Outpatient Antibiotic Use and Prevalence of Antibiotic-Resistant Pneumococci in France and Germany: A Sociocultural Perspective

The emergence of antibiotic-resistant pathogens due to worldwide antibiotic use is raising concern in several settings, including aquaculture. In this work, the selection of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) was evaluated after exposure of zebrafish to oxytetracycline (OTC) for two months, followed by a recovery period. The selection of ARB in water and fish was determined using selective media. The abundance of tetA genes was estimated through qPCR. Higher prevalence of ARB was measured in all samples exposed to the antibiotic when compared to control samples, although statistical significance was only achieved five days after exposure. Isolates recovered from samples exposed to the antibiotic were affiliated with Pseudomonas and Stenotrophomonas. Various antibiotic susceptibility profiles were detected and 37% of the isolates displayed multidrug resistance (MDR). The selection of the tetA gene was confirmed by qPCR at the highest OTC concentration tested. Two MDR isolates, tested using zebrafish embryos, caused significant mortality, indicating a potential impact on fish health and survival. Overall, our work highlights the potential impact of antibiotic contamination in the selection of potential pathogenic ARB and ARGS.

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Where future emerging pathogens will come from and what approaches can be used to find them, besides VFARs

Journal of Water and Health ◽

10.2166/wh.2009.096 ◽

2009 ◽

Vol 7 (S1) ◽

pp. S75-S93 ◽

Cited By ~ 8

Author(s):

Mark D. Sobsey ◽

Suresh D. Pillai

Keyword(s):

Human Health ◽

Antibiotic Use ◽

Epidemiological Surveillance ◽

Waterborne Pathogens ◽

Human Pathogens ◽

Emerging Pathogens ◽

Antibiotic Resistant ◽

Waterborne Pathogen ◽

Pathogen Virulence ◽

Human Health Effects

A consideration of available evidence for some known and well-characterized waterborne pathogens suggests that the diversity of pathogen virulence mechanisms and properties is too great to specifically predict the emergence and future human health impacts of new waterborne pathogens. However, some future emerging pathogens are existing microbes that will be discovered to cause disease. Some will arise from existing ones by either predictable evolutionary and adaptation changes or by unpredictable changes involving a variety of biotic and abiotic mechanisms. Many, and perhaps most, emerging waterborne human pathogens will be zoonotic agents or come from other non-human reservoirs. The emergence of some waterborne pathogens will be related to antibiotic use, resulting in emerging antibiotic-resistant waterborne pathogens. Reliably predicting pathogen emergence and human health effects based on VFARs or other properties of microbes and their hosts is not possible at this time. This is because of (1) the diversity of microbes and their virulence and pathogenicity properties, (2) their ability to change unpredictably, (3) their intimate and diverse interrelationships with a myriad of hosts and dynamic natural and anthropogenic environments and (4) the subtle variations in the immune status of individuals. The best available approach to predicting waterborne pathogen emergence is through vigilant use of microbial, infectious disease and epidemiological surveillance. Understanding the microbial metagenome of the human body can also lead to a better understanding of how we define and characterize pathogens, commensals and opportunists.

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Diagnostic Tests Can Stem the Threat of Antimicrobial Resistance: Infectious Disease Professionals Can Help

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1527 ◽

2020 ◽

Author(s):

Dana Trevas ◽

Angela M Caliendo ◽

Kimberly Hanson ◽

Jaclyn Levy ◽

Christine C Ginocchio

Keyword(s):

Infectious Disease ◽

Antimicrobial Resistance ◽

Diagnostic Tests ◽

Healthcare Providers ◽

Federal Funding ◽

Antibiotic Use ◽

Advisory Council ◽

Resistant Bacteria ◽

Research Development ◽

Antibiotic Resistant

Abstract Uptake of existing diagnostics to identify infections more accurately could minimize unnecessary antibiotic use and decrease the growing threat of antibiotic resistance. The Infectious Diseases Society of America (IDSA) and the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) agree that, to improve uptake of existing diagnostics, healthcare providers, health systems, and payors all need better clinical and economic outcomes data to support use of diagnostic tests over empiric use of antibiotics, providers need better tools and education about diagnostic tests, and diagnostics developers need federal funding in the absence of a viable diagnostics market. Recommendations from PACCARB and the IDSA are amplified. Incentives for—and challenges to—diagnostics research, development, and uptake are summarized. Advocacy opportunities are given for infectious disease professionals to join the fight against antimicrobial resistance.

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PROBLEM OF ANTIBIOTIC USE AND ANTIMICROBIAL RESISTANCE IN INDONESIA: ARE WE REALLY MAKING PROGRESS?

Indonesian Journal of Tropical and Infectious Disease ◽

10.20473/ijtid.v4i4.222 ◽

2013 ◽

Vol 4 (4) ◽

pp. 5 ◽

Cited By ~ 7

Author(s):

Usman Hadi ◽

Kuntaman Kuntaman ◽

Mariyatul Qiptiyah ◽

Hari Paraton

Keyword(s):

Antimicrobial Resistance ◽

Antibiotic Use ◽

Teaching Hospitals ◽

Resistant Bacteria ◽

Prevention Study ◽

Antibiotic Resistant ◽

Inappropriate Use ◽

Government Hospitals ◽

Inappropriate Antibiotics ◽

Very High

Background: Based on the results Antimicrobial Resistance in Indonesia: prevalence and prevention-study (AMRIN-study), the Ministry of Health of Indonesia in 2005 began a program antibiotic resistance control (PPRA) in some government hospitals, and is currently developing to all government teaching hospitals in Indonesia. Aim: The core activities of the PPRA are to implement standardized surveillance emergence of antibiotic resistant bacteria, and the surveillance of antibiotic use in terms of quantity and quality. Method: Our research in the years 2003 showed the proportion of antibiotic use 84% of patients in a hospital. The use of inappropriate antibiotics was very high, 42% no indication. Result: In 2012 the results of surveillance showed decline of inappropriate use of antibiotic, but prevalence extended-spectrum b-lactamase (ESBL)-producing K.pneumoniae (58%), and E.coli (52%) andmethicillin-resistant S.aures (MRSA) (24%) were increasing. Conclusion: It was needed to implement the most appropriate programs to prevent the growth and development of bacteria resistant to antibiotics.

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Better living through chemistry: Addressing emerging antibiotic resistance

Experimental Biology and Medicine ◽

10.1177/1535370218755659 ◽

2018 ◽

Vol 243 (6) ◽

pp. 538-553 ◽

Cited By ~ 3

Author(s):

Nathan P Coussens ◽

Ashley L Molinaro ◽

Kayla J Culbertson ◽

Tyler Peryea ◽

Gergely Zahoránszky-Köhalmi ◽

...

Keyword(s):

Drug Resistance ◽

Human Health ◽

Small Molecule ◽

Bacterial Infections ◽

Public Investment ◽

Antibiotic Use ◽

Unintended Consequences ◽

Resistant Bacteria ◽

Antibiotic Resistant ◽

Small Molecule Drugs

The increasing emergence of multidrug-resistant bacteria is recognized as a major threat to human health worldwide. While the use of small molecule antibiotics has enabled many modern medical advances, it has also facilitated the development of resistant organisms. This minireview provides an overview of current small molecule drugs approved by the US Food and Drug Administration (FDA) for use in humans, the unintended consequences of antibiotic use, and the mechanisms that underlie the development of drug resistance. Promising new approaches and strategies to counter antibiotic-resistant bacteria with small molecules are highlighted. However, continued public investment in this area is critical to maintain an edge in our evolutionary “arms race” against antibiotic-resistant microorganisms. Impact statement The alarming increase in antibiotic-resistant microorganisms is a rapidly emerging threat to human health throughout the world. Historically, small molecule drugs have played a major role in controlling bacterial infections and they continue to offer tremendous potential in countering resistant organisms. This minireview provides a broad overview of the relevant issues, including the diversity of FDA-approved small molecule drugs and mechanisms of drug resistance, unintended consequences of antibiotic use, the current state of development for small molecule antibacterials and financial challenges that impact progress towards novel therapies. The content will be informative to diverse stakeholders, including clinicians, basic scientists, translational scientists and policy makers, and may be used as a bridge between these key players to advance the development of much-needed therapeutics.

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The Future of Antibiotics and Meat

Impact of Meat Consumption on Health and Environmental Sustainability - Practice, Progress, and Proficiency in Sustainability ◽

10.4018/978-1-4666-9553-5.ch009 ◽

2016 ◽

pp. 178-200 ◽

Cited By ~ 4

Author(s):

Talia Raphaely ◽

Dora Marinova ◽

Mira Marinova

Keyword(s):

Antibiotic Resistance ◽

Food Chain ◽

Animal Husbandry ◽

Meat Consumption ◽

Antibiotic Use ◽

Meat Production ◽

Livestock Industry ◽

Antibiotic Resistant ◽

New Challenges ◽

Food Animals

This chapter discusses antibiotic use in the livestock industry and potential ramifications for human health. Antibiotics are routinely administered to food animals, primarily at sub-therapeutic levels. The extensive use of antibiotics in global animal husbandry in quantities greater than used for humans is creating antibiotic resistance. There is evidence that antibiotic resistant organisms emerging in food animals transfer to humans through the food chain, environmental contamination, direct association with animals or through mobile resistant genetic elements resulting in co-resistance to other antibiotics. No new classes of antibiotics have been developed since the 1980s. Intensifying use of existing antibiotics for meat production poses new challenges for treating humans, needs to be taken seriously and dealt with urgently. This chapter argues that reduced meat consumption is an under-considered but essential part in any suite of solutions aimed at preserving the use of antibiotics for human treatment.

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Increased Antimicrobial Resistance of MRSA Strains Isolated from Pigs in Spain between 2009 and 2018

Veterinary Sciences ◽

10.3390/vetsci6020038 ◽

2019 ◽

Vol 6 (2) ◽

pp. 38 ◽

Cited By ~ 3

Author(s):

Rossana Abreu ◽

Cristobalina Rodríguez-Álvarez ◽

María Lecuona ◽

Beatriz Castro ◽

Juan González ◽

...

Keyword(s):

Antimicrobial Agents ◽

Methicillin Resistant Staphylococcus Aureus ◽

Antibiotic Use ◽

Surveillance Program ◽

Antibiotic Resistant ◽

Resistance Increase ◽

Nasal Swabs ◽

Improper Use ◽

Mrsa Strains ◽

And Control

The problem of emerging resistant microorganisms such as Methicillin-Resistant Staphylococcus aureus (MRSA) associated to livestock is closely linked to improper use of antimicrobial agents. The aim of this study is to find out the prevalence and characteristics of these strains, as well as their evolution in healthy pigs on the Island of Tenerife, Spain. Between October 2009 and December 2010, 300 pigs from 15 wean-to-finishing farms were screened. Between 1 September 2017 and 31 March 2018, a new sampling was performed collecting 125 nasal swabs from pigs belonging to the same farms and under the same conditions as the previous study. MRSA antibiotic resistant patterns were studied. Results: Prevalence of MRSA isolates was 89.6%. All isolates belonged to Sequence Type 398 (ST398), a livestock related strain. All strains studied were resistant to beta-lactamic non-carbapenemic antibiotics and sensitive to teicoplanin, linezolid, vancomycin, rifampicin, quinupristin-dalfospristin, and mupirocine. Between 2009/2010–2017/2018 a significant increase in resistance to gentamicin, tobramycin, trimethoprim-sulfomethoxazole, clindamycin, Fosfomycin, and tigecycline antibiotics was observed in isolated MRSA strains compared to the previous period. We consider a major control and surveillance program of antibiotic use in veterinary care is needed in order to reduce the presence of MRSA strains in livestock and control this significant multi-resistance increase.

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Comparison of different approaches to antibiotic restriction in food-producing animals: stratified results from a systematic review and meta-analysis

BMJ Global Health ◽

10.1136/bmjgh-2019-001710 ◽

2019 ◽

Vol 4 (4) ◽

pp. e001710 ◽

Cited By ~ 7

Author(s):

Karen L Tang ◽

Niamh P Caffrey ◽

Diego B Nóbrega ◽

Susan C Cork ◽

Paul E Ronksley ◽

...

Keyword(s):

Systematic Review ◽

Antibiotic Resistance ◽

Meta Analysis ◽

Antibiotic Use ◽

Growth Promoter ◽

Antibiotic Resistant ◽

Random Effects Models ◽

Differential Effectiveness ◽

Different Types ◽

Meta Analyses

BackgroundWe have previously reported, in a systematic review of 181 studies, that restriction of antibiotic use in food-producing animals is associated with a reduction in antibiotic-resistant bacterial isolates. While informative, that report did not concretely specify whether different types of restriction are associated with differential effectiveness in reducing resistance. We undertook a sub-analysis of the systematic review to address this question.MethodsWe created a classification scheme of different approaches to antibiotic restriction: (1) complete restriction; (2) single antibiotic-class restriction; (3) single antibiotic restriction; (4) all non-therapeutic use restriction; (5) growth promoter and prophylaxis restriction; (6) growth promoter restriction and (7) other/undetermined. All studies in the original systematic review that were amenable to meta-analysis were included into this substudy and coded by intervention type. Meta-analyses were conducted using random effects models, stratified by intervention type.ResultsA total of 127 studies were included. The most frequently studied intervention type was complete restriction (n=51), followed by restriction of non-therapeutic (n=33) and growth promoter (n=19) indications. None examined growth promoter and prophylaxis restrictions together. Three and seven studies examined single antibiotic-class and single antibiotic restrictions, respectively; these two intervention types were not significantly associated with reductions in antibiotic resistance. Though complete restrictions were associated with a 15% reduction in antibiotic resistance, less prohibitive approaches also demonstrated reduction in antibiotic resistance of 9%–30%.ConclusionBroad interventions that restrict global antibiotic use appear to be more effective in reducing antibiotic resistance compared with restrictions that narrowly target one specific antibiotic or antibiotic class. Importantly, interventions that allow for therapeutic antibiotic use appear similarly effective compared with those that restrict all uses of antibiotics, suggesting that complete bans are not necessary. These findings directly inform the creation of specific policies to restrict antibiotic use in food-producing animals.

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Antibiotics as Major Disruptors of Gut Microbiota

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2020.572912 ◽

2020 ◽

Vol 10 ◽

Author(s):

Jaime Ramirez ◽

Francisco Guarner ◽

Luis Bustos Fernandez ◽

Aldo Maruy ◽

Vera Lucia Sdepanian ◽

...

Keyword(s):

Gut Microbiota ◽

Adaptive Immune System ◽

Antibiotic Use ◽

Negative Effects ◽

Antibiotic Resistant ◽

Childhood Exposure ◽

Clostridioides Difficile ◽

Culture Independent ◽

Health And Disease ◽

And Function

Advances in culture-independent research techniques have led to an increased understanding of the gut microbiota and the role it plays in health and disease. The intestine is populated by a complex microbial community that is organized around a network of metabolic interdependencies. It is now understood that the gut microbiota is vital for normal development and functioning of the human body, especially for the priming and maturation of the adaptive immune system. Antibiotic use can have several negative effects on the gut microbiota, including reduced species diversity, altered metabolic activity, and the selection of antibiotic-resistant organisms, which in turn can lead to antibiotic-associated diarrhea and recurrent Clostridioides difficile infections. There is also evidence that early childhood exposure to antibiotics can lead to several gastrointestinal, immunologic, and neurocognitive conditions. The increase in the use of antibiotics in recent years suggests that these problems are likely to become more acute or more prevalent in the future. Continued research into the structure and function of the gut microbiota is required to address this challenge.

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