scholarly journals The evolution of antibiotic resistance in a structured host population

2018 ◽  
Vol 15 (143) ◽  
pp. 20180040 ◽  
Author(s):  
François Blanquart ◽  
Sonja Lehtinen ◽  
Marc Lipsitch ◽  
Christophe Fraser
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Population ◽  
Public Health Problem ◽  
Host Population ◽  
Major Public Health Problem ◽  
Duration Of Treatment ◽  
Transmission Rates ◽  
Risk Of Death ◽  
Increased Risk ◽  
Resistant Strains

The evolution of antibiotic resistance in opportunistic pathogens such as Streptococcus pneumoniae , Escherichia coli or Staphylococcus aureus is a major public health problem, as infection with resistant strains leads to prolonged hospital stay and increased risk of death. Here, we develop a new model of the evolution of antibiotic resistance in a commensal bacterial population adapting to a heterogeneous host population composed of untreated and treated hosts, and structured in different host classes with different antibiotic use. Examples of host classes include age groups and geographic locations. Explicitly modelling the antibiotic treatment reveals that the emergence of a resistant strain is favoured by more frequent but shorter antibiotic courses, and by higher transmission rates. In addition, in a structured host population, localized transmission in host classes promotes both local adaptation of the bacterial population and the global maintenance of coexistence between sensitive and resistant strains. When transmission rates are heterogeneous across host classes, resistant strains evolve more readily in core groups of transmission. These findings have implications for the better management of antibiotic resistance: reducing the rate at which individuals receive antibiotics is more effective to reduce resistance than reducing the duration of treatment. Reducing the rate of treatment in a targeted class of the host population allows greater reduction in resistance, but determining which class to target is difficult in practice.

scholarly journals The prescription pattern and awareness about antibiotic prophylaxis and resistance among a group of Egyptian pediatric and general dentists: a cross sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mariam Mohsen Aly ◽  
Marwa Aly Elchaghaby
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Prophylaxis ◽  
Antibiotic Prescription ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Major Public Health Problem ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
General Dentists

Abstract Background The use of antibiotics in dentistry as prophylaxis and treatment is frequent. Their misuse has led to a major public health problem globally known as antibiotic resistance. This study aimed to assess the pattern of antibiotic prescription and its prophylactic use for systemic conditions. Besides, this study evaluated the awareness and adherence to antibiotic prescription guidelines and antibiotic prophylaxis guidelines along with awareness of antibiotic resistance across pediatric and general dentists. Methods An overall of 378 pediatric and general dentists meeting the required eligibility criteria, fulfilled a pre-designed validated questionnaire. Data were collected, tabulated, and statistically analyzed. Results A significant statistical difference was found among the pediatric and general dentists regarding antibiotics prescription for most of the oral conditions where Amoxicillin with clavulanic acid was the most frequently prescribed antibiotic among the two groups (53% pediatric dentist and 52% general dentist). The majority of pediatric and general dentists, on the other hand, were aware of antibiotic resistance and prescribing recommendations. Conclusions The present study showed a tendency to overprescribe and overuse antibiotics in certain dental conditions among the participants. The vast majority of dentists, especially general dentists do not have adherence to professional guidelines for antibiotics prescription in children despite their awareness of antibiotic resistance and prescription guidelines.

scholarly journals Internet Addiction Among Male Adolescents in Indonesia: A Qualitative Study

2021 ◽  
Vol 15 (3) ◽  
pp. 155798832110294
Author(s):  
Windy Rakhmawati ◽  
Cecep Eli Kosasih ◽  
Restuning Widiasih ◽  
Suryani Suryani ◽  
Hidayat Arifin
Keyword(s):  
Qualitative Study ◽  
Internet Addiction ◽  
Public Health Problem ◽  
Phenomenological Approach ◽  
Self Control ◽  
Easy Access ◽  
Major Public Health Problem ◽  
Psychosocial Effects ◽  
Male Adolescents ◽  
Increased Risk

Internet has become an important part of the daily life of adolescents. Easy access to internet and its social appeal among adolescent males render them at an increased risk of internet addiction and the associated adverse physical and psychosocial effects. We conducted a qualitative study using a phenomenological approach. A purposive sample of nine male adolescents was recruited in West Java, Indonesia. Semistructured interviews were conducted until data saturation was achieved. Data were subjected to thematic analysis. We identified four main themes from the experiences of adolescents with internet addition: reasons for internet addiction, unmet social need without the internet, effects of internet addiction, and self-control over internet usage. Internet addiction among male adolescents is a major public health problem that should be addressed. The findings of this study may be useful for health professionals and families to help male adolescents manage their internet addiction.

scholarly journals Role of Oxidative Stress as a Marker of Cardiovascular Risk in Children on Regular Hemodialysis

2021 ◽  
pp. 416-421
Author(s):  
Muhammad Abrar ◽  
Mazhar Nadeem ◽  
Sunila Fatima
Keyword(s):  
Oxidative Stress ◽  
Cardiovascular Risk ◽  
Prognostic Significance ◽  
Public Health Problem ◽  
Dialysis Session ◽  
Major Public Health Problem ◽  
Arterial Blood ◽  
Increased Risk ◽  
The Mean ◽  
Regular Hemodialysis

Introduction: Chronic kidney disease (CKD) is a major public health problem worldwide, and its main consequences include loss of renal function leading to end-stage renal disease (ESRD), increased risk of cardiovascular disease (CVD), significant increase in morbidity and mortality, and a decrease in health-related quality of life. Aims and Objectives: The basic aim of the study is to analyze the oxidative stress and total antioxidant capacity as a biomarker of cardiovascular risk in those children who are on regular hemodialysis. Materials and Methods: This cross sectional study was conducted at DHQ hospital, Faisalabad during July 2020 to January 2021. The data were collected from the age of less than 18 years children of both sexes. There were 50 children who was selected for this study. At the time of the study, all the patients were on regular three HD sessions per week. In HD patients, venous blood samples were drawn immediately before and after hemodialysis session. Baseline laboratory investigations were carried out for all patients and controls including complete blood count, serum urea and creatinine, arterial pH, arterial blood gases and infection screening, which included blood and urinary cultures by standard methods.  Results: The data were collected from 50 dialysis patients. The mean age of this study is 15years. We collected all the demographic data of patients. The mean value of Urea is 64.34±2.44 mg/dl). At before-dialysis session, duration of disease positively correlated with TPX (r = 0.969, P <0.001), but, negatively correlated with TAC (r = −0.469, P <0.002). At after-dialysis session, HIF-1α negatively correlated with each of TPX (r = −0.529, P <0.001) and OSI (r = −0.459, P <0.003); while, OSI positively correlated with TPX (r = 0.944, P <0.001). Conclusion: It is concluded that HD patients, the clinical and prognostic significance of oxidative status associated with cardiovascular risk factors is very different from the general population. Although a direct causality cannot be inferred from such kind of correlative investigations.

scholarly journals Sero-epidemiology and risk factors of syphilis in Makassar, Indonesia

2019 ◽  
Vol 11 (2) ◽  
pp. 43-49
Author(s):  
Maryam Kusumawaty ◽  
Khairuddin Djawad ◽  
Muh Nasrum Massi ◽  
Andi Muhammad Adam ◽  
Siswanto Wahab ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hiv Transmission ◽  
Treponema Pallidum ◽  
Public Health Problem ◽  
Sexual Relationships ◽  
Capital City ◽  
Major Public Health Problem ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Increased Risk

Abstract Introduction. Syphilis is an infectious disease caused by Treponema pallidum spirochete and is mainly transmitted by sexual contact. Syphilis has the potential to cause serious complications and is closely related to human immunodeficiency virus (HIV) infection thus making syphilis still a major public health problem. In Indonesia, surveys of high-risk populations in 2007 and 2011 reported an increase in the prevalence of syphilis, especially in men who have sexual relationships with other men (MSM). Moreover, studies have described risk factors for HIV transmission including MSM, heterosexual contacts, Intravenous (IV) drug use, and infected partners. Objectives. To assess the epidemiological aspects and risk factors for syphilis in Makassar, as well as the correlation with a coinfection of other sexually transmitted infections. Material and Methods. This study is a multi-centre cross-sectional descriptive study with consecutive sampling. We evaluated cases for eligibility by confirming the diagnosis based on the serological result using rapid plasma reagin assay (RPR), Treponema pallidum haemagglutination (TPHA), and HIV screening kit. The cases were analyzed based on epidemiological features, risk factors and clinical findings, co-infection with other sexually transmitted infection (ST), and stadium of the disease. Results. A total of 79 serologically confirmed syphilis cases were collected between January 2017 and December 2018 in Makassar, the capital city of South Sulawesi province in Indonesia. Of the 63 male subjects (79.7%), 38 (48.1%) were homosexual/MSM, and in 41 cases of HIV-infected subjects, 25 (60.9%) of them were also MSM. Conclusion. Our study showed there was a significant correlation between syphilis and an increased risk of HIV transmission in MSM groups. The higher number of cases of syphilis and HIV co-infection among MSM can increase transmission of both infections and should be considered a major risk factor for syphilis in Makassar.

scholarly journals Evolution of Cost-Free Resistance under Fluctuating Drug Selection in Pseudomonas aeruginosa

mSphere ◽  
2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Anita H. Melnyk ◽  
Nicholas McCloskey ◽  
Aaron J. Hinz ◽  
Jeremy Dettman ◽  
Rees Kassen
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Antibiotic Treatment ◽  
Experimental Evolution ◽  
Public Health Problem ◽  
Content Type ◽  
Compensatory Evolution ◽  
High Fitness ◽  
Treatment Conditions ◽  
Resistant Strains

ABSTRACT Antibiotic resistance is a global problem that greatly impacts human health. How resistance persists, even in the absence of antibiotic treatment, is thus a public health problem of utmost importance. In this study, we explored the antibiotic treatment conditions under which cost-free resistance arises, using experimental evolution of the bacterium Pseudomonas aeruginosa and the quinolone antibiotic ciprofloxacin. We found that intermittent antibiotic treatment led to the evolution of cost-free resistance and demonstrate that compensatory evolution is the mechanism responsible for cost-free resistance. Our results suggest that discontinuous administration of antibiotic may be contributing to the high levels of antibiotic resistance currently found worldwide. Antibiotic resistance evolves rapidly in response to drug selection, but it can also persist at appreciable levels even after the removal of the antibiotic. This suggests that many resistant strains can both be resistant and have high fitness in the absence of antibiotics. To explore the conditions under which high-fitness, resistant strains evolve and the genetic changes responsible, we used a combination of experimental evolution and whole-genome sequencing to track the acquisition of ciprofloxacin resistance in the opportunistic pathogen Pseudomonas aeruginosa under conditions of constant and fluctuating antibiotic delivery patterns. We found that high-fitness, resistant strains evolved readily under fluctuating but not constant antibiotic conditions and that their evolution was underlain by a trade-off between resistance and fitness. Whole-genome sequencing of evolved isolates revealed that resistance was gained through mutations in known resistance genes and that second-site mutations generally compensated for costs associated with resistance in the fluctuating treatment, leading to the evolution of cost-free resistance. Our results suggest that current therapies involving intermittent administration of antibiotics are contributing to the maintenance of antibiotic resistance at high levels in clinical settings. IMPORTANCE Antibiotic resistance is a global problem that greatly impacts human health. How resistance persists, even in the absence of antibiotic treatment, is thus a public health problem of utmost importance. In this study, we explored the antibiotic treatment conditions under which cost-free resistance arises, using experimental evolution of the bacterium Pseudomonas aeruginosa and the quinolone antibiotic ciprofloxacin. We found that intermittent antibiotic treatment led to the evolution of cost-free resistance and demonstrate that compensatory evolution is the mechanism responsible for cost-free resistance. Our results suggest that discontinuous administration of antibiotic may be contributing to the high levels of antibiotic resistance currently found worldwide.

scholarly journals Prevalence and Determinants of Falls among Older Adults in Ecuador: An Analysis of the SABE I Survey

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Carlos H. Orces
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Coastal Region ◽  
Public Health Problem ◽  
Linear Increase ◽  
Andes Mountains ◽  
Major Public Health Problem ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Nationally Representative

The present study based on a nationally representative sample of older adults living in the Andes mountains and coastal region of the country indicates that 34.7% of older adults had fallen in the previous year in Ecuador. Among fallers, 30.6% reported a fall-related injury. The prevalence of falls was higher in women and among older adults residing in the rural Andes mountains. In the multivariate model, women, subjects with cognitive impairment, those reporting urinary incontinence, and those being physically active during the previous year were variables found independently associated with increased risk of falling among older adults in Ecuador. Moreover, a gradual and linear increase in the prevalence of falls was seen as the number of risk factors increased. Falls represent a major public health problem among older adults in Ecuador. The present findings may assist public health authorities to implement programs of awareness and fall prevention among older adults at higher risk of falls.

scholarly journals A survey to assess awareness about fixed dose combinations (FDCs) among pharmacists in two Central Kashmir Districts, Srinagar and Budgam, Kashmir, India

2017 ◽  
Vol 6 (5) ◽  
pp. 1133
Author(s):  
Shakeel Ahmad Mir
Keyword(s):  
Adverse Drug Events ◽  
Technical Information ◽  
Public Health Problem ◽  
Fixed Dose ◽  
Healthcare Team ◽  
Major Public Health Problem ◽  
Increased Risk ◽  
Basic Facts ◽  
The Cost ◽  
Improve Patient

Background: FDCs are highly popular in Indian pharmaceutical market. The FDCs have both advantages as well as disadvantages. To be advantageous WHO guidelines for the manufacture and use of FDCs must be strictly followed. Irrational use of FDCs is a major public health problem and leads to increased risk of adverse drug events, higher treatment costs and antimicrobial resistance. FDCs as well as other single component drugs cannot be used rationally unless everyone involved directly or indirectly in the health care profession is involved. Pharmacist is a coordinator between different members of healthcare team and the patients. Hence, his role in safe use of medicines is important. The present study was undertaken to assess the knowledge of pharmacists about FDCs.Methods: A descriptive questionnaire survey was conducted in various government and private pharmacies of two Central Kashmir Districts, Srinagar and Budgam, aiming to assess the knowledge of pharmacists about FDCs. The questionnaires were distributed randomly among 79 pharmacists, out of which 60 returned the completed questionnaire.Results: 55.00% of the respondents knew the basic facts about FDCs. 96.66% knew that FDCs reduced the cost of therapy and 93.33% were aware that FDCs improve patient compliance. 60% answered incorrectly when asked about effect of FDCs on cumulative toxicity. Almost equal percentage (63.33%) answered incorrectly when asked about rationality and ADR profile of FDCs. 83.33% knew that it is difficult to know the offending agent in case ADRs occur after FDC use.78.33% respondents thought that all FDCs are approved by drug regulatory authorities.Conclusions: The study showed that pharmacists had not the enough knowledge about FDCs. Pharmacy students in their formative years of learning should be taught to promote rational use of FDCs as they are the future custodians of technical information on the products available on their domestic market.

scholarly journals Safety of intradermal rabies vaccine as pre-exposure prophylaxis among veterinary students

2017 ◽  
Vol 4 (2) ◽  
pp. 396
Author(s):  
Ravish H. S. ◽  
Aravind M. ◽  
Ashwath Narayana D. H. ◽  
Yannick P. ◽  
Phaneendra M. S.
Keyword(s):  
Chick Embryo ◽  
Adverse Reactions ◽  
Public Health Problem ◽  
Risk Groups ◽  
Embryo Cell ◽  
Rabies Vaccine ◽  
Major Public Health Problem ◽  
Veterinary Students ◽  
Chick Embryo Cell ◽  
Increased Risk

Background: Animal bites are a major public health problem in our country. Pre-exposure vaccination using cell culture vaccines is a safe and effective method of preventing rabies and is recommended for anyone who will be at continual, frequent or increased risk of exposure to the rabies virus, as a result of their occupation, such as veterinarians, animal handlers and laboratory workers dealing with any lyssaviruses. The present study was done to assess the safety of purified chick embryo cell rabies vaccine administered as pre-exposure regimen.Methods:The present study assessed the safety of purified chick embryo cell rabies vaccine administered as a 3 dose intradermal pre-exposure vaccination in healthy volunteered veterinary students of Government Veterinary College, Bangalore.  Results: 122 apparently healthy adults of both sex, between 18 and 30 years of age were enrolled in the study and 105 (86%) completed all three doses. A total of 342 doses of intradermal vaccine were administered, among which 38 adverse reactions were reported from 19 veterinary students. The adverse reactions were pain at the injection site 7 (2.1%), redness 13 (3.8%), itching at the site of injection 11 (3.2%), induration 6 (1.8%) and headache 1 (0.3%). All reactions subsided without any complication and none of them dropped out from the study because of any adverse drug reactions.  Conclusions:Pre-exposure vaccination is a useful tool for protecting high risk groups and purified chick embryo cell rabies vaccine has proved to be safe and well tolerated by intradermal route.

scholarly journals Old therapies, new science

2002 ◽  
Vol 23 (5) ◽  
pp. 18
Author(s):  
Thomas V Riley
Keyword(s):  
Public Health ◽  
Antibiotic Resistance ◽  
Pharmaceutical Company ◽  
Health Problem ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
New Science

With the emergence of antibiotic resistance as a major public health problem and the apparent decline in pharmaceutical company drive to produce new antimicrobials, there has been an increase in interest in revisiting remedies and agents once popular before the advent of the antibiotic era.

scholarly journals Molecular characterization of Vibrio cholerae O1 strains circulating in Assam: a north eastern state of India

2021 ◽  
Author(s):  
Ajanta Sharma ◽  
Bornali Sarmah Dutta ◽  
Debajit Rabha ◽  
Elmy Samsun Rasul ◽  
Naba Kumar Hazarika
Keyword(s):  
Antibiotic Resistance ◽  
Vibrio Cholerae ◽  
Virulence Genes ◽  
Multiple Drug Resistance ◽  
Public Health Problem ◽  
Amino Acid Sequences ◽  
Multiple Drug ◽  
Major Public Health Problem ◽  
Genotype 3 ◽  
El Tor

Background and Objectives: Information on the genetic epidemiology of cholera in Assam, a northeastern state of India is lacking despite cholera being a major public health problem. The study aimed to determine the virulence genes and genes encoding antibiotic resistance in Vibrio cholerae isolates and to determine the prevalent genotypes based on the presence or absence of the virulence genes and ctxB genotype. Materials and Methods: Twenty-five V. cholerae strains were subjected to conventional biotyping and serotyping followed by multiplex PCR to detect ctxA, ctxB, zot, ace, O1rfb, tcpA, ompU, ompW, rtxC, hly and toxR and antibiotic resistance genes. Cholera toxin B (ctxB) gene was amplified followed by sequencing. Results: All the V. cholerae O1 isolates were El Tor Ogawa and showed the presence of the core toxin region representing the genome of the filamentous bacteriophage CTXø. The complete cassette of virulence genes was seen in 48% of the isolates which was the predominant genotype. All the isolates possessed amino acid sequences identical to the El Tor ctxB subunit of genotype 3. sulII gene was detected in 68% of the isolates, dfrA1 in 88%, strB in 48% and SXT gene was detected in 36% of the isolates. Conclusion: Toxigenic V. cholerae O1 El Tor Ogawa strains of ctxB genotype 3 carrying a large pool of virulence genes are prevailing in Assam. Presence of a transmissible genetic element SXT in 36% of the strains is of major concern as it indicates the emergence of multiple drug resistance among the V. cholerae isolates.  

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