Diagnostic Tests Can Stem the Threat of Antimicrobial Resistance: Infectious Disease Professionals Can Help

Abstract Uptake of existing diagnostics to identify infections more accurately could minimize unnecessary antibiotic use and decrease the growing threat of antibiotic resistance. The Infectious Diseases Society of America (IDSA) and the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) agree that, to improve uptake of existing diagnostics, healthcare providers, health systems, and payors all need better clinical and economic outcomes data to support use of diagnostic tests over empiric use of antibiotics, providers need better tools and education about diagnostic tests, and diagnostics developers need federal funding in the absence of a viable diagnostics market. Recommendations from PACCARB and the IDSA are amplified. Incentives for—and challenges to—diagnostics research, development, and uptake are summarized. Advocacy opportunities are given for infectious disease professionals to join the fight against antimicrobial resistance.

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PROBLEM OF ANTIBIOTIC USE AND ANTIMICROBIAL RESISTANCE IN INDONESIA: ARE WE REALLY MAKING PROGRESS?

Indonesian Journal of Tropical and Infectious Disease ◽

10.20473/ijtid.v4i4.222 ◽

2013 ◽

Vol 4 (4) ◽

pp. 5 ◽

Cited By ~ 7

Author(s):

Usman Hadi ◽

Kuntaman Kuntaman ◽

Mariyatul Qiptiyah ◽

Hari Paraton

Keyword(s):

Antimicrobial Resistance ◽

Antibiotic Use ◽

Teaching Hospitals ◽

Resistant Bacteria ◽

Prevention Study ◽

Antibiotic Resistant ◽

Inappropriate Use ◽

Government Hospitals ◽

Inappropriate Antibiotics ◽

Very High

Background: Based on the results Antimicrobial Resistance in Indonesia: prevalence and prevention-study (AMRIN-study), the Ministry of Health of Indonesia in 2005 began a program antibiotic resistance control (PPRA) in some government hospitals, and is currently developing to all government teaching hospitals in Indonesia. Aim: The core activities of the PPRA are to implement standardized surveillance emergence of antibiotic resistant bacteria, and the surveillance of antibiotic use in terms of quantity and quality. Method: Our research in the years 2003 showed the proportion of antibiotic use 84% of patients in a hospital. The use of inappropriate antibiotics was very high, 42% no indication. Result: In 2012 the results of surveillance showed decline of inappropriate use of antibiotic, but prevalence extended-spectrum b-lactamase (ESBL)-producing K.pneumoniae (58%), and E.coli (52%) andmethicillin-resistant S.aures (MRSA) (24%) were increasing. Conclusion: It was needed to implement the most appropriate programs to prevent the growth and development of bacteria resistant to antibiotics.

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Antimicrobial Resistance and Food Animals: Influence of Livestock Environment on the Emergence and Dissemination of Antimicrobial Resistance

Antibiotics ◽

10.3390/antibiotics9020052 ◽

2020 ◽

Vol 9 (2) ◽

pp. 52 ◽

Cited By ~ 4

Author(s):

Nikola Vidovic ◽

Sinisa Vidovic

Keyword(s):

Antimicrobial Resistance ◽

Western Europe ◽

Growth Promotion ◽

Antibiotic Use ◽

Modern Trend ◽

Resistant Bacteria ◽

Growth Promoter ◽

Antibiotic Resistant ◽

Food Animals ◽

Control And Management

The emergence and dissemination of antimicrobial resistance among human, animal and zoonotic pathogens pose an enormous threat to human health worldwide. The use of antibiotics in human and veterinary medicine, and especially the use of large quantities of antibiotics in livestock for the purpose of growth promotion of food animals is believed to be contributing to the modern trend of the emergence and spread of bacteria with antibiotic resistant traits. To better control the emergence and spread of antimicrobial resistance several countries from Western Europe implemented a ban for antibiotic use in livestock, specifically the use of antibiotics for growth promotion of food animals. This review article summarizes the recent knowledge of molecular acquisition of antimicrobial resistance and the effects of implementation of antibiotic growth promoter bans on the spread of antimicrobial resistant bacteria in animals and humans. In this article, we also discuss the main zoonotic transmission routes of antimicrobial resistance and novel approaches designed to prevent or slow down the emergence and spread of antimicrobial resistance worldwide. Finally, we provide future perspectives associated with the control and management of the emergence and spread of antimicrobial resistant bacteria.

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Horizontal Gene Transfer Is the Main Driver of Antimicrobial Resistance in Broiler Chicks Infected with Salmonella enterica Serovar Heidelberg

mSystems ◽

10.1128/msystems.00729-21 ◽

2021 ◽

Vol 6 (4) ◽

Author(s):

Adelumola Oladeinde ◽

Zaid Abdo ◽

Maximilian O. Press ◽

Kimberly Cook ◽

Nelson A. Cox ◽

...

Keyword(s):

Gene Transfer ◽

Antimicrobial Resistance ◽

Horizontal Gene Transfer ◽

Antibiotic Use ◽

Resistant Bacteria ◽

Broiler Chicks ◽

Antibiotic Resistant ◽

Food Animal ◽

Main Driver ◽

Major Shift

The reported increase in antibiotic-resistant bacteria in humans has resulted in a major shift away from antibiotic use in food animal production. This shift has been driven by the assumption that removing antibiotics will select for antibiotic susceptible bacterial taxa, which in turn will allow the currently available antibiotic arsenal to be more effective.

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Tetracycline-Resistant Bacteria Selected from Water and Zebrafish after Antibiotic Exposure

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063218 ◽

2021 ◽

Vol 18 (6) ◽

pp. 3218

Author(s):

Ana Rita Almeida ◽

Marta Tacão ◽

Joana Soares ◽

Inês Domingues ◽

Isabel Henriques

Keyword(s):

Statistical Significance ◽

Recovery Period ◽

Antibiotic Resistance Genes ◽

Antibiotic Use ◽

Resistant Bacteria ◽

Antibiotic Resistant ◽

Potential Impact ◽

Susceptibility Profiles ◽

Selection Of ◽

Significant Mortality

The emergence of antibiotic-resistant pathogens due to worldwide antibiotic use is raising concern in several settings, including aquaculture. In this work, the selection of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) was evaluated after exposure of zebrafish to oxytetracycline (OTC) for two months, followed by a recovery period. The selection of ARB in water and fish was determined using selective media. The abundance of tetA genes was estimated through qPCR. Higher prevalence of ARB was measured in all samples exposed to the antibiotic when compared to control samples, although statistical significance was only achieved five days after exposure. Isolates recovered from samples exposed to the antibiotic were affiliated with Pseudomonas and Stenotrophomonas. Various antibiotic susceptibility profiles were detected and 37% of the isolates displayed multidrug resistance (MDR). The selection of the tetA gene was confirmed by qPCR at the highest OTC concentration tested. Two MDR isolates, tested using zebrafish embryos, caused significant mortality, indicating a potential impact on fish health and survival. Overall, our work highlights the potential impact of antibiotic contamination in the selection of potential pathogenic ARB and ARGS.

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Retail Chicken Carcasses as a Reservoir of Antimicrobial- Resistant Escherichia coli

University of the Future: Re-Imagining Research and Higher Education ◽

10.29117/quarfe.2020.0115 ◽

2020 ◽

Author(s):

Nahla Omer Eltai ◽

Hadi M. Yassine ◽

Sara H. Al-Hadidi ◽

Tahra ElObied ◽

Asmaa A. Al Thani ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Growth Promotion ◽

Multidrug Resistant ◽

Chicken Meat ◽

Resistant Bacteria ◽

Antibiotic Resistant ◽

E Coli ◽

Inappropriate Use ◽

Esbl Producers

The dissemination of antimicrobial resistance (AMR) bacteria has been associated with the inappropriate use of antibiotics in both humans and animals and with the consumption of food contaminated with resistant bacteria. In particular, the use of antibiotics as prophylactic and growth promotion purposes in food-producing animals has rendered many of the antibiotics ineffective. The increased global prevalence of AMR poses a significant threat to the safety of the world’s food supply. Objectives: This study aims at determining the prevalence of antibiotic-resistant Escherichia coli (E. coli) isolated from local and imported retail chicken meat in Qatar. Methodology: A total of 270 whole chicken carcasses were obtained from three different hypermarket stores in Qatar. A total of 216 E. coli were isolated and subjected to antibiotic susceptibility testing against 18 relevant antibiotics using disc diffusion and micro- dilution methods. Furthermore, extended-spectrum β-lactamase (ESBL) production was determined via a double-disc synergetic test. Isolates harboring colistin resistance were confirmed using multiplex-PCR and DNA sequencing. Results: Nearly 89% (192/216) of the isolates were resistant to at least one antibiotics. In general, isolates showed relatively higher resistance to sulfamethoxazole (62%), tetracycline (59.7%), ampicillin and trimethoprim (52.3%), ciprofloxacin (47.7%), cephalothin, and colistin (31.9%). On the other hand, less resistance was recorded against amoxicillin/clavulanic acid (6%), ceftriaxone (5.1%), nitrofurantoin (4.2%) and piperacillin/tazobactam (4.2%), cefepime (2.3%), meropenem (1.4%), ertapenem (0.9%), and amikacin (0.9%). Nine isolates (4.2%) were ESBL producers. Furthermore, 63.4% were multidrug-resistant (MDR). The percentage of MDR, ESBL producers, and colistin-resistant isolates was significantly higher among local isolates compared to imported chicken samples. Conclusion: We reported a remarkably high percentage of the antibiotic-resistant E. coli in chicken meat sold at retail in Qatar. The high percentage of MDR and colistin isolates is troublesome to the food safety of raw chicken meat and the potential of antibiotic resistance spread to public health. Our findings support the need for the implementation of one health approach to address the spread of antimicrobial resistance and the need for a collaborative solution.

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A study on antibiotic prescription among the hospitalized pediatric patients at a referral center in Puducherry, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20170922 ◽

2017 ◽

Vol 4 (3) ◽

pp. 700

Author(s):

M. Bala Gopal ◽

P. Thiyagarajan ◽

Vinayagamoorthy Venugopal ◽

Venkata Naveen Kumar

Keyword(s):

Infectious Disease ◽

Developing Countries ◽

Antimicrobial Resistance ◽

Significant Proportion ◽

Antibiotic Use ◽

Hospitalized Children ◽

Referral Centre ◽

Cross Sectional ◽

Microbial Resistance ◽

The Cost

Background: Antimicrobial resistance has reached to a significant proportion globally. This antimicrobial resistance increases the cost of health care in addition to the existing burden of the prevalence of infectious disease in developing countries. We need to have institutional protocols based on the standard guidelines. It is important for the clinician to use antibiotics only when it is necessary. The aim of the study was to analyze the rationality of the antibiotics used among the hospitalized children in the referral centre located in the rural area, to evaluate the pattern of antibiotics prescribed among the hospitalized children and to find out the factors associated with the usage of antibiotics among them. Methods: Analytical, cross sectional study was performed on all patients admitted to the inpatient pediatric medical service at a referral centre situated in the rural part of the Puducherry, India during the period from July 2015 to June 2016. Results: 959 children were included in our study.607 children belong to less than 5 years of age group. Overall 60% of the children have received either oral or parenteral antibiotics. Based on the categorization of children as per the final clinical diagnosis children requiring antibiotic, can be used and not required are 13% (125), 38.6% (370) and 48.4% (464) respectively. Respiratory, gastrointestinal and systemic infectious diseases were the major group of cases admitted in our centre. Antibiotic use in respiratory and systemic infectious disease were maximum with 248 (70.1%) and 179 (71.6%) respectively. Among the antibiotics cephalosporin, penicillin group and azithromycin constitute more than 90% of the antibiotics prescribed cases.Conclusions: Overuse of antibiotic is universal and seen in both developed and developing countries. This increases the cost of treatment and increases the chances of microbial resistance. As per the W.H.O. recommendations surveillance system is required in all the hospitals to assess the antibiotic use and to monitor the prevalence of microbial resistance.

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Better living through chemistry: Addressing emerging antibiotic resistance

Experimental Biology and Medicine ◽

10.1177/1535370218755659 ◽

2018 ◽

Vol 243 (6) ◽

pp. 538-553 ◽

Cited By ~ 3

Author(s):

Nathan P Coussens ◽

Ashley L Molinaro ◽

Kayla J Culbertson ◽

Tyler Peryea ◽

Gergely Zahoránszky-Köhalmi ◽

...

Keyword(s):

Drug Resistance ◽

Human Health ◽

Small Molecule ◽

Bacterial Infections ◽

Public Investment ◽

Antibiotic Use ◽

Unintended Consequences ◽

Resistant Bacteria ◽

Antibiotic Resistant ◽

Small Molecule Drugs

The increasing emergence of multidrug-resistant bacteria is recognized as a major threat to human health worldwide. While the use of small molecule antibiotics has enabled many modern medical advances, it has also facilitated the development of resistant organisms. This minireview provides an overview of current small molecule drugs approved by the US Food and Drug Administration (FDA) for use in humans, the unintended consequences of antibiotic use, and the mechanisms that underlie the development of drug resistance. Promising new approaches and strategies to counter antibiotic-resistant bacteria with small molecules are highlighted. However, continued public investment in this area is critical to maintain an edge in our evolutionary “arms race” against antibiotic-resistant microorganisms. Impact statement The alarming increase in antibiotic-resistant microorganisms is a rapidly emerging threat to human health throughout the world. Historically, small molecule drugs have played a major role in controlling bacterial infections and they continue to offer tremendous potential in countering resistant organisms. This minireview provides a broad overview of the relevant issues, including the diversity of FDA-approved small molecule drugs and mechanisms of drug resistance, unintended consequences of antibiotic use, the current state of development for small molecule antibacterials and financial challenges that impact progress towards novel therapies. The content will be informative to diverse stakeholders, including clinicians, basic scientists, translational scientists and policy makers, and may be used as a bridge between these key players to advance the development of much-needed therapeutics.

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The invisible pandemic: Antimicrobial resistance

Independent Nurse ◽

10.12968/indn.2021.5.14 ◽

2021 ◽

Vol 2021 (5) ◽

pp. 14-16

Author(s):

Graham Cope

Keyword(s):

Antimicrobial Resistance ◽

Resistant Bacteria ◽

Antibiotic Resistant Bacteria ◽

Antibiotic Resistant ◽

The Invisible

Graham Cope looks at how antibiotic resistant bacteria have fared during the coronavirus pandemic

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Antimicrobial resistance in United States retail ground beef with and without label claims regarding antibiotic use

Journal of Food Protection ◽

10.4315/jfp-20-376 ◽

2020 ◽

Author(s):

John W. Schmidt ◽

Amit Vikram ◽

Enrique Doster ◽

Kevin Thomas ◽

Margaret D Weinroth ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Production System ◽

Ground Beef ◽

Antibiotic Use ◽

Resistant Bacteria ◽

Antimicrobial Use ◽

Food Animal ◽

Antimicrobial Resistance Genes ◽

Human Health Impacts ◽

Beef Products

Antibiotics used during food-animal production account for approximately 77% of U.S. antimicrobial consumption by mass. Ground beef products labeled as raised without antibiotics (RWA) are perceived to harbor lower antimicrobial resistance (AMR) levels than conventional (CONV) products with no label claims regarding antimicrobial use. Retail ground beef samples were obtained from 6 U. S. cities. Samples with a RWA or USDA Organic claim ( N = 299) were assigned to the RWA production system. Samples lacking these claims ( N = 300) were assigned to the CONV production system. Each sample was cultured for the detection of five antimicrobial resistant bacteria. Genomic DNA was isolated from each sample and qPCR was used to determine the abundance of ten antimicrobial resistance genes (ARGs). Tetracycline-resistant Escherichia coli (CONV = 46.3%; RWA = 34.4%, P < 0.01) and erythromycin-resistant Enterococcus (CONV = 48.0%; RWA = 37.5%, P = 0.01) were more frequently detected in CONV. Salmonella were detected in 1.2% of samples. The ARG bla CTX-M (CONV = 4.1 log 10 normalized abundance, RWA = 3.8 log 10 normalized abundance, P < 0.01) was more abundant in CONV ground beef. The ARGs mecA (CONV = 4.4 log 10 normalized abundance, RWA = 4.9 log 10 normalized abundance, P = 0.05), tet (A) (CONV = 3.9 log 10 normalized abundance, RWA = 4.5 log 10 normalized abundance, P < 0.01), tet (B) (CONV = 3.9 log 10 normalized abundance, RWA = 4.5 log 10 normalized abundance, P < 0.01), and tet (M) (CONV = 5.4 log 10 normalized abundance, RWA = 5.8 log 10 normalized abundance, P < 0.01) were more abundant in RWA ground beef. Although these results suggest that antimicrobial use during U. S. cattle production does not increase human exposure to AMR via ground beef quantitative microbiological risk assessments are required for authoritative assessments regarding the human health impacts of antimicrobial uses during beef production.

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Seasonal resistome diversity and dissemination of WHO priority antibiotic-resistant pathogens in Lebanese estuaries

10.1101/2021.12.13.472353 ◽

2021 ◽

Author(s):

Wadad Hobeika ◽

Margaux Gaschet ◽

Marie-Cecile Ploy ◽

Elena Buelow ◽

Dolla Karam Sarkis ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Pathogenic Bacteria ◽

Anthropogenic Activities ◽

Resistant Bacteria ◽

Anthropogenic Pressure ◽

Significant Information ◽

Antibiotic Resistant ◽

Culture Techniques ◽

Antimicrobial Resistance Genes ◽

Key Drivers

Anthropogenic activities are demonstrated to be the key drivers of antimicrobial resistance (AMR) dissemination in the environment. Lebanese rivers that lead to the Mediterranean Sea were sampled at estuaries sites, under high anthropogenic pressure, in spring 2017 and winter 2018 to study seasonal variation of antimicrobial-resistant bacteria (ARBs) and antimicrobial resistance genes (ARGs). Methods: A combined approach using culture techniques and high throughput qPCR identified hotspots for antimicrobial resistance and anthropogenic pressure in particular locations along the Lebanese coast. Results: Multi-resistant Gram-negative (Enterobacterales and Pseudomonas spp) and Gram-positive bacterial pathogens were isolated. A high abundance of certain ARGs (vanB, blaBIC-1, blaGES, tetM, and mcr-1) was detected in 5 Lebanese estuaries. The relative abundance of ARGs was highest in winter and areas with high anthropogenic activities and population growth with an influx of refugees. Conclusion: Qualitative analysis of ARB and the analysis of the Lebanese estuaries resistome revealed critical levels of contamination with pathogenic bacteria and provided significant information about the spread of ARGs in anthropogenically impacted estuaries.

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