Recent Breakthroughs in Various Antimicrobial Resistance Induced Quorum Sensing Biosynthetic Pathway Mediated Targets and Design of their Inhibitors

2020 ◽  
Vol 23 (6) ◽  
pp. 458-476
Author(s):  
Mohit Kumar ◽  
Mridula Saxena ◽  
Anil K. Saxena ◽  
Sisir Nandi
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Quorum Sensing ◽  
Biosynthetic Pathway ◽  
Antimicrobial Agents ◽  
Economic Status ◽  
Action Plan ◽  
World Health ◽  
Action Plans ◽  
The World

Objective: The world is under the grasp of dangerous post-antibiotics and antimicrobials attack where common infections may become untreatable, leading to premature deaths due to antimicrobial resistance (AMR). While an estimated 7,00,000 people die annually due to AMR, which is a public health threat to all communities in different parts of the world regardless of their economic status; however, this threat is serious in low- and middle-income countries having lack of sanitation and health infrastructure. The 68th World Health Assembly endorsed the Global Action Plan on antimicrobial resistance. Consequently, many countries started drafting and committing to National Action Plans against AMR. As strong as National Action Plans are in terms of prescribing rational use of antimicrobials, infection control practices, and related public health measures, without strong healthcare systems, these measures will have a limited impact on AMR in developing countries. Methods: The major reason for AMR is microbial quorum sensing (QS) that may strengthen the microbial community to generate inter-communication and virulence effects via quorum sensing mechanisms. Global stewardship to combat antimicrobial resistance aims to develop anti-quorum sensing compounds that can inhibit the biosynthetic pathway mediated different quorum sensing targets. Results: It may pave an effective attempt to minimize microbial quorum sensing mediated antimicrobial resistance. The present review describes QS mediated various potential target enzymes, their connection to AMR, and finds out the corresponding QS biosynthetic target inhibitors. Conclusion: These potential inhibitors can be derivatized to design and develop next-generation antimicrobial agents.

scholarly journals The global governance of antimicrobial resistance: a cross-country study of alignment between the global action plan and national action plans

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Louise Munkholm ◽  
Olivier Rubin
Keyword(s):  
Antimicrobial Resistance ◽  
Global Governance ◽  
Action Plan ◽  
World Health ◽  
Action Plans ◽  
Vertical Alignment ◽  
Member States ◽  
Horizontal Alignment ◽  
Global Action ◽  
Global Action Plan

Abstract Background Antimicrobial resistance (AMR) is a growing problem worldwide in need of global coordinated action. With the endorsement of the Global Action Plan (GAP) on AMR in 2015, the 194 member states of the World Health Organization committed to integrating the five objectives and corresponding actions of the GAP into national action plans (NAPs) on AMR. The article analyzes patterns of alignment between existing NAPs and the GAP, bringing to the fore new methodologies for exploring the relationship between globally driven health policies and activities at the national level, taking income, geography and governance factors into account. Methods The article investigates the global governance of AMR. Concretely, two proxies are devised to measure vertical and horizontal alignment between the GAP and existing NAPs: (i) a syntactic indicator measuring the degree of verbatim overlap between the GAP and the NAPs; and (ii) a content indicator measuring the extent to which the objectives and corresponding actions outlined in the GAP are addressed in the NAPs. Vertical alignment is measured by the extent to which each NAP overlaps with the GAP. Horizontal alignment is explored by measuring the degree to which NAPs overlap with other NAPs across regions and income groups. In addition, NAP implementation is explored using the Global Database for Antimicrobial Resistance Country Self-Assessment. Findings We find strong evidence of vertical alignment, particularly among low-income countries and lower-middle-income countries but weaker evidence of horizontal alignment within regions. In general, we find the NAPs in our sample to be mostly aligned with the GAP’s five overarching objectives while only moderately aligned with the recommended corresponding actions. Furthermore, we see several cases of what can be termed ‘isomorphic mimicry’, characterized by strong alignment in the policies outlined but much lower levels of alignment in terms of actual implemented policies. Conclusion To strengthen the alignment of national AMR policies, we recommend global governance initiatives based on individualized responsibilities some of which should be legally binding. Our study provides limited evidence of horizontal alignment within regions, which implies that regional governance institutions (e.g., WHO regional offices) should primarily act as mediators between global and local demands to strengthen a global governance regime that minimizes policy fragmentation and mimicry behavior across member states.

Resistance to change: how much longer will our antibiotics work?

2018 ◽  
Vol 9 (3) ◽  
pp. 103-111 ◽  
Author(s):  
Amy Patrick ◽  
Thayalan Kandiah
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
World Health Organization ◽  
Resistance To Change ◽  
World Health ◽  
Major Surgery ◽  
Major Threat ◽  
The World ◽  
Health Organization ◽  
Common Infections

Antimicrobial resistance (AMR) is the ability of bacteria to change, rendering antimicrobials (such as antibiotics, antivirals and antimalarials) ineffective in treating common infections, or as prophylaxis after major surgery or cancer treatment. The World Health Organization (WHO) predicts that these ‘superbugs’ will become a major threat to public health. 1

scholarly journals 25.H. Workshop: Challenges in tackling antimicrobial resistance: economic and policy responses

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Antimicrobial Resistance ◽  
Environmental Health ◽  
One Health ◽  
Action Plan ◽  
National Level ◽  
World Health ◽  
Successful Implementation ◽  
Action Plans ◽  
Policy Responses ◽  
Human Animal

Abstract Antimicrobial resistance (AMR) is driven by inter-related dynamics in the human, animal, and environmental health sectors and one of the most significant and complex current public health issues of our time. Without effective antimicrobials even common infections may become life-threatening and many treatments such as surgical procedures and chemotherapy will not be possible. There is widespread consensus that the response to AMR requires multiple actions, including improving awareness and understanding of AMR, strengthening the knowledge and evidence based through surveillance and research, reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures, optimising the use of antimicrobials in human and animal health and stimulating research and development (R&D) in novel antimicrobials and alternatives. International and national efforts to combat AMR have grown steadily over the last two decades. Two major landmark developments include the launch of the World Health Organisation (WHO) Global Action Plan on AMR in 2015, which asks all countries to develop national action plans by 2017, and the United Nations (UN) General Assembly agreeing a political declaration on AMR in 2016 where countries committed to work at national, regional, and global levels to develop and implement multisectoral national action plans in accordance with the 'One Health' approach. The European Commission also published a One Health action plan against antimicrobial resistance in 2017. However, despite progress at international level, there remains inconsistent progress and implementation of recommended policies to tackle AMR at national level. The UN Interagency Coordination Group on Antimicrobial Resistance (IACG) recently concluded that currently the greatest challenge in AMR is not designing a national action plan but implementing it. The contrasting cultures, behaviours and incentives of each sector and relevant stakeholders is what makes the successful implementation of AMR national action plans so challenging. The purpose of this workshop will be to discuss the evidence and thinking on the different facets of the complex problem of tackling AMR for academics and policy-makers. These discussions will be informed by a forthcoming book jointly published by the European Observatory on Health Systems and Policies and the Organisation for Economic Co-operation and Development titled 'Challenges in Tackling Antimicrobial Resistance: Economic and Policy Responses'. The workshop will focus on five key questions; How can implementation of AMR national action plans be strengthened? What is the evidence on the rise of AMR and its health and economic impact? How can AMR be most effectively addressed in community healthcare settings? How can the discovery of new antibiotics be reinvigorated to replace those rendered ineffective by resistance? Can more use be made of vaccines to tackle AMR? Key messages Antimicrobial resistance is a complex issue which requires actions across the human, animal, environmental health sectors taking a 'One Health' approach. Improving the quality of governance within antimicrobial resistance national action plans is an essential step to strengthening implementation.

Preventing blindness and visual impairment in Europe: What do we have to do?

2018 ◽  
Vol 29 (2) ◽  
pp. 129-132 ◽  
Author(s):  
János Németh ◽  
Gábor Tóth ◽  
Serge Resnikoff ◽  
Jan Tjeerd de Faber
Keyword(s):  
Public Health ◽  
Visual Impairment ◽  
Action Plan ◽  
World Health ◽  
Eye Health ◽  
Common Task ◽  
The World ◽  
Global Action ◽  
Significant Public Health ◽  
Global Action Plan

Severe visual impairment and blindness are significant public health problems worldwide. Four-fifths of cases of blindness can be prevented or cured. The World Health organisation’s ‘Universal Eye Health: A Global Action Plan 2014–2019’ and the European Society of Ophthalmology’s Pilot Committee on Public Eye Health are aiming to decrease the prevalence of blindness in Europe and around the world. Starting discussions addressing possible actions and advocacies to improve current circumstances in public eye health is a common task of ophthalmologists and public health specialists in Europe.

Some Global Policies for Antibiotic Resistance Depend on Legally Binding and Enforceable Commitments

2015 ◽  
Vol 43 (S3) ◽  
pp. 68-73 ◽  
Author(s):  
Asha Behdinan ◽  
Steven J. Hoffman ◽  
Mark Pearcey
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Infectious Diseases ◽  
Action Plan ◽  
World Health ◽  
The World ◽  
Global Action ◽  
Dimension 2 ◽  
Health Organization ◽  
Global Action Plan

This article assesses which policies for addressing antibiotic resistance (ABR) as part of a multi-pronged approach would benefit from legalization through an international legal agreement. Ten candidate policies were identified based on a review of existing literature, especially The Lancet Series on Antimicrobial Resistance (AMR), The Lancet Infectious Diseases Commission on AMR, and the World Health Organization (WHO) Global Action Plan for AMR. These policies were then grouped under the headings of access, conservation, and innovation.Each of the ten policies were assessed using four criteria developed by Hoffman, Røttingen, and Frenk to help consider why their legalization may be helpful, necessary and/or justified. These criteria are: (1) the problem has a significant transnational dimension; (2) the goal justifies the coercive nature of law; (3) the outcome is likely to be beneficial; and (4) legalization represents the best commitment mechanism among competing alternatives.

scholarly journals Prevalence of methicillin-resistant Staphylococcus aureus and pattern of antimicrobial resistance in mastitis milk of cattle in Chitwan, Nepal

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Asmita Shrestha ◽  
Rebanta Kumar Bhattarai ◽  
Himal Luitel ◽  
Surendra Karki ◽  
Hom Bahadur Basnet
Keyword(s):  
Public Health ◽  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Subclinical Mastitis ◽  
World Health ◽  
Dairy Herds ◽  
Microbiological Analysis ◽  
Biochemical Tests ◽  
Methicillin Resistant ◽  
Milk Samples

Abstract Background The threat of methicillin-resistant Staphylococcus aureus (MRSA) exists globally and has been listed as a priority pathogen by the World Health Organization. One of the sources of MRSA emergence is livestock and its products, often raised in poor husbandry conditions. There are limited studies in Nepal to understand the prevalence of MRSA in dairy animals and its antimicrobial resistance (AMR) profile. A cross-sectional study was conducted in Chitwan, one of the major milk-producing districts of Nepal, from February 2018 to September 2019 to estimate the prevalence of MRSA in milk samples and its AMR profile. The collected milk samples (n = 460) were screened using the California Mastitis Test (CMT) and positive samples were subjected to microbiological analysis to isolate and identify S. aureus. Polymerase Chain Reaction (PCR) was used to identify the presence of the mecA gene and screen for MRSA. Results In total, 41.5% (191/460) of milk samples were positive in the CMT test. Out of 191 CMT positive milk samples, the biochemical tests showed that the prevalence of S. aureus was 15.2% (29/191). Among the 29 S. aureus isolates, 6.9% (2/29) were identified as MRSA based on the detection of a mecA gene. This indicates that that 1.05% (2/191) of mastitis milk samples had MRSA. The antibiotic sensitivity test showed that 75.9% (22/29) and 48.3% (14/29) S. aureus isolates were found to be sensitive to Cefazolin and Tetracycline respectively (48.3%), whereas 100% of the isolates were resistant to Ampicillin. In total 96.6% (28/29) of S. aureus isolates were multidrug-resistant (MDR). Conclusions This study revealed a high prevalence of S. aureus-mediated subclinical mastitis in dairy herds in Chitwan, Nepal, with a small proportion of it being MRSA carrying a mecA gene. This S. aureus, CoNS, and MRSA contaminated milk poses a public health risk due to the presence of a phenotype that is resistant to very commonly used antibiotics. It is suggested that dairy herds be screened for subclinical mastitis and treatments for the animals be based on antibiotic susceptibility tests to reduce the prevalence of AMR. Furthermore, future studies should focus on the Staphylococcus spp. to explore the antibiotic resistance genes in addition to the mecA gene to ensure public health.

scholarly journals Evaluation of the first pharmacy-led weight management programme in Greece

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i45-i46
Author(s):  
A Peletidi ◽  
R Kayyali
Keyword(s):  
Public Health ◽  
Health Services ◽  
Potential Role ◽  
Annual Report ◽  
World Health ◽  
Public Health Services ◽  
Cvd Risk ◽  
The World ◽  
Health Organization

Abstract Introduction Obesity is one of the main cardiovascular disease (CVD) risk factors.(1) In primary care, pharmacists are in a unique position to offer weight management (WM) interventions. Greece is the European country with the highest number of pharmacies (84.06 pharmacies per 100,000 citizens).(2) The UK was chosen as a reference country, because of the structured public health services offered, the local knowledge and because it was considered to be the closest country to Greece geographically, unlike Australia and Canada, where there is also evidence confirming the potential role of pharmacists in WM. Aim To design and evaluate a 10-week WM programme offered by trained pharmacists in Patras. Methods This WM programme was a step ahead of other interventions worldwide as apart from the usual measuring parameters (weight, body mass index, waist circumference, blood pressure (BP)) it also offered an AUDIT-C and Mediterranean diet score tests. Results In total,117 individuals participated. Of those, 97.4% (n=114), achieved the programme’s aim, losing at least 5% of their initial weight. The mean % of total weight loss (10th week) was 8.97% (SD2.65), and the t-test showed statistically significant results (P<0.001; 95% CI [8.48, 9.45]). The programme also helped participants to reduce their waist-to-height ratio, an early indicator of the CVD risk in both male (P=0.004) and female (P<0.001) participants. Additionally, it improved participants’ BP, AUDIT-C score and physical activity levels significantly (P<0.001). Conclusion The research is the first systematic effort in Greece to initiate and explore the potential role of pharmacists in public health. The successful results of this WM programme constitute a first step towards the structured incorporation of pharmacists in public’s health promotion. It proposed a model for effectively delivering public health services in Greece. This study adds to the evidence in relation to pharmacists’ CVD role in public health with outcomes that superseded other pharmacy-led WM programmes. It also provides the first evidence that Greek pharmacists have the potential to play an important role within primary healthcare and that after training they are able to provide public health services for both the public’s benefit and their clinical role enhancement. This primary evidence should support the Panhellenic Pharmaceutical Association, to “fight” for their rights for an active role in primary care. In terms of limitations, it must be noted that the participants’ collected data were recorded by pharmacists, and the analysis therefore depended on the accuracy of the recorded data, in particular on the measurements or calculations obtained. Although the sample size was achieved, it can be argued that it is small for the generalisation of findings across Greece. Therefore, the WM programme should be offered in other Greek cities to identify if similar results can be replicated, so as to consolidate the contribution of pharmacists in promoting public health. Additionally, the study was limited as it did not include a control group. Despite the limitations, our findings provide a model for a pharmacy-led public health programme revolving around WM that can be used as a model for services in the future. References 1. Mendis S, Puska P, Norrving B, World Health Organization., World Heart Federation., World Stroke Organization. Global atlas on cardiovascular disease prevention and control [Internet]. Geneva: World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization; 2011 [cited 2018 Jun 26]. 155 p. Available from: http://www.who.int/cardiovascular_diseases/publications/atlas_cvd/en/ 2. Pharmaceutical Group of the European Union. Pharmacy with you throughout life:PGEU Annual Report [Internet]. 2015. Available from: https://www.pgeu.eu/en/library/530:annual-report-2015.html

scholarly journals 31.C. Workshop: Development and implementation of action plans on health literacy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Literacy ◽  
Health Information ◽  
Digital Health ◽  
Action Plan ◽  
Knowledge Society ◽  
Implementation Strategies ◽  
Social Consequences ◽  
Action Plans

Abstract Health literacy (HL) has become an important topic in many countries. As HL - meaning the ability to access, understand, appraise and apply health information (Sørensen et al. 2012) - is important to make sound health decisions, to promote health and to take an active part in managing health and illness in everyday life and navigating the health care system. In the modern digital knowledge society, HL is also indispensable for orienting oneself in the abundance of mostly digital health information, including incorrect and false information, for locating reliable information and for assessing the trustworthiness and quality of information. However, available studies show that HL is insufficient in many countries. Low HL has - as many studies show - negative social consequences ranging from unhealthy behaviour, higher risk for diseases, less self-care and deficits in coping with illness and chronicity, to over- and misuse (extensive use) of health care. The promotion of HL is therefore an important public health task. An increasing number of population studies and policy documents currently underline this. The WHO has therefore included HL into many of its strategies, like the declarations of Shanghai (2016) and Astana (2018), and has published several publications focusing on HL, like the Solid Facts (2013), the 57th Health Evidence Network Report (2018) or the Roadmap for Implementing Health Literacy Activities (2019). In many countries, strategies and national action plans to improve HL have been developed in response to the political call for action, e.g. in Scotland, Germany and recently also in Portugal. Other countries and regions are currently working on the development of a HL action plan, e.g. Belgium and the WHO European Region action plan on HL. The development and especially the implementation strategies of action plans in different countries and the experiences gained will be discussed comparatively in the workshop. Following an introduction (10'), two countries, which already have action plans will introduce their implementation strategy in one presentation each: Germany and Portugal (30'). This will be followed by two presentations of countries/regions in which action plans are currently being developed: Belgium and WHO Europe (30'). Afterwards the participants will have the opportunity to ask questions and discuss on the different strategies (20'). The workshop will help other initiatives to successfully develop and implement policy plans and strategies in different fields of public health. Key messages Strategies and national action plans to improve HL have been developed in different countries/regions. It is important to reflect on the chosen development and implementation strategies and to discuss their effects, successes and barriers.

A Framework Convention on Alcohol Control: Getting Concrete about Its Contents

2020 ◽  
pp. 1-11
Author(s):  
Robin ROOM ◽  
Jenny CISNEROS ÖRNBERG
Keyword(s):  
Public Health ◽  
World Health ◽  
Alcohol Industry ◽  
Alcohol Control ◽  
The World ◽  
Draft Convention ◽  
History Of ◽  
Supplementary Material ◽  
Health Organization ◽  
Narcotic Drugs

This article proposes and discusses the text of a Framework Convention on Alcohol Control, which would serve public health and welfare interests. The history of alcohol’s omission from current drug treaties is briefly discussed. The paper spells out what should be covered in the treaty, using text adapted primarily from the Framework Convention on Tobacco Control, but for the control of trade from the 1961 narcotic drugs treaty. While the draft provides for the treaty to be negotiated under the auspices of the World Health Organization, other auspices are possible. Excluding alcohol industry interests from the negotiation of the treaty is noted as an important precondition. The articles in the draft treaty and their purposes are briefly described, and the divergences from the tobacco treaty are described and justified. The text of the draft treaty is provided as Supplementary Material. Specification of concrete provisions in a draft convention points the way towards more effective global actions and agreements on alcohol control, whatever form they take.

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