The Ethics of Fecal Microbiota Transplant as a Tool for Antimicrobial Stewardship Programs

2019 ◽  
Vol 47 (4) ◽  
pp. 541-554 ◽  
Author(s):  
Thomas S. Murray ◽  
Jennifer Herbst
Keyword(s):  
Public Health ◽  
Antimicrobial Stewardship ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Fecal Microbiota ◽  
Clinical Indication ◽  
Fecal Microbiota Transplant ◽  
Health Threat ◽  
Multidrug Resistant Organisms ◽  
Public Health Threat

Multidrug resistant organisms (MDROs) are a public health threat that have reduced the effectiveness of many available antibiotics. Antimicrobial stewardship programs (ASPs) have been tasked with reducing antibiotic use and therefore the emergence of MDROs. While fecal microbiota transplant (FMT) has been proposed as therapy to reduce patient colonization of MDROs, this will require additional evidence to support an expansion of the current clinical indication for FMT. This article discusses the evidence and ethics of the expanded utilization of FMT by ASPs for reasons other than severe recurrent or refractory Clostridioides (formerly Clostridium) difficile infection.

scholarly journals 2-Mercaptomethyl-thiazolidines use conserved aromatic-S interactions to achieve broad-range inhibition of metallo-β-lactamases

2021 ◽  
Author(s):  
Maria-Agustina Rossi ◽  
Veronica Martinez ◽  
Philip Hinchliffe ◽  
Maria-Fernanda Mojica ◽  
Valerie Castillo ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Health Threat ◽  
Public Health Threat

Infections caused by multidrug resistant (MDR) bacteria are a major public health threat. Carbapenems are among the most potent antimicrobial agents that are commercially available to treat MDR bacteria. Bacterial...

scholarly journals The Emergence of Extensively Drug-Resistant Tuberculosis (TB): TB/HIV Coinfection, Multidrug-Resistant TB and the Resulting Public Health Threat from Extensively Drug-Resistant TB, Globally and in Canada

2007 ◽  
Vol 18 (5) ◽  
pp. 289-291 ◽  
Author(s):  
Paul E Alexander ◽  
Prithwish De
Keyword(s):  
Public Health ◽  
Multidrug Resistant ◽  
Current Status ◽  
Drug Resistant ◽  
Global Public Health ◽  
Access To Treatment ◽  
Health Threat ◽  
Extensively Drug Resistant ◽  
Hiv Coinfection ◽  
Public Health Threat

Resistance to anti-tuberculosis (TB) drugs continues to present a major challenge to global public health. Resistance usually develops due to inadequate TB management, including improper use of medications, improper treatment regimens and failure to complete the treatment course. This may be due to an erratic supply or a lack of access to treatment, as well as to patient noncompliance. However, the emergence and transmission of drug-resistant TB, including the recently detected extensively drug resistant TB (XDR-TB), is driven, in part, by the synergistic relationship between TB and HIV (TB/HIV coinfection). There is evidence that persons infected with HIV are more likely to experience XDR-TB. XDR-TB is virtually untreatable with available TB medications. XDR-TB presents a grave global public health threat, particularly in high HIV prevalence settings. The present commentary discusses the current status of XDR-TB and draws attention to the urgency in addressing this problem, for both the global and Canadian public health networks. XDR-TB and the apparent XDR-TB and HIV association warrants further study.

scholarly journals Assessment of the In Vitro and In Vivo Antifungal Activity of NSC319726 against Candida auris

2021 ◽  
Author(s):  
Jizhou Li ◽  
Alix T. Coste ◽  
Daniel Bachmann ◽  
Dominique Sanglard ◽  
Frederic Lamoth
Keyword(s):  
Public Health ◽  
Antifungal Activity ◽  
Invasive Candidiasis ◽  
Multidrug Resistant ◽  
Candida Auris ◽  
Content Type ◽  
Health Threat ◽  
Public Health Threat

Candida auris is emerging as a major public health threat because of its ability to cause nosocomial outbreaks of severe invasive candidiasis. Management of C. auris infection is difficult because of its frequent multidrug-resistant profile for currently licensed antifungals.

scholarly journals Draft Genome Sequences of Four Metallo-Beta-Lactamase-Producing Multidrug-Resistant Klebsiella pneumoniae Clinical Isolates, Including Two Colistin-Resistant Strains, from Cairo, Egypt

2019 ◽  
Vol 8 (7) ◽  
Author(s):  
Heba Attia ◽  
Richard Szubin ◽  
Aymen S. Yassin ◽  
Jonathan M. Monk ◽  
Ramy K. Aziz
Keyword(s):  
Public Health ◽  
Klebsiella Pneumoniae ◽  
Draft Genome ◽  
Multidrug Resistant ◽  
Beta Lactamase ◽  
Genome Sequences ◽  
Content Type ◽  
Health Threat ◽  
Public Health Threat ◽  
Resistant Strains

The emergence and spread of metallo-beta-lactamase-producing multidrug-resistant Klebsiella pneumoniae are a serious public health threat. Here, we report the draft genome sequences of four K. pneumoniae strains isolated from Cairo, Egypt, including two panresistant colistin-resistant strains.

The Role of The Gut Microbiome in Parkinson’s Disease

2021 ◽  
Vol 34 (4) ◽  
pp. 253-262
Author(s):  
Amy Gallop ◽  
James Weagley ◽  
Saif-ur-Rahman Paracha ◽  
George Grossberg
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gut Microbiota ◽  
Symptom Relief ◽  
Antibiotic Use ◽  
Fecal Microbiota ◽  
Fermented Food ◽  
Fecal Microbiota Transplant ◽  
Disease States ◽  
Cord Blood Transplant

The gut microbiota is known to play a role in various disease states through inflammatory, immune and endocrinologic response. Parkinson’s Disease is of particular interest as gastrointestinal involvement is one of the earlier features seen in this disease. This paper examines the relationship between gut microbiota and Parkinson’s Disease, which has a growing body of literature. Inflammation caused by gut dysbiosis is thought to increase a-synuclein aggregation and worsen motor and neurologic symptoms of Parkinson’s disease. We discuss potential treatment and supplementation to modify the microbiota. Some of these treatments require further research before recommendations can be made, such as cord blood transplant, antibiotic use, immunomodulation and fecal microbiota transplant. Other interventions, such as increasing dietary fiber, polyphenol and fermented food intake, can be made with few risks and may have some benefit for symptom relief and speed of disease progression.

scholarly journals A road-map for addressing antimicrobial resistance in low- and middle-income countries: lessons learnt from the public private participation and co-designed antimicrobial stewardship programme in the State of Kerala, India

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sanjeev Singh ◽  
Esmita Charani ◽  
Sarada Devi ◽  
Anuj Sharma ◽  
Fabia Edathadathil ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Infection Prevention ◽  
The State ◽  
Action Plans ◽  
Public And Private ◽  
Middle Income ◽  
Middle Income Countries ◽  
Public Health Threat

Abstract Background The global concern over antimicrobial resistance (AMR) is gathering pace. Low- and middle-income countries (LMICs) are at the epicentre of this growing public health threat and governmental and healthcare organizations are at different stages of implementing action plans to tackle AMR. The South Indian state of Kerala was one of the first in India to implement strategies and prioritize activities to address this public health threat. Strategies Through a committed and collaborative effort from all healthcare related disciplines and its professional societies from both public and private sector, the Kerala Public Private Partnership (PPP) has been able to deliver a state-wide strategy to tackle AMR A multilevel strategic leadership model and a multilevel implementation approach that included developing state-wide antibiotic clinical guidelines, a revision of post-graduate and undergraduate medical curriculum, and a training program covering all general practitioners within the state the PPP proved to be a successful model for ensuring state-wide implementation of an AMR action plan. Collaborative work of multi-professional groups ensured co-design and development of disease based clinical treatment guidelines and state-wide infection prevention policy. Knowledge exchange though international and national platforms in the form of workshops for sharing of best practices is critical to success. Capacity building at both public and private institutions included addressing practical and local solutions to the barriers e.g. good antibiotic prescription practices from primary to tertiary care facility and infection prevention at all levels. Conclusion Through 7 years of stakeholder engagement, lobbying with government, and driving change through co-development and implementation, the PPP successfully delivered an antimicrobial stewardship plan across the state. The roadmap for the implementation of the Kerala PPP strategic AMR plan can provide learning for other states and countries aiming to implement action plans for AMR.

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