scholarly journals Estimating the Economic and Clinical Value of Reducing Antimicrobial Resistance to Three Gram-negative Pathogens in Japan

2021 ◽  
Vol 8 (2) ◽  
pp. 64-75
Author(s):  
Tetsuya Matsumoto ◽  
Oliver Darlington ◽  
Ryan Miller ◽  
Jason Gordon ◽  
Phil McEwan ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Action Plan ◽  
Economic Outcomes ◽  
Health Concern ◽  
Drug Resistant ◽  
Clinical Value ◽  
Gram Negative ◽  
Life Years ◽  
Hospitalization Costs

Background: Antimicrobial resistance (AMR) represents a significant global public health crisis. Despite ample availability of Gram-positive antibiotics, there is a distinct lack of agents against Gram-negative pathogens, including carbapenem-resistant Enterobacterales, which remains a real threat in Japan. The AMR Action Plans aim to mitigate the growing public health concern posed by AMR. Objective: This study aims to estimate the clinical and economic outcomes of drug-resistant Gram-negative pathogens forecasts for Japan to guide resource allocation defined within the upcoming National AMR Action Plan. Methods: A previously published and validated dynamic health economic model was adapted to the Japanese setting. The model used a 10-year time horizon with a willingness-to-pay threshold of ¥5 000 000 (US $46 827) and discounting was applied at a rate of 2% to costs and benefits. Clinical and economic outcomes were assessed as a function of varying AMR levels of three Gram-negative pathogens in Japan by up to 100% of the current level. Results: Reducing drug-resistant Gram-negative pathogens in Japan has the potential to save 4 249 096 life years, corresponding to 3 602 311 quality-adjusted life years. The associated maximum clinical and economic gains were estimated at up to 4 422 284 bed days saved, up to 3 645 480 defined daily doses of antibiotics avoided, up to ¥117.6 billion (US $1.1 billion) saved in hospitalization costs, and a net monetary benefit of up to ¥18.1 trillion (US $169.8 billion). Discussion: Learnings from this study can be used by the Japanese government to help inform decision-making on the strategies that may be included in the upcoming National AMR Action Plan and facilitate allocation of the required budget. Conclusions: This analysis demonstrated the considerable economic and clinical value of reducing AMR levels of three Gram-negative pathogens in Japan and could be utilized to support the valuation of antimicrobial treatment and resistance in Japan and more broadly.

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

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.

scholarly journals The role of disease burden measures in future estimates of endemic waterborne disease

2006 ◽  
Vol 4 (S2) ◽  
pp. 187-199 ◽  
Author(s):  
Glenn Rice ◽  
Matthew T. Heberling ◽  
Mary Rothermich ◽  
J. Michael Wright ◽  
Patricia A. Murphy ◽  
...  
Keyword(s):  
Public Health ◽  
Drinking Water ◽  
Burden Of Disease ◽  
The United States ◽  
Health Concern ◽  
Sufficient Information ◽  
Waterborne Disease ◽  
Life Years ◽  
Hospitalization Costs ◽  
The Impact

The 1996 Safe Drinking Water Act amendments require the US Environmental Protection Agency and the Centers for Disease Control and Prevention to develop a national estimate of the occurrence of waterborne infectious disease that is attributable to public drinking water systems in the United States. Much of the information for developing the national estimate will be derived from epidemiologic data, and the primary outcome of this effort will be an estimate of the number of cases of gastrointestinal illness. While quantifying the number of these cases provides some measure of waterborne disease impact, the usefulness of this measure may be limited because the full spectrum of societal impact also involves consideration of the additional effects of these diseases such as hospitalization costs and lost productivity. If decision-makers wish to compare the impact of waterborne infectious diseases to the impact of some other public health concern (e.g. to aid in resource allocation decisions), then a comparison of case numbers may prove inadequate. Case numbers alone do not provide sufficient information about the severity of different illnesses. Society may value the avoidance of a few cases of severely debilitating illness more than it values the avoidance of many cases of mild illness. In order to compare disparate public health concerns, “burden of disease” measures that incorporate indicators of disease severity, costs, or societal values may prove essential for some types of decisions. We describe epidemiologic measures of severity, quality adjusted life years (QALYs), disability adjusted life years (DALYs), willingness-to-pay, and cost-of-illness methods commonly used for burden of disease estimates, and discuss how some of these summary measures of burden might be used for waterborne disease estimates.

European Surveillance of Antimicrobial Consumption: the ESAC programme

2004 ◽  
Vol 8 (32) ◽  
Author(s):  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Health Concern ◽  
Antimicrobial Consumption ◽  
Public Health Concern ◽  
Major Public Health Concern

Resistance to antimicrobials has become a major public health concern, and it has been shown that there is a relationship, albeit complex, between antimicrobial resistance and consumption

scholarly journals Antimicrobial Resistance Profiling of Biofilm Forming Non Typhoidal Salmonella enterica Isolates from Poultry and Its Associated Food Products from Pakistan

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 785
Author(s):  
Abubakar Siddique ◽  
Sara Azim ◽  
Amjad Ali ◽  
Saadia Andleeb ◽  
Aitezaz Ahsan ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Biofilm Formation ◽  
Salmonella Enteritidis ◽  
Multiple Drug Resistance ◽  
Food Products ◽  
Health Concern ◽  
Multiple Drug ◽  
Zoonotic Potential ◽  
Salmonella Spp

Salmonellosis caused by non-typhoidal Salmonellaenterica from poultry products is a major public health concern worldwide. This study aimed at estimating the pathogenicity and antimicrobial resistance in S. enterica isolates obtained from poultry birds and their food products from different areas of Pakistan. In total, 95/370 (25.67%) samples from poultry droppings, organs, eggs, and meat were positive for Salmonella. The isolates were further identified through multiplex PCR (mPCR) as Salmonella Typhimurium 14 (14.7%), Salmonella Enteritidis 12 (12.6%), and other Salmonella spp. 69 (72.6%). The phenotypic virulence properties of 95 Salmonella isolates exhibited swimming and/or swarming motility 95 (100%), DNA degrading activity 93 (97.8%), hemolytic activity 92 (96.8%), lipase activity 87 (91.6%), and protease activity 86 (90.5%). The sopE virulence gene known for conferring zoonotic potential was detected in S. Typhimurium (92.8%), S. Enteritidis (100%), and other Salmonella spp. (69.5%). The isolates were further tested against 23 antibiotics (from 10 different antimicrobial groups) and were found resistant against fifteen to twenty-one antibiotics. All isolates showed multiple drug resistance and were found to exhibit a high multiple antibiotic-resistant (MAR) index of 0.62 to 0.91. The strong biofilm formation at 37 °C reflected their potential adherence to intestinal surfaces. There was a significant correlation between antimicrobial resistance and the biofilm formation potential of isolates. The resistance determinant genes found among the isolated strains were blaTEM-1 (59.3%), blaOxA-1 (18%), blaPSE-1 (9.5%), blaCMY-2 (43%), and ampC (8.3%). The detection of zoonotic potential MDR Salmonella in poultry and its associated food products carrying cephalosporin and quinolone resistance genes presents a major threat to the poultry industry and public health.

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

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.

scholarly journals Global Governance of Anti-microbial Resistance: A Legal and Regulatory Toolkit

2020 ◽  
pp. 401-420
Author(s):  
Calvin W. L. Ho ◽  
Tsung-Ling Lee
Keyword(s):  
Public Health ◽  
System Approach ◽  
Action Plan ◽  
World Health ◽  
Health Concern ◽  
Global Public Health ◽  
Agricultural Industry ◽  
Treatment And Prevention ◽  
Global Action ◽  
Health Organization

Abstract Recognizing that antimicrobial resistance (AMR) poses a serious threat to global public health, the World Health Organization (WHO) has adopted a Global Action Plan (GAP) at the May 2015 World Health Assembly. Underscoring that systematic misuse and overuse of drugs in human medicine and food production is a global public health concern, the GAP-AMR urges concerted efforts across governments and private sectors, including pharmaceutical industry, medical professionals, agricultural industry, among others. The GAP has a threefold aim: (1) to ensure a continuous use of effective and safe medicines for treatment and prevention of infectious diseases; (2) to encourage a responsible use of medicines; and (3) to engage countries to develop their national actions on AMR in keeping with the recommendations. While the GAP is a necessary step to enable multilateral actions, it must be supported by effective governance in order to realize the proposed aims. This chapter has a threefold purpose: (1) To identify regulatory principles embedded in key WHO documents relating to AMR and the GAP-AMR; (2) To consider the legal and regulatory actions or interventions that countries could use to strengthen their regulatory lever for AMR containment; and (3) To highlight the crucial role of the regulatory lever in enabling other levers under a whole-of-system approach. Effective AMR containment requires a clearer understanding of how the regulatory lever could be implemented or enabled within health systems, as well as how it underscores and interacts with other levers within a whole-of-system approach.

scholarly journals Colistin resistance among Gram-negative isolates in Nepal: A review

2020 ◽  
Vol 7 (1) ◽  
pp. 33-39
Author(s):  
Surya Prasad Devkota ◽  
Ashmita Paudel
Keyword(s):  
Public Health ◽  
Public Health Problem ◽  
Clinical Isolates ◽  
Clinical Settings ◽  
Drug Resistant ◽  
Colistin Resistance ◽  
Gram Negative ◽  
Food Industries ◽  
Animal Farms ◽  
Animal Isolates

Background: Colistin resistance among Gram-negative isolates is a tremendous public health problem, and there are very few studies in Nepal about these pathogens. Hence, this review provides comprehensive data on colistin resistance among Gram-negative isolates from various samples in Nepal. Methods: Articles reporting colistin resistance among various Gram-negative isolates from Nepal before July 2019 were selected; analyzed and relevant data was collected. Results: Colistin resistance was low among clinical isolates (less than 6%) in comparison to food and animal isolates (up to 69%). A wide variety of clinical isolates were colistin-resistant in comparison to food and animal isolates. Many of these isolates were highly drug-resistant and also harbored various drug-resistant determinants. Conclusion: Increased colistin resistance among Gram-negative pathogens is a serious concern. Screening of these isolates in clinical settings, animal farms, and food industries, as well as cautious use of colistin in both clinical and animal farms, is imminent.

scholarly journals Knowledge, Attitudes and Practices of Veterinarians Towards Antimicrobial Resistance and Stewardship in Nigeria

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 453
Author(s):  
Usman O. Adekanye ◽  
Abel B. Ekiri ◽  
Erika Galipó ◽  
Abubakar Bala Muhammad ◽  
Ana Mateus ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Online Survey ◽  
Action Plan ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Health Concern ◽  
Attitudes And Practices ◽  
Laboratory Services ◽  
Knowledge Attitudes And Practices

Antimicrobial resistance (AMR) is a global health concern and the inappropriate use of antibiotics in animals and humans is considered a contributing factor. A cross-sectional survey to assess the knowledge, attitudes and practices of veterinarians regarding AMR and antimicrobial stewardship was conducted in Nigeria. A total of 241 respondents completed an online survey. Only 21% of respondents correctly defined the term antimicrobial stewardship and 59.8% were unaware of the guidelines provided by the Nigeria AMR National Action Plan. Over half (51%) of the respondents indicated that prophylactic antibiotic use was appropriate when farm biosecurity was poor. Only 20% of the respondents conducted antimicrobial susceptibility testing (AST) frequently, and the unavailability of veterinary laboratory services (82%) and the owner’s inability to pay (72%) were reported as key barriers to conducting AST. The study findings suggest strategies focusing on the following areas may be useful in improving appropriate antibiotic use and antimicrobial stewardship among veterinarians in Nigeria: increased awareness of responsible antimicrobial use among practicing and newly graduated veterinarians, increased dissemination of regularly updated antibiotic use guidelines, increased understanding of the role of good biosecurity and vaccination practices in disease prevention, and increased provision of laboratory services and AST at affordable costs.

scholarly journals Lack of Antimicrobial Resistance in Yersinia pestis Isolates from 17 Countries in the Americas, Africa, and Asia

2011 ◽  
Vol 56 (1) ◽  
pp. 555-558 ◽  
Author(s):  
Sandra K. Urich ◽  
Linda Chalcraft ◽  
Martin E. Schriefer ◽  
Brook M. Yockey ◽  
Jeannine M. Petersen
Keyword(s):  
Public Health ◽  
Multidrug Resistance ◽  
Antimicrobial Resistance ◽  
Yersinia Pestis ◽  
Causative Agent ◽  
Multidrug Resistant ◽  
Antimicrobial Treatment ◽  
Health Concern ◽  
Public Health Concern ◽  
Content Type

ABSTRACTYersinia pestisis the causative agent of plague, a fulminant disease that is often fatal without antimicrobial treatment. Plasmid (IncA/C)-mediated multidrug resistance inY. pestiswas reported in 1995 in Madagascar and has generated considerable public health concern, most recently because of the identification of IncA/C multidrug-resistant plasmids in other zoonotic pathogens. Here, we demonstrate no resistance in 392Y. pestisisolates from 17 countries to eight antimicrobials used for treatment or prophylaxis of plague.

scholarly journals Genes de resistencia en bacilos Gram negativos: Impacto en la salud pública en Colombia

2016 ◽  
Vol 18 (1) ◽  
pp. 190 ◽  
Author(s):  
Diana Paola López Velandia ◽  
María Inés Torres Caycedo ◽  
Carlos Fernando Prada Quiroga
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Resistance Genes ◽  
Public Health Problem ◽  
Control Measures ◽  
World Health ◽  
Cochrane Library ◽  
Resistant Bacteria ◽  
Gram Negative ◽  
The Cochrane Library

ResumenIntroducción: La resistencia antimicrobiana es un grave problema de salud pública que se encuentra en aumento. Entre los factores más importantes relacionados con la diseminación de bacterias multirresistentes está el uso inapropiado de antibióticos y la aplicación insuficiente de las medidas de prevención y control. Adicionalmente, las bacterias tienen la capacidad de mutar o generar mecanismos de transferencia de genes de resistencia mediante plásmidos, transposones e integrones. Materiales y métodos: Se hizo una revisión crítica de la literatura sobre los principales genes de resistencia Gram negativos y su impacto en la salud pública. Fueron utilizadas las bases de datos de Medline, Embase, Lilacs, ScienceDirect, Scopus, SciELO, the Cochrane Library y Lilacs. Resultados: Se presenta una revisión de literatura que describe y analiza los principales genes de resistencia a antibióticos presentes en bacilos gram negativos, su origen, evolución y diseminación a microorganismos mediante la transferencia horizontal de genes; justificando la importancia de realizar una vigilancia epidemiológica del tránsito de clones con diferentes perfiles de resistencia y principales enzimas. Conclusiones: El seguimiento de la resistencia antimicrobiana desde el punto de vista de la epidemiología molecular forma parte transcendental de la vigilancia antibiótica como lo recomienda la Organización Mundial de la Salud; pues representa el futuro del monitoreo de la resistencia.AbstractIntroduction: Antimicrobial resistance is a serious public health problem that is increasing. Among the most important factors related to the spread of multi-resistant bacteria are the inappropriate use of antibiotics and the insufficient  implementation of prevention and control measures. Additionally, bacteria have the ability to mutate or create mechanisms for transfer of resistance genes via plasmids, transposons and integrons. Materials and methods: A critical review of the literature on major resistance genes in Gram negative bacteria and its impact on public health was conducted. Data have been collected from Medline, Embase, Lilacs, ScienceDirect, Scopus, SciELO, the Cochrane Library and Lilacs. Results: A review of literature that describes and analyzes the main antibiotic resistance genes present in gram-negative bacilli is presented, as well as their origin, evolution, and subsequent spread to hundreds of species of microorganisms by Horizontal gene transfer which justifies the importance of conducting an epidemiological surveillance on transit of clones with different resistance profiles and major enzymes. Conclusions: The control of antimicrobial resistance from the point of view of molecular epidemiology is part of the antibiotic surveillance control as recommended by the World Health Organization; as it represents the future of the surveillance of resistance.

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