of Social Pharmacy, University of Helsinki, Viikinkaari 5 E, PL 56 Helsinki, Finland.
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14
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Gattringer R, Sauermann R, Lagler H, Stich K, Buxbaum A, Graninger W, Georgopoulos A. Antimicrobial susceptibility and macrolide resistance genes in Streptococcus pyogenes collected in Austria and Hungary. Int J Antimicrob Agents 2004; 24:290-3. [PMID: 15325435 DOI: 10.1016/j.ijantimicag.2004.01.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2003] [Accepted: 01/14/2004] [Indexed: 11/26/2022]
Abstract
A total of 341 clinical isolates of Streptococcus pyogenes from Vienna, Austria and three Hungarian cities were tested for susceptibility to four macrolides and 12 other antibiotics. All isolates were fully susceptible to penicillin and the other beta-lactams tested. A high level of tetracycline resistance was found in Austria (26.7%) and in Hungary (30.5%). The rate of resistance to erythromycin, clarithromycin and azithromycin was 4.7% in Vienna and 3.7% in the Hungarian communities. In both countries, the MIC(90) values of erythromycin and clarithromycin were 0.12 mg/L and the MIC(90) of josamycin was 0.5mg/L. The M phenotype of resistance conferred by the mefA genes was predominant (n = 9) among the macrolide-resistant isolates (n = 14).
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Affiliation(s)
- Rainer Gattringer
- Department of Internal Medicine I, Division of Infectious Diseases and Chemotherapy, Vienna General Hospital, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
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Abstract
The frequency of resistance to antibiotics among common community-acquired pathogens, and the number of drugs to which they are resistant have been increasing worldwide. The relationship between antibiotic usage and resistance is strongly supported by data from several studies. Countries with the highest per capita antibiotic consumption have the highest resistance. The emergence of penicillin-resistant Streptococcus pneumoniae is related to high consumption of antibiotics in general, as well as to increased use of aminopenicillins and/or probably to wider use of oral cephalosporins. Increased consumption of macrolides, especially the long-acting ones, correlates significantly with the level of macrolide resistance of group A streptococci and S. pneumoniae while increased use of oral cephalosporins might be associated with the increase of beta-lactamase-producing strains of Moraxella catarrhalis. Trimethoprim/sulphamethoxazole resistance is strongly associated with resistance to penicillin. A rise in consumption of fluoroquinolones is consonant with a higher rate of resistance to quinolones of S. pneumoniae, Escherichia coli and other Gram-negative bacteria. Paediatric bacterial isolates are more often resistant to various antimicrobial agents than isolates from adult patients; this higher resistance rate may be due to more frequent antimicrobial treatments in children, and extensive child to child transmission. Reliable data on antimicrobial consumption and resistance should form a basis for national policies devised to reduce the resistance of microorganisms to antibiotics.
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Affiliation(s)
- Milan Cizman
- University Medical Centre, Department of Infectious Diseases, Japljeva 2, 1525 Ljubljana, Slovenia.
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Felmingham D, Feldman C, Hryniewicz W, Klugman K, Kohno S, Low DE, Mendes C, Rodloff AC. Surveillance of resistance in bacteria causing community-acquired respiratory tract infections. Clin Microbiol Infect 2002; 8 Suppl 2:12-42. [PMID: 12427206 DOI: 10.1046/j.1469-0691.8.s.2.5.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Bacterial resistance to antibiotics in community-acquired respiratory tract infections is a serious problem and is increasing in prevalence world-wide at an alarming rate. Streptococcus pneumoniae, one of the main organisms implicated in respiratory tract infections, has developed multiple resistance mechanisms to combat the effects of most commonly used classes of antibiotics, particularly the beta-lactams (penicillin, aminopenicillins and cephalosporins) and macrolides. Furthermore, multidrug-resistant strains of S. pneumoniae have spread to all regions of the world, often via resistant genetic clones. A similar spread of resistance has been reported for other major respiratory tract pathogens, including Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes. To develop and support resistance control strategies it is imperative to obtain accurate data on the prevalence, geographic distribution and antibiotic susceptibility of respiratory tract pathogens and how this relates to antibiotic prescribing patterns. In recent years, significant progress has been made in developing longitudinal national and international surveillance programs to monitor antibiotic resistance, such that the prevalence of resistance and underlying trends over time are now well documented for most parts of Europe, and many parts of Asia and the Americas. However, resistance surveillance data from parts of the developing world (regions of Central America, Africa, Asia and Central/Eastern Europe) remain poor. The quantity and quality of surveillance data is very heterogeneous; thus there is a clear need to standardize or validate the data collection, analysis and interpretative criteria used across studies. If disseminated effectively these data can be used to guide empiric antibiotic therapy, and to support-and monitor the impact of-interventions on antibiotic resistance.
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