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.

scholarly journals Research and Technological Advances Regarding the Study of the Spread of Antimicrobial Resistance Genes and Antimicrobial-Resistant Bacteria Related to Animal Husbandry

2019 ◽  
Vol 16 (24) ◽  
pp. 4896
Author(s):  
Na Li ◽  
Chong Liu ◽  
Zhiguo Zhang ◽  
Hongna Li ◽  
Tingting Song ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Resistance Genes ◽  
High Throughput Sequencing ◽  
Animal Husbandry ◽  
Control Measures ◽  
Research Progress ◽  
Future Research ◽  
Resistant Bacteria ◽  
Technological Advances ◽  
Antimicrobial Resistance Genes

The extensive use of antimicrobials in animal farms poses serious safety hazards to both the environment and public health, and this trend is likely to continue. Antimicrobial resistance genes (ARGs) are a class of emerging pollutants that are difficult to remove once introduced. Understanding the environmental transfer of antimicrobial-resistant bacteria (ARB) and ARGs is pivotal for creating control measures. In this review, we summarize the research progress on the spread and detection of ARB and ARG pollution related to animal husbandry. Molecular methods such as high-throughput sequencing have greatly enriched the information about ARB communities. However, it remains challenging to delineate mechanisms regarding ARG induction, transmission, and tempo-spatial changes in the whole process, from animal husbandry to multiple ecosystems. As a result, future research should be more focused on the mechanisms of ARG induction, transmission, and control. We also expect that future research will rely more heavily on metagenomic -analysis, metatranscriptomic sequencing, and multi-omics technologies

scholarly journals Case-based surveillance of antimicrobial resistance with full susceptibility profiles

2019 ◽  
Vol 1 (3) ◽  
Author(s):  
Sukhyun Ryu ◽  
Benjamin J Cowling ◽  
Peng Wu ◽  
Scott Olesen ◽  
Christophe Fraser ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Clinical Decision Making ◽  
Clinical Importance ◽  
Patient Characteristics ◽  
Clinical Decision ◽  
Control Measures ◽  
Resistant Bacteria ◽  
Susceptibility Profiles ◽  
Case Based

Abstract Surveillance of antimicrobial resistance (AMR) is essential for clinical decision-making and for public health authorities to monitor patterns in resistance and evaluate the effectiveness of interventions and control measures. Existing AMR surveillance is typically based on reports from hospital laboratories and public health laboratories, comprising reports of pathogen frequencies and resistance frequencies among each species detected. Here we propose an improved framework for AMR surveillance, in which the unit of surveillance is patients with specific conditions, rather than biological samples of a particular type. In this ‘case-based’ surveillance, denominators as well as numerators will be clearly defined with clinical relevance and more comparable at the local, national and international level. In locations with sufficient resources, individual-based data on patient characteristics and full antibiotic susceptibility profiles would provide high-quality evidence for monitoring resistant pathogens of clinical importance, clinical treatment of infections and public health responses to outbreaks of infections with resistant bacteria.

scholarly journals A review on Antibiotic Policy and Antimicrobial Stewardship Program (AMSP) – Need of the hour

2021 ◽  
Vol 12 (2) ◽  
pp. 1233-1237
Author(s):  
Manoj Kumar ◽  
Anu Sharma ◽  
Yasmeen M ◽  
Parwez
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Health Problem ◽  
Public Health Problem ◽  
Current Situation ◽  
Resistant Bacteria ◽  
Antimicrobial Stewardship Program ◽  
Antibiotic Policy ◽  
Stewardship Program

Emerging trends of antimicrobial resistance and development of multidrug resistance and pan resistant strains have become a significant public health problem worldwide. The rate at which newer drugs are developing has slowed down and clinicians are left with only limited therapeutic options for treatment of the patient. We are heading towards the pre antibiotic discovery phase where mortality was high due to unavailability of appropriate drugs; however, in current situation due to misuse or over use of antibiotics, microbes have developed newer methods of resistance, thus rendering these antimicrobials ineffective in their action which has resulted in increased morbidity and mortality among patient and increase in the health care expenditure. Antimicrobial resistance continues to be a major public health problem of international concern. As there is alarming situation globally due to development of multi and pan resistant bacteria which are also known as superbugs, these superbugs have resulted in havoc as these infections are not treatable and is of great concern to the treating physician. Judicious use of antibiotics and implementation of antibiotic stewardship program are the only ways to combat the current situation. The present review aims to provide information on framing of antibiotic policy and implementation of antimicrobial stewardship program.      

scholarly journals A Review of Superbug: A Global Threat in Health Care System

2018 ◽  
Vol 4 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Bhuiyan Mohammad Mahtab Uddin ◽  
Md Abdullah Yusuf ◽  
Zubair Ahmed Ratan
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Antimicrobial Agents ◽  
Public Health Problem ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Major Public Health Problem ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Hospital Acquired

The rapid spread and dissemination of the multidrug-resistant bacteria worldwide represents a major public health problem. The development of antibiotics decreased the mortality among the human and animals leading to a better life expectancy. But the injudicious use of antimicrobials and selection pressure the microbes have developed resistance which became more prominent during last few decades. With the evolution of Methicilin-resistant Staphylococcus aureus (MRSA), Hospital-acquired MRSA, Communityacquired MRSA and MDR TB (Multidrug resistant tuberculosis) challenge for the clinicians have increased to a greater extent. The global emergence and dissemination of acquired carbapenemases among gram negative bacteria are considered a major public health problem. Gram-negative bacteria, most notably Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii, are among the most important causes of serious hospital-acquired and community-onset bacterial infections in humans, and resistance to antimicrobial agents in these bacteria has become an increasingly relevant problem. Recent development in nanotechnology based drug delivery system may prove to be solution for combating these resistant bacteria. However policies and regulations for antibiotic use should be formulated to control the further development of resistance among the microbes.Bangladesh Journal of Infectious Diseases 2017;4(1):25-28

scholarly journals Antibiotic Resistance Profile and Resistance Determination of Bacteria Isolated from Water in Southern Benin

2021 ◽  
pp. 91-105
Author(s):  
Hornel Koudokpon ◽  
Victorien Dougnon ◽  
Christelle Lougbegnon ◽  
Esther Deguenon ◽  
Wassiyath Mousse ◽  
...  
Keyword(s):  
Drinking Water ◽  
Antimicrobial Resistance ◽  
Resistance Genes ◽  
Water Samples ◽  
Meca Gene ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Gram Negative ◽  
Antimicrobial Resistance Genes ◽  
Southern Benin

Background: The environment plays an important role in the dissemination of multidrug resistant bacteria, especially through the aquatic ecosystem, including hospital effluents, rivers, but also spring water and drinking water. This study aims to determine selected antimicrobial resistance genes in some aquatic matrices in southern Benin. Methods: Collected water samples were filtered through a membrane 0.22 µm thick. After filtration, the membrane was deposited on Muëller Hinton agar. Then the colonies resulting from this subculture were subjected to a microbiological examination by the conventional method. The antibiotic sensitivity test was carried out by the Kirby Bauer method according to the recommendations of the French Society of Microbiology. Resistance genes were looked for by PCR. Results: Of the 222 water samples collected, 265 bacterial strains were isolated, the majority of which were strains of Coagulase Negative Staphylococcus (CNS) with 37.74% (n = 100), followed by strains of Klebsiella pneumoniae (21.89%; n = 58), Escherichia coli (10.57%; n = 28). All isolated gram-negative bacilli strains are multidrug resistant with resistance of all strains to amoxicillin, ampicillin and amoxicillin + clavulanic acid. Of the 15 resistance genes searched in the genome of Gram-negative bacilli strains, 8 were detected, namely the TEM, SHV, CTX-M15, VIM, NDM, SUL1, SUL2 and AADA genes. Resistance of CNS strains to amoxicillin, oxacillin and cefoxitin was observed. The meca gene was detected in all CNS strains. The vanA and VanB genes were only detected in strains isolated from drinking water in sachets collected from producers and street sellers. Conclusion: These results show the dissemination of resistance genes in Benin and once again confirms the urgency of a global fight against antimicrobial resistance.

Prevalence of Carbapenemase Genes, qacE, qacEΔ1 and cepA in Multidrug-Resistant Gram-Negative Bacteria with Different Susceptibility to Chlorhexidine

2020 ◽  
Vol 19 (5) ◽  
pp. 49-60
Author(s):  
K. G. Kosyakova ◽  
N. B. Esaulenko ◽  
O. A. Kameneva ◽  
S. P. Kazakov ◽  
A. Y. Dubinina ◽  
...  
Keyword(s):  
Resistance Genes ◽  
Multidrug Resistant ◽  
World Health ◽  
Dynamic Monitoring ◽  
Resistant Bacteria ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Health Organization

Relevance The World Health Organization has provided a list of resistant bacteria that pose the greatest threat to society. Among them, the most important (critically high priority level) are Pseudomonas aeruginosa and Acinetobacter baumannii strains resistant to carbapenems, as well as enterobacteriaceae producing extended spectrum beta-lactamases and carbapenemases.Aim. To conduct a comparative analysis of the sensitivity to chlorhexidine of multiply-resistant gram-negative bacteria, the causative agents of infectious conditions in patients of various medical organizations, and to study the relationship between the presence of resistance genes and the minimum inhibitory concentration of chlorhexidine.Materials & methods. The study included 138 Gram-negative multidrug-resistant strains isolated during 2018–2019 from various clinical specimens. Susceptibility of the isolates to antibiotics were determined using Vitek-2 compact and Phoenix М50, susceptibility to chlorhexidine were determined by agar dilution method. The resistance genes were detected by the real-time PCR method.Results. The lowest level of resistance to chlorhexidine was determined in E. coli strains (MIC90 16 mg/l), other strains were highly resistant: MIC90 of P. aeruginosa and A. baumannii – 128 mg/l, K. pneumoniae, E. cloacae и P. mirabilis – 256 mg/l. The highest frequency of detection of carbapenemase genes observed in K. pneumoniae strains – 56.0% and P. aeruginosa – 48.1%. High prevalence of cepA gene was found out (the strains of enterobacteria – 47.8%, A. baumannii – 42.9%), genes qacE, qacEΔ1 were more often detected in non-fermenting Gram-negative bacteria then in enterobacteria. Conclusion. According to the results of our study, we did not reveal a significant correlation between the presence or absence of resistance genes and MIC of chlorhexidine in Gram-negative bacteria. However, taking into account complex mechanism of the adaptive response of bacteria to the effects of chlorhexidine, and to implement the concept of preventing health care-associated infections, it is proposed to continue dynamic monitoring of the resistance of microorganisms to antiseptics, disinfectants and antibiotics.

scholarly journals Using the NCBI AMRFinder Tool to Determine Antimicrobial Resistance Genotype-Phenotype Correlations Within a Collection of NARMS Isolates

2019 ◽  
Author(s):  
Michael Feldgarden ◽  
Vyacheslav Brover ◽  
Daniel H. Haft ◽  
Arjun B. Prasad ◽  
Douglas J. Slotta ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Resistance Gene ◽  
Monitoring System ◽  
Resistance Genes ◽  
Health Problem ◽  
Public Health Problem ◽  
Gene Symbol ◽  
Major Public Health Problem ◽  
Gene Database

AbstractAntimicrobial resistance (AMR) is a major public health problem that requires publicly available tools for rapid analysis. To identify acquired AMR genes in whole genome sequences, the National Center for Biotechnology Information (NCBI) has produced a high-quality, curated, AMR gene reference database consisting of up-to-date protein and gene nomenclature, a set of hidden Markov models (HMMs), and a curated protein family hierarchy. Currently, the Bacterial Antimicrobial Resistance Reference Gene Database contains 4,579 antimicrobial resistance gene proteins and more than 560 HMMs.Here, we describe AMRFinder, a tool that uses this reference dataset to identify AMR genes. To assess the predictive ability of AMRFinder, we measured the consistency between predicted AMR genotypes from AMRFinder against resistance phenotypes of 6,242 isolates from the National Antimicrobial Resistance Monitoring System (NARMS). This included 5,425Salmonella enterica, 770Campylobacterspp., and 47Escherichia coliphenotypically tested against various antimicrobial agents. Of 87,679 susceptibility tests performed, 98.4% were consistent with predictions.To assess the accuracy of AMRFinder, we compared its gene symbol output with that of a 2017 version of ResFinder, another publicly available resistance gene database. Most gene calls were identical, but there were 1,229 gene symbol differences between them, with differences due to both algorithmic differences and database composition. AMRFinder missed 16 loci that Resfinder found, while Resfinder missed 1,147 loci AMRFinder identified. Two missing drug classes from the 2017 version of ResFinder contributed 81% of missed loci. Based on these results, AMRFinder appears to be a highly accurate AMR gene detection system.ImportanceAntimicrobial resistance is a major public health problem. Traditionally, antimicrobial resistance has been identified using phenotypic assays. With the advent of genome sequencing, we now can identify resistance genes and deduce if an isolate could be resistant to antibiotics. We describe a database of 4,579 acquired antimicrobial resistance genes, the largest publicly available, and a software tool to identify genes in bacterial genomes, AMRFinder. Unlike other tools, AMRFinder uses a gene hierarchy to prevent overpredicting what the correct gene call should be, enabling more accurate assessment. To assess these resources, we determined the resistance gene content of over 6,200 bacterial isolates from the National Antimicrobial Resistance Monitoring System that have been assayed using traditional methods and that also have had their genomes sequenced. We also compared our gene assessments to those of a popularly used tool. We found that AMRFinder has a high overall consistency between genotypes and phenotypes.

Distribution of Antimicrobial Resistance Genes Across Salmonella enterica Isolates from Animal and Nonanimal Foods

2020 ◽  
Vol 83 (2) ◽  
pp. 295-304 ◽  
Author(s):  
J. B. PETTENGILL ◽  
H. TATE ◽  
K. GENSHEIMER ◽  
C. H. HSU ◽  
J. IHRIE ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Resistance Genes ◽  
Public Health Problem ◽  
Food Sources ◽  
Resistant Bacteria ◽  
Major Public Health Problem ◽  
Average Percentage ◽  
Gene Profiles ◽  
Antimicrobial Resistance Genes ◽  
High Prevalence

ABSTRACT Antimicrobial-resistant bacteria are a major public health problem. Of particular importance in the context of food safety is the prevalence of antimicrobial resistance (AMR) genes within nontyphoidal Salmonella, which is a leading bacterial cause of foodborne disease. We determined the prevalence of AMR genes across a very large number of Salmonella genomes (n = 25,647) collected from isolates from 16 common food sources. The average percentage of isolates from nonanimal foods, such as fruit, nuts and seeds, and vegetables, harboring at least one AMR gene was only marginally lower (72%) than that observed in isolates from animal foods such as beef, chicken, turkey, and pork (74%). This high prevalence of AMR genes was primarily driven by the high prevalence of aminoglycoside resistance genes in nearly all food isolates; genes for resistance to tetracycline and sulfonamide also were highly prevalent. However, evaluation of the number of genes per isolate revealed that the prevalence of AMR genes was higher in animal food isolates than in nonanimal food isolates (P = 0.018). A random forest analysis provided evidence that within a given serovar, resistance gene profiles differed according to isolate food source. AMR gene profiles could be used to correctly predict the food of origin for 71% of the isolates, but success differed according to serovar. This information can help inform AMR risk assessments of food commodities and refine processes for targeting interventions to limit the spread of AMR through the food supply. HIGHLIGHTS

scholarly journals Childhood Obesity and Overweight in Ghana: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Prince Kwaku Akowuah ◽  
Emmanuel Kobia-Acquah
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Childhood Obesity ◽  
Driving Forces ◽  
Meta Analysis ◽  
Public Health Problem ◽  
World Health ◽  
Cochrane Library ◽  
Public Health Issue ◽  
Obesity And Overweight

The increasing prevalence of childhood obesity and overweight is considered a public health issue in both developed and developing countries. This systematic review and meta-analysis estimates the prevalence of childhood obesity and overweight in Ghana. A multiple database search was conducted for articles published between January 1, 2001, and October 31, 2019, reporting the prevalence of childhood obesity and overweight in Ghana. Databases searched include PubMed, Google Scholar, Scopus, Cochrane Library, World Health Organization (WHO) Library Information System, and Africa Journals Online. Data were pooled from the articles to calculate an overall estimate of childhood obesity and overweight using a random-effects model after variance stabilization with Freeman–Tukey double arcsine transformation. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Sixteen studies with a combined sample size of 29,160 were included in the review. Analysis indicates that approximately 19% of children in Ghana either have obesity or are overweight. The prevalence of childhood obesity and overweight was 8.6% (95% CI: 4.8%–13.4%) and 10.7% (95% CI: 5.9%–16.6%), respectively. Although not significant, higher obesity (4.6% vs. 2.6%) and overweight (11.0% vs. 7.2%) prevalence were estimated for females than for males. There was a significantly higher obesity prevalence estimate (17.4% vs. 8.9%) in rural settings than in urban settings (p=0.0255). The high prevalence of childhood obesity and overweight estimated in this review is of worrying concern. It is a significant public health problem that has implications on the health of present and future generations in Ghana and as such calls for proactive measures to be put in place. Also, the driving forces behind the increasing prevalence of childhood obesity in Ghana need to be investigated.

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.

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