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Spiegel PB, Karadag O, Blanchet K, Undie CC, Mateus A, Horton R. The CHH-Lancet Commission on Health, Conflict, and Forced Displacement: reimagining the humanitarian system. Lancet 2024; 403:1215-1217. [PMID: 38493793 DOI: 10.1016/s0140-6736(24)00426-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024]
Affiliation(s)
- Paul B Spiegel
- Johns Hopkins Center for Humanitarian Health and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Ozge Karadag
- Bahcesehir University (BAU), School of Medicine, Istanbul, Türkiye
| | | | - Chi-Chi Undie
- Baobab Research Programme Consortium, Population Council, Nairobi, Kenya
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Farrell S, Bagcigil AF, Chaintoutis SC, Firth C, Aydin FG, Hare C, Maaland M, Mateus A, Vale AP, Windahl U, Damborg P, Timofte D, Singleton D, Allerton F. A multinational survey of companion animal veterinary clinicians: How can antimicrobial stewardship guidelines be optimised for the target stakeholder? Vet J 2024; 303:106045. [PMID: 38000694 DOI: 10.1016/j.tvjl.2023.106045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/03/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Abstract
Antimicrobial stewardship initiatives are widely regarded as a cornerstone for ameliorating the global health impact of antimicrobial resistance. Within companion animal health, such efforts have largely focused on development and dissemination of antimicrobial stewardship guidelines (ASGs). However, there have been few attempts to understand veterinarian attitudes towards and knowledge of ASGs or to determine how awareness regarding ASGs might best be increased. An online survey regarding ASGs was formulated for veterinarians who treat companion animals. The survey was distributed across 46 European and associated countries between 12 January and 30 June, 2022. In total, 2271 surveys were completed, with 64.9% of respondents (n = 1474) reporting awareness and usage of at least one ASG. Respondents from countries with greater awareness of ASGs tended to report more appropriate use of antimicrobials (Spearman's rank coefficient = 0.6084, P ≤ 0.001), with respondents from countries with country-specific ASGs tending to score highest across both awareness and appropriate use domains. Respondents prioritised guidance around antimicrobial choice (82.0%, n = 1863), duration of treatment (66.0%, n = 1499), and dosage (51.9%, n = 1179) for inclusion in future ASGs, with 78.0% (n = 1776) of respondents preferring ASGs to be integrated into their patient management system. Awareness of ASGs and their use in companion animal veterinary practice appears to be greater than previously reported, with respondents tending to report antimicrobial prescription decision making broadly in line with current clinical recommendations. However, further initiatives aimed at maximising accessibility to ASGs both within countries and individual veterinary practices are recommended.
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Affiliation(s)
- S Farrell
- Department of Computer Science, Durham University, Durham, UK
| | - A F Bagcigil
- Department of Microbiology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - S C Chaintoutis
- Diagnostic Laboratory, Department of Clinical Sciences, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 Stavrou Voutyra str., Thessaloniki, Greece
| | - C Firth
- Unit of Veterinary Public Health and Epidemiology, University of Veterinary Medicine, Veterinaerplatz 1, 1210 Vienna, Austria
| | - F G Aydin
- Ankara University, Faculty of Veterinary Medicine, Department of Pharmacology and Toxicology, 06070 Altindag/Ankara, Turkey
| | - C Hare
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
| | - M Maaland
- Department of Production Animal Clinical Sciences, Norwegian University of Life Sciences, 4325 Sandnes, Norway
| | - A Mateus
- World Organisation for Animal Health, 12 Rue de Prony, 75017 Paris, France
| | - A P Vale
- School of Veterinary Medicine, University College Dublin, UCD Belfield, Dublin, Ireland
| | - U Windahl
- Swedish National Veterinary Institute, 75189 Uppsala, Sweden
| | - P Damborg
- Department of Veterinary and Animal Sciences, University of Copenhagen, Stigbøjlen 4, 1870 Frederiksberg, Denmark
| | - D Timofte
- Department of Veterinary Anatomy Physiology and Pathology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK
| | - D Singleton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, UK
| | - F Allerton
- Willows Veterinary Centre and Referral Service, part of Linnaeus Veterinary Limited, Highlands Road, Shirley, Solihull B90 4NH, UK.
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Elkholly D, Fraser A, Booth R, O'Neill D, Mateus A, Brunton L, Brodbelt D. Antimicrobial usage in farm animal practices in the UK: A mixed-methods approach. Prev Vet Med 2023; 213:105870. [PMID: 36841042 DOI: 10.1016/j.prevetmed.2023.105870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 01/11/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
Antimicrobial resistance (AMR) is a growing One Health problem. Monitoring antimicrobial usage in farm animals is crucial for tackling AMR. A cohort study using the electronic clinical records during 2019 from 23 farm animal veterinary practices across the UK belonging to two corporate groups, with a range of 2-14 veterinarians per practice, estimated the usage of antimicrobials and highest priority critically important antimicrobials (HP-CIAs). Risk factors for using HP-CIAs were evaluated using hierarchical mixed-effects logistic regression modelling with practice ID and farm ID added as random effects. Using a qualitative approach, veterinarians from one of the participating practice groups were recruited for a qualitative study to explore the barriers and facilitators in relation to antimicrobial use. Semi-structured interviews were conducted with participants and analysed thematically. During the year 2019, 98,824 antimicrobial prescribing events overall were recorded from the treatment records of the 23 participating practices. The median count of antimicrobial events per practice was 3226 (range 263-22,159). There were 17,111/98,824 (17.3%) HP-CIAs events overall, with a median of 15.4% at practice level (range 4.8-22.1%). Penicillins were the most frequently used antimicrobials 29,539/98,824 (29.9%) followed by tetracyclines 19,015/98,824 (19.2%). HP-CIA use was strongly clustered, with more clustering seen at the farm level (intraclass correlation coefficient (ICC)= 0.56) than at the practice level (ICC= 0.32). Country, route of administration, season and practice type were significantly associated with the usage of HP-CIAs. Four main themes were identified from the analysis of the veterinarians' interviews: pressure from the industry, drug-related factors, knowledge level of veterinarians and clinical factors. Supermarket contracts and farm assurance schemes were facilitators for reducing antimicrobial use and the use of HP-CIAs. Ease of administration and the withdrawal period of the antimicrobials influenced veterinarians' choice of antimicrobials. The clinical condition and clinical signs presented on farm were reported to influence participating veterinarians' prescribing decision. Participants showed a good understanding of AMR, responsible use of antimicrobials and the term 'critically important antimicrobials'. In conclusion, integrating the quantitative and qualitative findings can inform policymaking on antimicrobials stewardship in farm practice. By estimating the relative levels of clustering of antimicrobial use at the practice and farm level, as well as identifying major risk factors for using HP-CIAs, more targeted interventions can be designed to promote responsible antimicrobial use in farm practice. Furthermore, better understanding the industry pressures on farms to reduce antimicrobials usage could reduce the barriers for responsible antimicrobial use by veterinarians.
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Affiliation(s)
- D Elkholly
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom.
| | - A Fraser
- King's Business School, King's College London, London, United Kingdom
| | - R Booth
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| | - D O'Neill
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| | - A Mateus
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| | - L Brunton
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| | - D Brodbelt
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
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Saman A, Chaudhry M, Ijaz M, Shaukat W, Zaheer MU, Mateus A, Rehman A. Assessment of knowledge, perception, practices and drivers of antimicrobial resistance and antimicrobial usage among veterinarians in Pakistan. Prev Vet Med 2023; 212:105836. [PMID: 36634489 DOI: 10.1016/j.prevetmed.2022.105836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Antimicrobial resistance (AMR) and irrational antimicrobial usage (AMU) are a global problem, particularly evident in low- and middle-income countries including Pakistan. Our study aimed to assess the knowledge, attitudes and prescribing practices (KAP) of field veterinarians regarding AMR and AMU. METHODS A questionnaire-based online survey was conducted using Google forms to collect data on AMR and AMU from veterinary practitioners in Pakistan between July 25, 2020, and February 2, 2021. The questionnaire was comprised of four sections: 1) Demographic information of the respondents, 2) Knowledge about AMR, and AMU, 3) Antibiotic prescribing behavior, attitudes and influencing drivers and 4) Practices of respondents about AMU and drug disposal. RESULTS A total of 545 participants (Male 84%, Female 16%) completed the survey. The respondents' qualification (P = 0.008), gender (P = 0.007) and type of practitioner (P < 0.001) had a significant association with the mean knowledge score about AMR. Most of the veterinarians had never attended any training, symposium, or awareness session on AMR (63%) and methods to detect antibiotic residues (71%). Participating veterinarians frequently included "critically important antimicrobials" in their treatment regimens. Most veterinarians (60%) prescribed antibiotics for viral diseases. Our study showed that about 44% of veterinarians disposed of expired drugs in the garbage. Antibiotics were prescribed as mass medication and for prophylaxis by 59% and 33% of the veterinarians, respectively, while about 60% of the veterinarians prescribed antibiotics starting with double doses in their treatment regimens. Importantly, only 4% of the veterinarians recognized the concept of One Health. Male veterinarians had higher odds of prescribing mass medication (OR=3.07, P < 0.001) and use of antibiotics for disease prophylaxis (OR=2.31, P = 0.002) than females, whereas improper disposal of expired antimicrobials (OR=2.12, P = 0.003) was more common in female veterinarians. Government veterinarians had 2 (OR=1.95, P = 0.016) and 3 (OR=3.05, P < 0.001) times higher odds to prescribe antibiotics prophylactically and for mass treatments, respectively compared to full-time private veterinarians. CONCLUSION Our study identifies key factors influencing veterinarians' decision about antimicrobial prescription and highlights important shortcomings such as lack of training on rational use of antimicrobials, frequent use of antimicrobials for mass medication and prophylaxis, widespread use of critically important antimicrobials, and improper disposal practices. There is a dire need to improve knowledge of veterinary practitioners regarding AMR and to adopt a One Health approach to rationalize AMU at the national level in line with the regional and international guidelines.
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Affiliation(s)
- Ayesha Saman
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan.
| | - Mamoona Chaudhry
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan.
| | - Muhammad Ijaz
- Department of Veterinary Medicine, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan.
| | - Waseem Shaukat
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
| | - Muhammad Usman Zaheer
- The Fleming Fund Country Grant Pakistan, Health Security Partners, Washington, DC 20037, USA; Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
| | - Ana Mateus
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
| | - Abdul Rehman
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan.
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Hennessey M, Ebata A, Samanta I, Mateus A, Arnold JC, Day D, Gautham M, Alarcon P. Pharma-cartography: Navigating the complexities of antibiotic supply to rural livestock in West Bengal, India, through value chain and power dynamic analysis. PLoS One 2023; 18:e0281188. [PMID: 36730354 PMCID: PMC9894437 DOI: 10.1371/journal.pone.0281188] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/18/2023] [Indexed: 02/03/2023] Open
Abstract
Antibiotic resistance threatens provision of healthcare and livestock production worldwide with predicted negative socioeconomic impact. Antibiotic stewardship can be considered of importance to people living in rural communities, many of which depend on agriculture as a source of food and income and rely on antibiotics to control infectious diseases in livestock. Consequently, there is a need for clarity of the structure of antibiotic value chains to understand the complexity of antibiotic production and distribution in community settings as this will facilitate the development of effective policies and interventions. We used a value chain approach to investigate how relationships, behaviours, and influences are established during antibiotic distribution. Interviews were conducted with key informants (n = 17), value chain stakeholders (n = 22), and livestock keeping households (n = 36) in Kolkata, and two rural sites in West Bengal, India. Value chain mapping and an assessment of power dynamics, using manifest content analysis, were conducted to investigate antibiotic distribution and identify entry points for antibiotic stewardship. The flow of antibiotics from manufacturer to stockists is described and mapped and two local level maps showing distribution to final consumers presented. The maps illustrate that antibiotic distribution occurred through numerous formal and informal routes, many of which circumvent antibiotic use legislation. This was partly due to limited institutional power of the public sector to govern value chain activities. A 'veterinary service lacuna' existed resulting in livestock keepers having higher reliance on private and informal providers, who often lacked legal mandates to prescribe and dispense antibiotics. The illegitimacy of many antibiotic prescribers blocked access to formal training who instead relied on mimicking the behaviour of more experienced prescribers-who also lacked access to stewardship guidelines. We argue that limited institutional power to enforce existing antibiotic legislation and guide antibiotic usage and major gaps in livestock healthcare services make attempts to curb informal prescribing unsustainable. Alternative options could include addressing public sector deficits, with respect to both healthcare services and antibiotic provision, and by providing resources such as locally relevant antibiotic guidelines to all antibiotic prescribers. In addition, legitimacy of informal prescribers could be revised, which may allow formation of associations or groups to incentivise good antibiotic practices.
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Affiliation(s)
- Mathew Hennessey
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
- * E-mail:
| | - Ayako Ebata
- Institute of Development Studies, Brighton, United Kingdom
| | - Indranil Samanta
- Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - Ana Mateus
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Jean-Christophe Arnold
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Dominic Day
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Meenakshi Gautham
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Pablo Alarcon
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
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Ramos P, Mateus A, Vale L, Botelho F, Manso M, Silva S, Pacheco-Figueiredo L, Silva C. Prognostic impact of variant histology in bladder cancer: Would early and aggressive treatment shift the paradigm? EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02356-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Myers J, Hennessey M, Arnold JC, McCubbin KD, Lembo T, Mateus A, Kitutu FE, Samanta I, Hutchinson E, Davis A, Mmbaga BT, Nasuwa F, Gautham M, Clarke SE. Crossover-Use of Human Antibiotics in Livestock in Agricultural Communities: A Qualitative Cross-Country Comparison between Uganda, Tanzania and India. Antibiotics (Basel) 2022; 11:1342. [PMID: 36290000 PMCID: PMC9598773 DOI: 10.3390/antibiotics11101342] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/02/2022] [Accepted: 09/28/2022] [Indexed: 12/24/2022] Open
Abstract
Antibiotic use in animal agriculture contributes significantly to antibiotic use globally and is a key driver of the rising threat of antibiotic resistance. It is becoming increasingly important to better understand antibiotic use in livestock in low-and-middle income countries where antibiotic use is predicted to increase considerably as a consequence of the growing demand for animal-derived products. Antibiotic crossover-use refers to the practice of using antibiotic formulations licensed for humans in animals and vice versa. This practice has the potential to cause adverse drug reactions and contribute to the development and spread of antibiotic resistance between humans and animals. We performed secondary data analysis of in-depth interview and focus-group discussion transcripts from independent studies investigating antibiotic use in agricultural communities in Uganda, Tanzania and India to understand the practice of antibiotic crossover-use by medicine-providers and livestock-keepers in these settings. Thematic analysis was conducted to explore driving factors of reported antibiotic crossover-use in the three countries. Similarities were found between countries regarding both the accounts of antibiotic crossover-use and its drivers. In all three countries, chickens and goats were treated with human antibiotics, and among the total range of human antibiotics reported, amoxicillin, tetracycline and penicillin were stated as used in animals in all three countries. The key themes identified to be driving crossover-use were: (1) medicine-providers' and livestock-keepers' perceptions of the effectiveness and safety of antibiotics, (2) livestock-keepers' sources of information, (3) differences in availability of human and veterinary services and antibiotics, (4) economic incentives and pressures. Antibiotic crossover-use occurs in low-intensity production agricultural settings in geographically distinct low-and-middle income countries, influenced by a similar set of interconnected contextual drivers. Improving accessibility and affordability of veterinary medicines to both livestock-keepers and medicine-providers is required alongside interventions to address understanding of the differences between human and animal antibiotics, and potential dangers of antibiotic crossover-use in order to reduce the practice. A One Health approach to studying antibiotic use is necessary to understand the implications of antibiotic accessibility and use in one sector upon antibiotic use in other sectors.
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Affiliation(s)
- Jessica Myers
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, Bloomsbury, London WC1E 7HT, UK
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK
| | - Mathew Hennessey
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK
| | - Jean-Christophe Arnold
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK
| | - Kayley D McCubbin
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Tiziana Lembo
- School of Biodiversity, One Health & Veterinary Medicine, University of Glasgow, Glasgow G12 8QQ, UK
| | - Ana Mateus
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK
| | - Freddy Eric Kitutu
- School of Public Health, Makerere University, New Mulago Hill Road, Kampala P.O. Box 7072, Uganda
| | - Indranil Samanta
- Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences, Kolkata 700037, India
| | - Eleanor Hutchinson
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Alicia Davis
- School of Social and Political Sciences, University of Glasgow, Glasgow G12 8RT, UK
| | - Blandina T Mmbaga
- Kilimanjaro Clinical Research Institute, Moshi P.O. Box 2236, Tanzania
- Department of Paediatric and Child Health, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi P.O. Box 2240, Tanzania
| | - Fortunata Nasuwa
- Kilimanjaro Clinical Research Institute, Moshi P.O. Box 2236, Tanzania
| | - Meenakshi Gautham
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Siân E Clarke
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, Bloomsbury, London WC1E 7HT, UK
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Lima T, Fernandes L, Matias M, Mateus A, Silveira E, Domingues S, Pomba C, Da Silva GJ. Longitudinal Study Detects the Co-Carriage of ESBL and mcr-1 and -4 Genes in Escherichia coli Strains in a Portuguese Farrow-to-Finish Swine Herd. Animals (Basel) 2022; 12:ani12172209. [PMID: 36077929 PMCID: PMC9454694 DOI: 10.3390/ani12172209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
Cephalosporins and polymyxins are employed in antimicrobial protocols to control and treat neonatal infections and post-weaning diarrhoea in swine operations. We conducted a longitudinal study to evaluate the colonization and transmission of antibiotic–resistant Escherichia coli in sows and their piglets in a farrow-to-finish operation, focusing on characterization of Extended Spectrum Beta-Lactamase (ESBL) and mcr genes, virulence traits and genetic relatedness. A total of 293 E. coli isolates were obtained from faecal samples collected in five time points. At birth blaCTX-M-1group cluster was detected in E. coli isolates from 9 sows and 49 piglets (73.41%), while in the following four’ piglets sampling moments it was detected in 91.8%, 57.6%, 71.4% and 97.4%. The gene mcr-1 was detected in E. coli from one sow and from three piglets from different litters at birth and increased in the first weeks of piglet life (68.85%, 100%, 90% and 8.1%). A new mcr-4 allele, mcr-4.7, was identified in 3.28%, 28.57%, 7.5% of E. coli isolates. Most mcr-positive E. coli isolates (96,7%) carried blaCTX-M-1Group genes and 93,33% carried both mcr-4 and mcr-1. CTX-M-1 and CTX-M-32 were the most predominant ESBLs. Plasmids belonged to IncI1, IncF and IncN groups. Most isolates belong to phylogenetic group B1; PAI IV536 marker was detected in nine isolates. The strains were kept in the different stages of the piglets’ life. The use of ceftiofur and colistin may explain the high prevalence and co-selection of blaCTX-M-1Group and mcr-1 and/or -4 genes, contributing to the maintenance of resistant and virulent isolates throughout the pig life cycle that may reach the food chain.
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Affiliation(s)
- Tiago Lima
- Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
| | - Laura Fernandes
- Centre for Interdisciplinary Research in Animal Health, Laboratory of Antibiotic Resistance, CIISA, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal
| | - Marta Matias
- Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
| | - Ana Mateus
- Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
| | - Eduarda Silveira
- Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
- Department of Veterinary Medicine, Veterinary School Vasco Da Gama, 3020-210 Coimbra, Portugal
| | - Sara Domingues
- Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
| | - Constança Pomba
- Centre for Interdisciplinary Research in Animal Health, Laboratory of Antibiotic Resistance, CIISA, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal
- Correspondence: (C.P.); (G.J.D.S.); Tel.: +351-213-652-037 (C.P.); +351-239-488-460 (G.J.D.S.)
| | - Gabriela Jorge Da Silva
- Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
- Correspondence: (C.P.); (G.J.D.S.); Tel.: +351-213-652-037 (C.P.); +351-239-488-460 (G.J.D.S.)
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Brunn A, Kadri-Alabi Z, Moodley A, Guardabassi L, Taylor P, Mateus A, Waage J. Characteristics and Global Occurrence of Human Pathogens Harboring Antimicrobial Resistance in Food Crops: A Scoping Review. Front Sustain Food Syst 2022. [DOI: 10.3389/fsufs.2022.824714] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BackgroundThe role of the crop environment as a conduit for antimicrobial resistance (AMR) through soil, water, and plants has received less attention than other sectors. Food crops may provide a link between the agro-environmental reservoir of AMR and acquisition by humans, adding to existing food safety hazards associated with microbial contamination of food crops.ObjectivesThe objectives of this review were: (1) to use a systematic methodology to characterize AMR in food crop value chains globally, and (2) to identify knowledge gaps in understanding exposure risks to humans.MethodsFour bibliographic databases were searched using synonyms of AMR in food crop value chains. Following two-stage screening, phenotypic results were extracted and categorized into primary and secondary combinations of acquired resistance in microbes of concern based on established prioritization. Occurrence of these pathogen-AMR phenotype combinations were summarized by sample group, value chain stage, and world region. Sub-analyses on antimicrobial resistance genes (ARG) focused on extended-spectrum beta-lactamase and tetracycline resistance genes.ResultsScreening of 4,455 citations yielded 196 studies originating from 49 countries, predominantly in Asia (89 studies) and Africa (38). Observations of pathogen-phenotype combinations of interest were reported in a subset of 133 studies (68%). Primary combinations, which include resistance to antimicrobials of critical importance to human medicine varied from 3% (carbapenem resistance) to 13% (fluoroquinolones), whereas secondary combinations, which include resistance to antimicrobials also used in agriculture ranged from 14% (aminoglycoside resistance) to 20% (aminopenicillins). Salad crops, vegetables, and culinary herbs were the most sampled crops with almost twice as many studies testing post-harvest samples. Sub-analysis of ARG found similar patterns corresponding to phenotypic results.DiscussionThese results suggest that acquired AMR in opportunistic and obligate human pathogens is disseminated throughout food crop value chains in multiple world regions. However, few longitudinal studies exist and substantial heterogeneity in sampling methods currently limit quantification of exposure risks to consumers. This review highlights the need to include agriculturally-derived AMR in monitoring food safety risks from plant-based foods, and the challenges facing its surveillance.
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Arnold JC, Day D, Hennessey M, Alarcon P, Gautham M, Samanta I, Mateus A. "If It Works in People, Why Not Animals?": A Qualitative Investigation of Antibiotic Use in Smallholder Livestock Settings in Rural West Bengal, India. Antibiotics (Basel) 2021; 10:antibiotics10121433. [PMID: 34943645 PMCID: PMC8698124 DOI: 10.3390/antibiotics10121433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/12/2021] [Accepted: 11/19/2021] [Indexed: 11/17/2022] Open
Abstract
Smallholder farms are the predominant livestock system in India. Animals are often kept in close contact with household members, and access to veterinary services is limited. However, limited research exists on how antibiotics are used in smallholder livestock in India. We investigated antibiotic supply, usage, and their drivers in smallholder livestock production systems, including crossover-use of human and veterinary antibiotics in two rural sites in West Bengal. Qualitative interviews were conducted with key informants (n = 9), livestock keepers (n = 37), and formal and informal antibiotic providers from veterinary and human health sectors (n = 26). Data were analysed thematically and interpreted following a One Health approach. Livestock keepers and providers used antibiotics predominantly for treating individual animals, and for disease prevention in poultry but not for growth promotion. All providers used (highest priority) critically important antimicrobials for human health and engaged in crossover-use of human antibiotic formulations in livestock. Inadequate access to veterinary drugs and services, and a perceived efficacy and ease of dosing of human antibiotics in animals drove crossover-use. Veterinary antibiotics were not used for human health due to their perceived adverse effects. Given the extent of usage of protected antibiotics and crossover-use, interventions at the community level should adopt a One Health approach that considers all antibiotic providers and livestock keepers and prioritizes the development of evidence-based guidelines to promote responsible use of antibiotics in animals.
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Affiliation(s)
- Jean-Christophe Arnold
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK; (M.H.); (P.A.)
- Correspondence: (J.-C.A.); (D.D.)
| | - Dominic Day
- South Wales Farm Vets, Tynewydd Farm, Cardiff CF72 8NE, UK
- Correspondence: (J.-C.A.); (D.D.)
| | - Mathew Hennessey
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK; (M.H.); (P.A.)
| | - Pablo Alarcon
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK; (M.H.); (P.A.)
| | - Meenakshi Gautham
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17, Tavistock Place, London WC1H 9SH, UK;
| | - Indranil Samanta
- Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences, Kolkata 700037, India;
| | - Ana Mateus
- World Organisation of Animal Health (OIE), 12 Rue de Prony, 75017 Paris, France;
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Khan MS, Durrance-Bagale A, Mateus A, Sultana Z, Hasan R, Hanefeld J. What are the barriers to implementing national antimicrobial resistance action plans? A novel mixed-methods policy analysis in Pakistan. Health Policy Plan 2021; 35:973-982. [PMID: 32743655 DOI: 10.1093/heapol/czaa065] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2020] [Indexed: 12/25/2022] Open
Abstract
Despite political commitment to address antimicrobial resistance (AMR), countries are facing challenges to implementing policies to reduce inappropriate use of antibiotics. Critical factors to the success of policy implementation in low- and middle-income countries (LMIC), such as capacity for enforcement, contestation by influential stakeholders and financial interests, have been insufficiently considered. Using Pakistan as a case study representing a populous country with extremely high antibiotic usage, we identified 195 actors who affect policies on antibiotic use in humans and animals through a snowballing process and interviewed 48 of these who were nominated as most influential. We used a novel card game-based methodology to investigate policy actors' support for implementation of different regulatory approaches addressing actions of frontline healthcare providers and antibiotic producers across the One Health spectrum. We found that there was only widespread support for implementing hard regulations (prohibiting certain actions) against antibiotic suppliers with little power-such as unqualified/informal healthcare providers and animal feed producers-but not to target more powerful groups such as doctors, farmers and pharmaceutical companies. Policy actors had limited knowledge to develop implementation plans to address inappropriate use of antibiotics in animals, even though this was recognized as a critical driver of AMR. Our results indicate that local political and economic dynamics may be more salient to policy actors influencing implementation of AMR national action plans than solutions presented in global guidelines that rely on implementation of hard regulations. This highlights a disconnect between AMR action plans and the local contexts where implementation takes place. Thus if the global strategies to tackle AMR are to become implementable policies in LMIC, they will need greater appreciation of the power dynamics and systemic constraints that relate to many of the strategies proposed.
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Affiliation(s)
- Mishal S Khan
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Anna Durrance-Bagale
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Ana Mateus
- Department of Pathobiology and Population Sciences, Royal Veterinary College, London WC1H 9SH, UK
| | - Zia Sultana
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi 74800, Pakistan
| | - Rumina Hasan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi 74800, Pakistan.,Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Johanna Hanefeld
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
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12
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Desbois AP, Garza M, Eltholth M, Hegazy YM, Mateus A, Adams A, Little DC, Høg E, Mohan CV, Ali SE, Brunton LA. Systems-thinking approach to identify and assess feasibility of potential interventions to reduce antibiotic use in tilapia farming in Egypt. Aquaculture 2021; 540:736735. [PMID: 34276104 PMCID: PMC8164158 DOI: 10.1016/j.aquaculture.2021.736735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/31/2021] [Accepted: 04/03/2021] [Indexed: 06/01/2023]
Abstract
Antibiotics are used in aquaculture to maintain the health and welfare of stocks; however, the emergence and selection of antibiotic resistance in bacteria poses threats to humans, animals and the environment. Mitigation of antibiotic resistance relies on understanding the flow of antibiotics, residues, resistant bacteria and resistance genes through interconnecting systems, so that potential solutions can be identified and issues around their implementation evaluated. Participatory systems-thinking can capture the deep complexity of a system while integrating stakeholder perspectives. In this present study, such an approach was applied to Nile tilapia (Oreochromis niloticus) production in the Nile Delta of Egypt, where disease events caused by antibiotic-resistant pathogens have been reported. A system map was co-produced with aquaculture stakeholders at a workshop in May 2018 and used to identify hotspots of antibiotic use, exposure and fate and to describe approaches that would promote fish health and thus reduce antibiotic use. Antibiotics are introduced into the aquaculture system via direct application for example in medicated feed, but residues may also be introduced into the system through agricultural drainage water, which is the primary source of water for most fish farms in Egypt. A follow-up survey of stakeholders assessed the perceived feasibility, advantages and disadvantages of potential interventions. Interventions that respondents felt could be implemented in the short-term to reduce antibiotic usage effectively included: more frequent water exchanges, regular monitoring of culture water quality parameters, improved storage conditions for feed, use of probiotics and greater access to farmer and service providers training programmes. Other potential interventions included greater access to suitable and rapid diagnostics, high quality feeds, improved biosecurity measures and genetically-improved fish, but these solutions were expected to be achieved as long-term goals, with cost being of one of the noted barriers to implementation. Identifying feasible and sustainable interventions that can be taken to reduce antibiotic use, and understanding implementation barriers, are important for addressing antibiotic resistance and ensuring the continued efficacy of antibiotics. This is vital to ensuring the productivity of the tilapia sector in Egypt. The approach taken in the present study provides a means to identify points in the system where the effectiveness of interventions can be evaluated and thus it may be applied to other food production systems to combat the problem of antibiotic resistance.
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Affiliation(s)
- Andrew P. Desbois
- Institute of Aquaculture, University of Stirling, FK9 4LA, United Kingdom
| | - Maria Garza
- Royal Veterinary College, University of London, AL9 7TA, United Kingdom
| | - Mahmoud Eltholth
- Institute of Aquaculture, University of Stirling, FK9 4LA, United Kingdom
- Department of Hygiene and Preventive Medicine, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
- Global Academy of Agriculture and Food Security, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, EH25 9RG, UK
| | - Yamen M. Hegazy
- Department of Animal Medicine, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Ana Mateus
- Royal Veterinary College, University of London, AL9 7TA, United Kingdom
| | - Alexandra Adams
- Institute of Aquaculture, University of Stirling, FK9 4LA, United Kingdom
| | - David C. Little
- Institute of Aquaculture, University of Stirling, FK9 4LA, United Kingdom
| | - Erling Høg
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
| | | | - Shimaa E. Ali
- WorldFish, Penang, Malaysia
- Department of Hydrobiology, National Research Centre, Egypt
| | - Lucy A. Brunton
- Royal Veterinary College, University of London, AL9 7TA, United Kingdom
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Allerton F, Prior C, Bagcigil AF, Broens E, Callens B, Damborg P, Dewulf J, Filippitzi ME, Carmo LP, Gómez-Raja J, Harpaz E, Mateus A, Nolff M, Phythian CJ, Timofte D, Zendri F, Jessen LR. Overview and Evaluation of Existing Guidelines for Rational Antimicrobial Use in Small-Animal Veterinary Practice in Europe. Antibiotics (Basel) 2021; 10:antibiotics10040409. [PMID: 33918617 PMCID: PMC8069046 DOI: 10.3390/antibiotics10040409] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial stewardship guidelines (ASGs) represent an important tool to help veterinarians optimize their antimicrobial use with the objective of decreasing antimicrobial resistance. The aim of this study was to map and qualitatively assess the ASGs for antimicrobial use in cats and dogs in Europe. Country representatives of the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT) were asked to identify ASGs published in their countries. All collated ASGs updated since January 2010 containing recommendations on antimicrobial therapy for at least three conditions affecting different organ systems in cats and dogs underwent detailed review including AGREE II analysis. Out of forty countries investigated, fifteen ASGs from eleven countries met the inclusion criteria. Several critical principles of antimicrobial use were identified, providing a framework that should assist development of stewardship guidance. The AGREE II analysis highlighted several methodological limitations of the currently available ASGs. This study sheds light on the lack of national ASGs for dogs and cats in multiple European countries and should encourage national bodies to prioritize guideline development in small animals. A greater awareness of the need to use a structured approach to guideline development could improve the quality of ASGs in the future.
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Affiliation(s)
- Fergus Allerton
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
- Correspondence:
| | - Cameron Prior
- Veterinary Specialists Scotland, 1 Deer Park Road Livingston, Scotland EH54 8AG, UK;
| | - Arzu Funda Bagcigil
- Department of Microbiology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpaşa, 34320 Avcılar, Istanbul, Turkey;
| | - Els Broens
- Faculty of Veterinary Medicine, Department of Biomolecular Health Sciences, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands;
| | - Bénédicte Callens
- Centre of Knowledge on Antimicrobial Use and Resistance, Galileelaan 5/02, 1210 Brussels, Belgium;
| | - Peter Damborg
- Department of Veterinary and Animal Sciences, University of Copenhagen, Stigbøjlen 4, 1870 Frederiksberg, Denmark;
| | - Jeroen Dewulf
- Veterinary Epidemiology Unit, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium;
| | | | - Luís Pedro Carmo
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Schwarzenburgstrasse 161, 3097 Liebefeld, Bern, Switzerland;
| | | | - Erez Harpaz
- Faculty of Veterinary Medicine, Institute for Production Animal Clinical Science, Norwegian University of Life Sciences, Small Ruminant Research and Herd Health, Høyland, 4325 Sandnes, Norway; (E.H.); (C.J.P.)
| | - Ana Mateus
- Hawkshead Campus, Royal Veterinary College, University of London, Hawkshead Lane, Hatfield AL9 7TA, Hertfordshire, UK;
| | - Mirja Nolff
- Clinic for Small Animal Surgery Tierspital Zürich, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, 8057 Zürich, Switzerland;
| | - Clare J. Phythian
- Faculty of Veterinary Medicine, Institute for Production Animal Clinical Science, Norwegian University of Life Sciences, Small Ruminant Research and Herd Health, Høyland, 4325 Sandnes, Norway; (E.H.); (C.J.P.)
| | - Dorina Timofte
- Department of Veterinary Anatomy, Leahurst Campus, Institute of Infection, Veterinary and Ecological Sciences, Physiology and Pathology, University of Liverpool, Neston CH64 7TE, UK; (D.T.); (F.Z.)
| | - Flavia Zendri
- Department of Veterinary Anatomy, Leahurst Campus, Institute of Infection, Veterinary and Ecological Sciences, Physiology and Pathology, University of Liverpool, Neston CH64 7TE, UK; (D.T.); (F.Z.)
| | - Lisbeth Rem Jessen
- Department of Veterinary Clinical Sciences, Faculty of Health Sciences, University of Copenhagen, Dyrlægevej 16, 1870 Frederiksberg C, Denmark;
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Crotta M, Lavazza A, Mateus A, Guitian J. Viraemic pigs entering the food chain are the most likely source of hepatitis E virus (HEV) in pork meat: Modelling the fate of HEV during slaughtering of pigs. Food Control 2021. [DOI: 10.1016/j.foodcont.2020.107662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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15
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Bennani H, Mateus A, Mays N, Eastmure E, Stärk KDC, Häsler B. Overview of Evidence of Antimicrobial Use and Antimicrobial Resistance in the Food Chain. Antibiotics (Basel) 2020; 9:E49. [PMID: 32013023 PMCID: PMC7168130 DOI: 10.3390/antibiotics9020049] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/25/2020] [Accepted: 01/27/2020] [Indexed: 01/06/2023] Open
Abstract
Antimicrobial resistance (AMR) is a global health problem. Bacteria carrying resistance genes can be transmitted between humans, animals and the environment. There are concerns that the widespread use of antimicrobials in the food chain constitutes an important source of AMR in humans, but the extent of this transmission is not well understood. The aim of this review is to examine published evidence on the links between antimicrobial use (AMU) in the food chain and AMR in people and animals. The evidence showed a link between AMU in animals and the occurrence of resistance in these animals. However, evidence of the benefits of a reduction in AMU in animals on the prevalence of resistant bacteria in humans is scarce. The presence of resistant bacteria is documented in the human food supply chain, which presents a potential exposure route and risk to public health. Microbial genome sequencing has enabled the establishment of some links between the presence of resistant bacteria in humans and animals but, for some antimicrobials, no link could be established. Research and monitoring of AMU and AMR in an integrated manner is essential for a better understanding of the biology and the dynamics of antimicrobial resistance.
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Affiliation(s)
- Houda Bennani
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK; (A.M.); (K.D.C.S.); (B.H.)
| | - Ana Mateus
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK; (A.M.); (K.D.C.S.); (B.H.)
| | - Nicholas Mays
- Policy Innovation Research Unit, Department of Health Services Research & Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK; (N.M.); (E.E.)
| | - Elizabeth Eastmure
- Policy Innovation Research Unit, Department of Health Services Research & Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK; (N.M.); (E.E.)
| | - Katharina D. C. Stärk
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK; (A.M.); (K.D.C.S.); (B.H.)
- SAFOSO AG, Waldeggstrasse 1, CH 3097 Liebefeld, Switzerland
| | - Barbara Häsler
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK; (A.M.); (K.D.C.S.); (B.H.)
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Vargas Naranjo S, Neves A, Silva JM, Mendes A, Cassama D, Cochicho J, Suleac M, Chinchilla Mata J, Calado N, Mateus A. Romper Paradigmas: Além do Prospetivo e Retrospetivo. Gaz Med 2019. [DOI: 10.29315/gm.v6i4.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Para que um estudo seja bem-sucedido, uma parte importante é a escolha do desenho do estudo que se deve utilizar para responder à pergunta de investigação. Dele dependerá o tipo de análise de dados e as conclusões, assim como a validade interna e externa do trabalho. Frequentemente, menciona-se que os estudos são prospetivos ou retrospetivos, mas, atualmente, esses termos deveriam ser apenas utilizados para indicar a forma como foi realizada a colheita dos dados. O presente trabalho pretende descrever os desenhos de estudos de uma forma concreta e concisa, permitindo uma visão mais além do prospetivo e retrospetivo.
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Dada S, McKay G, Mateus A, Lees S. Lessons learned from engaging communities for Ebola vaccine trials in Sierra Leone: reciprocity, relatability, relationships and respect (the four R's). BMC Public Health 2019; 19:1665. [PMID: 31829223 PMCID: PMC6907283 DOI: 10.1186/s12889-019-7978-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Building trust and engaging the community are important for biomedical trials. This was core to the set up and delivery of the EBOVAC-Salone and PREVAC Ebola vaccine trials in Sierra Leone during and following the 2014-2016 West African Ebola epidemic. Local community liaison teams (CLT) engaged with the community through public meetings, radio chat shows, and other activities, while a social science team (SST) assessed community members' and participants' perceptions and regularly updated the clinical team to adapt procedures to improve the acceptability and compliance of the trial. The objective of this study was to examine the community engagement (CE) program in these trials and to identify potential barriers and facilitators. METHODS Fifteen CLT and SST members participated in in-depth interviews and 23 community members attended three focus groups to discuss the Ebola vaccine trials and their experiences and perspectives of the CE activities. RESULTS A key aim of the CE program was to build trust between the community and the trial. Four main principles (the "four R's") evolved from the discussions with team members and the community that influenced this trust: reciprocity, relatability, relationships and respect. The CLT and SST ensured reciprocal communication between the trial team and the community. The CLT delivered key messages from the trial, whilst the SST completed ethnographic research in the field to uncover rumors and perceptions of the trial in the community. These ethnographic findings were shared with the CLT and addressed in targeted messaging to the community. Both the CLT and SST approached the communities in an egalitarian manner, by dressing modestly, speaking local dialects, and using relatable examples. Appreciation and understanding of the importance of interpersonal relationships and respect for the people, their customs, and traditions also played a large role in the CE program. CONCLUSION These findings provide an in-depth understanding of how interdisciplinary community liaison and social science teams can work with a clinical team to strengthen trust. The four R's suggest the ways in which trust relations are central to CE and confidence in vaccine trials, and could offer an approach to CE in vaccine trials.
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Affiliation(s)
- Sara Dada
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
- The Royal Veterinary College, Royal College Street, London, NW1 0TU UK
| | - Gillian McKay
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Ana Mateus
- The Royal Veterinary College, Royal College Street, London, NW1 0TU UK
| | - Shelley Lees
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
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Khan MS, Durrance-Bagale A, Legido-Quigley H, Mateus A, Hasan R, Spencer J, Hanefeld J. 'LMICs as reservoirs of AMR': a comparative analysis of policy discourse on antimicrobial resistance with reference to Pakistan. Health Policy Plan 2019; 34:178-187. [PMID: 30977804 DOI: 10.1093/heapol/czz022] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2019] [Indexed: 11/12/2022] Open
Abstract
Antimicrobial resistance (AMR) has recently emerged as a salient global issue, and policy formulation to address AMR has become a contested space, with various actors sharing competing-and sometimes contradictory-explanations of the problem and the range of possible solutions. To facilitate national policy setting and implementation around AMR, more needs to be done to effectively engage policymakers in low- and middle-income countries (LMICs). However, there is a dearth of research on differences in issue framing by external agencies and LMIC's national policymakers on the problem of AMR; such analyses are imperative to identify areas of conflict and/or potential convergence. We compared representations of AMR across nine policy documents produced by multilateral agencies, donor countries and an LMIC at the forefront of the global response to AMR-Pakistan. We analysed the texts in relation to five narratives that have been commonly used to frame health issues as requiring action: economic impact, stunting of human development, consequences for health equity, health security threats and relationship with food production. We found that AMR was most frequently framed as a threat to human health security and economic progress, with several US, UK and international documents depicting LMICs as 'hotspots' for AMR. Human development and equity dimensions of the problem were less frequently discussed as reasons to address the growing burden of AMR. It is clear that no single coherent narrative on AMR has emerged, with notable differences in framing in Pakistani and external agency led documents, as well as across stakeholders primarily working on human vs animal health. While framing AMR as a threat to economic growth and human security has achieved high-level political attention and catalysed action from governments in high-income countries, our analysis suggests that conflicting narratives relevant to policymakers in Pakistan may affect policy-making and impede the development and implementation of integrated initiatives needed to tackle AMR.
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Affiliation(s)
- Mishal S Khan
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | - Julia Spencer
- London School of Hygiene and Tropical Medicine, London, UK
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Mateus A, Rebelo J, Silva AG. Effects of a Multimodal Exercise Program Plus Neural Gliding on Postural Control, Pain, and Flexibility of Institutionalized Older Adults: A Randomized, Parallel, and Double-Blind Study. J Geriatr Phys Ther 2019; 43:3-11. [PMID: 31569173 DOI: 10.1519/jpt.0000000000000249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The effect of adding neural mobilization to a multimodal program of exercises has not been investigated, despite its potential positive effects. The aim of this study was to compare the acute effects of a multimodal exercise program and neural gliding against a multimodal exercise program only, on pain intensity, gait speed, Timed Up and Go (TUG) test, lower limb flexibility, and static balance of institutionalized older adults. METHODS Older adults who were institutionalized (n = 26) were randomized to receive a multimodal exercise program plus neural gliding or a multimodal exercise program only. Both interventions were delivered twice a week for 8 weeks. Participants were assessed for pain, gait velocity, balance, flexibility, and TUG at baseline and postintervention. RESULTS A significant main effect of time for pain intensity (F1,24 = 8.95, P = .006), balance (F1,24 = 10.29, P = .004), and gait velocity (F1,24 = 5.51, P = .028) was observed, indicating a positive impact of both interventions. No other significant effects were found (TUG and flexibility; P > .05). DISCUSSION A 45-minute multimodal exercise program, twice a week for 8 weeks, has a positive impact on pain intensity, balance, and gait velocity, but neural gliding has no additional benefit. It is unclear whether dose and type of neural mobilization may have had an impact on results. Considering the structural and physiological changes that tend to occur with age, future studies could explore the effects of neural tensioning or of higher doses of neural mobilization. CONCLUSIONS This study suggests that adding neural gliding to a multimodal exercise program has no additional benefit.
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Affiliation(s)
- Ana Mateus
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Portugal
| | - Jessica Rebelo
- Lar Santa Catarina do Reboleiro, Avenida da Ribeirinha, Trancoso, Portugal
| | - Anabela G Silva
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Portugal.,CINTESIS.UA, University of Aveiro, Campus Universitário de Santiago, Portugal
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20
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Dada S, Lees S, Mateus A, McKay G. The four R's: a community engagement framework for disease preparedness research in Sierra Leone. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Rego Silva J, Macau R, Oliveira Coelho H, Camelo F, Cruz P, Mateus A, Oliveira A, Oliveira C, Ramos A. Late-Onset Post-transplantation Central Nervous System Lymphoproliferative Disorder: Case Report. Transplant Proc 2018; 50:857-860. [DOI: 10.1016/j.transproceed.2018.02.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rego Silva J, Macau RA, Mateus A, Cruz P, Aleixo MJ, Brito M, Alcobia A, Oliveira C, Ramos A. Successful Treatment of Strongyloides stercoralis Hyperinfection in a Kidney Transplant Recipient: Case Report. Transplant Proc 2018; 50:861-866. [PMID: 29661454 DOI: 10.1016/j.transproceed.2018.02.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Strongyloides stercoralis (SS) can cause hyperinfection and disseminated infection in immunosuppressed individuals, with risk of mortality. We report the case of a cadaveric kidney transplant recipient who developed gastrointestinal symptoms and eosinophilia, approximately 3 months after transplantation. Stool examination and esophagogastroduodenoscopy with biopsies were positive for SS larvae. The patient was started on oral ivermectin and immunosuppression was reduced, but still the clinical picture got worse with metabolic ileus and respiratory symptoms, with the need for administration of subcutaneous ivermectin and combined therapy with albendazol. The patient survived and graft function was preserved. The patient was unlikely to be the source of infection. We also present a review of cases of SS infection in kidney transplant recipients.
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Affiliation(s)
- J Rego Silva
- Nephrology Department, Hospital Garcia de Orta, Almada, Portugal.
| | - R A Macau
- Nephrology Department, Hospital Garcia de Orta, Almada, Portugal
| | - A Mateus
- Nephrology Department, Hospital Garcia de Orta, Almada, Portugal
| | - P Cruz
- Nephrology Department, Hospital Garcia de Orta, Almada, Portugal
| | - M J Aleixo
- Infectious Diseases Department, Hospital Garcia de Orta, Almada, Portugal
| | - M Brito
- Pharmacy, Hospital Garcia de Orta, Almada, Portugal
| | - A Alcobia
- Pharmacy, Hospital Garcia de Orta, Almada, Portugal
| | - C Oliveira
- Nephrology Department, Hospital Garcia de Orta, Almada, Portugal
| | - A Ramos
- Nephrology Department, Hospital Garcia de Orta, Almada, Portugal
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Adenuga A, Mateus A, Ty C, Borin K, Holl D, San S, Duggan V, Clark M, Smith GJD, Coker R, Vaughn A, Rudge JW. Seroprevalence and awareness of porcine cysticercosis across different pig production systems in south-central Cambodia. Parasite Epidemiol Control 2017; 3:1-12. [PMID: 29774294 PMCID: PMC5952675 DOI: 10.1016/j.parepi.2017.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/31/2017] [Accepted: 10/31/2017] [Indexed: 10/30/2022] Open
Abstract
Background Taeniasis/cysticercosis, caused by the pork tapeworm Taenia solium, represents an important public health and economic burden in endemic countries. However, there is a paucity of data on infection among pigs in many parts of Southeast Asia, particularly Cambodia. We aimed to estimate seroprevalence of porcine cysticercosis, and investigate husbandary practices and knowledge of the disease among livestock workers, across different pig sector units in south-central Cambodia. Methods A cross sectional survey was conducted among pig smallholders, commercial farms, slaughterhouses and traders/middlemen from south-central Cambodia, selected through multistage sampling in proportion to local pig populations sizes. Questionnaires were administered to 163 pig workers to obtain data pig production, trading and slaughtering practices. Sera from 620 pigs were tested for Taenia antigens using a commercial ELISA-based test. Associations between seroprevalence and pig husbandry practices were assessed using generalised linear mixed models, adjusting for random-effects at herd-level. Results Of 620 pigs sampled, 29 (4.7%) tested positive for Taenia antigens. Seropositivity was associated with type of pig sector unit (P = 0.008), with the highest seroprevalence among pigs sampled from traders/middlemen (16.7%; 95% CI: 4.4%-37.8%), smallholders (7.6%; 95% CI: 3.8%-14.1%) and slaughterhouses (4.1%; 95% CI: 2.0%-7.5%), while none of the pigs sampled from small/medium or large commercial farms tested positive. Although the vast majority of pigs were penned, practices that might facilitate human-to-pig transmission, such as use of household waste and surface water sources to feed pigs, were prevalent among smallholders. However these were not found to be significantly associated with infection. Of 163 interviewed pig workers, 115 (70.5%) were aware of porcine cysticercosis, and 78 (47.8%) also knew it could affect humans. Twenty-six (16.0%) reported having noticed lesions typical of cysticercosis in their pigs. Conclusions Despite most pigs being kept confined in pens rather than raised in free-roaming systems, porcine cysticercosis appears to be endemic in south-central Cambodia and is associated with smallholder production. Further investigation is needed to identify which Taenia species are causing infections among pigs, and how seroprevalence and zoonotic risk may vary across the country, to understand the risks to public health and assess where interventions might be needed.
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Affiliation(s)
- Aderosoye Adenuga
- Royal Veterinary College, Hawkshead Campus, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK.,Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Ana Mateus
- Royal Veterinary College, Hawkshead Campus, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK
| | - Chhay Ty
- Centre for Livestock and Agriculture Development, Phnom Penh, Cambodia
| | - Khieu Borin
- Centre for Livestock and Agriculture Development, Phnom Penh, Cambodia
| | - Davun Holl
- National Veterinary Research Institute, Department of Animal Health and Production, Phnom Penh, Cambodia
| | - Sorn San
- National Veterinary Research Institute, Department of Animal Health and Production, Phnom Penh, Cambodia
| | - Victoria Duggan
- Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Madeleine Clark
- Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | | | - Richard Coker
- Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.,Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
| | | | - James W Rudge
- Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.,Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
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Pomba C, Rantala M, Greko C, Baptiste KE, Catry B, van Duijkeren E, Mateus A, Moreno MA, Pyörälä S, Ružauskas M, Sanders P, Teale C, Threlfall EJ, Kunsagi Z, Torren-Edo J, Jukes H, Törneke K. Public health risk of antimicrobial resistance transfer from companion animals. J Antimicrob Chemother 2017; 72:957-968. [PMID: 27999066 DOI: 10.1093/jac/dkw481] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Antimicrobials are important tools for the therapy of infectious bacterial diseases in companion animals. Loss of efficacy of antimicrobial substances can seriously compromise animal health and welfare. A need for the development of new antimicrobials for the therapy of multiresistant infections, particularly those caused by Gram-negative bacteria, has been acknowledged in human medicine and a future corresponding need in veterinary medicine is expected. A unique aspect related to antimicrobial resistance and risk of resistance transfer in companion animals is their close contact with humans. This creates opportunities for interspecies transmission of resistant bacteria. Yet, the current knowledge of this field is limited and no risk assessment is performed when approving new veterinary antimicrobials. The objective of this review is to summarize the current knowledge on the use and indications for antimicrobials in companion animals, drug-resistant bacteria of concern among companion animals, risk factors for colonization of companion animals with resistant bacteria and transmission of antimicrobial resistance (bacteria and/or resistance determinants) between animals and humans. The major antimicrobial resistance microbiological hazards originating from companion animals that directly or indirectly may cause adverse health effects in humans are MRSA, methicillin-resistant Staphylococcus pseudintermedius, VRE, ESBL- or carbapenemase-producing Enterobacteriaceae and Gram-negative bacteria. In the face of the previously recognized microbiological hazards, a risk assessment tool could be applied in applications for marketing authorization for medicinal products for companion animals. This would allow the approval of new veterinary medicinal antimicrobials for which risk levels are estimated as acceptable for public health.
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Affiliation(s)
- Constança Pomba
- Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Merja Rantala
- Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | | | | | | | | | - Ana Mateus
- Royal Veterinary College, University of London, London, UK
| | - Miguel A Moreno
- Faculty of Veterinary Medicine, Complutense University, Madrid, Spain
| | - Satu Pyörälä
- Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Modestas Ružauskas
- Veterinary Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Pascal Sanders
- Agence Nationale de Sécurité Sanitaire (ANSES), Fougères, France
| | | | | | | | - Jordi Torren-Edo
- European Medicines Agency, London, UK.,Facultat de Veterinària, UAB, Cerdanyola del Vallès, Spain
| | - Helen Jukes
- Veterinary Medicines Directorate, Addlestone, UK
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Lansbury LE, Smith S, Beyer W, Karamehic E, Pasic-Juhas E, Sikira H, Mateus A, Oshitani H, Zhao H, Beck CR, Nguyen-Van-Tam JS. Effectiveness of 2009 pandemic influenza A(H1N1) vaccines: A systematic review and meta-analysis. Vaccine 2017; 35:1996-2006. [DOI: 10.1016/j.vaccine.2017.02.059] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 02/20/2017] [Accepted: 02/27/2017] [Indexed: 11/26/2022]
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Silva M, Pereira A, Alves N, Mateus A, Malça C. A Hybrid Processing Approach to the Manufacturing of Polyamide Reinforced Parts with Carbon Fibers. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.promfg.2017.08.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Biscaia S, Dabrowska E, Tojeira A, Horta J, Carreira P, Morouço P, Mateus A, Alves N. Development of Heterogeneous Structures with Polycaprolactone-Alginate Using a New 3D Printing System – BioMED βeta : Design and Processing. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.promfg.2017.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Domingues J, Marques T, Mateus A, Carreira P, Malça C. An Additive Manufacturing Solution to Produce Big Green Parts from Tires and Recycled Plastics. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.promfg.2017.08.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Buckland EL, O'Neill D, Summers J, Mateus A, Church D, Redmond L, Brodbelt D. Characterisation of antimicrobial usage in cats and dogs attending UK primary care companion animal veterinary practices. Vet Rec 2016; 179:489. [PMID: 27543064 DOI: 10.1136/vr.103830] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2016] [Indexed: 11/03/2022]
Abstract
There is scant evidence describing antimicrobial (AM) usage in companion animal primary care veterinary practices in the UK. The use of AMs in dogs and cats was quantified using data extracted from 374 veterinary practices participating in VetCompass. The frequency and quantity of systemic antibiotic usage was described.Overall, 25 per cent of 963,463 dogs and 21 per cent of 594,812 cats seen at veterinary practices received at least one AM over a two-year period (2012-2014) and 42 per cent of these animals were given repeated AMs. The main agents used were aminopenicillin types and cephalosporins. Of the AM events, 60 per cent in dogs and 81 per cent in cats were AMs classified as critically important (CIAs) to human health by the World Health Organisation. CIAs of highest importance (fluoroquinolones, macrolides, third-generation cephalosporins) accounted for just over 6 per cent and 34 per cent of AMs in dogs and cats, respectively. The total quantity of AMs used within the study population was estimated to be 1473 kg for dogs and 58 kg for cats.This study has identified a high frequency of AM usage in companion animal practice and for certain agents classified as of critical importance in human medicine. The study highlights the usefulness of veterinary practice electronic health records for studying AM usage.
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Affiliation(s)
- E L Buckland
- The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK
| | - D O'Neill
- The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK
| | - J Summers
- The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK
| | - A Mateus
- The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK
| | - D Church
- The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK
| | - L Redmond
- Veterinary Medicines Directorate, Woodham Lane, New Haw, Addlestone, Surrey KT15 3LS, UK
| | - D Brodbelt
- The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK
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Vildhede A, Mateus A, Khan EK, Lai Y, Karlgren M, Artursson P, Kjellsson MC. Mechanistic Modeling of Pitavastatin Disposition in Sandwich-Cultured Human Hepatocytes: A Proteomics-Informed Bottom-Up Approach. Drug Metab Dispos 2016; 44:505-16. [DOI: 10.1124/dmd.115.066746] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 02/01/2016] [Indexed: 01/04/2023] Open
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De Sousa E, Del Peso G, Alvarez L, Ros S, Mateus A, Aguilar A, Selgas R, Bajo MA. Peritoneal resting with heparinized lavage reverses peritoneal type I membrane failure. A comparative study of the resting effects on normal membranes. Perit Dial Int 2014; 34:698-705. [PMID: 25292401 DOI: 10.3747/pdi.2013.00286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Ultrafiltration failure (UFF) is a serious complication of long-term peritoneal dialysis (PD). Peritoneal rest (PR) has been demonstrated as a valid treatment to reverse the functional changes that occur in UFF. The effects of PR on a normally functioning human peritoneum are unknown but are expected to be neutral. Our hypothesis was that PR positively modifies peritoneal function in patients with UFF, in contrast to the absence of effects when PR is applied under normal conditions. PATIENTS AND METHODS We studied 84 PR periods, comparing 35 patients with UFF and 49 controls (resting for abdominal surgery with temporary discontinuation of PD). We analyzed peritoneal transport pre-PR and post-PR by calculating the mass transfer coefficients of creatinine (Cr-MTAC), the dialysate/plasma creatinine ratio (D/P Cr) and the ultrafiltration (UF). RESULTS Baseline data was similar for the 2 groups, although the UFF group had a longer median time in PD (39 [18 - 60] vs 10 [5 - 23] months; p = 0.00001). Peritoneal rest induced a decrease in D/P Cr, Cr-MTAC and an increase in UF capacity in the UFF group (p = 0.0001, p = 0.004 and p = 0.001, respectively), without causing changes in the control group. Peritoneal rest in patients with more than 6 months of UFF was not able to reduce peritoneal solute transport or improve UF capacity. Response to PR did not differ among UFF patients with or without a previous history of peritonitis. Peritoneal rest enabled patients with UFF to continue on PD for a median time of 23 months (range, 13 - 46 months). CONCLUSIONS Peritoneal rest induces functional changes in patients with UFF but not in those with no functional abnormalities. This demonstrates that PR works only when abnormal but reversible functional conditions are present. However, the effect is highly dependent on how early PR is applied.
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Affiliation(s)
- Erika De Sousa
- Department of Nephrology, University Hospital La Paz, IdiPAZ, Madrid, Spain; and Department of Nephrology, Hospital Carlos Haya, Malaga, Spain
| | - Gloria Del Peso
- Department of Nephrology, University Hospital La Paz, IdiPAZ, Madrid, Spain; and Department of Nephrology, Hospital Carlos Haya, Malaga, Spain
| | - Laura Alvarez
- Department of Nephrology, University Hospital La Paz, IdiPAZ, Madrid, Spain; and Department of Nephrology, Hospital Carlos Haya, Malaga, Spain
| | - Silvia Ros
- Department of Nephrology, University Hospital La Paz, IdiPAZ, Madrid, Spain; and Department of Nephrology, Hospital Carlos Haya, Malaga, Spain
| | - Ana Mateus
- Department of Nephrology, University Hospital La Paz, IdiPAZ, Madrid, Spain; and Department of Nephrology, Hospital Carlos Haya, Malaga, Spain
| | - Ana Aguilar
- Department of Nephrology, University Hospital La Paz, IdiPAZ, Madrid, Spain; and Department of Nephrology, Hospital Carlos Haya, Malaga, Spain
| | - Rafael Selgas
- Department of Nephrology, University Hospital La Paz, IdiPAZ, Madrid, Spain; and Department of Nephrology, Hospital Carlos Haya, Malaga, Spain
| | - María-Auxiliadora Bajo
- Department of Nephrology, University Hospital La Paz, IdiPAZ, Madrid, Spain; and Department of Nephrology, Hospital Carlos Haya, Malaga, Spain
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Locatelli F, Choukroun G, Fliser D, Moecks J, Wiggenhauser A, Gupta A, Swinkels DW, Lin V, Guss C, Pratt R, Carrilho P, Martins AR, Alves M, Mateus A, Gusmao L, Parreira L, Assuncao J, Rodrigues I, Stamopoulos D, Mpakirtzi N, Afentakis N, Grapsa E, Zitt E, Sturm G, Kronenberg F, Neyer U, Knoll F, Lhotta K, Weiss G, Robinson BM, Larkina M, Bieber B, Kleophas W, Li Y, Locatelli F, McCullough K, Nolen JG, Port FK, Pisoni RL, Kalicki RM, Uehlinger DE, Ogawa C, Kanda F, Tomosugi N, Maeda T, Kuji T, Fujikawa T, Shino M, Shibata K, Kaneda T, Nishihara M, Satta H, Kawata SI, Koguchi N, Tamura K, Hirawa N, Toya Y, Umemura S, Chanliau J, Martin H, Stamatelou K, Gonzalez-Tabares L, Manamley N, Farouk M, Addison J, Donck J, Schneider A, Gutjahr-Lengsfeld L, Ritz E, Scharnagl H, Gelbrich G, Pilz S, Macdougall IC, Wanner C, Drechsler C, Kuntsevich V, Charen E, Kobena D, Sheth N, Siktel H, Levin NW, Winchester JF, Kotanko P, Kaysen G, Kuragano T, Kida A, Yahiro M, Nanami M, Nagasawa Y, Hasuike Y, Nakanishi T, Stamopoulos D, Mpakirtzi N, Dimitratou V, Griveas I, Lianos E, Grapsa E, Sasaki Y, Yamazaki S, Fujita K, Kurasawa M, Yorozu K, Shimonaka Y, Suzuki N, Yamamoto M, Zwiech R, Szczepa ska J, Bruzda-Zwiech A, Rao A, Gilg J, Caskey F, Kirkpantur A, Balci MM, Turkvatan A, Afsar B, Alkis M, Mandiroglu F, Kim YO, Yoon SA, Kim YS, Choi SJ, Min JW, Cheong MA, Hasuike Y, Kida A, Oue M, Yamamoto K, Kimura T, Fukao W, Yahiro M, Kaibe S, Nanami M, Nakanishi T, Djuric PS, Ikonomovski J, Tosic J, Jankovic A, Majster Z, Stankovic Popovic V, Dimkovic N, Aicardi Spalloni V, Del Vecchio L, Longhi S, Violo L, La Milia V, Pontoriero G, Locatelli F, Shino M, Kuji T, Fujikawa T, Toya Y, Umemura S, Macdougall I, Rumjon A, Mangahis E, Goldstein L, Ryzlewicz T, Becker F, Kilgallon W, Fukasawa M, Otake Y, Yamagishi T, Kamiyama M, Kobayashi H, Takeda M, Toida T, Sato Y, Fujimoto S. DIALYSIS ANAEMIA. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Stärk K, Alonso S, Dadios N, Dupuy C, Ellerbroek L, Georgiev M, Hardstaff J, Huneau-Salaün A, Laugier C, Mateus A, Nigsch A, Afonso A, Lindberg A. Strengths and weaknesses of meat inspection as a contribution to animal health and welfare surveillance. Food Control 2014. [DOI: 10.1016/j.foodcont.2013.11.009] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
INTRODUCTION Induction therapy reduces rejection episodes among patients at high immunologic risk. Antithymocyte globulins appear to be superior to basiliximab in this population, despite the greater potential risk of infection and neoplasia. The aim of this study was to evaluate graft function and acute rejection episodes in 6 HLA-mismatched patients who underwent induction with basiliximab but had no other immunologic risk factors. METHODS We analyzed retrospectively patients who were transplanted using basiliximab for induction therapy during a 4 year period, comparing patients with full HLA mismatches with those who had 5 or fewer mismatches. None of the patients had other immunological risk factors for rejection. RESULTS We observed no significant differences between the groups concerning demographic features, cold ischemia times, and panel reactive antibodies. Graft function at 12 and 24 months was not different between both groups. Acute rejection episodes were also not different between groups. DISCUSSION In this population of full HLA mismatches and no other immunological risk factors, induction immunosuppression therapy with basiliximab was safe in terms of graft function and acute rejection episodes.
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Abstract
INTRODUCTION The shortage of suitable organ donors is now the most important limiting factor in the field of transplantation and more expanded criteria have been accepted to overcome this problem. OBJECTIVE The objectives of this study were to evaluate the outcome of patients who received an organ from an infected donor and to compare them with patients who received organs from noninfected donors. METHODS Retrospective analysis of all patients who underwent transplantation in our unit between January 2008 and June 2011 was performed. The definition of infected donor included: (1) documented bacteremia at the time of transplantation; and (2) organ-related infection, either with or without isolation from biological products (urine, liquor, and bronchial secretions). RESULTS Nineteen of 77 transplant recipients (24.7%) received organs from infected donors. There were 9 cases of pneumonia, 4 cases of meningitis with bacteremia, 5 cases of urinary tract infection, 1 case of bacteremia due to Staphylococcus aureus, and 1 case of ventriculo-peritoneal shunt infection. All these recipients were prescribed antibiotic prophylaxis for 10.9 ± 3.2 days, according to the antibiotic administered to the donor. Significant differences between both groups were not observed concerning demographics features, graft thrombosis, arterial disruption, delayed graft function, rejection episodes, and renal graft and patient survivals at 12 months. The recipients of infected donor kidneys were mostly treated with basiliximab for induction therapy. There was a trend toward fewer infectious complications among patients who received organs from infected donors (21.1% vs 44.8%; P = .065) and shorter hospital stay durations (median, 11 vs 17.5 days; P = .041). DISCUSSION Kidney transplantation using organs from infected donors did not seem to be associated with a greater risk of complications. Antibiotic therapy initiated in the donor and continued in the recipient may explain these results, perhaps by reducing infectious complications that necessarily prolong the hospital stay.
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Affiliation(s)
- C Outerelo
- Nephrology Department, Hospital Garcia de Orta, Almada, Portugal.
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Reis M, Freitas MC, Dung HM, Mateus A, Paiva I, Madruga MJ, Gonçalves MA, Silva L, Dionísio I. Characterization of geomaterials from NE Portugal using k 0-based instrumental neutron activation analysis (k 0-INAA) and gamma spectrometry methods. J Radioanal Nucl Chem 2012. [DOI: 10.1007/s10967-012-1613-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
A questionnaire was sent to 2951 mixed and small animal veterinary practices to examine the use of perioperative antimicrobials in cats and dogs in the UK. The percentage of respondents who always used antimicrobials in two surgical procedures classified according to NRC criteria as 'clean' was 25.3 per cent for removal of a 1 cm cutaneous mass and 32.1 per cent for routine prescrotal castration. Factors considered important in decision-making about when to use antimicrobial agents included immunosuppression, presence of a drain, degree of wound contamination, potential for spillage of visceral contents and implantation of prosthesis. The most common antimicrobial agents mentioned were potentiated amoxicillin (98.0 per cent), amoxicillin (60.5 per cent), clindamycin (21.8 per cent), enrofloxacin (21.7 per cent), cephalexin (18.6 per cent) and metronidazole (12.7 per cent). Forty-three per cent of all responding veterinarians listed a long-acting preparation for perioperative use. The routes used were subcutaneous (76.1 per cent), intravenous (25.8 per cent), intramuscular (19.8 per cent), oral (13.5 per cent) and topical (7.7 per cent). Antimicrobials were given before surgery (66.6 per cent), during surgery (30.2 per cent), immediately after surgery (12.0 per cent) and after surgery (6.3 per cent). This survey has identified the suboptimal use of perioperative antimicrobials in small animal surgery with improvements needed with respect to timing, duration, choice of antimicrobial and a more prudent selection of surgical cases requiring prophylaxis.
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Affiliation(s)
- C B Knights
- Wolfson Centre for Age Related Disease, Room 1.24 Hodgkin Building, Guys Campus, Kings College London, St Thomas St, London, SE1 1UL, UK.
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Jones ID, Luis Fuentes V, Boswood A, Hezzell MJ, Wrigglesworth D, Mateus A, Moonarmart W, Elliott J. Ultrasonographic measurement of flow-mediated vasodilation in dogs with chronic valvular disease. J Vet Cardiol 2012; 14:203-10. [DOI: 10.1016/j.jvc.2011.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Revised: 07/24/2011] [Accepted: 09/02/2011] [Indexed: 10/28/2022]
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Abstract
OBJECTIVES To provide baseline data on patterns of antimicrobial usage in dogs and cats through the analysis of data stored in electronic practice management systems. METHODS Clinical data from 11 first opinion veterinary practices were extracted for the year 2007. Descriptive statistical analysis was performed to assess the usage of antimicrobials. RESULTS Widespread usage of systemic broad-spectrum antimicrobials was observed. Antimicrobials most frequently used in both species were potentiated amoxicillin (44·4% and 46.1% in cats and dogs, respectively) and amoxicillin (14·3% and 20·7%). Cephalexin (13·4%) and cefovecin (15·0%) were also commonly used in dogs and cats, respectively. Systemic critically important antimicrobials in human medicine were widely used in dogs (60·5%) and cats (82·7%). Topical antimicrobials used in both species included fusidic acid (48·4% and 54·8%), framycetin (20·4% and 13·4%), polymyxin B (12·6% and 9·3%) and neomycin (6·5% and 6·6%). CLINICAL SIGNIFICANCE Inappropriate usage of broad-spectrum antimicrobials may contribute to the development of antimicrobial resistance and loss of efficacy of antimicrobials in veterinary settings. Data recorded in practice management systems were demonstrated to be a practical source for monitoring antimicrobial usage in pets.
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Affiliation(s)
- A Mateus
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Campus, North Mymms, Hertfordshire AL9 7TA School of Pharmacy, University of London, 29-39 Brunswick Square, London WC1N 1AX
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Mateus A, Pinto A, Alves L, Matos J, Figueiras J, Neng N. Roman and modern slag at S. Domingos mine (IPB, Portugal): compositional features and implications for their long-term stability and potential reuse. ACTA ACUST UNITED AC 2011. [DOI: 10.1504/ijewm.2011.040971] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Renal dysplasia and nephrosclerosis in six calves, which were aged three to six months and from different farms in western Scotland and north-west England, was characterised clinically by stunted growth and renal failure with uraemia. Affected animals were depressed and one case exhibited severe neurological signs. Reduced erythrocyte counts were evident in three of four animals from which blood samples were submitted for haematology. At postmortem examination, the kidneys were bilaterally small, pale and firm, with marked fibrosis and sometimes contraction of the capsule. Histologically, affected calves had disorganised atrophic glomeruli, dilatation of tubules, loss of nephrons, areas of undifferentiated mesenchyme and diffuse interstitial and periglomerular fibrosis. There was minimal inflammation. Renal dysplasia and nephrosclerosis is a form of juvenile nephropathy of unknown aetiology that occurs sporadically in calves in the UK.
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Affiliation(s)
- A W Philbey
- Division of Pathological Sciences, Institute of Comparative Medicine, University of Glasgow, Faculty of Veterinary Medicine, Glasgow G61 1QH.
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Figueiras J, Goncalves M, Mateus A, Marques F, Santos FM, Mota R. Initial stages of pollutants dispersion around municipal waste disposal facilities: a case study in Northern Portugal. ACTA ACUST UNITED AC 2009. [DOI: 10.1504/ijewm.2009.027401] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ponce P, Mateus A, Santos L. Anatomical correlation of a well-functioning access graft for haemodialysis. Nephrol Dial Transplant 2008; 24:535-8. [DOI: 10.1093/ndt/gfn512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bexiga R, Mateus A, Philbey AW, Ellis K, Barrett DC, Mellor DJ. Clinicopathological presentation of cardiac disease in cattle and its impact on decision making. Vet Rec 2008; 162:575-80. [PMID: 18453376 DOI: 10.1136/vr.162.18.575] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The records of 116 cattle suffering from cardiac disease were examined retrospectively. On the basis of the results of postmortem examinations there were 52 cases of endocarditis, 39 of pericarditis and 25 congenital cardiac defects. The most useful clinical tool for differentiating between these conditions was auscultation of the heart. The cases of pericarditis were characterised by muffled heart sounds, and the cases of endocarditis and congenital cardiac defects were characterised by a cardiac murmur. Endocarditis could be differentiated from congenital cardiac defects by the presence of a jugular pulse, venous distension, oedema, a reduced appetite, pain and polyarthritis, whereas congenital defects were associated with conformational abnormalities. These two conditions could also be differentiated by differences in the plasma sodium concentration, the albumin:globulin ratio, red blood cell count, lymphocyte count and haematocrit. The ability to differentiate between these three groups of cardiac diseases can help the veterinary practitioner in deciding whether treatment, economic salvage (slaughter for human consumption) or disposal (slaughter not for human consumption) is likely to be the best option.
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Affiliation(s)
- R Bexiga
- Division of Animal Production and Public Health, Institute of Comparative Medicine, University of Glasgow Veterinary School, Bearsden Road, Glasgow
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Stear MJ, Belch A, Donskow-Schmelter K, Fitton LA, Innocent GT, Ishikane C, Mateus A, Murphy L, Rennie K, Smith A, Sayers G. Detection of genes with moderate effects on disease resistance using ovine mhc and resistance to nematodes as an example. Vet Immunol Immunopathol 2007; 120:3-9. [PMID: 17765323 DOI: 10.1016/j.vetimm.2007.07.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Detecting some of the genes that influence disease resistance would improve our understanding of the processes that cause disease and also simplify disease control. Genes within the major histocompatibility complex (mhc) are strong candidates for disease resistance and they have been intensely studied for the last 30 years. Recently, several groups working independently have reported the existence of alleles within the mhc that are associated with enhanced resistance to nematode infection. This article uses hindsight to describe some of the potential pitfalls that hinder the search for valid disease resistance genes. The search requires a good understanding of disease biology, molecular genetics, statistical genetics and especially, the design and analysis of experiments. The power to detect mhc effects is quite low and is quite sensitive to the frequency of the putative resistance alleles.
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Affiliation(s)
- M J Stear
- Veterinary Genes and Proteins Group, Division of Animal Health and Production, Institute of Comparative Medicine, University of Glasgow, Bearsden Road, Glasgow G61 1QH, UK
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Vali L, Hamouda A, Mateus A, Walker D, Dave J, Gibb A, Amyes S. P692 A two-year study of antibiotic resistance in Enterococci isolated from food, abattoirs and farms in Scotland and its link to hospital-acquired infections. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70533-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Keller G, Vogelsang H, Becker I, Plaschke S, Ott K, Suriano G, Mateus A, Seruca R, Biedermann K, Döring C, Siewert J, Höfler H. Germline mutations in the E-cadherin and TP53 genes, but not in HPP1 or RUNX3 are associated with genetic predisposition for gastric cancer. Pathol Res Pract 2004. [DOI: 10.1016/s0344-0338(04)80712-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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