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Bastidas-Caldes C, Romero-Alvarez D, Valdez-Vélez V, Morales RD, Montalvo-Hernández A, Gomes-Dias C, Calvopiña M. Extended-Spectrum Beta-Lactamases Producing Escherichia coli in South America: A Systematic Review with a One Health Perspective. Infect Drug Resist 2022; 15:5759-5779. [PMID: 36204394 PMCID: PMC9531622 DOI: 10.2147/idr.s371845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Carlos Bastidas-Caldes
- One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, Ecuador
- Doctoral Program in Public and Animal Health, Faculty of Veterinary Medicine, University of Extremadura, Cáceres, Spain
- Correspondence: Carlos Bastidas-Caldes, One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, 170124, Ecuador, Tel +593 983 174949, Email
| | - Daniel Romero-Alvarez
- One Health Reserch Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
- Biodiversity Institute and Department of Ecology & Evolutionary Biology, The University of Kansas, Lawrence, KS, USA
| | - Victor Valdez-Vélez
- One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, Ecuador
| | - Roberto D Morales
- One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, Ecuador
| | - Andrés Montalvo-Hernández
- One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, Ecuador
| | - Cicero Gomes-Dias
- Department of Basic Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Manuel Calvopiña
- One Health Reserch Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
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Cabrera-Rodríguez LE, Miralles-Suarez AI, Ones-Roque R, Torres-Herrera Y, Pantaleón-Hernández M. Prevalencia de aislamientos de Escherichia coli y Klebsiella pneumoniae productoras de betalactamasas de espectro extendido en pacientes cubanos ambulatorios con infección del tracto urinario. REVISTA DE LA FACULTAD DE MEDICINA 2022. [DOI: 10.15446/revfacmed.v71n2.99767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. Las infecciones del tracto urinario (UTI) adquiridas en la comunidad causadas por enterobacterias productoras de β-lactamasas de espectro extendido (BLEE) son un fenómeno creciente a nivel mundial.
Objetivo. Determinar la prevalencia de aislamientos de Escherichia coli y Klebsiella pneumoniae productoras de BLEE obtenidos de muestras de orina de pacientes ambulatorios con ITU adquirida en la comunidad, así como los perfiles de resistencia a antibióticos asociados al fenotipo BLEE.
Materiales y métodos. Estudio descriptivo retrospectivo. Se analizaron 304 aislamientos de E. coli y 34 de K. pneumoniae obtenidos de urocultivos de pacientes con ITU adquirida en la comunidad atendidos entre enero 1 de 2019 y diciembre 31 de 2020 en el Hospital Clínico-Quirúrgico Docente Aleida Fernández Chardiet, provincia Mayabeque, Cuba. Se realizó un análisis bivariado (prueba x2) para determinar diferencias en las tasas de resistencia antibiótica entre las bacterias productoras de BLEE y las no productoras.
Resultados. El 16.77% (51/304) y el 17.64 % (6/34) de los aislamientos de E. coli y K. pneumoniae se clasificaron como bacterias productoras de BLEE. En el caso de los aislados de E. coli productoras de BLEE, BLEE+ciprofloxacina fue el patrón de resistencia más frecuente (22/51; 43.13%), seguido por BLEE+ciprofloxacino y amikacina (14/51; 27.45%). Además, 41.17% (21/51); fueron multirresistentes. En el caso de K. pneumoniae productoras de BLEE, predominó el patrón de resistencia BLEE + ciprofloxacino, amikacina y nitrofurantoina (2/6; 33.33%), y 50 % (3/6) fueron multirresistentes.
Conclusiones. Los resultados confirman la presencia de E. coli y K. pneumoniae productoras de BLEE, con una alta prevalencia de multirresistencia en pacientes con ITU adquirida en la comunidad en el municipio de Güines, Cuba.
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Medina-Pizzali ML, Hartinger SM, Salmon-Mulanovich G, Larson A, Riveros M, Mäusezahl D. Antimicrobial Resistance in Rural Settings in Latin America: A Scoping Review with a One Health Lens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189837. [PMID: 34574760 PMCID: PMC8464982 DOI: 10.3390/ijerph18189837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 12/18/2022]
Abstract
Antimicrobial resistance (AMR) in rural Latin America is not fully understood. The transmission pathways are partially known since research predominantly focuses on the urban hospital setting. The contribution to AMR from environmental factors is usually only mentioned in large-scale animal production. To understand the state of the literature on AMR in rural LA, we carried out a scoping review using the One Health (OH) perspective. OH recognises the concomitant contributions and interconnectedness of humans, animal, and the environment, thus, we used the OH perspective to select those articles adopting a holistic view of the problem. We searched original articles in English, Spanish, and Portuguese in four peer-reviewed databases and included 21 publications in the analysis. We charted data on bibliometrics, design, data collection sources, and instruments. We identified the human, animal, and environmental contributions to AMR in rural locations, and information gaps on AMR transmission routes and AMR drivers. Intensive and non-intensive animal production systems and agricultural practices were the most frequently found human contributions to AMR. Poultry, swine, cattle, and fish were the most frequent livestock mentioned as sources of AMR bacteria. Animal carriage and/or transfer of AMR determinants or bacteria was recognised as the primary contribution of livestock to the problem, while water, soil, and farming were predominant environmental contributions. We found that only 1 article out of 21 considered the OH approach as a framework for their sampling scheme, whereas 5 out 21 discussed all the three OH components. There were hardly any descriptions of humans or human waste as reservoirs for AMR in rural locations, and rural health centres or hospitals and wildlife were not represented. No studies identified mining as an anthropogenic activity driving AMR. More OH-oriented studies, with emphasis on molecular approaches—for identification and comparison of AMR genes—are sorely needed to understand better the existence of a network of interconnected transmission routes in rural Latin America and provide efficient strategies to prevent further AMR emergence.
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Affiliation(s)
- Maria Luisa Medina-Pizzali
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 31, Peru; (M.L.M.-P.); (G.S.-M.); (A.L.)
| | - Stella M. Hartinger
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 31, Peru; (M.L.M.-P.); (G.S.-M.); (A.L.)
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4057 Basel, Switzerland;
- Swiss Tropical and Public Health Institute, University of Basel, Petersplatz 1, 4051 Basel, Switzerland
- Correspondence:
| | - Gabriela Salmon-Mulanovich
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 31, Peru; (M.L.M.-P.); (G.S.-M.); (A.L.)
- Institute for Earth, Nature and Energy at Pontificia Universidad Catolica del Peru, Av. Universitaria 1801, San Miguel, Lima 32, Peru
| | - Anika Larson
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 31, Peru; (M.L.M.-P.); (G.S.-M.); (A.L.)
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA
| | - Maribel Riveros
- School of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 31, Peru;
| | - Daniel Mäusezahl
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4057 Basel, Switzerland;
- Swiss Tropical and Public Health Institute, University of Basel, Petersplatz 1, 4051 Basel, Switzerland
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Antimicrobial Resistance in Humans, Animals, Water and Household Environs in Rural Andean Peru: Exploring Dissemination Pathways through the One Health Lens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094604. [PMID: 33925280 PMCID: PMC8123641 DOI: 10.3390/ijerph18094604] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 01/26/2023]
Abstract
Antimicrobial resistance (AMR) is a global public health threat, especially for low and middle-income countries (LMIC) where the threat has not been fully identified. Our study aims to describe E. coli AMR in rural communities to expand our knowledge on AMR bacterial contamination. Specifically, we aim to identify and describe potential dissemination routes of AMR-carrying bacteria in humans (children’s stools), community water sources (reservoirs and household sources), household environments (yard soil) and domestic animals of subsistence farmers in rural Andean areas. Our cross-sectional study was conducted in rural households in the region of Cajamarca, Peru. A total of 266 samples were collected. Thirty-four point six percent of reservoir water and 45% of household water source samples were positive for thermotolerant coliforms. Of the reservoir water samples, 92.8% were positive for E. coli, and 30.8% displayed resistance to at least one antibiotic, with the highest resistance to tetracycline. E. coli was found in 57.1% of the household water sources, 18.6% of these isolates were multidrug-resistant, and displayed the highest resistance to tetracycline (31.3%). Among samples from the children’s drinking water source, 32.5% were positive for thermotolerant coliforms, and 57.1% of them were E. coli. One third of E. coli isolates were multidrug-resistant and displayed the highest AMR to tetracycline (41.6%) and ampicillin (25%). Thermotolerant coliforms were found in all the soil samples, 43.3% of the isolates were positive for E. coli, 34.3% of the E. coli isolates displayed AMR to at least one antibiotic, and displayed the highest AMR to tetracycline (25.7%). We determined thermotolerant coliforms in 97.5% of the child feces samples; 45.3% of them were E. coli, 15.9% displayed multidrug resistance, and displayed the highest resistance to ampicillin (34.1%). We identified thermotolerant coliforms in 67.5% of the animal feces samples. Of those, 38.7% were E. coli, and 37.7% were resistant to at least one antibiotic. For all the samples, the prevalence of resistance to at least one antibiotic in the E. coli and Klebsiella spp. isolates was almost 43% and the prevalence of MDR in the same isolates was nearly 9%, yet the latter nearly doubled (15.9%) in children’s stools. Our results provide preliminary evidence for critical pathways and the interconnectedness of animal, human and environmental transmission but molecular analysis is needed to track dissemination routes properly.
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