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Alabi ED, Rabiu AG, Adesoji AT. A review of antimicrobial resistance challenges in Nigeria: The need for a one health approach. One Health 2025; 20:101053. [PMID: 40370425 PMCID: PMC12077226 DOI: 10.1016/j.onehlt.2025.101053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Revised: 04/24/2025] [Accepted: 04/25/2025] [Indexed: 05/16/2025] Open
Abstract
The discovery of penicillin and other antibiotics has revolutionized modern medicine. However, overreliance on antibiotics has led to a global antimicrobial resistance (AMR) crisis, jeopardizing progress made over the past decades. Antimicrobial resistance poses a critical public health challenge, affecting humans, animals, and the environment. The AMR challenge is particularly dire in Nigeria owing to the extensive antibiotic use across various sectors and ineffective antimicrobial stewardship programs. This narrative review summarizes the literature from January 2018 to December 2023, focusing on the current trends in AMR in Nigeria, including knowledge of antimicrobial usage, prescription patterns, and adherence to guidelines for humans, animals, and their shared environments. High antibiotic resistance patterns were detected in isolates recovered from healthcare settings, food supply chains, companion animals, wildlife, and the environment. Factors exacerbating the AMR crisis in Nigeria include poor regulation of antimicrobial agents, improper empirical prescriptions, inadequate infection prevention practices, arbitrary and prophylactic use of antibiotics in food-producing animals, environmental contamination, and insufficient surveillance programs. To effectively mitigate this crisis, it is essential to adopt the One Health approach, which prioritizes collaborative efforts among stakeholders, including governmental agencies, healthcare institutions, veterinary experts, farmers, and the scientific community, to address the convergence of human, animal, and environmental health. These efforts will promote transdisciplinary surveillance approaches and the establishment of policies aimed at ameliorating the impact of AMR on the Nigerian economy, the well-being of its population, and diverse ecosystems.
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Affiliation(s)
- Emmanuel Dayo Alabi
- Department of Microbiology, Federal University Dutsin-Ma,
Dutsin-Ma 821101, Nigeria
| | - Akeem Ganiyu Rabiu
- Department of Microbiology, Federal University of Health
Sciences, Ila-Orangun, Nigeria
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2
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Kou R, Li X, Wang H, Wu Y, Zou D, Hu J, Qiu S, Yang L, Zhang X. Panel data analysis of the effect of ambient temperature on antimicrobial resistance in China. Sci Rep 2025; 15:18391. [PMID: 40419687 DOI: 10.1038/s41598-025-02861-8] [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: 01/07/2025] [Accepted: 05/16/2025] [Indexed: 05/28/2025] Open
Abstract
Antimicrobial resistance (AMR) has been causing tremendous loss of life, health and economic property, and WHO identified carbapenem-resistant gram-negative (CRGN) as the most urgent bacteria. The impact of climate change on AMR has received worldwide attention, but the evidence is insufficient. The prevalence of carbapenem-resistant antibiotic-resistant Klebsiella pneumoniae (CRKP), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CRPA) from the Chinese Antibiotic Resistance Surveillance System from 2014 to 2023 were used as the dependent variable, the average ambient temperature from the China Statistical Yearbook was used as the independent variable. After controlling factors from socio-economic, environmental and medical services, natural log-linear regression analysis was used and found that CRKP and CRAB increased 1.093-fold and 1.021-fold, respectively, for every 1˚C ambient temperature increase. And this effect was similarly validated in the subgroup models for seasons and regions. In addition, we determined that health facilities, hospital beds per capita, and PM2.5 had a significant effect on the AMR of different strains. Changes in ambient temperature have a cumulative effect, with the greatest cumulative four-year impact. The effects of ambient temperature and its changes on AMR and the identification of influencing factors in this study provide innovative insights and important evidence for combating AMR.
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Affiliation(s)
- Ruxin Kou
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiying Li
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Haixia Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuanyang Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dongdong Zou
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jinwen Hu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shengyue Qiu
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lianping Yang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Li Y, Liang J, Li W, Jia Y, Yuan S, Zhou Y, Hou Y, Zhang N. The analysis of antimicrobials epidemiological cut-off values of mycoplasma gallisepticum isolated from goose. Poult Sci 2025; 104:104974. [PMID: 40080949 PMCID: PMC11953973 DOI: 10.1016/j.psj.2025.104974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 02/12/2025] [Accepted: 02/28/2025] [Indexed: 03/15/2025] Open
Abstract
Mycoplasma gallisepticum (MG) poses a significant threat to the goose breeding industry, with antimicrobial agents commonly employed for its treatment. However, the absence of standardized criteria for antimicrobial selection complicates clinical decision-making regarding the choice and dosage of these agents, contributing to the emergence of clinical resistance. In this study, we isolated 102 clinical strains of MG from geese in Guangdong. We determined the minimum inhibitory concentration (MIC) values for various antimicrobials frequently used in MG treatment, including danofloxacin, enrofloxacin, tilmicosin, tylosin, tylvalosin, valnemulin, tiamulin, and spectinomycin. After conducting a statistical analysis of the susceptibility test results, we employed ECOFFinder to establish the wild-type cutoff values (ECOFFs) for these antimicrobials against the MG isolates. The findings revealed a significant reduction in sensitivity among the clinical isolates to the eight tested antimicrobial agents. While valnemulin and tiamulin maintained relatively good sensitivity, enrofloxacin, danofloxacin, and spectinomycin exhibited notably diminished effectiveness. The determined ECOFFs for MG isolated from geese against the aforementioned antimicrobials were 3.2, 3.2, 0.8, 0.8, 0.08, 0.05, 0.05, and 3.2 μg/mL, respectively. This study is crucial for identifying resistant strains and investigating resistance mechanisms, in addition to providing a precise assessment of the resistance levels of MG isolated from geese in Guangdong. The insights gained from this research will serve as a valuable reference for the prevention and treatment of MG infections and will promote more effective clinical strategies regarding the use of antimicrobials.
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Affiliation(s)
- Yangshuo Li
- School of Animal Science and Technology, Foshan University, Foshan, PR China
| | - Jingyi Liang
- School of Animal Science and Technology, Foshan University, Foshan, PR China
| | - Weihuo Li
- School of Animal Science and Technology, Foshan University, Foshan, PR China
| | - Yixin Jia
- School of Animal Science and Technology, Foshan University, Foshan, PR China
| | - Sheng Yuan
- School of Animal Science and Technology, Foshan University, Foshan, PR China
| | - Yuanyuan Zhou
- School of Animal Science and Technology, Foshan University, Foshan, PR China
| | - Yuee Hou
- Zhuhai Kerric Testing, Zhuhai, PR China
| | - Nan Zhang
- School of Animal Science and Technology, Foshan University, Foshan, PR China.
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Cao H, Ma K, Zheng D, Qiao X. Population Structure, Antimicrobial Susceptibility, and Virulence-Associated Gene Profiling of Salmonella from Clinical Patients in the Jiangsu Province, China, from 2015 to 2019. Microb Drug Resist 2025; 31:144-153. [PMID: 40277431 DOI: 10.1089/mdr.2024.0240] [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] [Indexed: 04/26/2025] Open
Abstract
Salmonella is a foodborne zoonotic pathogen and a hazard to public health. Surveillance of the prevalence of Salmonella is important. This study sought to understand the population structure, antimicrobial susceptibility, and virulence-associated gene profile of 100 Salmonella, which were randomly selected from clinical foodborne diarrhea fecal samples during 2015 and 2019 in the Jiangsu Province, China. After whole-genome sequencing and in silico analysis, we found that the prevalence of clinical foodborne Salmonella in Jiangsu Province was periodic and that the serotypes were diverse, covering 9 serogroups and 19 serotypes. S. Enteritidis was the most prevalent serotype, followed by S. Typhimurium. A high prevalence of antimicrobial resistance was also observed in this study, nearly half (47/100) of Salmonella isolates were determined to be multidrug-resistant (resistant to ≥3 antimicrobial agents), the antimicrobial resistance genotype and phenotype were associated but not closely related, and antimicrobial resistance differed between the major Salmonella sequence types. Additionally, we found that the virulence-associated gene profile is highly concordant with the serotype. Our work shows the association among serotype, antimicrobial resistance, and virulence gene profile, demonstrating the connection between genotype and phenotype and providing epidemiological data for Salmonella.
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Affiliation(s)
- Hui Cao
- Institute of Nutrition and Food Safety, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Kai Ma
- Institute of Nutrition and Food Safety, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Dongyu Zheng
- Institute of Nutrition and Food Safety, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xin Qiao
- Institute of Nutrition and Food Safety, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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Mekasha YT, Belay Mekonnen E, Gessese AT, Berrie K, Melaku Beyene A, Dessalegn B. Assessment of the magnitude, economic impact, and factors associated with expired veterinary pharmaceuticals in animal health facilities in South Wollo, Ethiopia. Front Vet Sci 2025; 11:1390891. [PMID: 39840337 PMCID: PMC11747527 DOI: 10.3389/fvets.2024.1390891] [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: 05/08/2024] [Accepted: 12/11/2024] [Indexed: 01/23/2025] Open
Abstract
Background The issue of veterinary pharmaceutical expiration is a significant concern in animal health facilities globally. The existence of veterinary pharmaceutical expiration can be mainly associated with inadequate inventory control, store management, and a lack of effective pharmaceutical regulatory policies and guidelines. Hence, the study aimed to evaluate expired veterinary pharmaceuticals' scope, economic impact, and contributing factors. Methods A cross-sectional, explanatory sequential study design involving a mixed quantitative and qualitative approach was employed among 13 animal health facilities from March 2022 to December 2023 in and around Dessie town, South Wollo, Ethiopia. A key informant interview guide was used to retrieve the qualitative data that were analyzed through thematic content analysis. Then, the collected data were coded and analyzed using SPSS version 25. A mean score was used to determine the critical factors associated with veterinary pharmaceutical expiration. Results The study found that the magnitude of expired veterinary pharmaceuticals in the fourth fiscal year was 7%. This wastage rate of veterinary pharmaceuticals led to a loss of approximately 69,564.54 USD. From expired veterinary pharmaceutical unit pack perspectives, approximately 403-unit packs (66%) expired in veterinary clinics, resulting in a loss of approximately 38,229.33 USD, and 209-unit packs (34%) expired in private veterinary pharmacies, incurring a loss of approximately 31,335.22 USD. From Anatomical Therapeutic Classification (ATC), antibiotics accounted for 14.8% of the total financial loss. Additionally, approximately 53% of liquid dosage forms were expired. The quantitative study identifies the lack of an information system and necessary software, poor store management, and lack of strict accountability as critical contributors to veterinary pharmaceutical expiration. Additionally, inadequate inventory management systems and a lack of adherence to established policies and guidelines for managing veterinary pharmaceutical expiration were the most vital contributors as key informants cited. Conclusion The financial burden associated with expired veterinary pharmaceuticals exceeded the permissible threshold of 2%, indicating a significant concern for animal health budgets and the aquatic environment. This study underlines that the issue of veterinary pharmaceutical expiration is a critical problem that necessitates policy implications. To mitigate the expiration rate of veterinary pharmaceuticals, collaboration among multidisciplinary veterinary professionals, the Ethiopian Agricultural Authority, pharmaceutical supply chain agency, and researchers is essential.
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Affiliation(s)
- Yesuneh Tefera Mekasha
- Pharmaceutical Sciences, Pharmaceutical Quality Assurance and Regulatory Affairs, University of Gondar, Gondar, Ethiopia
| | - Ermias Belay Mekonnen
- Department of Veterinary Medicines, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Tesfaye Gessese
- Department of Veterinary Biomedical Sciences, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Berrie
- Veterinary Epidemiology and Public Health, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia
| | - Achenef Melaku Beyene
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bereket Dessalegn
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia
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Abou-Jaoudeh C, Andary J, Abou-Khalil R. Antibiotic residues in poultry products and bacterial resistance: A review in developing countries. J Infect Public Health 2024; 17:102592. [PMID: 39551017 DOI: 10.1016/j.jiph.2024.102592] [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: 08/20/2024] [Revised: 11/04/2024] [Accepted: 11/07/2024] [Indexed: 11/19/2024] Open
Abstract
Antimicrobial resistance (AMR) is a growing global concern, particularly in poultry farming, where antibiotics are widely used for both disease prevention and growth promotion. This review examines the misuse of antibiotics in poultry production, especially in developing countries, and its contribution to the emergence of antibiotic-resistant bacteria. The findings highlight that factors such as increasing demand for poultry protein, the availability of inexpensive antibiotics, and weak regulatory oversight have led to widespread misuse, accelerating the spread of resistance genes. Although evidence links poultry farming to AMR, significant data gaps remain, especially regarding resistance transmission from poultry to humans. The review underscores the urgent need for stronger regulatory frameworks, phased-out use of antimicrobial growth promoters, and enhanced awareness campaigns to address this issue. Improving the capacity of regulatory bodies and developing more robust national data monitoring systems are essential steps to mitigate the threat of AMR in poultry farming and to protect both animal and human health.
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Affiliation(s)
- Chantal Abou-Jaoudeh
- Holy Spirit University of Kaslik, Faculty of Arts and Sciences, Biology Department, B.P. 446 Jounieh, Lebanon
| | - Jeanne Andary
- Modern University for Business and Science, Faculty of Health Sciences, Lebanon
| | - Rony Abou-Khalil
- Holy Spirit University of Kaslik, Faculty of Arts and Sciences, Biology Department, B.P. 446 Jounieh, Lebanon.
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Pattnaik M, Nayak AK, Karna S, Rehman T, Sahoo SK, Palo SK, Kanungo S, Kshatri JS, Parai D, Walia K, Pati S, Bhattacharya D. Social and biological evaluation of antimicrobial resistance (SOBEAR) in rural India: a study protocol. Front Public Health 2024; 12:1296382. [PMID: 38362213 PMCID: PMC10867149 DOI: 10.3389/fpubh.2024.1296382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024] Open
Abstract
Background Antimicrobial resistance (AMR) has been one of the biggest global health threats in recent years, mostly in low- and middle-income countries, which requires urgent research using a multidisciplinary research approach. The use of large quantities of antimicrobial drugs inappropriately for humans, poultry and agriculture has been recognized as a leading cause of antibiotic resistance and the predominance of drug-resistance pathogens in the environment. This protocol aims to describe the use/misuse of antibiotics (ABs) in the community and evaluate clinical samples from healthcare settings to detect genes associated with antimicrobial resistance. Methods We will conduct a community-level survey in different villages of the Tigiria block to assess knowledge and awareness on ABs and AMR. We will conduct in-depth interviews (IDIs) with doctors, pharmacists, nurses and drug sellers, as well as focus group discussions (FGDs) with ASHA and ANM workers who are involved in antibiotic supplies to the community. Quantitative data from the community survey and qualitative data of IDIs and FGDs will be linked and analyzed using statistical modeling and iterative thematic content analysis. Specimens (stool, urine, blood and wound/pus) will be collected from clinically diagnosed patients of different healthcare centers of Tigiria block. The samples will be cultured for bacterial isolation and antibiotic sensitivity testing. Genomic DNA will be isolated from positive bacterial cultures and sequenced using PCR to evaluate high-threat multi-drug resistance organisms (MDROs), screening of plasmid-mediated quinolone resistance (PMQR) genes, antimicrobial genes responsible for MDR and quinolone resistance-determining regions (QRDRs). Conclusion This is the community-based protocol to evaluate the knowledge, attitudes, awareness and practices regarding ABs and AMR. The study protocol establishes a foundation for evaluating population-based prevalence and risk factors for AMR and MDROs in rural areas of the Odisha state, India.
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Affiliation(s)
- Matrujyoti Pattnaik
- Model Rural Health Research Unit, ICMR-Regional Medical Research Centre, Cuttack, India
| | - Ashish Kumar Nayak
- Model Rural Health Research Unit, ICMR-Regional Medical Research Centre, Cuttack, India
| | - Sonam Karna
- Model Rural Health Research Unit, ICMR-Regional Medical Research Centre, Cuttack, India
| | - Tanveer Rehman
- Model Rural Health Research Unit, ICMR-Regional Medical Research Centre, Cuttack, India
| | - Subrat Kumar Sahoo
- Model Rural Health Research Unit, ICMR-Regional Medical Research Centre, Cuttack, India
| | - Subrata Kumar Palo
- Model Rural Health Research Unit, ICMR-Regional Medical Research Centre, Cuttack, India
| | - Srikanta Kanungo
- Model Rural Health Research Unit, ICMR-Regional Medical Research Centre, Cuttack, India
| | - Jaya Singh Kshatri
- Model Rural Health Research Unit, ICMR-Regional Medical Research Centre, Cuttack, India
| | - Debaprasad Parai
- Model Rural Health Research Unit, ICMR-Regional Medical Research Centre, Cuttack, India
| | - Kamini Walia
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Sanghamitra Pati
- Model Rural Health Research Unit, ICMR-Regional Medical Research Centre, Cuttack, India
| | - Debdutta Bhattacharya
- Model Rural Health Research Unit, ICMR-Regional Medical Research Centre, Cuttack, India
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Li W, Liu C, Ho HC, Shi L, Zeng Y, Yang X, Huang Q, Pei Y, Huang C, Yang L. Association between antibiotic resistance and increasing ambient temperature in China: An ecological study with nationwide panel data. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2023; 30:100628. [PMID: 36406382 PMCID: PMC9672962 DOI: 10.1016/j.lanwpc.2022.100628] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/20/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022]
Abstract
Background Antibiotic resistance leads to longer hospital stays, higher medical costs, and increased mortality. However, research into the relationship between climate change and antibiotic resistance remains inconclusive. This study aims to address the gap in the literature by exploring the association of antibiotic resistance with regional ambient temperature and its changes over time. Methods Data were obtained from the China Antimicrobial Surveillance Network (CHINET), monitoring the prevalence of carbapenem-resistant Acinetobacter baumannii (CRAB), Klebsiella pneumoniae (CRKP) and Pseudomonas aeruginosa (CRPA) in 28 provinces/regions over the period from 2005 to 2019. Log-linear regression models were established to determine the association between ambient temperature and antibiotic resistance after adjustment for variations in socioeconomic, health service, and environmental factors. Findings A 1 °C increase in average ambient temperature was associated with 1.14-fold increase (95%-CI [1.07–1.23]) in CRKP prevalence and 1.06-fold increase (95%-CI [1.03–1.08]) in CRPA prevalence. There was an accumulative effect of year-by-year changes in ambient temperature, with the four-year sum showing the greatest effect on antibiotic resistance. Higher prevalence of antibiotic resistance was also associated with higher antibiotic consumption, lower density of health facilities, higher density of hospital beds and higher level of corruption. Interpretation Higher prevalence of antibiotic resistance is associated with increased regional ambient temperature. The development of antibiotic resistance under rising ambient temperature differs across various strains of bacteria. Funding The 10.13039/501100012166National Key R&D Program of China (grant number: 2018YFA0606200), 10.13039/501100001809National Natural Science Foundation of China (grant number: 72074234), 10.13039/501100012476Fundamental Scientific Research Funds for Central Universities, P.R. China (grant number: 22qntd4201), 10.13039/100001547China Medical Board (grant number: CMB-OC-19-337).
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Affiliation(s)
- Weibin Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Hung Chak Ho
- Department of Anaesthesiology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Lin Shi
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yingchao Zeng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xinyi Yang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qixian Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yi Pei
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Lianping Yang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Corresponding author.
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Aljeldah MM. Antimicrobial Resistance and Its Spread Is a Global Threat. Antibiotics (Basel) 2022; 11:antibiotics11081082. [PMID: 36009948 PMCID: PMC9405321 DOI: 10.3390/antibiotics11081082] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/20/2022] [Accepted: 07/27/2022] [Indexed: 02/07/2023] Open
Abstract
Antimicrobial resistance (AMR) is a challenge to human wellbeing the world over and is one of the more serious public health concerns. AMR has the potential to emerge as a serious healthcare threat if left unchecked, and could put into motion another pandemic. This establishes the need for the establishment of global health solutions around AMR, taking into account microdata from different parts of the world. The positive influences in this regard could be establishing conducive social norms, charting individual and group behavior practices that favor global human health, and lastly, increasing collective awareness around the need for such action. Apart from being an emerging threat in the clinical space, AMR also increases treatment complexity, posing a real challenge to the existing guidelines around the management of antibiotic resistance. The attribute of resistance development has been linked to many genetic elements, some of which have complex transmission pathways between microbes. Beyond this, new mechanisms underlying the development of AMR are being discovered, making this field an important aspect of medical microbiology. Apart from the genetic aspects of AMR, other practices, including misdiagnosis, exposure to broad-spectrum antibiotics, and lack of rapid diagnosis, add to the creation of resistance. However, upgrades and innovations in DNA sequencing technologies with bioinformatics have revolutionized the diagnostic industry, aiding the real-time detection of causes of AMR and its elements, which are important to delineating control and prevention approaches to fight the threat.
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Affiliation(s)
- Mohammed M Aljeldah
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafar al-Batin 31991, Saudi Arabia
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10
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A. Al-Shammery K, Hozzein WN. Antibacterial activities of two potential peptides extracted from Polistes wattii Cameron, 1900 (Vespidae: Polistinae) wasp venom collected at Eastern Province, Saudi Arabia. PLoS One 2022; 17:e0264035. [PMID: 35255107 PMCID: PMC8901064 DOI: 10.1371/journal.pone.0264035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/02/2022] [Indexed: 11/19/2022] Open
Abstract
Alternatives of conventional antibiotics have become an urgent need to control drug-resistant bacteria. Therefore, search for new antibacterial agents has become a trend in several microbiological and pharmaceutical scientific works. Insects, one of the most successful and evolved species on earth is known to be an effective natural source of several medically useful chemicals including antibacterial agents. There is considerable evidence of using wasp venom against medical ailments in several parts of the world. In this work venom from Polistes wattii Cameron, 1900 collected from Eastern Province, Saudi Arabia was evaluated for its antibacterial activities. Such activity was tested against four pathogenic bacteria: two-gram positive Staphylococcus aureus (ATCC 25923) and Streptococcus mutans (RCMB 017(1) ATCC 25175) and two gram-negative (Salmonella typhimurium NCTC 12023 ATCC 14028 and Enterobacter cloacae (RCMB 001(1) ATCC 23355). Also, chemical characterization of wasp venom was done using HPLC and two isolated peptides were sequenced. The result indicates the potent anti-microbial effect of the venom against the four tested bacteria. The most sensitive bacteria were Staphylococcus aureus (ATCC 25923) and Streptococcus mutans (RCMB 017(1) ATCC 25175). The sequence of the two purified peptides indicates that they belong to mastoparan. The study results may pave way to use this wasp venom in future antibiotics especially in controlling skin infection by Staphylococcus aureus.
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Affiliation(s)
- Kholoud A. Al-Shammery
- Department of Biology, College of Science, Ha’il University, Ha’il, Saudi Arabia
- * E-mail:
| | - Wael N. Hozzein
- Botany and Microbiology Department, Faculty of Science Beni-Suef University, Beni-Suef, Egypt
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11
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Shen W, Chen H, Geng J, Wu RA, Wang X, Ding T. Prevalence, serovar distribution, and antibiotic resistance of Salmonella spp. isolated from pork in China: A systematic review and meta-analysis. Int J Food Microbiol 2022; 361:109473. [PMID: 34768041 DOI: 10.1016/j.ijfoodmicro.2021.109473] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 12/23/2022]
Abstract
The epidemiological characteristics of Salmonella spp. in pork have been widely studied in China, but the results remain inconsistent. This study aimed to summarize the epidemiological characteristics of Salmonella spp. isolated from pork, including its prevalence, serovar distribution, and antibiotic resistance rate. We systematically reviewed published studies on Salmonella spp. isolated from pork in China between 2000 and 2020 in two Chinese and three English databases and quantitatively summarized its prevalence, serovar distribution, and antibiotic resistance using meta-analysis methods. Furthermore, we conducted subgroup analysis and meta-regression to explore the source of the heterogeneity from historical changes and regional difference perspectives. Ninety-one eligible studies published between 2000 and 2020 were included. The meta-analysis showed that the pooled prevalence of Salmonella isolated from pork was 0.17 (95% CI: 0.14, 0.20), with a detected growing trend over time. For the proportions of serovars, Derby (0.32, 95% CI: 0.26, 0.38), Typhimurium (0.10, 95% CI: 0.07, 0.15) and London (0.05, 95% CI: 0.03, 0.08) were dominant in these studies. The antibiotic resistance rates were high for tetracycline (0.68, 95% CI: 0.59, 0.77), sulfisoxazole (0.65, 95% CI: 0.45, 0.83), ampicillin (0.43, 95% CI: 0.34, 0.53), streptomycin (0.42, 95% CI: 0.29, 0.56), and sulfamethoxazole (0.42, 95% CI: 0.25, 0.60). The results of this study revealed a high prevalence, the regional characteristics of serovar distribution, and the severe challenges of antibiotic resistance of Salmonella originating from pork in China, suggesting the potential increasing risk and disease burden. Therefore, it is necessary to improve the prevention and control strategies of Salmonella in pork.
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Affiliation(s)
- Wangwang Shen
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | - Hui Chen
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China; Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Jiawei Geng
- Center for Global Health, School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Ricardo A Wu
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | - Xiang Wang
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Tian Ding
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.
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12
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Long Y, Lu X, Ni X, Liu J, Wang M, Li X, Li Z, Zhou H, Li Z, Wu K, Wang W, Yang L, Xu J, Chen H, Kan B. High Carriage Rate of the Multiple Resistant Plasmids Harboring Quinolone Resistance Genes in Enterobacter spp. Isolated from Healthy Individuals. Antibiotics (Basel) 2021; 11:antibiotics11010015. [PMID: 35052892 PMCID: PMC8773380 DOI: 10.3390/antibiotics11010015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/27/2021] [Accepted: 12/04/2021] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial-resistant bacteria causing intractable and even fatal infections are a major health concern. Resistant bacteria residing in the intestinal tract of healthy individuals present a silent threat because of frequent transmission via conjugation and transposition. Plasmids harboring quinolone resistance genes are increasingly detected in clinical isolates worldwide. Here, we investigated the molecular epidemiology of plasmid-mediated quinolone resistance (PMQR) in Gram-negative bacteria from healthy service trade workers. From 157 rectal swab samples, 125 ciprofloxacin-resistant strains, including 112 Escherichia coli, 10 Klebsiella pneumoniae, two Proteus mirabilis, and one Citrobacter braakii, were isolated. Multiplex PCR screening identified 39 strains harboring the PMQR genes (including 17 qnr,19 aac(6')-Ib-cr, and 22 oqxA/oqxB). The genome and plasmid sequences of 39 and 31 strains, respectively, were obtained by short- and long-read sequencing. PMQR genes mainly resided in the IncFIB, IncFII, and IncR plasmids, and coexisted with 3-11 other resistance genes. The high PMQR gene carriage rate among Gram-negative bacteria isolated from healthy individuals suggests the high-frequency transmission of these genes via plasmids, along with other resistance genes. Thus, healthy individuals may spread antibiotic-resistant bacterial, highlighting the need for improved monitoring and control of the spread of antibiotic-resistant bacteria and genes in healthy individuals.
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Affiliation(s)
- Yongyan Long
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Jiangxi Province Key Laboratory of Animal-Origin and Vector-Borne Disease, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China; (Y.L.); (X.N.); (M.W.); (K.W.); (W.W.)
| | - Xin Lu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (J.L.); (Z.L.); (H.Z.); (Z.L.); (L.Y.)
| | - Xiansheng Ni
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Jiangxi Province Key Laboratory of Animal-Origin and Vector-Borne Disease, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China; (Y.L.); (X.N.); (M.W.); (K.W.); (W.W.)
| | - Jiaqi Liu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (J.L.); (Z.L.); (H.Z.); (Z.L.); (L.Y.)
- Beijing Technology and Business University, Beijing 102206, China; (X.L.); (J.X.)
| | - Mengyu Wang
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Jiangxi Province Key Laboratory of Animal-Origin and Vector-Borne Disease, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China; (Y.L.); (X.N.); (M.W.); (K.W.); (W.W.)
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (J.L.); (Z.L.); (H.Z.); (Z.L.); (L.Y.)
| | - Xu Li
- Beijing Technology and Business University, Beijing 102206, China; (X.L.); (J.X.)
| | - Zhe Li
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (J.L.); (Z.L.); (H.Z.); (Z.L.); (L.Y.)
| | - Haijian Zhou
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (J.L.); (Z.L.); (H.Z.); (Z.L.); (L.Y.)
| | - Zhenpeng Li
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (J.L.); (Z.L.); (H.Z.); (Z.L.); (L.Y.)
| | - Kui Wu
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Jiangxi Province Key Laboratory of Animal-Origin and Vector-Borne Disease, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China; (Y.L.); (X.N.); (M.W.); (K.W.); (W.W.)
| | - Wei Wang
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Jiangxi Province Key Laboratory of Animal-Origin and Vector-Borne Disease, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China; (Y.L.); (X.N.); (M.W.); (K.W.); (W.W.)
| | - Liya Yang
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (J.L.); (Z.L.); (H.Z.); (Z.L.); (L.Y.)
- Beijing Technology and Business University, Beijing 102206, China; (X.L.); (J.X.)
| | - Jialiang Xu
- Beijing Technology and Business University, Beijing 102206, China; (X.L.); (J.X.)
| | - Haiying Chen
- The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Jiangxi Province Key Laboratory of Animal-Origin and Vector-Borne Disease, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China; (Y.L.); (X.N.); (M.W.); (K.W.); (W.W.)
- Correspondence: (H.C.); (B.K.)
| | - Biao Kan
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (X.L.); (J.L.); (Z.L.); (H.Z.); (Z.L.); (L.Y.)
- School of Public Health, Shandong University, Jinan 250012, China
- Correspondence: (H.C.); (B.K.)
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13
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Yin H, Li J, Huang H, Wang Y, Qian X, Ren J, Xue F, Dai J, Tang F. Microencapsulated phages show prolonged stability in gastrointestinal environments and high therapeutic efficiency to treat Escherichia coli O157:H7 infection. Vet Res 2021; 52:118. [PMID: 34521472 PMCID: PMC8439058 DOI: 10.1186/s13567-021-00991-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/27/2021] [Indexed: 11/10/2022] Open
Abstract
Escherichia coli (E. coli) O157:H7 bacterial infection causes severe disease in mammals and results in substantial economic losses worldwide. Due to the development of antibiotic resistance, bacteriophage (phage) therapy has become an alternative to control O157:H7 infection. However, the therapeutic effects of phages are frequently disappointing because of their low resistance to the gastrointestinal environment. In this study, to improve the stability of phages in the gastrointestinal tract, E. coli O157:H7 phages were microencapsulated and their in vitro stability and in vivo therapeutic efficiency were investigated. The results showed that compared to free phages, the resistance of microencapsulated phages to simulated gastric fluid and bile salts significantly increased. The microencapsulated phages were efficiently released into simulated intestinal fluid, leading to a better therapeutic effect in rats infected with E. coli O157:H7 compared to the effects of the free phages. In addition, the microencapsulated phages were more stable during storage than the free phages, showing how phage microencapsulation can play an essential role in phage therapy.
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Affiliation(s)
- Hanjie Yin
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Key Lab of Animal Bacteriology, Ministry of Agriculture, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China
| | - Jing Li
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Key Lab of Animal Bacteriology, Ministry of Agriculture, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China
| | - Haosheng Huang
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Key Lab of Animal Bacteriology, Ministry of Agriculture, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China
| | - Yuxin Wang
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Key Lab of Animal Bacteriology, Ministry of Agriculture, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China
| | - Xinjie Qian
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Key Lab of Animal Bacteriology, Ministry of Agriculture, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China
| | - Jianluan Ren
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Key Lab of Animal Bacteriology, Ministry of Agriculture, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China
| | - Feng Xue
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Key Lab of Animal Bacteriology, Ministry of Agriculture, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China
| | - Jianjun Dai
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Key Lab of Animal Bacteriology, Ministry of Agriculture, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China.,China Pharmaceutical University, Nanjing, China
| | - Fang Tang
- MOE Joint International Research Laboratory of Animal Health and Food Safety, Key Lab of Animal Bacteriology, Ministry of Agriculture, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China.
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Lin L, Sun R, Yao T, Zhou X, Harbarth S. Factors influencing inappropriate use of antibiotics in outpatient and community settings in China: a mixed-methods systematic review. BMJ Glob Health 2021; 5:bmjgh-2020-003599. [PMID: 33184066 PMCID: PMC7662435 DOI: 10.1136/bmjgh-2020-003599] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND For decades, antibiotics have been excessively consumed around the world, contributing to increased antimicrobial resistance (AMR) and negatively impacting health outcomes and expenditures. Antibiotic use in China accounts for half of worldwide antibiotic consumption, which mainly takes place in outpatient and community settings, and often unnecessarily for self-limiting community-acquired infections. This study aimed to identify and assess factors of inappropriate use of antibiotics in the Chinese context to inform the development of interventions to mitigate inappropriate consumption in the absence of clinical indications. METHODS We conducted a mixed-methods systematic review and included empirical studies with original data conducted in mainland China, Hong Kong and Taiwan that investigated factors of antibiotic use in the community including outpatient care among patients, caregivers and prescribers. We searched MEDLINE, EMBASE, the Cochrane Library, PsycINFO, Google Scholar and one Chinese database CNKI (China Knowledge Resource Integrated Database), using a combination of the key terms 'antibiotic', 'antimicrobial', 'use', 'consumption', 'behaviour', 'prescribe' and related syntax for all peer-reviewed publications published before June 2020. Health Belief Model was employed for data synthesis. FINDINGS Fifty-four studies were included in the full-text review: 44 quantitative, 5 qualitative and 5 mixed-methods studies. Despite a high AMR awareness, public perception/misconception of antibiotic efficacy and easy access to antibiotics for self-limiting conditions drive inappropriate demand and use in the community including primary care setting. Providers' prescribing behaviours are influenced by financial incentives, lack of diagnostic capacity and concerns over complications. CONCLUSIONS Inappropriate outpatient and community antibiotic use is influenced by non-biomedical factors at the individual, community, health system and societal levels in mainland China, contributing to a high antibiotic use rate. This study calls for context-tailored One Health interventions, restrictive antibiotic drug policy and multifaceted antibiotic stewardship programmes that simultaneously address drivers of inappropriate use from both the supply-side and demand-side within and beyond clinical settings. PROSPERO REGISTRATION NUMBER CRD42019139591.
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Affiliation(s)
- Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ruyu Sun
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Tingting Yao
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xudong Zhou
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Stephan Harbarth
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.,Infectious Diseases Division, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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15
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Lin L, Harbarth S, Wang X, Zhou X. Survey of Parental Use of Antimicrobial Drugs for Common Childhood Infections, China. Emerg Infect Dis 2021; 26:1517-1520. [PMID: 32568044 PMCID: PMC7323518 DOI: 10.3201/eid2607.190631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In a large-scale survey of 9,526 parents in China, we investigated antimicrobial drug use for common childhood infections. Of children with self-limiting conditions, formal care was sought for 69.2%; of those, 53.4% received drug prescriptions, including 11.2% from parental demands. Where drugs were taken without prescriptions, 70% were from community pharmacies.
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16
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Risk factors for antibiotic resistance development in healthcare settings in China: a systematic review. Epidemiol Infect 2021; 149:e141. [PMID: 34078502 PMCID: PMC8220497 DOI: 10.1017/s0950268821001254] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Antibiotic resistance (ABR) threatens the effectiveness of infectious disease treatments and contributes to increasing global morbidity and mortality. In this study, we systematically reviewed the identified risk factors for ABR among people in the healthcare system of mainland China. Five databases were systematically searched to identify relevant articles published in either English and Chinese between 1 January 2003 and 30 June 2019. A total of 176 facility-based references were reviewed for this study, ranging across 31 provinces in mainland China and reporting information from over 50 000 patients. Four major ABR risk factor domains were identified: (1) sociodemographic factors (includes migrant status, low income and urban residence), (2) patient clinical information (includes disease status and certain laboratory results), (3) admission to healthcare settings (includes length of hospitalisation and performance of invasive procedures) and (4) drug exposure (includes current or prior antibiotic therapy). ABR constitutes an ongoing major public health challenge in China. The healthcare sector-associated risk factors was the most important aspect identified in this review and need to be addressed. Primary health care system and ABR surveillance networks need to be further strengthened to prevent and control the communicable diseases, over-prescription and overuse of antibiotics.
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17
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Balachandra SS, Sawant PS, Huilgol PG, Vithya T, Kumar GS, Prasad R. Antimicrobial resistance (AMR) at the community level: An urban and rural case study from Karnataka. J Family Med Prim Care 2021; 10:1404-1411. [PMID: 34041186 PMCID: PMC8140222 DOI: 10.4103/jfmpc.jfmpc_888_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/14/2020] [Accepted: 10/14/2020] [Indexed: 11/14/2022] Open
Abstract
Context: The emergence of antimicrobial resistance (AMR) is a major public health crisis in India and globally. While national guidelines exist, the sources of data which form the basis of these guidelines are limited to a few well-established tertiary care centres. There is inadequate literature on AMR and antibiotic mismatch from India at community level and even less literature on AMR patterns from rural India. Aims: The aims of this study were as follows: 1) to describe the patterns of AMR at an urban tertiary care hospital and a rural 100 bedded hospital; 2) to compare and contrast the AMR patterns noted with published ICMR guidelines; 3) to examine the issue of AMR and antibiotic mismatch; and 4) to identify local factors influencing drug-bug mismatch at the local level. Settings and Design: The data were obtained from two independently conceived projects (Site 1: Urban tertiary care hospital, Site 2: Rural 100-bedded hospital). Methods and Materials: Local antibiograms were made, and the antibiotic resistance patterns were compared between the urban and rural sites and with data published in the 2017 ICMR national guideline for AMR. Statistical Analysis Used: Descriptive statistics including means and medians were used. Results: Our data reveal: a) a significant mismatch between sensitivity patterns and antibiotics prescribed; b) The national guidelines fail to capture the local picture of AMR, highlighting the need for local data; and c) challenges with data collection/retrieval, access and accuracy of diagnostic tools, administrative issues, and lack of local expertise limit antimicrobial stewardship efforts. Conclusions: Our study finds the burden of AMR high in both rural and urban sites, reinforcing that AMR burden cannot be ignored in rural settings. It also highlights that national data obtained from tertiary care settings fail to capture the local picture, highlighting the need for local data. Mechanisms of linking rural practices, primary health centres, and small hospitals with a common microbiology laboratory and shared data platforms will facilitate antibiotic stewardship at the community level.
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Affiliation(s)
- Swathi S Balachandra
- Primary Care Physician & Researcher, PCMH Restore Health, Bangalore & Coordinator, Spice Route Movement, Karnataka, Academy of Family Physicians of India (AFPI), Karnataka, India
| | - Prathamesh S Sawant
- Clinical Pharmacist Practitioner, Division of Family Medicine & Primary Care, PCMH Restore Health, Bengaluru, Karnataka, India
| | - Poorva G Huilgol
- Lab Manager, Molecular Solutions Care Health (MSCH), Bengaluru, Karnataka, India
| | - T Vithya
- Department of Clinical Pharmacy Practice, Al Ameen College of Pharmacy, Bengaluru, Karnataka, India
| | - G S Kumar
- Department of Paediatrics, Vivekananda Memorial Hospital (VMH), Swami Vivekananda Youth Movement (SVYM), Saragur, Karnataka, India
| | - Ramakrishna Prasad
- Division of Family Medicine & Primary Care, PCMH Restore Health, AFPI National Centre for Primary Care Research and Policy, Bengaluru, Karnataka, India
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Large-scale survey of parental antibiotic use for paediatric upper respiratory tract infections in China: implications for stewardship programmes and national policy. Int J Antimicrob Agents 2021; 57:106302. [PMID: 33588014 DOI: 10.1016/j.ijantimicag.2021.106302] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/26/2020] [Accepted: 02/06/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Inappropriate use of antibiotics for upper respiratory tract infections (URTIs) in Chinese children is rampant. Parents' decision-making processes with respect to treatment choices and antibiotic use for paediatric URTIs were investigated to identify key constructs for effective interventions that target the public. METHODS Data were collected between June 2017 and April 2018 from a random cluster sample of 3188 parents of children aged 0-13 years across three Chinese provinces, representing different stages of economic development. Risk factors of parents' treatment choices and antibiotic use for paediatric URTIs were assessed using binary and multinomial logistic regressions, adjusting for socio-demographic characteristics. RESULTS A total of 1465 (46.0%) children of the 3188 parents who self-diagnosed their children with a URTI were given antibiotics, with or without prescription. Among these children, 40.5% were self-medicated with antibiotics by their parents and 56.1% obtained further antibiotic prescriptions at healthcare facilities. About 70% of children (n=2197) with URTI symptoms sought care; of these, 54.8% obtained antibiotic prescriptions and 7.7% asked for antibiotic prescriptions, with 79.4% successfully obtaining them. Those perceiving antibiotics as effective for treating the common cold and fever (adjusted odds ratio [aOR]=1.82[95% confidence interval, 1.51-2.19] and 1.77[1.47-2.13], respectively), who had access to non-prescription antibiotics (aOR=5.08[4.03-6.39]), and with greater perceived severity of infection (aOR=2.01[1.58-2.56]), were more likely to use antibiotics. CONCLUSIONS Multifaceted, context-appropriate interventions are vital to untangle the perpetual problem of self-medication, over-prescription and ill-informed demands for antibiotics. The findings in this study emphasise the need to prioritise interventions that enhance clinical training, neutralise the pressure from patients for antibiotics, educate on appropriate home care, discourage antibiotic self-medication and improve antibiotic dispensing.
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Sun F, Li X, Wang Y, Wang F, Ge H, Pan Z, Xu Y, Wang Y, Jiao X, Chen X. Epidemic patterns of antimicrobial resistance of Salmonella enterica serovar Gallinarum biovar Pullorum isolates in China during the past half-century. Poult Sci 2020; 100:100894. [PMID: 33652525 PMCID: PMC7936142 DOI: 10.1016/j.psj.2020.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/29/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022] Open
Abstract
Pullorum is a chicken-specific systemic disease caused by Salmonella enterica serovar Gallinarum biovar Pullorum (S. Pullorum). This study was carried out to provide basic data for understanding the trends of S. Pullorum. A total of 652 S. Pullorum isolates collected in China during 1962-2019 were examined. Overall, 525 (80.5%) isolates were resistant to at least one antibiotic; 280 (42.9%) isolates resisted 3 or more classes of antibiotics and showed an increasing trend until 2015 and then decreased significantly. The most common multidrug-resistant pattern was ampicillin-tetracycline-nalidixic acid (13.6%). After 2008, 6 classes of antibiotic-resistant strains began to appear, and they have been prevalent ever since. In 2014, a strain resistant to 7 antibiotics (ampicillin-cefazolin-streptomycin-tetracycline-sulphonamides-nalidixic acid-nitrofurantoin) was isolated. The highest antimicrobial resistance was observed for nalidixic acid (71.9%), and the lowest was found for cefotaxime, meropenem, amikacin, gentamicin, fosfomycin, and polymyxin (0%). Our findings monitored the prevalence of the resistance of S. Pullorum during the past half-century in China. Continued surveillance of antimicrobial resistance and the rational use of antimicrobials is necessary and important to control the rapid increase in antimicrobial resistance in S. Pullorum.
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Affiliation(s)
- Fan Sun
- Jiangsu Key Laboratory of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agrifood Safety and Quality, Ministry of Agriculture and Rural Affairs, Yangzhou University, Yangzhou, China
| | - Xiu Li
- Jiangsu Key Laboratory of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agrifood Safety and Quality, Ministry of Agriculture and Rural Affairs, Yangzhou University, Yangzhou, China
| | - Yan Wang
- Jiangsu Key Laboratory of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agrifood Safety and Quality, Ministry of Agriculture and Rural Affairs, Yangzhou University, Yangzhou, China
| | - Fan Wang
- Jiangsu Key Laboratory of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agrifood Safety and Quality, Ministry of Agriculture and Rural Affairs, Yangzhou University, Yangzhou, China
| | - Haojie Ge
- Jiangsu Key Laboratory of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agrifood Safety and Quality, Ministry of Agriculture and Rural Affairs, Yangzhou University, Yangzhou, China
| | - Zhiming Pan
- Jiangsu Key Laboratory of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agrifood Safety and Quality, Ministry of Agriculture and Rural Affairs, Yangzhou University, Yangzhou, China
| | - Yaohui Xu
- College of Veterinary Medicine, Henan University of Animal Husbandry and Economy, Henan, China
| | - Yanhong Wang
- Jiangsu Key Laboratory of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agrifood Safety and Quality, Ministry of Agriculture and Rural Affairs, Yangzhou University, Yangzhou, China
| | - Xin'an Jiao
- Jiangsu Key Laboratory of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agrifood Safety and Quality, Ministry of Agriculture and Rural Affairs, Yangzhou University, Yangzhou, China
| | - Xiang Chen
- Jiangsu Key Laboratory of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agrifood Safety and Quality, Ministry of Agriculture and Rural Affairs, Yangzhou University, Yangzhou, China.
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20
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Antimicrobial Properties and Application of Polysaccharides and Their Derivatives. CHINESE JOURNAL OF POLYMER SCIENCE 2020. [DOI: 10.1007/s10118-021-2506-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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21
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Liu Y, Yu Y, Dai H, Fei A. Efficacy of Shufeng Jiedu Capsules in the treatment of sepsis: A prospective, randomized, placebo-controlled trial. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Silva V, Peixoto F, Parelho C, Garcia P, Rodrigues A, Silva A, Carvalho I, Pereira JE, Igrejas G, Poeta PACQD. Occurrence of ESBL-producing Escherichia coli in soils subjected to livestock grazing in Azores archipelago: an environment-health pollution issue? Int Microbiol 2020; 23:619-624. [PMID: 32514644 DOI: 10.1007/s10123-020-00134-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 04/21/2020] [Accepted: 06/02/2020] [Indexed: 10/24/2022]
Abstract
Antibiotics are successful drugs used in human and animal therapy; however, they must be considered as environmental pollutants. This study aims to isolate and characterize the extended-spectrum β-lactamase (ESBL) producing Escherichia coli soil from Azores Archipelago subjected to livestock agricultural practices. Twenty-four soil samples were collected from three different pasture systems with different number of cattle heads, and from a control site. Antibiotic susceptibility method was performed by Kirby-Bauer disk diffusion method against 16 antibiotics, and the presence of genes encoding lactamases, antimicrobial resistance genes, virulence factors, and phylogenetic groups was determined by polymerase chain reaction (PCR). Nine ESBLs were recovered from the three grazing sites, and all isolates presented the beta-lactamase genes blaCTX-M-3 and blaSHV. E. coli isolates were resistance to tetracycline and streptomycin and harbored the tetB, strA, and strB genes. One isolate also showed resistance to sulfonamides, and the genes sul1 and sul2 were detected. The isolates were grouped into the following phylogenic groups: B1 (n = 6), D (n = 2), and A (n = 1). The presence of antibiotics and resistance genes in soils may be the source to the development of antimicrobial resistance, which may have negative consequences in human and animal health.
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Affiliation(s)
- Vanessa Silva
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Functional Genomics and Proteomics Unit, University of Tras-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, Caparica, Lisboa, Portugal
| | - Fernando Peixoto
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - Carolina Parelho
- Faculty of Sciences and Technology, University of the Azores, Ponta Delgada, Portugal.,cE3c, Centre for Ecology, Evolution and Environmental Changes, and Azorean Biodiversity Group, University of the Azores, Ponta Delgada, Portugal
| | - Patrícia Garcia
- Faculty of Sciences and Technology, University of the Azores, Ponta Delgada, Portugal.,cE3c, Centre for Ecology, Evolution and Environmental Changes, and Azorean Biodiversity Group, University of the Azores, Ponta Delgada, Portugal
| | - Armindo Rodrigues
- Faculty of Sciences and Technology, University of the Azores, Ponta Delgada, Portugal.,IVAR, Institute of Volcanology and Risks Assessment, University of the Azores, Ponta Delgada, Portugal
| | - Adriana Silva
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Functional Genomics and Proteomics Unit, University of Tras-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, Caparica, Lisboa, Portugal
| | - Isabel Carvalho
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Functional Genomics and Proteomics Unit, University of Tras-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, Caparica, Lisboa, Portugal
| | | | - Gilberto Igrejas
- Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Functional Genomics and Proteomics Unit, University of Tras-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, Caparica, Lisboa, Portugal
| | - Patrícia Alexandra Curado Quintas Dinis Poeta
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal. .,Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, Caparica, Lisboa, Portugal.
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Feng L, Cheng Y, Zhang Y, Li Z, Yu Y, Feng L, Zhang S, Xu L. Distribution and human health risk assessment of antibiotic residues in large-scale drinking water sources in Chongqing area of the Yangtze River. ENVIRONMENTAL RESEARCH 2020; 185:109386. [PMID: 32222632 DOI: 10.1016/j.envres.2020.109386] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/07/2020] [Accepted: 03/11/2020] [Indexed: 06/10/2023]
Abstract
Antibiotic contamination in drinking water sources has been increasingly prominent in recent years. The water quality in the Chongqing area is not only essential for the local people but also is crucial for the downstream of Yangzi River. To understand the level of antibiotic contamination in the large-scale drinking water sources, this study measured antibiotic residues in nine large-scale drinking water sources (five urban drinking water sources and four township drinking water sources) in Chongqing area of the Yangtze River. Results demonstrated that eight antibiotics of three categories in total were detected, including sulfonamide metformin (SMX), sulfonamide metformin (SMZ), erythromycin (ERM), Roxithromycin (ROM), Tylosin (TYL), Lincomycin (LIN), Chloramphenicol (CAP), and Florfenicol (FF). The mass concentration of antibiotic residues in five urban drinking water sources ranged from 13.9 to 76.6 ng/L, with an average of 46.4 ng/L, and that in four township drinking water sources ranged from 20.6 to 188.1 ng/L, with an average of 88.45 ng/L. The mass concentrations of antibiotic residues in Chongqing area were much lower than those in other cities. Antibiotics posed the maximum risk with a value of 0.005 for 0-3 months of the infant. The risk quotients of antibiotic residues in all water sources were much lower than 1 and thus did not pose a direct threat to human health.
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Affiliation(s)
- Li Feng
- Environmental Engineering Technology Research Center, Chongqing Academy of Ecology and Environmental Sciences, No. 252 Qishan Road, Yubei District, Chongqing, 401147, China; Faculty of Materials Science and Engineering, Chongqing University, No.174 Shazhengjie, Shapingba, Chongqing, 400044, China
| | - Yanru Cheng
- Environmental Engineering Technology Research Center, Chongqing Academy of Ecology and Environmental Sciences, No. 252 Qishan Road, Yubei District, Chongqing, 401147, China
| | - Yiyi Zhang
- Department of Water Management Civil Engineering and Geosciences (CEG) Stevinweg 1, 2628, CN, Delft, Netherlands
| | - Ziwei Li
- Environmental Engineering Technology Research Center, Chongqing Academy of Ecology and Environmental Sciences, No. 252 Qishan Road, Yubei District, Chongqing, 401147, China
| | - Yichang Yu
- Environmental Engineering Technology Research Center, Chongqing Academy of Ecology and Environmental Sciences, No. 252 Qishan Road, Yubei District, Chongqing, 401147, China
| | - Lei Feng
- Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences, No.266 Fangzheng Avenue,Shuitu Hi-tech Industrial Park, Shuitu Town, Beibei District, Chongqing, 400714, China
| | - Sheng Zhang
- Environmental Engineering Technology Research Center, Chongqing Academy of Ecology and Environmental Sciences, No. 252 Qishan Road, Yubei District, Chongqing, 401147, China
| | - Linji Xu
- Environmental Engineering Technology Research Center, Chongqing Academy of Ecology and Environmental Sciences, No. 252 Qishan Road, Yubei District, Chongqing, 401147, China.
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Pan Y, Dong J, Wan L, Sun S, MacIsaac HJ, Drouillard KG, Chang X. Norfloxacin pollution alters species composition and stability of plankton communities. JOURNAL OF HAZARDOUS MATERIALS 2020; 385:121625. [PMID: 31753672 DOI: 10.1016/j.jhazmat.2019.121625] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/18/2019] [Accepted: 11/05/2019] [Indexed: 06/10/2023]
Abstract
Despite recent advances in assessing lethal effects of antibiotics on freshwater organisms, little is known about their potential consequences on community composition and function, which are essential for assessing the ecological risk of these pollutants. Here, we investigated the impact of norfloxacin (NOR) on the short-term (≤ 6 days) dynamics of co-cultured Scenedesmusquadricauda-Chlorella vulgaris and Scenedesmusobliquus-C. vulgaris, and the long-term (≤ 70 days) dynamics of co-cultured S.obliquus-C. vulgaris in experiments with or without grazer Daphnia magna at sublethal antibiotic concentrations (0, 0.5, 2 and 8 mg L-1). NOR increased the relative abundance of Scenedesmus species in the absence of grazers but exerted opposite effects when Daphnia was present in both short- and long-term experiments due to reduced colony size. Meanwhile, increasing NOR concentrations led to quickly increased total algal density in the initial stage, followed by a sharp decline in the long-term experiment in the absence of grazers; when Daphnia was present, population fluctuations were even larger for both prey and predator species (e.g., grazer extinction at the highest concentration). Thus, NOR affected the outcome of species interactions and decreased temporal stability of plankton ecosystems, suggesting that antibiotics have more extensive impacts than presently recognized.
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Affiliation(s)
- Ying Pan
- School of Ecology and Environmental Science, Yunnan University, Kunming, 650091, Yunnan, China; Yunnan Key Laboratory for Plateau Mountain Ecology and Restoration of Degraded Environments, Yunnan University, Kunming, 650091, Yunnan, China; Department of Ecology, School of Life Sciences, Nanjing University, Nanjing, China
| | - Jinyan Dong
- School of Ecology and Environmental Science, Yunnan University, Kunming, 650091, Yunnan, China; Yunnan Key Laboratory for Plateau Mountain Ecology and Restoration of Degraded Environments, Yunnan University, Kunming, 650091, Yunnan, China
| | - Lingling Wan
- School of Ecology and Environmental Science, Yunnan University, Kunming, 650091, Yunnan, China; Yunnan Key Laboratory for Plateau Mountain Ecology and Restoration of Degraded Environments, Yunnan University, Kunming, 650091, Yunnan, China
| | - Shucun Sun
- Department of Ecology, School of Life Sciences, Nanjing University, Nanjing, China
| | - Hugh J MacIsaac
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, ON, N9 B 3P4, Canada
| | - Ken G Drouillard
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, ON, N9 B 3P4, Canada
| | - Xuexiu Chang
- School of Ecology and Environmental Science, Yunnan University, Kunming, 650091, Yunnan, China; Great Lakes Institute for Environmental Research, University of Windsor, Windsor, ON, N9 B 3P4, Canada.
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Li Q, Yin J, Li Z, Li Z, Du Y, Guo W, Bellefleur M, Wang S, Shi H. Serotype distribution, antimicrobial susceptibility, antimicrobial resistance genes and virulence genes of Salmonella isolated from a pig slaughterhouse in Yangzhou, China. AMB Express 2019; 9:210. [PMID: 31884559 PMCID: PMC6935380 DOI: 10.1186/s13568-019-0936-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/17/2019] [Indexed: 11/21/2022] Open
Abstract
Salmonella is an important food-borne pathogen associated with public health and high economic losses. To investigate the prevalence and the characteristics of Salmonella in a pig slaughterhouse in Yangzhou, a total of 80 Salmonella isolates were isolated from 459 (17.43%) samples in 2016–2017. S. Derby (35/80, 43.75%) was the most prevalent, followed by S. Rissen (16/80, 20.00%) and S. Newlands (11/80, 13.75%). The highest rates of susceptibility were observed to cefoxitin (80/80, 100.0%) and amikacin (80/80, 100.0%), followed by aztreonam (79/80, 98.75%) and nitrofurantoin (79/80, 98.75%). The highest resistance rate was detected for tetracycline (65/80, 81.25%), followed by ampicillin (60/80, 75.00%), bactrim (55/80, 68.75%), and sulfisoxazole (54/80, 67.50%). Overall, 91.25% (73/80) of the isolates were resistant to at least one antibiotic, while 71.25% (57/80) of the isolate strains were multidrug resistant in the antimicrobial susceptibility tested. In addition, 86.36% (19/22) of the 22 antimicrobial resistance genes in the isolates were identified. Our data indicated that the resistance to certain antimicrobials was significantly associated, in part, with antimicrobial resistance genes. Furthermore, 81.25% (65/80) isolates harbored the virulence gene of mogA, of which 2 Salmonella Typhimurium isolates carried the mogA, spvB and spvC virulence genes at the same time. The results showed that swine products in the slaughterhouse were contaminated with multidrug resistant Salmonella commonly, especially some isolates carry the spv virulence genes. The virulence genes might facilitate the dissemination of the resistance genes to consumers along the production chain, suggesting the importance of controlling Salmonella during slaughter for public health.
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Dadgostar P. Antimicrobial Resistance: Implications and Costs. Infect Drug Resist 2019; 12:3903-3910. [PMID: 31908502 PMCID: PMC6929930 DOI: 10.2147/idr.s234610] [Citation(s) in RCA: 968] [Impact Index Per Article: 161.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 11/29/2019] [Indexed: 12/24/2022] Open
Abstract
Antimicrobial resistance (AMR) has developed as one of the major urgent threats to public health causing serious issues to successful prevention and treatment of persistent diseases. In spite of different actions taken in recent decades to tackle this issue, the trends of global AMR demonstrate no signs of slowing down. Misusing and overusing different antibacterial agents in the health care setting as well as in the agricultural industry are considered the major reasons behind the emergence of antimicrobial resistance. In addition, the spontaneous evolution, mutation of bacteria, and passing the resistant genes through horizontal gene transfer are significant contributors to antimicrobial resistance. Many studies have demonstrated the disastrous financial consequences of AMR including extremely high healthcare costs due to an increase in hospital admissions and drug usage. The literature review, which included articles published after the year 2012, was performed using Scopus, PubMed and Google Scholar with the utilization of keyword searches. Results indicated that the multifactorial threat of antimicrobial resistance has resulted in different complex issues affecting countries across the globe. These impacts found in the sources are categorized into three different levels: patient, healthcare, and economic. Although gaps in knowledge about AMR and areas for improvement are obvious, there is not any clearly understood progress to put an end to the persistent trends of antimicrobial resistance.
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Affiliation(s)
- Porooshat Dadgostar
- Milken Institute of Public Health, George Washington University, Washington, DC, USA
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27
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Zeng S, Xu Z, Wang X, Liu W, Qian L, Chen X, Wei J, Zhu M, Gong Z, Yan Y. Time series analysis of antibacterial usage and bacterial resistance in China: observations from a tertiary hospital from 2014 to 2018. Infect Drug Resist 2019; 12:2683-2691. [PMID: 31695444 PMCID: PMC6717838 DOI: 10.2147/idr.s220183] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/15/2019] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To describe trends and correlation between antibacterial exposure and bacterial resistance from hospitalized patients in a hospital in southern China. PATIENTS AND METHODS This study used hospital-wide data regarding antimicrobial resistance and consumption between January 1, 2014 and December 31, 2018. Antibacterial consumption was expressed as antimicrobial use density (AUD). The changes in trends and associations between antibacterial utilization and resistance were analyzed using linear regression and time series analysis. RESULTS The total AUD of all antimicrobials decreased year by year (50.66 in 2014 vs 44.28 in 2018, P=0.03). The annual use of antimicrobials, such as penicillins, monobactams, aminoglycosides, macrolides, and lincosamides, significantly decreased (P<0.05), while the annual use of quinolones and tetracyclines significantly increased (P<0.05). Among the top ten isolated bacteria, antimicrobial resistance trends of Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Staphylococcus aureus, and Staphylococcus epidermidis significantly decreased (P<0.05). Significant positive correlation was found between AUD of carbapenems and resistance rate of Acinetobacter baumannii to imipenem (β=32.87, P<0.01), as well as the correlation between AUD of quinolones and resistance rate of Enterococcus faecium to levofloxacin (β=104.40, P<0.01). CONCLUSION The consumption of antibiotics and antibiotic resistance has been significantly improved in this tertiary hospital. Additionally, the efforts of China's antibiotic management may be suggested by the relationship between indicated antibiotic resistance and consumption. However, overall AUD levels and poor control of the use of antibiotics, such as quinolones and tetracyclines, still require strengthened management.
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Affiliation(s)
- Shuangshuang Zeng
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
- Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
| | - Zhijie Xu
- Department of Pathology, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
| | - Xiang Wang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
- Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
| | - Wanli Liu
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
- Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
| | - Long Qian
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
- Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
| | - Xi Chen
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
- Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
| | - Jie Wei
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
- Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
| | - Minwen Zhu
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
- Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
| | - Zhicheng Gong
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
- Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
| | - Yuanliang Yan
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
- Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha410008, Hunan, People’s Republic of China
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Value of antibiotic prophylaxis in routine knee arthroscopy : A retrospective study. DER ORTHOPADE 2019; 47:246-253. [PMID: 28993891 DOI: 10.1007/s00132-017-3486-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Prophylactic antibiotic use prior to routine knee arthroscopy remains controversial. It is important to know whether antibiotics help decrease the surgical site infection (SSI) rate. Our aims were to assess the efficacy of antibiotic prophylaxis in preventing SSI and to identify risk factors for SSI following routine knee arthroscopy without an implant. METHODS A retrospective study was conducted using the electronic medical records at the authors' hospital to identify patients that underwent routine knee arthroscopy without an implant between October 2010 and October 2016. Data on demographics, clinical characteristics and antibiotic administration were extracted. Arthroscopic diagnosis, debridement, partial or complete meniscectomy, arthroscopic shaving and microfracture, removal of loose bodies, synovectomy and lateral retinacular release were included. Complex knee arthroscopy with an implant was excluded. Patients were divided into evaluation (with prophylactic antibiotics) and control (no antibiotic treatment) groups. Continuous variables between groups were compared using the Student's t-test. Data were analyzed using the Chi-squared test for percentages between groups. Multivariate logistic regression was used to identify independent risk factors of SSI. RESULTS Of 1326 patients, 614 (46.3%) received prophylactic antibiotics, while 712 (53.7%) did not. There were seven (0.53%) SSIs. The SSI rate did not differ significantly between patients receiving antibiotics (0.49%, three) and those not (0.56%, four). Five patients (0.37%) had superficial infections, two (0.33%) were in the prophylactic antibiotic group and three (0.42%) were in the other group. Deep infections occurred in two patients (0.15%), one (0.16%) in the prophylactic antibiotic group and one (0.14%) in the other group. The difference between the two groups was not statistically significant (P = 1.0). Age over 50 years was associated with an increased risk of SSI (relative ratio [RR] = 1.469, 95% confidence interval [CI] 1.09-2.13, P = 0.009). CONCLUSIONS Prophylactic antibiotic use in routine knee arthroscopy without an implant may not be necessary. Age over 50 years was associated with an increased risk of SSI.
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Zhang J, Folgori L, Hsia Y, Sharland M, Yang Y. Pattern of Antimicrobial Resistance in Bloodstream Isolates From Chinese Neonates. Pediatr Infect Dis J 2019; 38:600-604. [PMID: 30672894 DOI: 10.1097/inf.0000000000002246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Jiaosheng Zhang
- From the Laboratory of Microbiology and Immunology, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China.,Department of Internal Medicine, Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Laura Folgori
- Paediatric infectious Disease Research Group, Division of Clinical Sciences, St. George's University of London, United Kingdom
| | - Yingfen Hsia
- Paediatric infectious Disease Research Group, Division of Clinical Sciences, St. George's University of London, United Kingdom
| | - Mike Sharland
- Paediatric infectious Disease Research Group, Division of Clinical Sciences, St. George's University of London, United Kingdom
| | - Yonghong Yang
- From the Laboratory of Microbiology and Immunology, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China.,Department of Internal Medicine, Shenzhen Children's Hospital, Shenzhen, People's Republic of China
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Haque M, Che Roos N, Bakar M. Knowledge, attitude and practice among Malaysian medical students, doctors, other health professionals and common people regarding antibiotic use, prescribing and resistance: A systematic review. ADVANCES IN HUMAN BIOLOGY 2019. [DOI: 10.4103/aihb.aihb_42_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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31
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Guzel M, Afsar Y, Akdogan D, Moncheva P, Hristova P, Erdem G. Evaluation of metallo-beta-lactamase production in multiple antibiotic-resistant Pseudomonas spp. and Acinetobacter baumannii strains. BIOTECHNOL BIOTEC EQ 2018. [DOI: 10.1080/13102818.2018.1500146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Mustafa Guzel
- Microbiology Laboratory, Private Maltepe Medical Center, Istanbul, Turkey
| | - Yusuf Afsar
- Microbiology Laboratory, Ağrı State Hospital, Ağrı, Turkey
| | - Dogan Akdogan
- Microbiology Laboratory, 29 Mayıs State Hospital, Ankara, Turkey
| | - Penka Moncheva
- Department of Microbiology, Faculty of Biology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Petya Hristova
- Department of Microbiology, Faculty of Biology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Gul Erdem
- Department of Medical Microbiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Manyi-Loh C, Mamphweli S, Meyer E, Okoh A. Antibiotic Use in Agriculture and Its Consequential Resistance in Environmental Sources: Potential Public Health Implications. Molecules 2018; 23:E795. [PMID: 29601469 PMCID: PMC6017557 DOI: 10.3390/molecules23040795] [Citation(s) in RCA: 762] [Impact Index Per Article: 108.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/14/2018] [Accepted: 03/02/2018] [Indexed: 01/08/2023] Open
Abstract
Due to the increased demand of animal protein in developing countries, intensive farming is instigated, which results in antibiotic residues in animal-derived products, and eventually, antibiotic resistance. Antibiotic resistance is of great public health concern because the antibiotic-resistant bacteria associated with the animals may be pathogenic to humans, easily transmitted to humans via food chains, and widely disseminated in the environment via animal wastes. These may cause complicated, untreatable, and prolonged infections in humans, leading to higher healthcare cost and sometimes death. In the said countries, antibiotic resistance is so complex and difficult, due to irrational use of antibiotics both in the clinical and agriculture settings, low socioeconomic status, poor sanitation and hygienic status, as well as that zoonotic bacterial pathogens are not regularly cultured, and their resistance to commonly used antibiotics are scarcely investigated (poor surveillance systems). The challenges that follow are of local, national, regional, and international dimensions, as there are no geographic boundaries to impede the spread of antibiotic resistance. In addition, the information assembled in this study through a thorough review of published findings, emphasized the presence of antibiotics in animal-derived products and the phenomenon of multidrug resistance in environmental samples. This therefore calls for strengthening of regulations that direct antibiotic manufacture, distribution, dispensing, and prescription, hence fostering antibiotic stewardship. Joint collaboration across the world with international bodies is needed to assist the developing countries to implement good surveillance of antibiotic use and antibiotic resistance.
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Affiliation(s)
- Christy Manyi-Loh
- Fort Hare Institute of Technology, University of Fort Hare, Alice Campus, Alice 5700, Eastern Cape, South Africa.
- Applied and Environmental Microbiology Research Group (AEMREG), Department of Biochemistry and Microbiology, University of Fort Hare, Alice Campus, Alice 5700, Eastern Cape, South Africa.
- SAMRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice Campus, Alice 5700, Eastern Cape, South Africa.
| | - Sampson Mamphweli
- Fort Hare Institute of Technology, University of Fort Hare, Alice Campus, Alice 5700, Eastern Cape, South Africa.
| | - Edson Meyer
- Fort Hare Institute of Technology, University of Fort Hare, Alice Campus, Alice 5700, Eastern Cape, South Africa.
| | - Anthony Okoh
- Applied and Environmental Microbiology Research Group (AEMREG), Department of Biochemistry and Microbiology, University of Fort Hare, Alice Campus, Alice 5700, Eastern Cape, South Africa.
- SAMRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice Campus, Alice 5700, Eastern Cape, South Africa.
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Liu M, Zhang H, Song X, Wei C, Xiong Z, Yu F, Li C, Ai F, Guo G, Wang X. NaCl: for the safer in vivo use of antibacterial silver based nanoparticles. Int J Nanomedicine 2018; 13:1737-1748. [PMID: 29606867 PMCID: PMC5868575 DOI: 10.2147/ijn.s153168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background As antibiotics progressively cease to be effective, silver based nanoparticles (SBNs), with broad antibacterial spectrum, might be the last line of defense against malicious bacteria. Unfortunately, there are still no proper SBNs-based strategies for in vivo antibacterial therapies. In this article, new carbon membrane packaged Ag nanoparticles (Ag-C) were synthesized. We assessed the effect of Ag-C with NaCl on size, cytotoxicity, antibacterial properties, metabolism and sepsis models. Methods The size of Ag-C with NaCl was accessed with UV-vis, TEM and SEM. Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa were used to illustrate the antibacterial properties of SBNs affected by NaCl. L929 and 3T3 cell lines were cultured in vitro; CCK-8 assay was used to test cytotoxicity. Then, we explored the metabolism of Ag-C with NaCl in vivo. Finally, the effect of Ag-C with 4× NaCl on sepsis was observed. Results NaCl could regulate the size of Ag-C. Ag-C exhibited superior antibacterial properties compared to similar sized pure Ag nanoparticles. Furthermore, the addition of NaCl could not only reduce the cytotoxicity of Ag-C, but could also continue to discharge Ag-C from major organs. Based on these factors, this method was used to treat a sepsis model (induced via cecal ligation and puncture), and it achieved satisfactory survival results. Conclusion This discovery, though still in its infancy, could significantly improve the safety and feasibility of SBNs and could potentially play an important role in modern in vivo antibacterial applications. Thus, a new method to combating the growing threat from drug-resistant bacteria could be possible. NaCl is the key to excretion of SBNs after in vivo antibacterial use.
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Affiliation(s)
- Mingzhuo Liu
- Department of Burns, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Huiqing Zhang
- Department of Burns, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Xiangwei Song
- Department of Translational Medicine, Nanchang University, Nanchang, Jiangxi, China
| | - Chaochao Wei
- Department of Translational Medicine, Nanchang University, Nanchang, Jiangxi, China
| | - Zhenfang Xiong
- Department of Pathology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Fen Yu
- Department of Translational Medicine, Nanchang University, Nanchang, Jiangxi, China
| | - Chen Li
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Fanrong Ai
- School of Mechanical & Electronic Engineering, Nanchang University, Nanchang, Jiangxi, China
| | - Guanghua Guo
- Department of Burns, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Xiaolei Wang
- Department of Translational Medicine, Nanchang University, Nanchang, Jiangxi, China
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Wang S, Han LZ, Ni YX, Zhang YB, Wang Q, Shi DK, Li WH, Wang YC, Mi CR. Changes in antimicrobial susceptibility of commonly clinically significant isolates before and after the interventions on surgical prophylactic antibiotics (SPAs) in Shanghai. Braz J Microbiol 2018; 49:552-558. [PMID: 29449171 PMCID: PMC6066744 DOI: 10.1016/j.bjm.2017.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 09/20/2017] [Accepted: 12/01/2017] [Indexed: 12/24/2022] Open
Abstract
Surveillances and interventions on antibiotics use have been suggested to improve serious drug-resistance worldwide. Since 2007, our hospital have proposed many measures for regulating surgical prophylactic antibiotics (carbapenems, third gen. cephalosporins, vancomycin, etc.) prescribing practices, like formulary restriction or replacement for surgical prophylactic antibiotics and timely feedback. To assess the impacts on drug-resistance after interventions, we enrolled infected patients in 2006 (pre-intervention period) and 2014 (post-intervention period) in a tertiary hospital in Shanghai. Proportions of targeted pathogens were analyzed: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp. (VRE), imipenem-resistant Escherichia coli (IREC), imipenem-resistant Klebsiella pneumoniae (IRKP), imipenem-resistant Acinetobacter baumannii (IRAB) and imipenem-resistant Pseudomonas aeruginosa (IRPA) isolates. Rates of them were estimated and compared between Surgical Department, ICU and Internal Department during two periods. The total proportions of targeted isolates in Surgical Department (62.44%, 2006; 64.09%, 2014) were more than those in ICU (46.13%, 2006; 50.99%, 2014) and in Internal Department (44.54%, 2006; 51.20%, 2014). Only MRSA has decreased significantly (80.48%, 2006; 55.97%, 2014) (p < 0.0001). The percentages of VRE and IREC in 3 departments were all <15%, and the slightest change were also both observed in Surgical Department (VRE: 0.76%, 2006; 2.03%, 2014) (IREC: 2.69%, 2006; 2.63%, 2014). The interventions on surgical prophylactic antibiotics can be effective for improving resistance; antimicrobial stewardship must be combined with infection control practices.
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Affiliation(s)
- Su Wang
- Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Department of Clinical Microbiology, Shanghai, China
| | - Li-Zhong Han
- Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Department of Clinical Microbiology, Shanghai, China.
| | - Yu-Xing Ni
- Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Department of Clinical Microbiology, Shanghai, China
| | - Yi-Bo Zhang
- Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Department of Hospital Infection Control, Shanghai, China
| | - Qun Wang
- Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Department of Hospital Infection Control, Shanghai, China
| | - Da-Ke Shi
- Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Department of Hospital Infection Control, Shanghai, China
| | - Wen-Hui Li
- Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Department of Hospital Infection Control, Shanghai, China
| | - Yi-Chen Wang
- Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Department of Hospital Infection Control, Shanghai, China
| | - Chen-Rong Mi
- Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Department of Hospital Infection Control, Shanghai, China.
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Ma Y, Zhao Y, Tang J, Tang C, Chen J, Liu J. Antimicrobial susceptibility and presence of resistance & enterotoxins/enterotoxin-likes genes in Staphylococcus aureusfrom food. CYTA - JOURNAL OF FOOD 2018. [DOI: 10.1080/19476337.2017.1340341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Yisalan Ma
- College of life science and technology, Southwest University for Nationalities, Chengdu, China
| | - Yanying Zhao
- College of life science and technology, Southwest University for Nationalities, Chengdu, China
| | - Junni Tang
- College of life science and technology, Southwest University for Nationalities, Chengdu, China
| | - Cheng Tang
- College of life science and technology, Southwest University for Nationalities, Chengdu, China
| | - Juan Chen
- College of life science and technology, Southwest University for Nationalities, Chengdu, China
| | - Ji Liu
- College of life science and technology, Southwest University for Nationalities, Chengdu, China
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Manhanzva R, Marara P, Duxbury T, Bobbins AC, Pearse N, Hoel E, Mzizi T, Srinivas SC. Gender and leadership for health literacy to combat the epidemic rise of noncommunicable diseases. Health Care Women Int 2017; 38:833-847. [PMID: 28524810 DOI: 10.1080/07399332.2017.1332062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Until recently, the noncommunicable diseases (NCDs) epidemic has been considered only a significant burden to men in high-income countries. However, latest figures indicate that half of all NCD-related deaths affect women, especially in low- and middle-income countries (LMICs), with global responses to the NCD epidemic overlooking the significance of women and girls in their approaches and programs. This case study highlights the burden of disease challenging South Africa that disproportionately affects women in the country and suggests that the country, along with other LMICs internationally, requires a shift in the gender-based leadership of health literacy and self-empowerment.
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Affiliation(s)
- Rufaro Manhanzva
- a Faculty of Pharmacy , Rhodes University , Grahamstown , South Africa
| | - Praise Marara
- a Faculty of Pharmacy , Rhodes University , Grahamstown , South Africa
| | - Theodore Duxbury
- a Faculty of Pharmacy , Rhodes University , Grahamstown , South Africa
| | | | - Noel Pearse
- b Rhodes Business School , Rhodes University, Grahamstown , South Africa
| | - Erik Hoel
- c Hedmark University of Applied Sciences , Elverum , Norway
| | - Thandi Mzizi
- d Wellness Centre , Rhodes University , Grahamstown , South Africa
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