Prevalence, Risk Factors, and Genetic Characterization of Extended-Spectrum Beta-Lactamase Escherichia coli Isolated From Healthy Pregnant Women in Madagascar

Antimicrobial resistance is a major public health concern worldwide affecting humans, animals and the environment. However, data is lacking especially in developing countries. Thus, the World Health Organization developed a One-Health surveillance project called Tricycle focusing on the prevalence of ESBL-producing Escherichia coli in humans, animals, and the environment. Here we present the first results of the human community component of Tricycle in Madagascar. From July 2018 to April 2019, rectal swabs from 492 pregnant women from Antananarivo, Mahajanga, Ambatondrazaka, and Toamasina were tested for ESBL-E. coli carriage. Demographic, sociological and environmental risk factors were investigated, and E. coli isolates were characterized (antibiotic susceptibility, resistance and virulence genes, plasmids, and genomic diversity). ESBL-E. coli prevalence carriage in pregnant women was 34% varying from 12% (Toamasina) to 65% (Ambatondrazaka). The main risk factor associated with ESBL-E. coli carriage was the rainy season (OR = 2.9, 95% CI 1.3–5.6, p = 0.009). Whole genome sequencing was performed on 168 isolates from 144 participants. blaCTX–M–15 was the most frequent ESBL gene (86%). One isolate was resistant to carbapenems and carried the blaNDM–5 gene. Most isolates belonged to commensalism associated phylogenetic groups A, B1, and C (90%) and marginally to extra-intestinal virulence associated phylogenetic groups B2, D and F (10%). Multi locus sequence typing showed 67 different sequence types gathered in 17 clonal complexes (STc), the most frequent being STc10/phylogroup A (35%), followed distantly by the emerging STc155/phylogroup B1 (7%), STc38/phylogroup D (4%) and STc131/phylogroup B2 (3%). While a wide diversity of clones has been observed, SNP analysis revealed several genetically close isolates (n = 34/168) which suggests human-to-human transmissions. IncY plasmids were found with an unusual prevalence (23%), all carrying a blaCTX–M–15. Most of them (85%) showed substantial homology (≥85%) suggesting a dissemination of IncY ESBL plasmids in Madagascar. This large-scale study reveals a high prevalence of ESBL-E. coli among pregnant women in four cities in Madagascar associated with warmth and rainfall. It shows the great diversity of E. coli disseminating throughout the country but also transmission of specific clones and spread of plasmids. This highlights the urgent need of public-health interventions to control antibiotic resistance in the country.

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Multidrug resistant E. coli recovered from household reared female budgerigar pet bird (Melopsittacus undulatus) in Ibadan, Oyo State Nigeria: a case report

Bulletin of the National Research Centre ◽

10.1186/s42269-021-00617-8 ◽

2021 ◽

Vol 45 (1) ◽

Author(s):

Adelekan Oluseyi Okunlade ◽

Oluwaseun Olanrewaju Esan ◽

Akinlabi Oladele Ogunleye

Keyword(s):

Public Health ◽

Disease Transmission ◽

Multidrug Resistant ◽

World Health ◽

Health Concern ◽

Microbial Culture ◽

Melopsittacus Undulatus ◽

E Coli ◽

Pet Birds ◽

Health Organization

Abstract Background Pet birds are housed and reared exclusively for ornamental use. These include psittaciformes (parrots, parakeets, budgerigars, love birds) and passeriformes (e.g. canaries, finches, sparrows, also called songbirds). E. coli is a Gram negative bacterium. In birds, it is called Avian Pathogenic E. coli and is a causative agent of avian colibacillosis. Antimicrobial resistance is the process through which bacteria evade the activity of antibiotics. According to WHO (World Health Organization), antibiotic resistance is the result of indiscriminate use of these drugs which are used both in Veterinary and human medicine. Case presentation A one and half year old yellow female budgerigar pet bird (Melopsittacus undulatus) with patches of black and white on wings and back, kept as companion (one out of four) was presented dead at the avian clinic section of the Veterinary Teaching Hospital, University of Ibadan, Nigeria. It was reported to have presented signs of anorexia and diarrhea for two days before death. Provisional diagnosis was colibacillosis. Intestinal samples were sent for microbial culture and sensitivity. The samples yielded growth of E. coli. Antimicrobial susceptibility revealed that the organism showed resistance to all tested antibiotics. Conclusions Multidrug-resistant Escherichia coli constitutes a major public health concern. The constant interaction between household companion birds and humans gives room for disease transmission. Wild birds kept as pets or companions harbor pathogenic and zoonotic pathogens, hence a threat to public health.

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Anaemia - a pale ale?

South African Family Practice ◽

10.4102/safp.v59i3.4688 ◽

2017 ◽

Vol 59 (3) ◽

pp. 17-23

Author(s):

George L Muntingh ◽

M Viljoen

Keyword(s):

Public Health ◽

Pregnant Women ◽

Public Health Problem ◽

The Elderly ◽

Reproductive Age ◽

World Health ◽

Health Concern ◽

Global Public Health ◽

Women Of Reproductive Age ◽

Global Database

Despite some modest improvements described recently, anaemia remains a significant global public health concern affecting both developed and developing countries. It affects a quarter of the global population, including 293 million (47%) children who are younger than five years of age. A prevalence of 42% and 30% has been described in pregnant and non-pregnant women, respectively. Children and women of reproductive age are at high risk, partly because of physiological vulnerability, followed by the elderly. Africa and Asia are the most heavily affected regions, accounting for 85% of the absolute anaemia burden in highrisk groups. According to the World Health Organization global database on anaemia (1993–2005), this disorder was considered to be a moderate public health problem in South African preschool children, pregnant women and non-pregnant women of reproductive age. There has been an increased awareness of anaemia and its consequences on the health and development of women and children in the past few decades. The many underlying causes of the various types of anaemia seen in general practice means it is essential that practitioners’ clinical decisions be underpinned by a sound knowledge of the pathological processes involved. Thorough history-taking will guide practitioners to request specific tests to confirm or refute differential diagnoses. Management must be developed around the specific type of anaemia and the potential physical and psychological effects it may have on the individual.

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Risk factors for hepatitis B virus infections among pregnant women in East Lombok District

Public Health and Preventive Medicine Archive ◽

10.15562/phpma.v6i2.113 ◽

2018 ◽

Vol 6 (2) ◽

pp. 108

Author(s):

Eka Faizaturrahmi ◽

Luh Seri Ani ◽

Komang Ayu Kartika Sari

Keyword(s):

Public Health ◽

Risk Factors ◽

Hepatitis B ◽

Pregnant Women ◽

Family Income ◽

Significant Risk ◽

World Health ◽

Hepatitis B Infection ◽

First Marriage ◽

History Of

Background and objectives: The World Health Organization has set a target of 90% reduction in new Hepatitis B infections by 2030. The program includes prevention of new infections, and increases testing uptake and treatment. In order to effectively foster prevention, it is necessary to understand the risk factors for transmission. This study aims to determine the risk factors of Hepatitis B infection in pregnant women.Method: A case control study was carried out among 52 pregnant women with HBsAg (+) as cases and 104 pregnant women with HBsAg (-) as controls. The source of cases and controls was the register of pregnant women at the Pringgasela Public Health Center from January 2016 to October 2017. Cases were selected using systematic random sampling from 67 HBsAg (+) pregnant women and controls were selected in the same way from 1644 pregnant women with HBsAg (-). Cases and controls were matched by domicile. The data collected were age, age of first marriage, education, family income, parity, history of miscarriage, maternal or husband’s history of working abroad, frequency of marriage, history of injection, surgery, blood transfusion and dental care. Data collection was carried out with a pre-tested questionnaire in April-May 2018 through interviews at the home of each respondent. Multivariate analysis with logistic regression was carried out to determine the adjusted odds ratio of each risk factor.Results: Case and control characteristics were found to be similar in terms of age, domicile, education and income. Significant risk factors were the history of husband working abroad (AOR=4,115; 95%CI: 1,657-11,075), age of first marriage <20 years (AOR=2,420; 95%CI: 1,157-5,481) and frequency of husband's marriage more than one time (AOR=3,081; 95%CI: 1,345-7,080).Conclusion: Husbands with history of working abroad, age of first marriage <20 years and frequency of husband's marriage more than one time were found to be the risk factors for Hepatitis B infection in pregnant women. These factors require public health attention in order to reduce the transmission of Hepatitis B.

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Genomic Diversity and Virulence Potential of ESBL- and AmpC-β-Lactamase-Producing Escherichia coli Strains From Healthy Food Animals Across Europe

Frontiers in Microbiology ◽

10.3389/fmicb.2021.626774 ◽

2021 ◽

Vol 12 ◽

Author(s):

Christa Ewers ◽

Anno de Jong ◽

Ellen Prenger-Berninghoff ◽

Farid El Garch ◽

Ursula Leidner ◽

...

Keyword(s):

Large Scale ◽

Geographic Origin ◽

Virulence Gene ◽

Genomic Diversity ◽

Phylogenetic Groups ◽

E Coli ◽

Virulence Potential ◽

Cephalosporin Resistance ◽

Clonal Spread ◽

Promoter Mutations

The role of livestock animals as a putative source of ESBL/pAmpC E. coli for humans is a central issue of research. In a large-scale pan-European surveillance, 2,993 commensal Escherichia spp. isolates were recovered from randomly collected fecal samples of healthy cattle, pigs and chickens in various abattoirs. One-hundred Escherichia spp. isolates (0.5% from cattle, 1.3% pigs, 8.0% chickens) fulfilled the criteria for cefotaxime and ceftazidime non-wildtype (EUCAST). In silico screening of WGS data of 99 isolates (98 E. coli and 1 E. fergusonii) revealed blaSHV–12 (32.3%), blaCTX–M–1 (24.2%), and blaCMY–2 (22.2%) as predominant ESBL/pAmpC types. Other types were blaSHV–2 (1.0%), blaCTX–M–2/–14/–15 (1.0/6.1/1.0%), and blaTEM–52 (5.1%). Six isolates revealed AmpC-promoter mutations (position −42 (C > T) and one carried mcr-1. The majority (91.3%) of ESBL/pAmpC genes were located on plasmids. SHV-12 was mainly (50%) encoded on IncI1α plasmids (pST-3/-26/-95), followed by IncX3 (12.5%) and IncK2 (3.1%). The blaTEM–52 genes were located on IncI1α-pST-36 (60%) and IncX1 plasmids (20%). The dominant plasmid lineage among CTX-M-1 isolates was IncI1α (pST-3/-295/-317) (87.5%), followed by IncN-pST-1 (8.3%). CMY-2 was mostly identified on IncI1α (pST-12/-2) (54.5%) and IncK2 (31.8%) plasmids. Several plasmids revealed high similarity to published plasmids from human and animal Enterobacteriaceae. The isolates were assigned to phylogroups A/C (34.7/7.1%), B1 (27.6%), B2 (3.1%), D/F (9.2/10.2%), E (5.1%), and to E. clades (3.0%). With 51 known and 2 novel MLST types, a wide variety of STs was found, including STs previously observed in human isolates (ST10/38/117/131/648). ESBL/AmpC types or STs were rarely correlated with the geographic origin of the isolates or animal species. Virulence gene typing identified extraintestinal pathogenic E. coli (ExPEC; 2.0%), avian pathogenic E. coli (APEC; 51.5%), and atypical enteropathogenic E. coli (EPEC; 6.1%). In conclusion, the high diversity of STs and phylogenetic groups provides hardly any hint for clonal spread of single lineages but hints toward the dissemination of cephalosporin resistance genes in livestock via distinct, globally successful plasmid lineages. Even though a number of isolates could not be assigned to a distinct pathotype, our finding of combined multidrug-resistance and virulence in this facultative pathogen should be considered an additional threat to public health.

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Legal Analysis of Government Policy on Large Scale Social Restrictions in Handling Covid-19

The Indonesian Journal of International Clinical Legal Education ◽

10.15294/ijicle.v2i2.38326 ◽

2020 ◽

Vol 2 (2) ◽

pp. 181-200

Author(s):

Ratna Desinta Mega Kumala

Keyword(s):

Public Health ◽

Risk Factors ◽

Health Risk ◽

Large Scale ◽

Virus Disease ◽

World Health ◽

Health Risk Factors ◽

Public Health Risk ◽

Public Health Emergencies ◽

Corona Virus

Corona Virus Disease 2019 (COVID-19) has been declared by the World Health Organization (WHO) as a pandemic so prevention efforts need to be made to avoid an increase in cases. In the context of prevention efforts carried out the implementation of health quarantine as regulated in Act Number 6 of 2018 concerning Health Quarantine. The implementation of health quarantine is a joint responsibility of the Central Government and Regional Governments as a form of protection of public health from diseases and / or public health risk factors that have the potential to cause public health emergencies. Health quarantine is carried out through disease observation activities and public health risk factors for transportation, people, goods, and or the environment, as well as responses to public health emergencies in the form of Health quarantine measures. One of the acts of health quarantine is in the form of large-scale social restrictions. The spread of Corona Virus Disease 2019 (COVID-19) in Indonesia is now increasing and expanding across regions and across countries accompanied by the number of cases and / or the number of deaths. The increase has an impact on political, economic, social, cultural, defense and security aspects, as well as the welfare of the people in Indonesia, so it is necessary to accelerate the handling of Corona Virus Disease 2019 (COVID-19) in the form of large-scale social restrictions in order to reduce the spread of Corona Virus Disease 2019 (COVID-19) is expanding.

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Molecular characterization and antimicrobial resistance of potentially human‐pathogenic Escherichia coli strains isolated from riding horses

BMC Veterinary Research ◽

10.1186/s12917-021-02832-x ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Pouya Reshadi ◽

Fatemeh Heydari ◽

Reza Ghanbarpour ◽

Mahboube Bagheri ◽

Maziar Jajarmi ◽

...

Keyword(s):

Public Health ◽

Escherichia Coli ◽

Antimicrobial Resistance ◽

Health Concern ◽

Zoonotic Potential ◽

Drug Resistant ◽

Public Health Concern ◽

E Coli ◽

Pathogenic Escherichia Coli ◽

Amoxicillin Clavulanic Acid

Abstract Background Transmission of antimicrobial resistant and virulent Escherichia coli (E. coli) from animal to human has been considered as a public health concern. This study aimed to determine the phylogenetic background and prevalence of diarrheagenic E. coli and antimicrobial resistance in healthy riding-horses in Iran. In this research, the genes related to six main pathotypes of E. coli were screened. Also, genotypic and phenotypic antimicrobial resistance against commonly used antibiotics were studied, then phylo-grouping was performed on all the isolates. Results Out of 65 analyzed isolates, 29.23 % (n = 19) were determined as STEC and 6.15 % (n = 4) as potential EPEC. The most prevalent antimicrobial resistance phenotypes were against amoxicillin/clavulanic acid (46.2 %) and ceftriaxone (38.5 %). blaTEM was the most detected resistance gene (98.4 %) among the isolates and 26.15 % of the E. coli isolates were determined as multi-drug resistant (MDR). Three phylo-types including B1 (76.92 %), A (13.85 %) and D (3.08 %) were detected among the isolates. Conclusions Due to the close interaction of horses and humans, these findings would place emphasis on the pathogenic and zoonotic potential of the equine strains and may help to design antimicrobial resistance stewardship programs to control the dissemination of virulent and multi-drug resistant E. coli strains in the community.

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Otitis media in Indigenous Australian children: review of epidemiology and risk factors

The Journal of Laryngology & Otology ◽

10.1017/s0022215113003083 ◽

2013 ◽

Vol 128 (S1) ◽

pp. S16-S27 ◽

Cited By ~ 27

Author(s):

Jake Jervis-Bardy ◽

L Sanchez ◽

A S Carney

Keyword(s):

Public Health ◽

Risk Factors ◽

Otitis Media ◽

Bacterial Load ◽

Grey Literature ◽

Acute Otitis Media ◽

Chronic Otitis Media ◽

Health Concern ◽

Indigenous Australian ◽

Indigenous Children

AbstractBackground:Otitis media represents a major health concern in Australian Indigenous children (‘Indigenous children’), which has persisted, despite public health measures, for over 30 years.Methods:Global searches were performed to retrieve peer-reviewed and ‘grey’ literature investigating the epidemiology of and risk factors for otitis media in Indigenous children, published between 1985 and 2012.Results:In Indigenous children, the prevalence of otitis media subtypes is 7.1–12.8 per cent for acute otitis media, 10.5–30.3 per cent for active chronic otitis media and 31–50 per cent for tympanic membrane perforation. The initial onset of otitis media in Indigenous children occurs earlier and persists for longer after the first year of life, compared with non-Indigenous children. Indigenous children are colonised by otopathogens more frequently, at younger ages and with a higher bacterial load. Poor community and domestic infrastructure, overcrowding and exposure to tobacco smoke increase the risk of otitis media in Indigenous children; however, the availability of swimming pools plays no role in the prevention or management of otitis media.Conclusion:Despite awareness of the epidemiological burden of otitis media and its risk factors in Indigenous children, studies undertaken since 1985 demonstrate that otitis media remains a significant public health concern in this population.

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Microcystin Exposure Pathways and Human Health

Passive Remote Study of the Aerosol in the Upper Atmosphere of the Earth ◽

10.47363/jeesr/2020(2)130 ◽

2020 ◽

pp. 1-5

Author(s):

Rajesh Melaram ◽

Keyword(s):

Public Health ◽

Policy Development ◽

Mitigation Strategies ◽

World Health ◽

Health Concern ◽

Human Populations ◽

Algal Toxins ◽

Potential Health ◽

Exposure Pathways ◽

Green Algal

Microcystins (MCs) are blue-green algal toxins produced by freshwater cyanobacteria. Their environmentally relevant concentrations throughout global surface waters have tampered with human populations’ drinking and recreational supplies. MCs have gained immense public health attention due to their potential health effects. Microcystin-LR (MC-LR) is the most toxic variant of the MCs. Investigations on MC-LR toxicity and detection in water signify a growing potential environmental health concern worldwide. The World Health Organization established a provisional drinking water guidance value of 1 μg/L and a provisional recreational exposure guidance value of 10 μg/L for MC-LR. This review surveys human MC exposure pathways and integrates epidemiological studies to support MCs’ critical exposure pathways. A discussion on monitoring and mitigation strategies provides a guide for policy development in adopting MCs’ regulatory levels to protect public health.

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Serum microRNA-122 Levels in Egyptian Patients with Chronic Hepatitis C virus Genotype 4 Infection before and after treatment with Direct Acting Antiviral Drugs

QJM ◽

10.1093/qjmed/hcab100.105 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Essam Mohammad Bayoumy Helal ◽

Moataz Mohammad Sayed ◽

Tari Magdy Aziz George ◽

Christina Alfons Anwar ◽

Sara Hassan Agwa ◽

...

Keyword(s):

Public Health ◽

Viral Hepatitis ◽

Large Scale ◽

Antiviral Drug ◽

University Hospital ◽

Health Concern ◽

Virus Genotype ◽

Genotype 4 ◽

Hcv Therapy ◽

Therapeutic Value

Abstract Background Viral hepatitis was estimated to be the 7th leading cause of mortality globally. About half of this mortality is attributed to HCV, a primary cause for liver fibrosis, cirrhosis and cancer. The recent development of highly efficacious oral DAAs provides opportunities for reducing HCV disease burden and its onward transmission, with the potential for eliminating this blood-borne virus as a public health concern. WHO has recently formulated the ‘Global Health Sector Strategy on Viral Hepatitis, 2016– 2021 with service coverage targets to eliminate HCV as a public health threat by 2030. Objective To asses the possible relation of miRNA 122 to HCC development after HCV therapy with direct antiviral drug. Patients and Methods Previous studies suspect that HCV therapy by DAAS may increase risk of HCC so the aim of our study is to evaluate miR-122level at end of HCV treatment by DAAS and compare the results with miR-122level in HCC patients. The study was performed as a case control study in Ain Shams University hospital and Suez Canal authority hospital (Outpatient Clinic), at Ismailia Egypt in the period between Augusts to October 2018. Results These results revealed an effect of treatment by DAAs in HCV infected patients leading to miRNA 122 reduction and this may be related to hepatocarcinogenesis. However, further studies on a large patients number are needed to clarify this point and determine the diagnostic and possible therapeutic value of miRNA 122 in HCV infected patients. Conclusion Baseline MiR-122 level at cutoff value ≤0.26 was significantly lower in HCC patients than chronic HCV patients and normal controls, with a sensitivity of 80%, a specificity of 70%. MiR-122 was significantly reduced at end of HCV therapy with DAAs and became similar to values in HCC patients. Whether this observed reduction is mechanistically related to hepatocarcinogenesis is still a possibility, to be clarified in furtur large scale studies. The reduction of MiR-122 at the end of HCV therapy with DAAs was significantly observed in (F3,F4) patients than those with early fibrosis stages(F1,F2).This again gives a possible explanation of HCC development in HCV patients with advanced fibrosis(cirrhosis)and raises the question about the diagnostic and therapeutic value of miRNA 122 (and possibly other miRNAs)in the management strategy of HCV infected patients.

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Antimicrobial Resistance of Escherichia coli and Salmonella isolated from Raw Retail Broiler Chickens in Zambia

10.21203/rs.2.14062/v1 ◽

2019 ◽

Author(s):

Elizabeth Muligisa Muonga ◽

Geoffrey Mainda ◽

Mercy Mukuma ◽

Geoffrey Kwenda ◽

Bernard Hang'ombe ◽

...

Keyword(s):

Public Health ◽

Escherichia Coli ◽

Antimicrobial Resistance ◽

Broiler Chickens ◽

Target Genes ◽

Health Concern ◽

Poultry Production ◽

Public Health Concern ◽

E Coli ◽

Open Markets

Abstract Background Antimicrobial resistance (AMR) of foodborne pathogens is of public health concern, especially in developing countries like Zambia. This study was undertaken to determine the resistance profiles of Escherichia coli ( E. coli ) and Salmonella isolated from dressed broiler chickens purchased from open markets and supermarkets in Zambia.Results A total of 189 E. coli and five Salmonella isolates were isolated. Identification and confirmation of the isolates was done using Analytical Profile Index (API 20E) (Biomerieux ® ) and 16S rRNA sequencing. Antimicrobial susceptibility tests (AST) were performed using the Kirby Bauer disk diffusion technique using a panel of 10 different antibiotics and multiplex PCR was used to determine the presence of three target genes encoding for resistance: tetA, Sul1 and CTXM. AST results were entered and analyzed in WHONET 2018 software. A total of 189 E. coli and five Salmonella isolates were identified. Among the E. coli isolates, Tetracycline recorded the highest resistance of 79.4%, followed by Ampicillin 51.9%, Trimethoprim/Sulfamethoxazole 49.7%, Nalidixic Acid 24.3%, Chloramphenicol 16.4%, Cefotaxime 16.4%, Ciprofloxacin 10.1%, Colistin 7.4%, Amoxicillin/Clavulanic acid 6.9%, and Imipenem 1.1%. Two of the five Salmonella isolates were resistant to at least one antibiotic. Forty- seven (45.2%) of the isolates possessed at least one of the targeted resistance genes.Conclusion This study has demonstrated the presence of AMR E. coli and Salmonella on raw broiler chickens from both open markets and supermarkets. Such resistance is of public health concern and measures need to be put in place to regulate the use of these antimicrobials in poultry production.

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