scholarly journals Antimicrobial Resistance: Then and Now

2020 ◽  
Vol 2 (02) ◽  
pp. 50-55
Author(s):  
Kanika Sharma ◽  
Baitullah Abdali ◽  
Payal Kesharwani ◽  
Neha Mittal ◽  
Hemlata Bisht
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
20Th Century ◽  
Mechanisms Of Resistance ◽  
Resistance Development ◽  
Development History ◽  
The Past ◽  
Genetic Makeup ◽  
Resistance Data ◽  
Alexander Fleming

Antibiotics have been regarded as one of the major discoveries of the 20th century. But the problem that came attached with is the rise of antibiotic resistance in hospitals and communities. The genetic makeup of microbes has benefitted from man's overuse of antibiotics to exploit every source of resistance genes and means of horizontal gene transmission to give rise to various mechanisms of resistance. Alexander Fleming upon accepting the 1945 Nobel Prize in Medicine said “It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them. There is a danger that an ignorant man may easily under dose himself and by exposing his microbes to non lethal quantities of the drug and make them resistant”. This review presents the multifaceted aspects of antibiotic resistance development, history, superbug and superresiatance and resistance data observed over the past years with an overt conclusion showing undeniable methods to overcome the discussed problem, glaringly striking that it is time to act.

scholarly journals Origins and Evolution of Antibiotic Resistance

2010 ◽  
Vol 74 (3) ◽  
pp. 417-433 ◽  
Author(s):  
Julian Davies ◽  
Dorothy Davies
Keyword(s):  
Antibiotic Resistance ◽  
20Th Century ◽  
Resistance Genes ◽  
Mechanisms Of Resistance ◽  
Resistance Development ◽  
The Past ◽  
Past Half Century ◽  
Past Half ◽  
Novel Antibiotics

SUMMARY Antibiotics have always been considered one of the wonder discoveries of the 20th century. This is true, but the real wonder is the rise of antibiotic resistance in hospitals, communities, and the environment concomitant with their use. The extraordinary genetic capacities of microbes have benefitted from man's overuse of antibiotics to exploit every source of resistance genes and every means of horizontal gene transmission to develop multiple mechanisms of resistance for each and every antibiotic introduced into practice clinically, agriculturally, or otherwise. This review presents the salient aspects of antibiotic resistance development over the past half-century, with the oft-restated conclusion that it is time to act. To achieve complete restitution of therapeutic applications of antibiotics, there is a need for more information on the role of environmental microbiomes in the rise of antibiotic resistance. In particular, creative approaches to the discovery of novel antibiotics and their expedited and controlled introduction to therapy are obligatory.

scholarly journals Antibiotic Resistance in Oral/Respiratory Bacteria

1998 ◽  
Vol 9 (4) ◽  
pp. 522-540 ◽  
Author(s):  
M.C. Roberts
Keyword(s):  
Antibiotic Resistance ◽  
Mercury Resistance ◽  
Resistant Bacteria ◽  
Antibiotic Residues ◽  
Mechanisms Of Resistance ◽  
Antibiotic Resistant Bacteria ◽  
Antibiotic Resistant ◽  
The Past ◽  
Resistant Gene ◽  
Rapid Transport

In the last 20 years, changes in world technology have occurred which have allowed for the rapid transport of people, food, and goods. Unfortunately, antibiotic residues and antibiotic-resistant bacteria have been transported as well. Over the past 20 years, the rise in antibiotic-resistant gene carriage in virtually every species of bacteria, not just oral/respiratory bacteria, has been documented. In this review, the main mechanisms of resistance to the important antibiotics used for treatment of disease caused by oral/respiratory bacteria-including β-lactams, tetracycline, and metronidazole-are discussed in detail. Mechanisms of resistance for macrolides, lincosamides, streptogramins, trimethoprim, sulfonamides, aminoglycosides, and chloramphenicol are also discussed, along with the possible role that mercury resistance may play in the bacterial ecology.

scholarly journals Making Sense of Antimicrobial Resistance Surveillance: A successful intervention

2018 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Antibiotic Resistance ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Clinical Laboratory ◽  
Gram Negative Bacteria ◽  
Third Generation ◽  
Resistance Development ◽  
Antibiotic Policy ◽  
Gram Negative ◽  
High Level

Background: The intensive care units are epicenters for the emergence of antibiotic resistant Gram-negative bacteria because of the high use of antibiotics, prolonged hospital stay, reduced patient immunity, use of medical devices, and the frequent contact between healthcare workers and patients. Surveillance of bacterial resistance is the key element to understand the size of the problem, drive interventions, and measures the effect of these measures. Several reports have linked the use of third generation cephalosporins with β-lactam resistance in gram-negative bacteria. Several strategies were introduced by the Antibiotic Stewardship Programs to reduce antibiotic resistance but the efficacies of these interventions are not well studied. Methods: The Microbiology Laboratory of Hamad Medical Corporation (HMC) monitors antimicrobial resistance by continuous surveillance using the National Committee for Clinical Laboratory Standards (NCCLS) - currently Clinical Laboratory Standards Institute interpretive criteria. Surveillance data were released annually and shared with clinicians and policy makers for review of the antibiotic policy and the antibiotic formulary. Results: Surveillance data in 2001 showed high level β-lactam antibiotics resistance and high level production of extended spectrum β-lactamases (ESBL) among gram-negative bacteria. As a result, the Hospital Antibiotic Policy Committee decided to withdraw ceftazidime a third –generation cephalosporin known to be a strong inducer of ESBL, from the hospital formulary. Subsequent resistance surveillance over the following three years in the Medical Intensive Care unit (MICU) demonstrated a gradual drop in the resistance of Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli; the commonest isolated gram negative bacteria from MICU), not only to third and fourth generation cephalosporins, but also to Piperacillin – Tazobactam in spite of the increased use of the later drug in the MICU. Discussion and conclusion: Antibiotic resistance is an increasing global problem. Surveillance studies are needed to monitor resistance development, to guide local empirical therapy, and to implement timely and adequate countermeasures. Since resistance development is an evolutionary process, constant surveillance is necessary to gain insight into the problem in a timely fashion. Several measures were taken including antibiotic cycling, antibiotic rotation and restriction. Restriction of the use of Ceftazidime resulted in a significant drop in the resistance of the common Gram-negative bacteria to the betalactam antibiotics. The sustainability and efficacy of these measures need to be monitored over time.

scholarly journals Reporting epidemiology of antibiotic resistance

2015 ◽  
Vol 30 (2) ◽  
Author(s):  
Simone Ambretti ◽  
Carlo Gagliotti ◽  
Francesco Luzzaro ◽  
Paolo Malacarne ◽  
Angelo Pan ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Temporal Trends ◽  
Surveillance Data ◽  
Surveillance Systems ◽  
Treatment Protocols ◽  
The Us ◽  
Resistance Data ◽  
Single Set ◽  
Critical Aspects

The aim of antimicrobial resistance surveillance is to monitor temporal trends and provide clinicians with data to define empirical treatment protocols. The surveillance methods adopted in different settings can be significantly different and, therefore, no reference can be made to a single set of standards. This paper outlines the main features of analysis and reporting of antimicrobial resistance data according to the guidelines issued by the US Clinical and Laboratory Standards Institute, and the surveillance systems adopted in Europe. In this article the strengths and weaknesses of the various types of analyses will be discussed highlighting the critical aspects to be taken into account in surveillance data reporting.

Mycoplasma genitalium and antimicrobial resistance in Europe: a comprehensive review

2020 ◽  
Vol 31 (3) ◽  
pp. 190-197 ◽  
Author(s):  
Miguel Fernández-Huerta ◽  
María J Barberá ◽  
Judit Serra-Pladevall ◽  
Juliana Esperalba ◽  
Xavier Martínez-Gómez ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Sexually Transmitted Infections ◽  
Mycoplasma Genitalium ◽  
Fluoroquinolone Resistance ◽  
Review Of The Literature ◽  
Limited Data ◽  
Comprehensive Review ◽  
Sexually Transmitted ◽  
Resistance Data

Antibiotic resistance in Mycoplasma genitalium has been emerging in Europe. Also, discrepancies on the management and treatment of sexually transmitted infections may have distinctly influenced the prevalence of antimicrobial resistance among European countries. This comprehensive review of the literature published between 2012 and 2018 updates antimicrobial resistance data in M. genitalium in Europe. Overall, macrolide resistance is rapidly increasing in this region, where many countries are exceeding 50%. The limited data regarding fluoroquinolone resistance estimate a prevalence of 5% (interquartile range, 5–6%). The study supports the need to conduct representative and well-defined surveillance on antimicrobial resistance in M. genitalium at both local and European levels. Also, further investigations on new promising antibiotics are required to fight against M. genitalium that may soon become untreatable.

scholarly journals Translational control of antibiotic resistance

Open Biology ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. 190051 ◽  
Author(s):  
Anne Witzky ◽  
Rodney Tollerson ◽  
Michael Ibba
Keyword(s):  
Antibiotic Resistance ◽  
Drug Discovery ◽  
Translational Control ◽  
Treatment Options ◽  
Mechanisms Of Resistance ◽  
Translation Elongation ◽  
The Past ◽  
New Treatment ◽  
Bacterial Translation ◽  
Ribosomal Protection

Many antibiotics available in the clinic today directly inhibit bacterial translation. Despite the past success of such drugs, their efficacy is diminishing with the spread of antibiotic resistance. Through the use of ribosomal modifications, ribosomal protection proteins, translation elongation factors and mistranslation, many pathogens are able to establish resistance to common therapeutics. However, current efforts in drug discovery are focused on overcoming these obstacles through the modification or discovery of new treatment options. Here, we provide an overview for common mechanisms of resistance to translation-targeting drugs and summarize several important breakthroughs in recent drug development.

scholarly journals Transmission and antibiotic resistance of Achromobacter in cystic fibrosis

2020 ◽  
Author(s):  
Migle Gabrielaite ◽  
Jennifer A. Bartell ◽  
Niels Nørskov-Lauritsen ◽  
Tacjana Pressler ◽  
Finn C. Nielsen ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Antibiotic Resistance ◽  
Severe Disease ◽  
Treatment Strategies ◽  
Clinic Visit ◽  
Resistance Development ◽  
Epidemiological Analysis ◽  
Maldi Tof ◽  
First Time ◽  
Resistance Data

AbstractAchromobacter species are increasingly being detected in patients with cystic fibrosis (CF), and this emerging pathogen is associated with antibiotic resistance and more severe disease outcomes. Nonetheless, little is known about the extent of transmission and antibiotic resistance development in Achromobacter infections.We sequenced the genomes of 101 clinical isolates of Achromobacter (A. xylosoxidans based on MALDI-TOF/API N20 typing) collected from 51 patients with CF—the largest longitudinal dataset to-date. We performed phylogenetic analysis on the genomes and combined this with epidemiological and antibiotic resistance data to identify patient-to-patient transmission and development of antibiotic resistance.We found that MALDI-TOF/API N20 was not sufficient for Achromobacter species-level typing, and that the population of Achromobacter isolates was composed of five different species where A. xylosoxidans accounted for 52% of infections. Most patients were infected by unique Achromobacter clone types; nonetheless, suspected patient-to-patient transmission cases identified by shared clone types were observed in 35% (N=18) of patients. In 15 of 16 cases the suspected transmissions were further supported by genome- or clinic visit-based epidemiological analysis. Finally, we found that resistance developed over time.We show that whole-genome sequencing (WGS) is essential for Achromobacter species typing and patient-to-patient transmission identification which was identified in A. ruhlandii, A. xylosoxidans and, for the first time, A. insuavis. Furthermore, we show that the development of antibiotic resistance is associated with chronic Achromobacter infections. Our findings emphasize that transmission and antibiotic resistance should be considered in future treatment strategies.

scholarly journals Transmission and antibiotic resistance of Achromobacter in cystic fibrosis

2021 ◽  
Author(s):  
Migle Gabrielaite ◽  
Jennifer A. Bartell ◽  
Niels Nørskov-Lauritsen ◽  
Tacjana Pressler ◽  
Finn C. Nielsen ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Antibiotic Resistance ◽  
Severe Disease ◽  
Treatment Strategies ◽  
Clinic Visit ◽  
Resistance Development ◽  
Epidemiological Analysis ◽  
Maldi Tof ◽  
First Time ◽  
Resistance Data

Achromobacter species are increasingly being detected in patients with cystic fibrosis (CF), and this emerging pathogen is associated with antibiotic resistance and more severe disease outcomes. Nonetheless, little is known about the extent of transmission and antibiotic resistance development in Achromobacter infections. We sequenced the genomes of 101 clinical isolates of Achromobacter (A. xylosoxidans based on MALDI-TOF/API N20 typing) collected from 51 patients with CF—the largest longitudinal dataset to-date. We performed phylogenetic analysis on the genomes and combined this with epidemiological and antibiotic resistance data to identify patient-to-patient transmission and development of antibiotic resistance. We confirmed that MALDI-TOF/API N20 was not sufficient for Achromobacter species-level typing, and that the population of Achromobacter isolates was composed of five different species where A. xylosoxidans accounted for 52% of infections. Most patients were infected by unique Achromobacter clone types; nonetheless, suspected patient-to-patient transmission cases identified by shared clone types were observed in 35% (N=18) of patients. In 15 of 16 cases the suspected transmissions were further supported by genome- or clinic visit-based epidemiological analysis. Finally, we found that resistance developed over time. We show that whole-genome sequencing (WGS) is essential for Achromobacter species typing and patient-to-patient transmission identification which was identified in A. ruhlandii, A. xylosoxidans and, for the first time, A. insuavis. Furthermore, we show that the development of antibiotic resistance is associated with chronic Achromobacter infections. Our findings emphasize that transmission and antibiotic resistance should be considered in future treatment strategies.

scholarly journals Perception, Attitude, and Confidence of Physicians About Antimicrobial Resistance and Antimicrobial Prescribing Among COVID-19 Patients: A Cross-Sectional Study From Punjab, Pakistan

2022 ◽  
Vol 12 ◽  
Author(s):  
Khezar Hayat ◽  
Zia Ul Mustafa ◽  
Muhammad Nabeel Ikram ◽  
Muhammad Ijaz-Ul-Haq ◽  
Irum Noor ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Antibiotic Therapy ◽  
Empiric Antibiotic Therapy ◽  
Years Of Experience ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Antimicrobial Prescribing ◽  
Local Antibiotic ◽  
Resistance Data

Background: Patients with coronavirus disease 2019 (COVID-19) could experience multiple coinfections, and judicial antimicrobials, including antibiotics, is paramount to treat these coinfections. This study evaluated physicians’ perception, attitude, and confidence about antimicrobial resistance (AMR) and antimicrobial prescribing in patients with COVID-19.Methods: A self-administered and validated online questionnaire comprised of six sections was disseminated among physicians working in public sector hospitals in Punjab, Pakistan, using the convenience sampling method from April to May 2021. The study also assessed the validity and reliability of the study questionnaire using exploratory factor analysis and Cronbach’s alpha. In addition, the descriptive and inferential statistics present survey results.Results: A total of 387 physicians participated in this study. The study showed that the questionnaire demonstrated good internal consistency (Cronbach’s alpha = 0.77). Most physicians (n = 221, 57.1%) believed that AMR is a considerable problem in Pakistan. Less than a quarter of respondents (n = 91, 23.5%) consulted with local antibiotic resistance data to prescribe antibiotics in COVID-19 patients. However, the respondents were confident to select a suitable antibiotic (n = 229, 59.2%). More than three-quarters of the respondents believed that advice from a senior colleague (n = 336, 86.8%), infectious disease (ID) physician (n = 315, 81.4%), and implementing antimicrobial stewardship programs (ASPs) could facilitate appropriate prescribing of antibiotics in COVID-19 patients. Multivariate logistic regression revealed that physicians with more than 10 years of experience had higher odds of consulting local guidelines for antibiotic therapy (OR, 4.71 95% CI: 1.62–13.73, p = 0.004) than physicians with less than 5 years of experience. Similar trends were found for consulting national guidelines and local resistance data to select an empiric antibiotic therapy.Conclusion: AMR-related awareness was optimal among physicians. Only a few physicians looked up local antibiotic resistance data before prescribing antibiotics to COVID-19 patients empirically. The significant approaches advised by physicians to reduce AMR risk among COVID-19 patients were the implementation of ASPs combined with advice from ID physicians.

Cosmetic Allergen in the Past and Present

2017 ◽  
Vol 2 (3) ◽  
Keyword(s):  
World War Ii ◽  
20Th Century ◽  
Normal Skin ◽  
World War ◽  
Patch Tests ◽  
The Past ◽  
Skin Conditions ◽  
Cosmetic Dermatitis ◽  
Facial Dermatitis ◽  
International Research Project

For almost 20 years after the end of World War II, many Japanese women were challenged by a dark secondary hyper pigmentation on their faces. The causation of this condition was unknown and incurable at the time. However this symptom became curable after a number of new cosmetic allergens were discovered through patch tests and as an aftermath, various cosmetics and soaps that eliminated all these allergens were put into production to be used exclusively for these patients. An international research project conducted by seven countries was set out to find out the new allergens and discover non-allergic cosmetic materials. Due to these efforts, two disastrous cosmetic primary sensitizers were banned and this helped to decrease allergic cosmetic dermatitis. Towards the end of the 20th century, the rate of positives among cosmetic sensitizers decreased to levels of 5% - 8% and have since maintained its rates into the 21th century. Currently, metal ions such as the likes of nickel have been identified as being the most common allergens found in cosmetics and cosmetic instruments. They often produce rosacea-like facial dermatitis and therefore allergen controlled soaps and cosmetics have been proved to be useful in recovering normal skin conditions.

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