ANTIMICROBIAL RESISTANCE AND FORMATION OF BIOFILM IN CLINICS ISOLATES CAUSERS OF INFECTIONS RELATED TO HEALTH CARE

Abstract Background Antimicrobial resistance is an emerging problem worldwide and poses a significant threat to human health. Antimicrobial stewardship programmes are being implemented in health systems globally, primarily in hospitals, to address the growing threat of antimicrobial resistance. Despite the significance of primary health care services in providing health care to communities, antimicrobial stewardship programmes are not well established in this sector, especially in rural and remote settings. This narrative review aims to identify in rural and remote primary health care settings the (1) correlation of antimicrobial resistance with antibiotic prescribing and volume of antibiotic use, (2) appropriateness of antimicrobial prescribing, (3) risk factors associated with inappropriate use/prescribing of antibiotics, and (4) effective antimicrobial stewardship strategies. Methods The international literature was searched for English only articles between 2000 and 2020 using specified keywords. Seven electronic databases were searched: Scopus, Cochrane, Embase, CINAHL, PubMed, Ovid Medline and Ovid Emcare. Publication screening and analysis were conducted using Joanna Briggs Institute systematic review tools. Results Fifty-one eligible articles were identified. Inappropriate and excessive antimicrobial prescribing and use directly led to increases in antimicrobial resistance. Increasing rurality of practice is associated with disproportionally higher rates of inappropriate prescribing compared to those in metropolitan areas. Physician knowledge, attitude and behaviour play important roles in mediating antimicrobial prescribing, with strong intrinsic and extrinsic influences including patient factors. Antimicrobial stewardship strategies in rural and remote primary health care settings focus on health care provider and patient education, clinician support systems, utility of antimicrobial resistance surveillance, and policy changes. Results of these interventions were generally positive with decreased antimicrobial resistance rates and improved appropriateness of antimicrobial prescribing. Conclusions Inappropriate prescribing and excessive use of antimicrobials are an important contributor to the increasing resistance towards antimicrobial agents particularly in rural and remote primary health care. Antimicrobial stewardship programmes in the form of education, clinical support, surveillance, and policies have been mostly successful in reducing prescribing rates and inappropriate prescriptions. The narrative review highlighted the need for longer interventions to assess changes in antimicrobial resistance rates. The review also identified a lack of differentiation between rural and remote contexts and Indigenous health was inadequately addressed. Future research should have a greater focus on effective interventional components and patient perspectives.

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Evolution of antimicrobial resistance of Salmonella enteritidis (1972–2005)

Onderstepoort Journal of Veterinary Research ◽

10.4102/ojvr.v81i1.807 ◽

2014 ◽

Vol 81 (1) ◽

Cited By ~ 5

Author(s):

Jermaine Khumalo ◽

Bamusi Saidi ◽

Joshua Mbanga

Keyword(s):

Public Health ◽

Health Care ◽

Antimicrobial Resistance ◽

Salmonella Enteritidis ◽

Genetic Changes ◽

Plasmid Profiles ◽

Resistance Patterns ◽

The Common ◽

Veterinary Laboratory ◽

Epidemiological Information

With the extensive use of antibiotics in livestock production, surveillance revealed an increase in Salmonella resistance to the commonly used antimicrobials in veterinary and public health. This serious threat to health care is further exacerbated by the limited epidemiological information about the common zoonotic agent, Salmonella enteritidis, required to determine antibiotic therapy. The aim was to characterise the antimicrobial resistance patterns of S. enteritidis isolates across different timelines (1972–2005) with accompanying genetic changes being investigated. Thirty-seven stored S. enteritidis isolates were collected from the Central Veterinary Laboratory, Harare, with antimicrobial susceptibility determined against eight antibiotics. Plasmids were isolated to analyse any genetic variation. An overall significant increase in resistance (p < 0.05) to nalidixic acid (0% – 10%), ampicillin (14.3% – 50%), tetracycline (14.3% – 30%) and erythromycin (71.4% – 100%) was observed across the timeline. However, the highest rates of susceptibility were maintained for gentamicin, sulphamethoxazole-trimethoprim, kanamycin and chloramphenicol. We report an increase in multidrug resistance (MDR) of 14.2% – 50% with an increase in resistotypes and plasmid profiles across the timeline. Eleven plasmid profiles were obtained in the 37 isolates studied with a minority of isolates (21.6%, 8/37) harbouring a 54 kb plasmid, commonly serovar-specific. A concerning increase in antimicrobial resistance to commonly administered drugs was observed across the timeline. The surge in MDR is of great concern and implies the need for consistent antimicrobial stewardship. No correlation was observed between the plasmid and antibiotic profiles.

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Views of health care professionals and policy-makers on the use of surveillance data to combat antimicrobial resistance

10.21203/rs.2.17118/v4 ◽

2020 ◽

Author(s):

Mustafa Al-Haboubi ◽

Andrew Trathen ◽

Nick Black ◽

Elizabeth Eastmure ◽

Nicholas Mays

Keyword(s):

Health Care ◽

Antimicrobial Resistance ◽

Health Care Professionals ◽

Secondary Care ◽

Local Level ◽

Surveillance Data ◽

Data Availability ◽

Electronic Prescribing ◽

Data Systems ◽

Policy Makers

Abstract Background Providing healthcare professionals with health surveillance data aims to support professional and organisational behaviour change. The UK Five Year Antimicrobial Resistance (AMR) Strategy 2013 to 2018 identified better access to and use of surveillance data as a key component. Our aim was to determine the extent to which data on antimicrobial use and resistance met the perceived needs of health care professionals and policy-makers at national, regional and local levels, and how provision could be improved. Methods We conducted 41 semi-structured interviews with national policy makers in the four Devolved Administrations and 71 interviews with health care professionals in six locations across the United Kingdom selected to achieve maximum variation in terms of population and health system characteristics. Transcripts were analysed thematically using a mix of a priori reasoning guided by the main topics in the interview guide together with themes emerging inductively from the data. Views were considered at three levels - primary care, secondary care and national - and in terms of availability of data, current uses, benefits, gaps and potential improvements. Results Respondents described a range of uses for prescribing and resistance data. The principal gaps identified were prescribing in private practice, internet prescribing and secondary care (where some hospitals did not have electronic prescribing systems). Some respondents under-estimated the range of data available. There was a perception that the responsibility for collecting and analysing data often rests with a few individuals who may lack sufficient time and appropriate skills. Conclusions There is a need to raise awareness of data availability and the potential value of these data, and to ensure that data systems are more accessible. Any skills gap at local level in how to process and use data needs to be addressed. This requires an identification of the best methods to improve support and education relating to AMR data systems.

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Antibiotic Resistance Surveillance and Control in the Mediterranean Region: report of the ARMed Consensus Conference

The Journal of Infection in Developing Countries ◽

10.3855/jidc.210 ◽

2009 ◽

Vol 3 (09) ◽

pp. 654-659 ◽

Cited By ~ 5

Author(s):

Michael A. Borg ◽

Barry D. Cookson ◽

Peter Zarb ◽

Elizabeth A. Scicluna ◽

ARMed Steering Group & Collaborators *

Keyword(s):

Health Care ◽

Antibiotic Resistance ◽

Antimicrobial Resistance ◽

Mediterranean Region ◽

Care Delivery ◽

Eastern Mediterranean ◽

Eastern Mediterranean Region ◽

Consensus Conference ◽

The Mediterranean ◽

And Control

Antimicrobial resistance has become a global threat to effective health care delivery. This is particularly the case within the Mediterranean region, where data from recent studies suggests the situation to be particularly acute. A better knowledge base, as well as a collaborative effort, is therefore required to address this ever increasing challenge to effective patient care. Over its four-year period, the Antibiotic Resistance Surveillance and Control in the Mediterranean Region (ARMed) project investigated the epidemiology of antimicrobial resistance, as well as its contributory factors, in a number of countries in the southern and eastern Mediterranean region through the collection of comparable and validated data. The project culminated in a consensus conference held in Malta in November 2006. The conference provided a forum for expert delegates to agree on a number of priority strategic recommendations that would be relevant to resistance containment efforts in the region. There was general agreement on the need for surveillance and audit to underpin any intervention to tackle antimicrobial resistance, both to monitor changing epidemiological trends in critical pathogens as well as to identify antibiotic consumption practices and effectiveness of prevention and control of health care associated infections. In addition, the importance to convey these data to key users was also stressed in all workshops, as was better education and training of health care workers. The recommendations also made it clear that ownership of the problem needs to be improved throughout the region and that resources, both financial as well as human, must be allocated by the respective policy makers in order to combat it.

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Assessment of Community Pharmacists Knowledge on dispensing of Antimicrobial drugs and Prevention of Antimicrobial Resistance in Community practice

International Journal of Pharma and Bio Sciences ◽

10.22376/ijpbs/lpr.2021.11.6.p14-20 ◽

2021 ◽

Vol 11 (6) ◽

pp. 14-20

Author(s):

Nisar Ahmed ◽

Mohanta GP ◽

Bhagat MP

Keyword(s):

Health Care ◽

Antimicrobial Resistance ◽

Health Care Cost ◽

Community Pharmacists ◽

Cross Sectional Study ◽

Community Practice ◽

Antimicrobial Drugs ◽

Cross Sectional ◽

Before And After ◽

Prevention Programmes

The antimicrobial resistance has more impact on the health care division which would increase the mortality and hospital readmission duration. Our objective is to assess the community pharmacist’s knowledge on dispensing of antimicrobial drugs and prevention of antimicrobial resistance in community practice. A cross-sectional study was conducted for six months. A sample size of 150 registered community pharmacists participated in the study. We have used simple random techniques to select the community pharmacists. Questionnaire were distributed to the community pharmacists at pre and post visits and the response was analyzed. The collected data was analyzed using graph pad prism software. The mean and standard deviation was calculated and P<0.005 was considered to be statistically significant. For 25-30 years of age , community pharmacists were more 68 (45.33%) as compared to other ages. Pre visit before and after average mean antimicrobial resistance score was found to be 4.87. Proper implementation of antimicrobial resistance prevention programmes would drastically increases the rational use of antimicrobials could and minimizes the health care cost.

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