Tracking Antimicrobial Resistance Determinants in Diarrheal Pathogens: A Cross-Institutional Pilot Study

Infectious diarrhea affects over four billion individuals annually and causes over a million deaths each year. Though not typically prescribed for treatment of uncomplicated diarrheal disease, antimicrobials serve as a critical part of the armamentarium used to treat severe or persistent cases. Due to widespread over- and misuse of antimicrobials, there has been an alarming increase in global resistance, for which a standardized methodology for geographic surveillance would be highly beneficial. To demonstrate that a standardized methodology could be used to provide molecular surveillance of antimicrobial resistance (AMR) genes, we initiated a pilot study to test 130 diarrheal pathogens (Campylobacter spp., Escherichia coli, Salmonella, and Shigella spp.) from the USA, Peru, Egypt, Cambodia, and Kenya for the presence/absence of over 200 AMR determinants. We detected a total of 55 different determinants conferring resistance to ten different categories of antimicrobials: genes detected in ≥ 25 samples included blaTEM, tet(A), tet(B), mac(A), mac(B), aadA1/A2, strA, strB, sul1, sul2, qacEΔ1, cmr, and dfrA1. The number of determinants per strain ranged from none (several Campylobacter spp. strains) to sixteen, with isolates from Egypt harboring a wider variety and greater number of genes per isolate than other sites. Two samples harbored carbapenemase genes, blaOXA-48 or blaNDM. Genes conferring resistance to azithromycin (ere(A), mph(A)/mph(K), erm(B)), a first-line therapeutic for severe diarrhea, were detected in over 10% of all Enterobacteriaceae tested: these included >25% of the Enterobacteriaceae from Egypt and Kenya. Forty-six percent of the Egyptian Enterobacteriaceae harbored genes encoding CTX-M-1 or CTX-M-9 families of extended-spectrum β-lactamases. Overall, the data provide cross-comparable resistome information to establish regional trends in support of international surveillance activities and potentially guide geospatially informed medical care.

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Species and serovars of enteropathogenic agents associated with acute diarrheal disease in Rosario, Argentina

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46651996000100002 ◽

1996 ◽

Vol 38 (1) ◽

pp. 5-7 ◽

Cited By ~ 3

Author(s):

Rodolfo Notario ◽

Noemi Borda ◽

Telma Gambande ◽

Emma Sutich

Keyword(s):

Escherichia Coli ◽

Vibrio Cholerae ◽

Diarrheal Disease ◽

Enteropathogenic Escherichia Coli ◽

E Coli ◽

Frequent Species ◽

Shigella Spp ◽

Campylobacter Spp

We report the most frequent species and serovars of enteropathogenic organisms in Rosario from 1985 to 1993. Enteropathogenic Escherichia coli was the most prevalent agent affecting 144/570 (25.2%) children; 0111 represented 41.8%, 055: 13.6%, 0119: 12.7%. Among enterotoxigenic E. coli (ETEC) the most frequent were ETEC-ST 0128:H21 and 0153:H45. Shigella spp were isolated in 8.8%; S.flexneri: 7%, principally type 2 (59.5%); S. sonnei: 1.6%, and S. dysenteriae type 2: 0.2%. Campylobacter spp were found in 6.1% of patients; C.jejuni: 4.6%; C. coli: 1.4% and C. lari: 0.2%; except groups 0 13,50 and 0 4 (2 cases each), no predominant serogroups were found. Salmonella was isolated in 2.8% of cases, being the predominant serovar S. typhimurium until 1986, but a dramatically increase of cases due to S. enteritidis was observed since 1987. There was 1.9% of Aeromonas spp and 2 cases due to Vibrio cholerae non 0-1. No Yersinia was found. In patients with gastroenteritis due to Shigella, Campylobacter, Salmonella, or EPEC as the unique pathogen, leukocytes were observed in the faeces in 70%, 50%, 20%, and 10% of cases respectively.

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Socioeconomic Determinants of Ciprofloxacin-Resistant Shigella Infections in Bangladeshi Children

Pathogens and Immunity ◽

10.20411/pai.v2i1.174 ◽

2017 ◽

Vol 2 (1) ◽

pp. 89

Author(s):

Randon J. Gruninger ◽

Russell A. Johnson ◽

Sumon K. Das ◽

Eric J. Nelson ◽

Emily S. Spivak ◽

...

Keyword(s):

Socioeconomic Status ◽

Antimicrobial Resistance ◽

South Asia ◽

Multivariable Logistic Regression Analysis ◽

Healthcare Facilities ◽

Severe Diarrhea ◽

Development Of Resistance ◽

Shigella Species ◽

Recent Emergence ◽

Shigella Spp

Background: Shigella species (spp.) are a leading cause of moderate to severe diarrhea in children worldwide. The recent emergence of quinolone-resistant Shigella spp. gives cause for concern, and South Asia has been identified as a reservoir for global spread. The influence of socioeconomic status on antimicrobial resistance in developing countries, such as those in South Asia, remains unknown.Methods: We used data collected from 2009 to 2014 from a hospital specializing in the treatment of diarrhea in Dhaka, Bangladesh, to determine the relationship between ciprofloxacin-resistant Shigella spp. isolates and measures of socioeconomic status in Bangladeshi children less than 5 years of age.Results: We found 2.7% (230/8, 672) of children who presented with diarrhea had Shigella spp. isolated from their stool, and 50% (115/230) had resistance to ciprofloxacin. Using multivariable logistic regression analysis, we found that children from families where the father’s income was in the highest quintile had significantly higher odds of having ciprofloxacin-resistant Shigella spp. compared to children in the lowest quintile (OR = 6.1, CI 1.9-19). Factors protective against the development of resistance included access to improved sanitation (OR = 0.27, CI 0.11-0.7), and improved water sources (OR = 0.48, CI 0.25-0.92). We did not find a relationship between ciprofloxacin resistance and other proxies for socioeconomic status, including the presence of animals in the home, nutritional status, paternal education level, and the number of family members in the home.Conclusions: Although the associations between wealth and antimicrobial resistance are not fully understood, possible explanations include increased access and use of antibiotics, greater access to healthcare facilities and thus resistant pathogens, or greater consumption of commercially produced foods prepared with antibiotics.

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Denitrification of Sewage Effluents in Deep Bed Sand Filters

Water Science & Technology ◽

10.2166/wst.1993.0516 ◽

1993 ◽

Vol 27 (5-6) ◽

pp. 381-390 ◽

Cited By ~ 4

Author(s):

John Upton

Keyword(s):

Waste Water ◽

Pilot Study ◽

Water Industry ◽

Trickling Filter ◽

Sand Filters ◽

The United Kingdom ◽

The Usa ◽

Water Plants ◽

The Cost ◽

Pilot Plant Study

The European waste water industry will need to develop denitrification processes to remove nitrogen as pressures increase to reduce nutrient levels discharged in effluents. In the USA deep bed filter technology has been used extensively to provide denitrification to levels less than 5 mg/l TN. This paper describes this technology and the full scale performance at some waste water plants in Florida, USA. This paper also describes a pilot study in the United Kingdom at Severn Trent Water. The results of the pilot plant study indicate that denitrification in deep bed sand filters is a sound robust technology using methanol addition. Nitrogen removals greater than the 70% required in the EC Directive 1991 are possible at winter sewage temperatures. The process is most suitable for achieving nitrogen removal at trickling filter plants. The cost of methanol addition is calculated to be ₤10/1000m3.

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Global research activity on antimicrobial resistance in food-producing animals

Archives of Public Health ◽

10.1186/s13690-021-00572-w ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Waleed M. Sweileh

Keyword(s):

Antimicrobial Resistance ◽

Hot Spots ◽

One Health ◽

Research Collaboration ◽

Search Query ◽

Scientific Publications ◽

Research Theme ◽

The Usa ◽

Number Of Publications ◽

Number Of Citations

Abstract Background Antimicrobial resistance (AMR) is a global challenge that requires a “One Health” approach to achieve better public health outcomes for people, animals, and the environment. Numerous bibliometric studies were published on AMR in humans. However, none was published in food-producing animals. The current study aimed at assessing and analyzing scientific publications on AMR in food-producing animals. Method A validated search query was developed and entered in Scopus advanced search function to retrieve and quantitatively analyze relevant documents. Bibliometric indicators and mapping were presented. The study period was from 2000 to 2019. Results The search query retrieved 2852 documents. During the period from 2015 to 2019, approximately 48% of the retrieved documents were published. The article about the discovery of plasmid-mediated colistin resistance in pigs received the highest number of citations (n = 1970). The Journal of Food Protection (n = 123; 4.3%) ranked first in the number of publications while the Applied and Environmental Microbiology journal ranked first in the number of citations per document. The USA led with 576 (20.2%) documents followed by China (n = 375; 13.1%). When the number of publications was standardized by income and population size, India (n = 51.5) ranked first followed by China (n = 38.3) and Brazil (n = 13.4). The growth of publications from China exceeded that of the USA in the last 3 years of the study period. Research collaboration in this field was inadequate. Mapping author keywords showed that E. coli, Salmonella, poultry, Campylobacter, chicken, cattle, and resistant genes were most frequent. The retrieved documents existed in five research themes. The largest research theme was about AMR in Salmonella in food-producing animals. The most recent research theme was about the dissemination and molecular transfer of AMR genes into the environment and among different bacterial strains. Conclusion Hot spots of research on AMR in food-producing animals match the world regions of reported hot spots of AMR in animals. Research collaboration in this field is of great importance, especially with low- and middle-income countries. Data on AMR need to be collected nationally and internationally to implement the “One Health” approach in the fight against AMR.

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Impact of Ceftiofur Administration in Steers on the Prevalence and Antimicrobial Resistance of Campylobacter spp.

Microorganisms ◽

10.3390/microorganisms9020318 ◽

2021 ◽

Vol 9 (2) ◽

pp. 318

Author(s):

Sicun Fan ◽

Derek Foster ◽

William G. Miller ◽

Jason Osborne ◽

Sophia Kathariou

Keyword(s):

Antimicrobial Resistance ◽

Bacterial Resistance ◽

Active Drug ◽

Free Acid ◽

Structural Similarity ◽

Drug Concentrations ◽

Pre Treatment ◽

Ceftiofur Hydrochloride ◽

Campylobacter Spp

Bacterial resistance to ceftiofur raises health concerns due to ceftiofur’s extensive veterinary usage and structural similarity with the human antibiotic ceftriaxone. Ceftiofur crystalline-free acid (CCFA) and ceftiofur hydrochloride (CHCL) are ceftiofur types used therapeutically in cattle, but their potential impacts on Campylobacter prevalence and antimicrobial resistance remain unclear. In this study two groups of steers were each treated with CCFA or CHCL. In vivo active drug concentrations were measured and fecal samples were analyzed for Campylobacter for up to 42 days post-treatment. Following administration, the colonic concentration of ceftiofur initially increased then dropped to pre-treatment levels by day 8. The estimated prevalence of Campylobacter spp. was significantly (p = 0.0009) higher during the first week after CCFA treatment than after CHCL treatment (81.3% vs. 45.2%). Campylobacter jejuni predominated overall, with other Campylobacter spp. mainly identified in the first week after CCFA treatment. No treatment impacts were noted on ceftiofur minimum inhibitory concentration (MIC) for C. jejuni (10–20 μg/mL). More C. jejuni genotypes were detected in CCFA-treated than CHCL-treated steers. These findings suggest that ceftiofur did not significantly impact Campylobacter prevalence or ceftiofur MIC. However, CHCL may be preferable due to the lower likelihood of temporary increases in Campylobacter prevalence.

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Phenotypic Antimicrobial Susceptibility of Escherichia coli from Raw Meats, Ready-to-Eat Meats, and Their Related Samples in One Health Context

Microorganisms ◽

10.3390/microorganisms9020326 ◽

2021 ◽

Vol 9 (2) ◽

pp. 326

Author(s):

Frederick Adzitey ◽

Nurul Huda ◽

Amir Husni Mohd Shariff

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Antimicrobial Susceptibility ◽

Resistance Index ◽

Diffusion Method ◽

Resistant Bacteria ◽

Disk Diffusion Method ◽

E Coli ◽

The Usa ◽

Raw Meats

Meat is an important food source that can provide a significant amount of protein for human development. The occurrence of bacteria that are resistant to antimicrobials in meat poses a public health risk. This study evaluated the occurrence and antimicrobial resistance of E. coli (Escherichia coli) isolated from raw meats, ready-to-eat (RTE) meats and their related samples in Ghana. E. coli was isolated using the USA-FDA Bacteriological Analytical Manual and phenotypic antimicrobial susceptibility test was performed by the disk diffusion method. Of the 200 examined meats and their related samples, 38% were positive for E. coli. Notably, E. coli was highest in raw beef (80%) and lowest in RTE pork (0%). The 45 E. coli isolates were resistant ≥ 50% to amoxicillin, trimethoprim and tetracycline. They were susceptible to azithromycin (87.1%), chloramphenicol (81.3%), imipenem (74.8%), gentamicin (72.0%) and ciprofloxacin (69.5%). A relatively high intermediate resistance of 33.0% was observed for ceftriaxone. E. coli from raw meats, RTE meats, hands of meat sellers and working tools showed some differences and similarities in their phenotypic antimicrobial resistance patterns. Half (51.1%) of the E. coli isolates exhibited multidrug resistance. The E. coli isolates showed twenty-two different resistant patterns, with a multiple antibiotic resistance index of 0.0 to 0.7. The resistant pattern amoxicillin (A, n = 6 isolates) and amoxicillin-trimethoprim (A-TM, n = 6 isolates) were the most common. This study documents that raw meats, RTE meats and their related samples in Ghana are potential sources of antimicrobial-resistant E. coli and pose a risk for the transfer of resistant bacteria to the food chain, environment and humans.

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A cross-cultural comparison of dietary intakes and physical activity between American and Czech school-aged children

Public Health Nutrition ◽

10.1017/s1368980008003546 ◽

2009 ◽

Vol 12 (7) ◽

pp. 986-990 ◽

Cited By ~ 2

Author(s):

Lenka Humenikova Shriver ◽

Gail Gates

Keyword(s):

Physical Activity ◽

Czech Republic ◽

Public Schools ◽

Pilot Study ◽

Fast Food ◽

Dietary Intakes ◽

Cross Sectional ◽

The Czech Republic ◽

The Usa ◽

American Children

AbstractObjectiveThe prevalence of child overweight in the Czech Republic is substantially lower than that in the USA. The objective of the present pilot study was to explore dietary intakes, frequency of dining in fast-food establishments, and the amount and intensity of physical activity between a sample of American and Czech children.DesignA cross-sectional correlational pilot study.SettingFour public schools in the USA and four public schools in the Czech Republic.SubjectsNinety-five Czech and forty-four American 4–6th graders from urban public schools participated in the study. Dietary intake and number of fast-food visits were evaluated using two multiple-pass 24 h recalls. Physical activity was measured using the modified Self-Administered Physical Activity Checklist.ResultsAmerican children (mean age 10·8 (se 0·2) years) consumed more energy and fat, less fruits and vegetables, more soft drinks, and visited fast-food establishments more often than Czech children (mean age 11·0 (se 0·1) years). Although no differences were found in vigorous activity by nationality, Czech children spent significantly more time in moderate physical activities than American children.ConclusionsDespite the influx of some negative Western dietary trends into the country, Czech children had a healthier diet and were more physically active than American children. Further research is warranted to determine whether the same differences in dietary intakes, physical activity and fast-food visits exist between nationally representative samples of American and Czech children.

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Glycyrrhizic acid: the assessment of a no effect level

Human & Experimental Toxicology ◽

10.1191/096032700682694251 ◽

2000 ◽

Vol 19 (8) ◽

pp. 434-439 ◽

Cited By ~ 39

Author(s):

C E M van Gelderen ◽

J A Bijlsma ◽

W van Dokkum ◽

T J F Savelkoull

Keyword(s):

Body Weight ◽

Pilot Study ◽

Glycyrrhizic Acid ◽

Mild Hypertension ◽

Daily Intake ◽

Long Term Effects ◽

Healthy Female ◽

The Usa ◽

Effect Level

Because from earlier experiments in rats and a pilot study in humans a no effect level of glycyrrhizic acid could not be established, a second experiment was performed in healthy volunteers. The experiment was performed in females only, because the effects were most marked in females in the pilot study. Doses of 0, 1, 2 and 4 mg glycyrrhizic acid/kg body weight were administered orally for 8 weeks to 39 healthy female volunteers aged 19-40 years. The experimentlasted 12 weeks including an adaptation and a “wash-out” period.Ano-effectlevel of2 mg/kgis proposed from the results ofthis study, from which an acceptable daily intake (ADI) of 0.2 mg/kg body weight can be extrapolated with a safety factor of 10. This means consumption of 12 mg glycyrrhizic acid/day for a person with a body weight of 60 kg. This would be equal to 6 g licorice a day, assuming that licorice contains 0.2% of glycyrrhizic acid. The proposed ADI is below the limit advised by the Dutch Nutrition Council of 200 mg glycyrrhizic acid/day. This reflects the relatively mild acute toxicity of glycyrrhizic acid, which is also emphasised by the “generally recognised as safe” (GRAS) status of glycyrrhizic acid in the USA in 1983. However, the long-term effects of a mild chronic intoxication (causing, for example, a mild hypertension), although not immediately lethal, justify special attention to the amount of glycyrrhizic acid used daily.

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