Global geographic trends in antimicrobial resistance: the role of international travel

2019 ◽  
Vol 26 (8) ◽  
Author(s):  
Isabel Frost ◽  
Thomas P Van Boeckel ◽  
João Pires ◽  
Jessica Craig ◽  
Ramanan Laxminarayan
Keyword(s):  
Travel Medicine ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Modern Medicine ◽  
International Travel ◽  
Sexual Practices ◽  
Resistant Bacteria ◽  
Clean Water ◽  
Resistant Strains

Abstract Background Rising antimicrobial resistance (AMR) is a threat to modern medicine, and increasing international mobility facilitates the spread of AMR. Infections with resistant organisms have higher morbidity and mortality, are costlier to treat, result in longer hospital stays and place a greater burden on health systems than infections caused by susceptible organisms. Here we review the role of travel in the international dissemination of AMR and consider actions at the levels of travelers, travel medicine practitioners and policymakers that would mitigate this threat. Results Resistant pathogens do not recognize international borders; travelers to areas with high AMR prevalence are likely to be exposed to resistant bacteria and return to their home countries colonized. Medical tourists go between health facilities with drastically different rates of AMR, potentially transmitting highly resistant strains. Drug-resistant bacteria have been found in every continent; however, differences between countries in the prevalence of AMR depend on multiple factors. These include levels of antibiotic consumption (including inappropriate use), access to clean water, adequate sanitation, vaccination coverage, the availability of quality healthcare and access to high-quality medical products. Conclusions Travelers to areas with high levels of AMR should have vaccines up to date, be aware of ways of treating and preventing travelers’ diarrhea (other than antibiotic use) and be informed on safe sexual practices. The healthcare systems of low- and middle-income countries require investment to reduce the transmission of resistant strains by improving access to clean water, sanitation facilities and vaccines. Efforts are needed to curb inappropriate antibiotic use worldwide. In addition, more surveillance is needed to understand the role of the movement of humans, livestock and food products in resistance transmission. The travel medicine community has a key role to play in advocating for the recognition of AMR as a priority on the international health agenda. Key policy recommendations AMR is a threat to modern medicine, and international travel plays a key role in the spread of highly resistant strains. It is essential that this is addressed at multiple levels. Individual travelers can reduce antibiotic consumption and the likelihood of infection. Travelers should have up-to-date vaccines and be informed on methods of preventing and treating travelers’ diarrhea, other than use of antibiotics and on safe sexual practices, such as condom use. Healthcare facilities need to be aware of the travel history of patients to provide appropriate treatment to those who are at high risk of exposure and to prevent further spread. Internationally, in countries without reliable and universal access to clean water, sanitation and hygiene, investment is needed to reduce the emergence and spread of resistance and ensure the antimicrobials available are of assured quality. High-income countries must ensure their use of antimicrobials is appropriate to reduce selection for AMR. Surveillance across all countries is needed to monitor and respond to this emerging threat.

Selective infection of maize roots by streptomycin-resistant Azospirillum lipoferum and other bacteria

1979 ◽  
Vol 25 (11) ◽  
pp. 1264-1269 ◽  
Author(s):  
Johanna Döbereiner ◽  
Vera Lucia Divan Baldani
Keyword(s):  
Antibiotic Resistance ◽  
Rhizosphere Soil ◽  
Resistant Bacteria ◽  
Root Infection ◽  
Azospirillum Lipoferum ◽  
Wheat Roots ◽  
Low Level ◽  
Maize Roots ◽  
Resistant Strains

The percentage of low-level streptomycin-resistant (20 μg/mL) bacteria in surface-sterilized or washed maize roots was more than a thousand times higher than that in soil populations. There was also a higher incidence of resistant bacteria in rhizosphere as compared with non-rhizosphere soil and bacteria isolated from maize roots were relatively tolerant to several other antibiotics. Azospirillum lipoferum was predominant in surface-sterilized roots of field-grown maize and was low-level streptomycin-resistant while most soil isolates were sensitive. Inoculation with A. brasilense isolated from wheat roots was unsuccessful in terms of establishment even when streptomycin-resistant strains were used. Unidentified causes of specific plant–bacteria affinities therefore transcend the role of antibiotic resistance in maize root infection.

scholarly journals From Point-of-Care Testing (PoCT) and vaccination to changing the care paradigm: the role of primary care

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Petelos ◽  
C Lionis
Keyword(s):  
Primary Care ◽  
Cancer Patients ◽  
Point Of Care ◽  
Behavioural Change ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Prescribing Patterns ◽  
Patient Treatment ◽  
Therapeutic Decisions

Abstract The speaker will discuss the role of primary care for all patients and cancer patients, elaborating on prescribing patterns vaccinations, recommendations for Over-The-Counter medicines (OTCs) nutritional supplements, and as well as its contribution of behavioural change to raise awareness and change prescription practice. The role of PoCT for reducing the threat of AMR and for improving the differential diagnosis will be discussed, according to the WHO Approach of “diagnostic stewardship” for the appropriate use of microbiological diagnostics to guide therapeutic decisions. In the context of syndromic surveillance and preparedness, as well as in terms of protecting cancer patients at times of epidemics, methods of specimen collection for limited community transmission and for the timely pathogen identification along with accurate, timely reporting of results to guide patient treatment will be discussed. The role of behavioural modification interventions will be discussed, incl. in relation to vaccination and the role it can play in AMR. Improvement of the survivorship experience will be examined in the context of improving health literacy. The case of Greece, currently having the highest antibiotic consumption in Europe and the fourth highest globally, along with an increasing trend on antibiotic use will also be discussed.

scholarly journals Anthropogenic Activities and the Problem of Antibiotic Resistance in Latin America: A Water Issue

Water ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 2693
Author(s):  
Delfina C. Domínguez ◽  
Luz María Chacón ◽  
D’Janique Wallace
Keyword(s):  
Antibiotic Resistance ◽  
Latin America ◽  
Antimicrobial Resistance ◽  
Latin American ◽  
Anthropogenic Activities ◽  
Antibiotic Use ◽  
Modern Medicine ◽  
Resistant Bacteria ◽  
Beta Lactam ◽  
Water Ecosystems

Antibiotics revolutionized modern medicine and have been an excellent tool to fight infections. However, their overuse and misuse in different human activities such as health care, food production and agriculture has resulted in a global antimicrobial resistance crisis. Some regions such as Latin America present a more complex scenario because of the lack of resources, systematic studies and legislation to control the use of antimicrobials, thus increasing the spread of antibiotic resistance. This review aims to summarize the state of environmental antibiotic resistance in Latin America, focusing on water resources. Three databases were searched to identify publications on antimicrobial resistance and anthropogenic activities in relation to natural and artificial water ecosystems. We found that antibiotic resistant bacteria, mainly against beta lactam antibiotics, have been reported in several Latin American countries, and that resistant bacteria as well as resistant genes can be isolated from a wide variety of aquatic environments, including drinking, surface, irrigation, sea and wastewater. It is urgent to establish policies and regulations for antibiotic use to prevent the increase of multi-drug resistant microorganisms in the environment.

scholarly journals A Survey and Analysis of the American Public's Perceptions and Knowledge About Antibiotic Resistance

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Rebecca R. Carter ◽  
Jiayang Sun ◽  
Robin L. P. Jump
Keyword(s):  
Immune Response ◽  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
The Body ◽  
Amazon Mechanical Turk ◽  
Resistant Bacteria ◽  
Free Text ◽  
Bacterial Adaptation ◽  
Antibiotic Overuse

Abstract Background.  Little is known about the American public's perceptions or knowledge about antibiotic-resistant bacteria or antibiotic misuse. We hypothesized that although many people recognize antibiotic resistance as a problem, they may not understand the relationship between antibiotic consumption and selection of resistant bacteria. Methods.  We developed and tested a survey asking respondents about their perceptions and knowledge regarding appropriate antibiotic use. Respondents were recruited with the Amazon Mechanical Turk crowdsourcing platform. The survey, carefully designed to assess a crowd-sourced population, asked respondents to explain “antibiotic resistance” in their own words. Subsequent questions were multiple choice. Results.  Of 215 respondents, the vast majority agreed that inappropriate antibiotic use contributes to antibiotic resistance (92%), whereas a notable proportion (70%) responded neutrally or disagreed with the statement that antibiotic resistance is a problem. Over 40% of respondents indicated that antibiotics were the best choice to treat a fever or a runny nose and sore throat. Major themes from the free-text responses included that antibiotic resistance develops by bacteria, or by the infection, or the body (ie, an immune response). Minor themes included antibiotic overuse and antibiotic resistance caused by bacterial adaptation or an immune response. Conclusions.  Our findings indicate that the public is aware that antibiotic misuse contributes to antibiotic resistance, but many do not consider it to be an important problem. The free-text responses suggest specific educational targets, including the difference between an immune response and bacterial adaptation, to increase awareness and understanding of antibiotic resistance.

scholarly journals Outpatient Antibiotic Consumption Fluctuations in a View of Unreasonable Antibacterial Therapy

2017 ◽  
Vol 66 (1) ◽  
pp. 119-123 ◽  
Author(s):  
Marcin Ciszewski ◽  
Tomasz Czekaj ◽  
Eligia M. Szewczyk
Keyword(s):  
Primary Care ◽  
Viral Infection ◽  
Central Europe ◽  
Antibacterial Therapy ◽  
Seasonal Variability ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Resistant Bacteria ◽  
Primary Care System ◽  
Consumption Fluctuations

Unreasonable antibacterial therapy is suspected to be the main reason of emergence of multi-resistant bacteria. The connection between seasonal variability of antibiotic use and reasonable antibacterial therapy has been described. We examined the issue basing on the data obtained from the primary care system in Szczecin (Poland) in order to verify the situation in this region of Central Europe. Increase in antibiotic consumption in a viral infection season was proved to be statistically significant. Statistically significant differences in various drug forms dispensation were also observed. Increased consumption of antibiotics in seasons of influenza-like illnesses might be connected with a lack of proper diagnostics or numerous cases of bacterial co-infections.

Change in Antibiotic Use in Secondary and Tertiary Hospitals Nationwide After a National Antimicrobial Stewardship Campaign Was Launched in China, 2011–2016: An Observational Study

2020 ◽  
Vol 221 (Supplement_2) ◽  
pp. S148-S155 ◽  
Author(s):  
Yonghong Xiao ◽  
Ping Shen ◽  
Beiwen Zheng ◽  
Kai Zhou ◽  
Qixia Luo ◽  
...  
Keyword(s):  
Observational Study ◽  
Antimicrobial Stewardship ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Resistant Bacteria ◽  
Total Drug ◽  
Antibiotic Resistant ◽  
Drug Procurement ◽  
Carbapenem Resistant ◽  
Tertiary Hospitals

Abstract Background An antimicrobial stewardship campaign was launched in 2011 by the Ministry of Health. This study aimed to assess the achievements and trends in the clinical use of antibiotics in secondary and tertiary hospitals following this campaign in China. Methods This observational study analyzed nationwide hospital antibiotic procurement and consumption data and antibiotic-resistance surveillance data based on claims filed in 2010–2016. Results After a 6-year national campaign, the proportion of outpatients and surgical patients who received antibiotic treatment decreased from 19.5% to 8.5% and from 97.9% to 38.3%, respectively. The intensity of antibiotic use among inpatients decreased from 85.3±29.8 defined daily dosage (DDD) per 100 patient days to 48.5±8.0 DDD per 100 patient days. Moreover, the antibiotic procurement expenditure among hospitals declined from 22.3% of total drug procurement costs in 2010 to 12.1% in 2016, although total drug procurement costs doubled during that time. The incidence of methicillin-resistant Staphylococcus aureus isolates also dropped (from 54.4% in 2010 to 34.4% in 2016), as did the proportion of carbapenem-resistant Pseudomonas aeruginosa isolates (from 30.8% to 22.3%). Conclusions The 6-year campaign successfully reduced antibiotic consumption and irrational drug use in Chinese hospitals which was associated with declines in the prevalence of common antibiotic-resistant bacteria.

scholarly journals Antimicrobial Susceptibility Profiles and Resistance Genes in Genus Aeromonas spp. Isolated from the Environment and Rainbow Trout of Two Fish Farms in France

2021 ◽  
Vol 9 (6) ◽  
pp. 1201
Author(s):  
Niki Hayatgheib ◽  
Ségolène Calvez ◽  
Catherine Fournel ◽  
Lionel Pineau ◽  
Hervé Pouliquen ◽  
...  
Keyword(s):  
Resistance Genes ◽  
Antibiotic Use ◽  
Resistant Bacteria ◽  
Aquatic Environments ◽  
Fish Farms ◽  
Antibiotic Resistant ◽  
Resistant Strains ◽  
Trout Farms ◽  
Susceptibility Profiles ◽  
The Impact

This study presents the occurrence and abundance of Aeromonas antibiotic-resistant bacteria (ARB) and genes (ARGs) isolated from water, biofilm and fish in two commercial trout farms before and one week after flumequine treatment. Wild (WT) and non-wild (NWT) strains were determined for quinolones (flumequine, oxolinic acid and enrofloxacin), oxytetracycline (OXY), florfenicol (FFN), trimethoprim-sulfamethoxazole (TMP) and colistin (COL), and pMAR (presumptive multi-resistant) strains were classified. Forty-four ARGs for the mentioned antibiotics, β-lactams and multi-resistance were quantified for 211 isolates. BlaSHV-01, mexF and tetE were the dominant ARGs. A greater occurrence and abundance of tetA2, sul3, floR1, blaSHV-01 and mexF were observed for NWT compared to WT. The occurrence of pMAR and NWT Aeromonas for quinolones, OXY, FFN, TMP, COL and ARGs depended on the Aeromonas origin, antibiotic use and the presence of upstream activities. Our results revealed the impact of a flumequine treatment on Aeromonas present on a fish farm through an increase in NWT and pMAR strains. The link between fish and their environment was shown by the detection of identical ARB and ARGs in the two types of samples. There appears to be a high risk of resistance genes developing and spreading in aquatic environments.

Role of gut microbiota in travel-related acquisition of extended spectrum β-lactamase-producing Enterobacteriaceae

2021 ◽  
Author(s):  
Ye Peng ◽  
Suisha Liang ◽  
Kanchana Poonsuk ◽  
Hilda On ◽  
Sze Wang Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Random Forest ◽  
Gut Microbiota ◽  
Area Under The Curve ◽  
International Travel ◽  
Resistant Bacteria ◽  
Extended Spectrum ◽  
Related Risk ◽  
Associated Risk Factors

Abstract Background International travel could facilitate the spread of antimicrobial-resistant bacteria including extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E). Previous studies, which attempted to understand the role of gut microbiota in the acquisition of antimicrobial resistant bacteria during international travels, are limited to western travelers. Methods We established a prospective cohort of 90 Hong Kong travelers to investigate gut microbiota determinants and associated risk factors for the acquisition of ESBL-E. Baseline characteristics and travel-associated risk factors were gathered through questionnaires. Fecal samples were collected in 3–4 days before and after travel. Antimicrobial susceptibility of ESBL-E isolates was tested, and gut microbiota were profiled by 16S rDNA amplicon sequencing. Non-parametric tests were used to detect potential associations, and logistic regression models were used to quantify the associations. Random forest models were constructed to identify microbial predictors for ESBL-E acquisition. Results 49 (54.4%) participants were tested negative for ESBL-E colonization before travel and were followed up after travel. A total of 60 ESBL-E isolates were cultured from 20 (40.8%) participants. Having low Actinobacteria richness and low abundance of short-chain fatty acid-producing bacteria in the gut microbiota before travel increased the risk of acquiring ESBL-E and the risk can be further exacerbated by eating raw seafood during travel. Besides, post-travel ESBL-E positive participants had increased abundances of several opportunistic pathogens such as Staphylococcus, Enterococcus, Escherichia/Shigella and Klebsiella. The random forest model integrating pre-travel microbiota and the identified travel-related risk factor could predict ESBL-E acquisition with an area under the curve of 75.4% (95% confidence interval: 57.9%–93.0%). Conclusions In this study, we identified both travel-related risk factors and microbiota predictors for the risk of ESBL-E acquisition. Our results provide foundational knowledge for future developments of microbiota-based interventions to prevent ESBL-E acquisition during international travels.

scholarly journals Role of Heavy Metal Resistant Bacteria for Bioremediation of Polluted Environment

2020 ◽  
Vol 1 (2) ◽  
pp. 9-18
Author(s):  
Fariha Zakria Rizvi ◽  
Muhammad Faisal
Keyword(s):  
Reduction Potential ◽  
Resistant Bacteria ◽  
Rrna Gene ◽  
Polluted Environment ◽  
Bacterial Strains ◽  
Genus Bacillus ◽  
Blast Analysis ◽  
Resistant Strains ◽  
Removal Of Arsenic

Bioremediation refers to the use of microorganisms to reduce or eliminate contaminants from water and soil. In the current research, different bacterial strains were screened for their chromate and arsenate reduction potential. For the removal of arsenic, eight arsenic resistant bacterial strains AsK03, AsK04, AsK06, AsK07, AsK08, AsK09, AsK15 and AsK18 and for chromium removal, eight chromium resistant bacterial strains CrK02, CrK08, CrK12, CrK14, CrK16, CrK19, CrK20 and CrK21 were isolated and selected, respectively, from several contaminated soil and water samples taken from tanneries located in Kasur. Resistance to chromium and arsenic was shown by all the strains on nutrient agar at preliminary concentration of 500 µg ml-1 . The maximum tolerable concentration (MTC) of these isolates was also studied. It was found that for arsenic resistance, two strains AsK04 and AsK09 had highest MTC of 100 mg ml-1 , AsK18 had 75 mg ml-1 , AsK03, AsK06 and AsK15 had 50 mg ml-1 and AsK07 and AsK08 had 45 mg ml-1 of Na2HAsO4 concentration. Similarly, chromium resistant strains were also checked for their MTC against K2CrO4. Here MTC of CrK16 and CrK19 were highest (75 mg ml-1 ), CrK08 and CrK12 were 50 mg ml-1 , CrK02 and CrK20 were 25 mg ml-1 , CrK14 and CrK21 had least MTC of 7.5 mg ml-1 . Fifteen of the bacterial strains were genetically identified by sequencing of 16S rRNA gene. BLAST analysis revealed that the seven strains are homologous to genus Bacillus.

scholarly journals Impact of an antibiotic stewardship programme in a surgical setting

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Muhammad A. Bashar ◽  
Jacqui Miot ◽  
Evan Shoul ◽  
Robyn L. Van Zyl
Keyword(s):  
Antibiotic Stewardship ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Modern Medicine ◽  
Cross Sectional ◽  
Defined Daily Doses ◽  
Surgical Setting ◽  
Antibiotic Stewardship Programme

Background: Antibiotics are miracles of science and critical for many surgical procedures. However, the emergence of multidrug resistant pathogens resulting from inappropriate antibiotic use is a threat to modern medicine. This study aimed to determine the appropriateness of antibiotic use, cost, consumption and impact of an antibiotic stewardship intervention round in a surgical ward setting.Methods: Baseline antibiotic utilisation was determined with a retrospective cross-sectional study in two surgical wards in a tertiary academic hospital in South Africa where medical records of 264 patients who received antibiotics were reviewed. In the second stage of the study, records of 212 patients who received antibiotics were reviewed during a weekly antibiotic stewardship intervention round. The volume of antibiotics consumed was determined using defined daily doses (DDDs)/1000 patients’ days, and the appropriateness of the antibiotic prescription for treatment was also determined using a quality-of-use algorithm.Results: There was a reduction in the volume of antibiotic consumption from a total 739.30 DDDs/1000 to 564.93 DDDs/1000 patient days, with reduction in inappropriate antibiotic use from 35% to 26% from baseline to antibiotic stewardship programme stages, respectively. There was an overall increase in culture targeted therapy in both wards in the antibiotic stewardship programme stage.Conclusion: The implementation of an antibiotic stewardship programme led to a reduction in antibiotic consumption and improvement in appropriate use of antibiotics.

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