scholarly journals Hospital use of antibiotics as the main driver of infections with antibiotic-resistant bacteria – a reanalysis of recent data from the European Union

2019 ◽  
Author(s):  
Matthias M. Fischer ◽  
Matthias Bild
Keyword(s):  
European Union ◽  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Antibiotic Use ◽  
Resistant Bacteria ◽  
Individual Member ◽  
The European Union ◽  
Hospital Sector ◽  
Main Driver ◽  
Resistance Rates

AbstractAntimicrobial resistance in bacteria causes significant morbidity worldwide. The development and acquisition of resistance to antibiotics is believed to primarily develop under the selective pressure of widespread antibiotic use in humans, however antimicrobial usage in livestock has been proposed as additional, if not principal, driver of antibiotic resistance. In this work, we correlate recent data from the European Union on antibiotic resistance rates with data on antibiotic usage in the primary care and hospital sector and data on veterinary antimicrobial consumption across the individual member states. We quantify the strength of these different potential drivers of antimicrobial resistance in order to compare their biological importance. We found that the correlation between antibiotic use in the hospital sector and antibiotic resistance rates is significantly higher than the correlation between resistance rates and any of the other two predictors. This suggests increased antibiotic use in hospitals as the main driver of the development of antibiotic resistances and necessitates further research on and a re-evaluation of the risks associated with antibiotic use in human and veterinary medicine.

scholarly journals The Role of Aquatic Ecosystems (River Tua, Portugal) as Reservoirs of Multidrug-Resistant Aeromonas spp.

Water ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 698
Author(s):  
Sónia Gomes ◽  
Conceição Fernandes ◽  
Sandra Monteiro ◽  
Edna Cabecinha ◽  
Amílcar Teixeira ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Nalidixic Acid ◽  
Water Samples ◽  
Aquatic Ecosystems ◽  
Anthropogenic Activities ◽  
Aquatic Organisms ◽  
Resistant Bacteria ◽  
Anthropogenic Pressures ◽  
Resistance Rates

The inappropriate use of antibiotics, one of the causes of the high incidence of antimicrobial-resistant bacteria isolated from aquatic ecosystems, represents a risk for aquatic organisms and the welfare of humans. This study aimed to determine the antimicrobial resistance rates among riverine Aeromonas spp., taken as representative of the autochthonous microbiota, to evaluate the level of antibacterial resistance in the Tua River (Douro basin). The prevalence and degree of antibiotic resistance was examined using motile aeromonads as a potential indicator of antimicrobial susceptibility for the aquatic environment. Water samples were collected from the middle sector of the river, which is most impacted area by several anthropogenic pressures. Water samples were plated on an Aeromonas-selective agar, with and without antibiotics. The activity of 19 antibiotics was studied against 30 isolates of Aeromonas spp. using the standard agar dilution susceptibility test. Antibiotic resistance rates were fosfomycin (FOS) 83.33%, nalidixic acid (NA) 60%, cefotaxime (CTX) 40%, gentamicin (CN) 26.67%, tobramycin (TOB) 26.67%, cotrimoxazole (SXT) 26.67%, chloramphenicol (C) 16.67%, and tetracycline (TE) 13.33%. Some of the nalidixic acid-resistant strains were susceptible to fluoroquinolones. Multiple resistance was also observed (83.33%). The environmental ubiquity, the natural susceptibility to antimicrobials and the zoonotic potential of Aeromonas spp. make them optimal candidates for studying antimicrobial resistance (AMR) in aquatic ecosystems. Aquatic environments may provide an ideal setting for the acquisition and dissemination of antibiotic resistance because anthropogenic activities frequently impact them. The potential risk of multi- and pan-resistant bacteria transmission between animals and humans should be considered in a “One Health—One World” concept.

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 The Use of Liquids Ionic Fluids as Pharmaceutically Active Substances Helpful in Combating Nosocomial Infections Induced by Klebsiella Pneumoniae New Delhi Strain, Acinetobacter Baumannii and Enterococcus Species

2018 ◽  
Vol 19 (9) ◽  
pp. 2779 ◽  
Author(s):  
Andrzej Miskiewicz ◽  
Piotr Ceranowicz ◽  
Mateusz Szymczak ◽  
Krzysztof Bartuś ◽  
Paweł Kowalczyk
Keyword(s):  
European Union ◽  
Antibiotic Resistance ◽  
Ionic Liquids ◽  
Klebsiella Pneumoniae ◽  
Acinetobacter Baumannii ◽  
Nosocomial Infections ◽  
Resistant Bacteria ◽  
New Delhi ◽  
The European Union ◽  
Enterococcus Species

This review deals with various microbiological activities of ionic liquids, which constitute the first anti-infective defense against multi-drug-resistant bacteria—with a particular emphasis placed on medicine and pharmacology. The quoted data on the biological activity of ionic liquids including their antimicrobial properties (depending on the type of a cation or an anion) and are discussed in view of possible applications in nosocomial infections. Dedicated attention is given to finding infections with the Klebsiella pneumoniae New Delhi strain, Acinetobacter baumannii, and Enterococcus species, which are responsible for the induction of antibiotic resistance in intensive care units. Diagnosis and treatment using current antibiotics is a significant problem in hospital care, and the relevant burden on the health systems of the European Union member states induces the search for new, effective methods of treatment. Ionic liquids, due to their antibacterial effect, can be considered topical and general medications and may provide the basis for treatment to eliminate the antibiotic resistance phenomenon in the future. At present, the number of infections with resistant pathogens in hospitals and outpatient clinics in the European Union is growing. In 2015–2017, a significant incidence of respiratory and bloodstream infections with bacteria resistant to antibiotics from the 3rd generation group of cephalosporins, glycopeptides, and carbapenems were observed. The paper presents examples of synthesized bifunctional salts with at least one pharmaceutically active ion in obtaining a controlled release, controlled delivery, and biological impact on the pathogenic bacteria, viruses and fungi. The ionic liquids obtained in the presented way may find applications in the treatment of wounds and infections.

Econometric ARIMA methodology to elucidate the evolution of trends in nosocomial antimicrobial resistance rates in the European Union

2020 ◽  
Vol 55 (1) ◽  
pp. 105800 ◽  
Author(s):  
Rafael Ortega-Huedo ◽  
Marina Cuesta ◽  
Andreas Hoefer ◽  
Bruno Gonzalez-Zorn
Keyword(s):  
European Union ◽  
Antimicrobial Resistance ◽  
The European Union ◽  
Resistance Rates

scholarly journals The Knowledge on antibiotics and antimicrobial resistance among Polish medical students

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
T Sobierajski ◽  
M Wanke-Rytt ◽  
B Mazińska ◽  
K Karpierz ◽  
W Hryniewicz
Keyword(s):  
Antibiotic Resistance ◽  
Medical Students ◽  
Antimicrobial Resistance ◽  
Viral Infections ◽  
Treatment Options ◽  
Antibiotic Use ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Medical University ◽  
Future Education

Abstract Background Antimicrobial resistance (AMR) is one of the biggest threats to public health worldwide, compromising ability to treat infections. Medical students as a future doctors will have an important role to play in preventing the spread of antibiotic resistance. The aim of this study was to analyse the knowledge and attitudes of Polish medical students towards antibiotics and AMR. Methods A questionnaire containing 24 questions, on medical students’ knowledge, attitudes and perceptions of antibiotic prescribing and antibiotic resistance was developed. The survey was conducted in May-June 2018 among medical students of Medical University of Warsaw at various years of their studies. Results The study group consisted of 291 students (70% women, 30% men). Forty six of the students had used antibiotics within the previous 12 months. The prevailing reasons for taking an antibiotic were: pharyngitis (25%), bronchitis (12,8%), sore throat (12%), cough (8.3%), pneumonia (7.9%), urinary tract infection (7.6%), cold (6.6%). Ninety-two percent of the respondents considered AMR to be a significant problem, and 7.9% stated it will become in the future. Four percent of respondents believed that antibiotics are effective in treating common cold. The majority of students (83.5%) expressed the opinion that doctors often prescribe an antibiotic without need. Most respondents think that too frequent prescription and low awareness of the consequences of their overuse have an impact on the rise and spread of antibiotic resistant bacteria. The vast majority of respondents (80%) declared that university studies enabled the gaining of a wider knowledge about the use of antibiotics. The vast majority of respondents (92.4%) indicated a willingness to extend their knowledge on antibiotic use. Conclusions Medical students are aware that AMR is a growing problem resulting in diminishing treatment options. The results of the study should be taken into future education programs. Key messages Medical students have a good understanding of the health risk of AMR but consider antibiotics for viral infections. More training on rationale antibiotic use included in the curriculum is warranted.

scholarly journals Outpatient consumption of antibiotics is linked to antibiotic resistance in Europe: results from the European Surveillance of Antimicrobial Consumption

2005 ◽  
Vol 10 (8) ◽  
Author(s):  
A Johnson
Keyword(s):  
European Union ◽  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Selective Pressure ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
European Countries ◽  
Antimicrobial Consumption ◽  
Antibiotic Resistant ◽  
Resistant Strains

There is increasing recognition that antibiotic consumption provides a major selective pressure for the emergence and persistence of antibiotic-resistant strains of bacteria. In 2001, a European Union Council Recommendation stated that data should be gathered on antibiotic use and antimicrobial resistance in European countries

«One Health» approach: transfer of antimicrobial resistance from animals to humans

2018 ◽  
Vol 2 (1) ◽  
pp. 64-83
Author(s):  
A.G. Salmanov ◽  
I.Ya. Kotsyumbas ◽  
V.V. Stybel ◽  
V.P. Muzyka ◽  
O.M. Brezvyn ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Resistance Genes ◽  
Genetic Interaction ◽  
Growth Promotion ◽  
Scientific Evidence ◽  
Ecological Impact ◽  
Antibiotic Use ◽  
Resistant Bacteria ◽  
Food Animals

Antimicrobials are valuable therapeutics whose efficacy is seriously compromised by the emergence and spread of antimicrobial resistance. The current science provides overwhelming evidence that antibiotic use is a powerful selector of resistance that can appear not only at the point of origin but also nearly everywhere else. The latter phenomenon occurs because of the enormous ramifications of horizontal gene transfer. A mounting body of evidence shows that antimicrobial use in animals, including the nontherapeutic use of antimicrobials, leads to the propagation and shedding of substantial amounts of antimicrobial-resistant bacteria — both as pathogens, which can directly and indirectly infect humans, and as commensals, which may carry transferable resistance determinants across species borders and reach humans through multiple routes of transfer. These pathways include not only food but also water and sludge and manure applications to food crop soils. Continued nontherapeutic use of antimicrobials in food animals will increase the pool of resistance genes, as well as their density, as bacteria migrate into the environment at large. The lack of species barriers for gene transmission argues that the focus of research efforts should be directed toward the genetic infrastructure and that it is now imperative to take an ecological approach toward addressing the impacts of NTA use on human disease. The study of animal-to-human transmission of antibiotic resistance therefore requires a greater understanding of the genetic interaction and spread that occur in the larger arena of commensal and environmental bacteria. The provision of antibiotics to food animals encompasses a wide variety of nontherapeutic purposes that include growth promotion. The concern over resistance emergence and spread to people by nontherapeutic use of antimicrobials has led to conflicted practices and opinions. Considerable evidence supported the removal of nontherapeutic antimicrobials in Europe and North America, based on the «precautionary principle». Still, concrete scientific evidence of the favorable versus unfavorable consequences of nontherapeutic antimicrobials is not clear to all stakeholders. Substantial data show elevated antibiotic resistance in bacteria associated with animals fed nontherapeutic antimicrobials and their food products. This resistance spreads to other animals and humans-directly by contact and indirectly via the food chain, water, air, and manured and sludge-fertilized soils. Modern genetic techniques are making advances in deciphering the ecological impact of nontherapeutic antimicrobials, but modeling efforts are thwarted by deficits in key knowledge of microbial and antibiotic loads at each stage of the transmission chain. Still, the substantial and expanding volume of evidence reporting animal-to-human spread of resistant bacteria, including that arising from use of nontherapeutic antimicrobials, supports eliminating antibiotics use in order to reduce the growing environmental load of resistance genes.

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

mSystems ◽  
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.

scholarly journals International surveillance of antimicrobial resistance in Europe: now we also need to monitor antibiotic use

2001 ◽  
Vol 6 (1) ◽  
pp. 1-2 ◽  
Author(s):  
S L A M Bronzwaer ◽  
U Buchholz ◽  
J. L. Kool
Keyword(s):  
Staphylococcus Aureus ◽  
European Union ◽  
Antimicrobial Resistance ◽  
Hospital Stay ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Antibiotic Use ◽  
European Countries ◽  
The European Union ◽  
Prolonged Hospital Stay ◽  
Prolonged Hospital

With travel and trade within the European Union (EU) increasing over the years, the risk of dissemination of (resistant) pathogens grows. Many studies have shown that there is a growing problem with antimicrobial resistance. For example, methicillin resistant Staphylococcus aureus (MRSA) was initially largely a problem of hospitals, but it is now increasingly reported as a community acquired infection. Certain strains have been shown to spread between European countries. Antimicrobial resistance may result in prolonged hospital stay, higher costs, and higher morbidity or even mortality.

scholarly journals European Union One Health Country Visits as Driver to Combat on Antimicrobial Resistance

2020 ◽  
Vol 41 (S1) ◽  
pp. s222-s222
Author(s):  
Pita Spruijt ◽  
Paul Bergervoet ◽  
Robbin Westerhof ◽  
Merel Langelaar ◽  
Marie-Cécile Ploy
Keyword(s):  
European Union ◽  
Antimicrobial Resistance ◽  
Peer Review ◽  
Infection Prevention ◽  
One Health ◽  
Competent Authority ◽  
Political Agenda ◽  
The European Union ◽  
Review System ◽  
Set Up

Background: In 2016, the European Union adopted unanimously Council Conclusions on the next steps to combat antimicrobial resistance under a One Health approach. To implement some of the provisions laid down in the Council Conclusions, a European Joint Action on Antimicrobial Resistance (AMR) and Healthcare-Associated Infections (HCAI) or EU-JAMRAI was set up, gathering 44 partners. Methods: As part of EU-JAMRAI, 13 participating European countries set up a country-to-country peer review system to evaluate each other’s national action plans (NAPs). This review system entailed a self-assessment, strengths–weaknesses–opportunities–threats (SWOT) analysis, and country visits. All steps were executed with representatives from both the human and the veterinary domains (One Health approach). Special attention was given to supervision and the way supervision can enhance the implementation of guidelines on AMR, both at the policy level and within healthcare institutions. Results: Despite differences in the stage of developing and implementing NAPs, all 13 countries are working on NAPs. In this process, country visits function as a moment to exchange best practices and to provide an outsider’s point of view. At the end of 2019, 13 country-to-country visits had taken place, resulting in tailor-made recommendations for each country. These recommendations were shared with the competent authority. An example is a country that used the recommendation to improve infection prevention as an immediate reason to get the topic on the agenda of the Ministry of Health. During the country visits, intersectoral participation was perceived as desirable, but in some cases it was challenging to arrange. For some highly relevant topics, it has been recognized that discussion should take place on a European level. Examples of such topics include supervision, infection prevention guidelines, funding, surveillance, and regular audits of antibiotic prescriptions for physicians including feedback loops. Conclusions: Peer review is a cooperative and friendly working method compared to common audits. The country visits function as an agenda setting tool to get or to keep AMR on the political agenda and presenting the most relevant topic(s) to address for each country.Funding: NoneDisclosures: None

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