scholarly journals A One Health approach to assessing occupational exposure to antimicrobial resistance in Thailand: The FarmResist project

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245250
Author(s):  
Duangdao Sudatip ◽  
Kittipong Chasiri ◽  
Anamika Kritiyakan ◽  
Wantanee Phanprasit ◽  
Chuanphot Thinphovong ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Resistance Genes ◽  
One Health ◽  
Close Contact ◽  
Antibiotic Use ◽  
Farm Animals ◽  
Resistant Bacteria ◽  
Wild Rodents ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase

This Southeast Asia-Europe research project will use a One Health approach to identify the major parameters responsible for the presence of animal-associated antimicrobial resistant bacteria in animal production facilities in Thailand and the risk of their transmission from animals to humans. We will focus on traditional, small, extensive pig and poultry farms where information on antibiotic use is scarce and animals live in close contact with humans. This cross-sectional study will be based on the epidemiological analysis of the antimicrobial resistance (AMR) present in fecal samples from animals and humans. Extended spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E) and Enterobacteriaceae resistant to colistin will be actively searched in the feces of farm animals (pigs and poultry), small wild rodents and farmers. Phenotypic (selective plating) and genotypic (multilocus seuquence typing and sequencing) methods will be used for the detection of AMR, the identification of antibiotic resistance genes (ARGs) and the characterization of strains carrying resistance genes. Questionnaires will be administered to investigate the effects of antibiotic use, farm characteristics and biosecurity measures on the occurrence of AMR in animals. Subsequently, the fecal carriage of AMR and ARGs in farmers will be compared to a control population with no occupational contacts with animals, thus enabling an estimation of the risk of transmission of AMR/ARGs from animals to farmers.

«One Health» approach: transfer of antimicrobial resistance from animals to humans

2018 ◽  
Vol 2 (1) ◽  
pp. 64-83
Author(s):  
A.G. Salmanov ◽  
I.Ya. Kotsyumbas ◽  
V.V. Stybel ◽  
V.P. Muzyka ◽  
O.M. Brezvyn ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Resistance Genes ◽  
Genetic Interaction ◽  
Growth Promotion ◽  
Scientific Evidence ◽  
Ecological Impact ◽  
Antibiotic Use ◽  
Resistant Bacteria ◽  
Food Animals

Antimicrobials are valuable therapeutics whose efficacy is seriously compromised by the emergence and spread of antimicrobial resistance. The current science provides overwhelming evidence that antibiotic use is a powerful selector of resistance that can appear not only at the point of origin but also nearly everywhere else. The latter phenomenon occurs because of the enormous ramifications of horizontal gene transfer. A mounting body of evidence shows that antimicrobial use in animals, including the nontherapeutic use of antimicrobials, leads to the propagation and shedding of substantial amounts of antimicrobial-resistant bacteria — both as pathogens, which can directly and indirectly infect humans, and as commensals, which may carry transferable resistance determinants across species borders and reach humans through multiple routes of transfer. These pathways include not only food but also water and sludge and manure applications to food crop soils. Continued nontherapeutic use of antimicrobials in food animals will increase the pool of resistance genes, as well as their density, as bacteria migrate into the environment at large. The lack of species barriers for gene transmission argues that the focus of research efforts should be directed toward the genetic infrastructure and that it is now imperative to take an ecological approach toward addressing the impacts of NTA use on human disease. The study of animal-to-human transmission of antibiotic resistance therefore requires a greater understanding of the genetic interaction and spread that occur in the larger arena of commensal and environmental bacteria. The provision of antibiotics to food animals encompasses a wide variety of nontherapeutic purposes that include growth promotion. The concern over resistance emergence and spread to people by nontherapeutic use of antimicrobials has led to conflicted practices and opinions. Considerable evidence supported the removal of nontherapeutic antimicrobials in Europe and North America, based on the «precautionary principle». Still, concrete scientific evidence of the favorable versus unfavorable consequences of nontherapeutic antimicrobials is not clear to all stakeholders. Substantial data show elevated antibiotic resistance in bacteria associated with animals fed nontherapeutic antimicrobials and their food products. This resistance spreads to other animals and humans-directly by contact and indirectly via the food chain, water, air, and manured and sludge-fertilized soils. Modern genetic techniques are making advances in deciphering the ecological impact of nontherapeutic antimicrobials, but modeling efforts are thwarted by deficits in key knowledge of microbial and antibiotic loads at each stage of the transmission chain. Still, the substantial and expanding volume of evidence reporting animal-to-human spread of resistant bacteria, including that arising from use of nontherapeutic antimicrobials, supports eliminating antibiotics use in order to reduce the growing environmental load of resistance genes.

scholarly journals Updated research agenda for water, sanitation and antimicrobial resistance

2020 ◽  
Vol 18 (6) ◽  
pp. 858-866
Author(s):  
Daisuke Sano ◽  
Astrid Louise Wester ◽  
Heike Schmitt ◽  
Mohan Amarasiri ◽  
Amy Kirby ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Resistance Genes ◽  
One Health ◽  
Action Plan ◽  
Geographical Area ◽  
Health Surveillance ◽  
World Health ◽  
Resistant Bacteria ◽  
Relative Role ◽  
Human Waste

Abstract The emergence and spread of antimicrobial resistance (AMR), including clinically relevant antimicrobial-resistant bacteria, genetic resistance elements, and antibiotic residues, presents a significant threat to human health. Reducing the incidence of infection by improving water, sanitation, and hygiene (WASH) is one of five objectives in the World Health Organization's (WHO) Global Action Plan on AMR. In September 2019, WHO and the Health-Related Water Microbiology specialist group (HRWM-SG) of the International Water Association (IWA) organized its third workshop on AMR, focusing on the following three main issues: environmental pathways of AMR transmission, environmental surveillance, and removal from human waste. The workshop concluded that despite an increase in scientific evidence that the environment may play a significant role, especially in low-resource settings, the exact relative role of the environment is still unclear. Given many antibiotic-resistant bacteria (ARB) can be part of the normal gut flora, it can be assumed that for environmental transmission, the burden of fecal-oral transmission of AMR in a geographical area follows that of WASH-related infections. There are some uncertainties as to the potential for the propagation of particular resistance genes within wastewater treatment plants (WWTPs), but there is no doubt that the reduction in viable microbes (with or without resistance genes) available for transmission via the environment is one of the goals of human waste management. Although progress has been made in the past years with respect to quantifying environmental AMR transmission potential, still more data on the spread of environmental AMR within human communities is needed. Even though evidence on AMR in WWTPs has increased, the reduction in the emergence and spread of AMR by basic sanitation methods is yet unresolved. In order to contribute to the generation of harmonized One Health surveillance data, WHO has initiated an integrated One Health surveillance strategy that includes the environment. The main challenge lies in rolling it out globally including to the poorest regions.

scholarly journals Assessing Knowledge and Perception Regarding Antimicrobial Stewardship and Antimicrobial Resistance in University Students of Pakistan: Findings and Implications

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 866
Author(s):  
Iltaf Hussain ◽  
Nisa Yousaf ◽  
Sana Haider ◽  
Pervisha Jalil ◽  
Muhammad Usman Saleem ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
University Students ◽  
Antimicrobial Stewardship ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Dosing Regimen ◽  
Student Knowledge ◽  
Chi Square ◽  
Cross Sectional ◽  
Self Administered Questionnaire

The irrational use of antimicrobials has enormously contributed to antimicrobial resistance (AMR) globally and especially in the developing world. To assess the knowledge and perception regarding AMR and antimicrobial stewardship (AMS), a descriptive cross-sectional study was carried out in university students enrolled in pharmacy, veterinary, and biology programs by using an online self-administered questionnaire. The Chi-square and Fisher exact tests (where applicable) were performed to assess the association of the demographics with the students’ knowledge and perception regarding AMR and AMS. A total of 496 students completed the questionnaire, among which, 85.7% of the participants were familiar with the term AMR and 79.4% of the participants correctly identified a poorly designed dosing regimen as a contributing factor towards AMR. The majority of participants (57.9%) were familiar with the term AMS and 86.5% were aware of the aim of AMS. The participants showed good knowledge regarding AMR and AMS, but to further improve student knowledge and perception of AMS and AMR, it is suggested that dedicated modules on antibiotic use and AMS should be incorporated into the curricula of these undergraduate and postgraduate programs.

scholarly journals Unsafe “crossover-use” of chloramphenicol in Uganda: importance of a One Health approach in antimicrobial resistance policy and regulatory action

2021 ◽  
Author(s):  
Kayley D. McCubbin ◽  
John W. Ramatowski ◽  
Esther Buregyeya ◽  
Eleanor Hutchinson ◽  
Harparkash Kaur ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Focus Group ◽  
Low Income ◽  
One Health ◽  
Antibiotic Use ◽  
Regulatory Action ◽  
Health Concern ◽  
Drug Shop ◽  
Human Consumption ◽  
Human Use

AbstractSince the introduction of antibiotics into mainstream health care, resistance to these drugs has become a widespread issue that continues to increase worldwide. Policy decisions to mitigate the development of antimicrobial resistance are hampered by the current lack of surveillance data on antibiotic product availability and use in low-income countries. This study collected data on the antibiotics stocked in human (42) and veterinary (21) drug shops in five sub-counties in Luwero district of Uganda. Focus group discussions with drug shop vendors were also employed to explore antibiotic use practices in the community. Focus group participants reported that farmers used human-intended antibiotics for their livestock, and community members obtain animal-intended antibiotics for their own personal human use. Specifically, chloramphenicol products licensed for human use were being administered to Ugandan poultry. Human consumption of chloramphenicol residues through local animal products represents a serious public health concern. By limiting the health sector scope of antimicrobial resistance research to either human or animal antibiotic use, results can falsely inform policy and intervention strategies. Therefore, a One Health approach is required to understand the wider impact of community antibiotic use and improve overall effectiveness of intervention policy and regulatory action.

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

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.

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

2013 ◽  
Vol 4 (4) ◽  
pp. 5 ◽  
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.

scholarly journals A study on antibiotic prescription among the hospitalized pediatric patients at a referral center in Puducherry, India

2017 ◽  
Vol 4 (3) ◽  
pp. 700
Author(s):  
M. Bala Gopal ◽  
P. Thiyagarajan ◽  
Vinayagamoorthy Venugopal ◽  
Venkata Naveen Kumar
Keyword(s):  
Infectious Disease ◽  
Developing Countries ◽  
Antimicrobial Resistance ◽  
Significant Proportion ◽  
Antibiotic Use ◽  
Hospitalized Children ◽  
Referral Centre ◽  
Cross Sectional ◽  
Microbial Resistance ◽  
The Cost

Background: Antimicrobial resistance has reached to a significant proportion globally. This antimicrobial resistance increases the cost of health care in addition to the existing burden of the prevalence of infectious disease in developing countries. We need to have institutional protocols based on the standard guidelines. It is important for the clinician to use antibiotics only when it is necessary. The aim of the study was to analyze the rationality of the antibiotics used among the hospitalized children in the referral centre located in the rural area, to evaluate the pattern of antibiotics prescribed among the hospitalized children and to find out the factors associated with the usage of antibiotics among them.  Methods: Analytical, cross sectional study was performed on all patients admitted to the inpatient pediatric medical service at a referral centre situated in the rural part of the Puducherry, India during the period from July 2015 to June 2016. Results: 959 children were included in our study.607 children belong to less than 5 years of age group. Overall 60% of the children have received either oral or parenteral antibiotics. Based on the categorization of children as per the final clinical diagnosis children requiring antibiotic, can be used and not required are 13% (125), 38.6% (370) and 48.4% (464) respectively. Respiratory, gastrointestinal and systemic infectious diseases were the major group of cases admitted in our centre. Antibiotic use in respiratory and systemic infectious disease were maximum with 248 (70.1%) and 179 (71.6%) respectively. Among the antibiotics cephalosporin, penicillin group and azithromycin constitute more than 90% of the antibiotics prescribed cases.Conclusions: Overuse of antibiotic is universal and seen in both developed and developing countries. This increases the cost of treatment and increases the chances of microbial resistance. As per the W.H.O. recommendations surveillance system is required in all the hospitals to assess the antibiotic use and to monitor the prevalence of microbial resistance. 

scholarly journals Aquatic environments in the One Health context: modulating the antimicrobial resistance phenomenon

2020 ◽  
Vol 32 ◽  
Author(s):  
Juliana Alves Resende ◽  
Vânia Lúcia da Silva ◽  
Claudio Galuppo Diniz
Keyword(s):  
Antimicrobial Resistance ◽  
One Health ◽  
Anthropogenic Activities ◽  
Treatment Strategies ◽  
Chemical Pollution ◽  
Resistant Bacteria ◽  
Aquatic Environments ◽  
Antimicrobial Substances ◽  
Antimicrobial Resistance Genes ◽  
The One

Abstract: From an anthropocentric perspective, aquatic environments are important to maintain health and survival, however, as they are sometimes managed based on misconception, they are considered a convergent pathway for anthropogenic residues and sanitation. Thus, it is observed that these ecosystems have been threatened by chemical pollution due to xenobiotics, especially from a more contemporary approach, by the selective pressure associated with antimicrobials. There are several studies that report the enrichment of antimicrobial resistant bacteria and mobilizable antimicrobial resistance genes in aquatic and adjacent ecosystems. From the perspective of the emerging and reemerging number of diseases related to the interplay of human, animal, and environmental factors, a new conception arose to address these issues holistically, which is known as the One Health approach. Scientific and political discourse on this conception should lead to effective action plans for preventing and controlling the spread of infectious diseases in open environment, including those impacted by anthropogenic activities. Therefore, nowadays, discussions on antimicrobial resistance are becoming broader and are requiring a multi-disciplinary view to address health and environmental challenges, which includes aquatic environment management. Water may represent one of the most important ecosystems for the in antimicrobial resistance phenomenon that arises when a dynamic and singular microbial community may be influenced by several characteristics. As antimicrobial substances do not all degrade at the same time under the same treatment, strategies concerning their removal from the environment should consider their individualized chemical characteristics.

A cross-sectional research conducted in Malatya province, Turkey: Knowledge levels and awareness about rational antibiotic use and antimicrobial resistance before and after graduation

2019 ◽  
Author(s):  
ADEM KOSE
Keyword(s):  
Antimicrobial Resistance ◽  
Family Physicians ◽  
Antibiotic Use ◽  
Theoretical Knowledge ◽  
Cross Sectional ◽  
Before And After ◽  
Group 2 ◽  
Senior Students ◽  
Rational Antibiotic Use ◽  
Group 1

Abstract Background Irrational antibiotic use can adversely affect treatment outcomes or even lead to increased antimicrobial resistance. We aimed to determine antimicrobial prescribing habits and to evaluate the level of theoretical knowledge of rational antibiotic use and awareness about antimicrobial resistance among the senior students of medical faculty and the family physicians in Malatya province in Turkey. Methods This study was cross-sectional research and was carried out between dates of 01 February-30 April 2019, in Malatya province. Power analysis was calculated as minimum 240 participants when considering a proportion difference of 0.18 between the groups, a type I error of 0.05 and a type II error of 0.20. A total 225 senior students in Inonu University Medical Faculty (Group 1) and 230 actively-working family physicians in Malatya primary healthcare services who were found eligible (Group 2) were included in to this study. A questionnaire form was prepared including seven sections and thirty questions. All of the participants were interviewed face to face. Before the questions, the purpose of the study and the contents of the questions were explained to participants. Qualitative data were analyzed by Pearson chi-square test. A p<0.05 value was considered to be statistically significant. Results The group 1 had a tendency to apply to specialist physician when starting to themselves antibiotic treatment, they were more cautious when making antibiotic decision, and their theoretical knowledge level was better. They argued that penal sanctions could be more effective by developing strict use policies to raise awareness of resistance to antibiotics. The group 2 had higher self-confidence and it was also concluded that forgot their theoretical antibiotic knowledge over time and could not follow the novel information because of the intensity of working life. Both groups stated that post-graduation trainings could be used effectively for reducing the antibiotic resistance. Conclusion This study highlighted the need for immediate action of training and corrective actions and might create awareness to determine the difference in theoretical knowledge levels and behavior models of physicians before and after graduation and to reduce higher use rates to lower levels. Key words: Antimicrobial resistance, antibiotic, awareness, rational use

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