There was an error in the original publication [...].
There was an error in the original publication [...].
Background: Antimicrobial resistance (AMR) has been predicted to worsen with rising ambient temperatures and climate change, though the causal association between temperature and antimicrobial resistance in Salmonella species remains unconfirmed. This study investigates the association between rising ambient temperatures and resistance to antimicrobials used to treat Salmonella bacteraemia in Queensland, Australia. Methods: Time-series analysis with distributed lag non-linear models was used to test associations between deseasonalised temperature and resistance to ampicillin, ciprofloxacin, gentamicin, and third-generation cephalosporins, adjusting for precipitation, seasonality, and temporal trends. Results: A total of 1012 Salmonella bacteraemia cases were analysed in this study. Resistance to any antibiotic occurred in 25.5% of cases (95% CI: 22.8-28.3), resistance to gentamicin in 15.4% (95% CI: 13.2-17.8), and resistance to cephalosporins in 15% (95% CI: 12.9-17.4), with variation among Salmonella serotypes. After adjustment, no antimicrobial resistance was significantly associated with temperature: gentamicin (RR = 1.23 per 1 °C, 95% CI: 0.57-2.65, p = 0.59), cephalosporins (RR = 1.19, 95% CI: 0.52-2.72, p = 0.68), ciprofloxacin (RR = 1.88, 95% CI: 0.29-12.03, p = 0.50), and ampicillin (RR = 1.93, 95% CI: 0.28-13.17, p = 0.50). A marginal temperature-precipitation interaction for cephalosporins, identified using GAM (p = 0.048), did not remain significant after multiple testing correction, nor was it robust across model specifications (GLM p = 0.058) or cross-validation. Conclusions: The findings demonstrate that climate-AMR relationships are not universal, highlighting the importance of geographic, epidemiologic, and organism contexts in these associations.
Background: There are many methods of identifying microbial resistance to therapeutic agents; however, they can generally be classified into two main categories: phenotypic and genotypic. The study aims to determine drug sensitivity and to analyze the correlation between the results obtained from cultures on commercial chromogenic media BrillianceTM CRE (OXOID) and BrillianceTM ESBL (OXOID) and the occurrence of specific resistance genes carbapenemase (IMP, NDM, VIM, KPC, OXA), ESBL β-lactamase (TEM, SHV, CTX-M), and AmpC (CMY, DHA), which will be used in drug sensitivity tests. Methods: The present study used bacteria, including Klebsiella pneumoniae, Acinetobacter baumannii, and Escherichia coli, obtained from patients hospitalized in military hospitals in Poland. All strains were plated on the commercial chromogenic media and subjected to antimicrobial susceptibility testing. Additionally, molecular assays detecting three main classes according to the mechanism of action, enzyme type carbapenemase (IMP, NDM, VIM, KPC, OXA), ESBL β-lactamase (TEM, SHV, CTX-M), and AmpC (CMY, DHA) were performed using the real-time PCR method. Results: The results of the studies indicate the presence of carbapenemases and ESBL genes. Among K. pneumoniae strains, the dominant gene was CTX-M-15 (88.89%), followed by the SHV (84.12%), NDM (46.03%), TEM (41.26%), KPC (34.92%), and OXA-48 (19.04%). In contrast, A. baumanii was dominated by carbapenemases from the OXA family (OXA-51 in 96.00% and OXA-24/40 in 84.00%). E. coli exhibits a high prevalence of CTX-M-15 (53.85%), TEM (46.15%), NDM (38.46%), and CMY-2 (30.77%). It was observed that the CTX-M-15 gene was commonly co-identified with SHV (n = 43). All tested strains grew on chromogenic BrillianceTM CRE medium. In the case of BrillianceTM ESBL medium, the genes determining the resistance mechanism were detected in 41.7% for A. baumannii, 53.8% for E. coli, and 100% for K. pneumoniae. Chromogenic media perfectly differentiate strains to species. A moderate positive correlation of the occurrence of the antibiotic resistance genes was observed for OXA-51 and OXA-24/40 genes, which were resistant to meropenem (rho = 0.45, p < 0.001). K-means cluster analysis performed on integrated genotype-phenotype data allowed for the identification of three distinct clusters characterized by distinct resistance gene profiles. These results demonstrate that selective agar media enable faster identification compared to other conventional techniques; however, the obtained results should be confirmed by other validated phenotypic methods, and, if possible, by a molecular assay.
Background: Microbiological culture and histology are gold standards for diagnosing chronic osteomyelitis (cOM) and fracture-related infection (FRI). This study investigated whether combining these modalities within a single tissue sample provides additional insight into disease severity. We hypothesized that high neutrophil and osteoclast numbers correlate with culture-positive microbiology and that double-positive samples may indicate more severe disease. Methods: In this prospective single-centre study, adults undergoing surgery for confirmed FRI or cOM were included. Clinical and disease classification data (FRI and BACH) were recorded. Five deep-tissue samples were collected intraoperatively and divided for paired microbiological culture and histological assessment of neutrophil infiltration, according to international diagnostic guidelines. Results: Forty-one patients were included (11 cOM, 30 FRI) of whom 68% received preoperative antibiotics. Nineteen patients (46%) were identified as culture-positive, while 32 patients (78%) were histologically positive according to international diagnostic guidelines, respectively. Among the 205 samples, 31% were culture-positive, 56% histology-positive, and 26% double-positive. Histological scores were significantly higher in culture-positive samples (p < 0.001). Treatment failure occurred in seven patients (18%), all with FRI. Paired positive samples were associated with increased odds of clinical failure and earlier revision, with odds increasing 1.68-fold for each additional paired positive sample (95% CI, 1.10-2.77). Conclusions: The paired analysis demonstrated a strong concordance between culture-positivity and suppurative inflammation within the same sample. Combining microbiology and histology may help identify patients at increased risk of revision and enhance diagnostic certainty, particularly in patients identified as culture-negative.
Background: Antimicrobial resistance (AMR) is now a critical issue in South Africa, enhanced by considerable inappropriate prescribing of antibiotics. There is currently variable dispensing of antibiotics without a prescription. Where this occurs, it is principally for urinary tract infections (UTIs) and sexually transmitted infections (STIs). Consequently, there is a need to comprehensively evaluate antibiotic dispensing patterns and factors influencing this to reduce AMR. Methods: A previously piloted questionnaire was administered to patients exiting three different categories of community pharmacies in a rural province. The questionnaire included data on the prevalence of antibiotics dispensed, whether without a prescription, and the rationale for this. Results: A total of 465 patients leaving community pharmacies with a medicine were interviewed. 54.4% of interviewed patients were dispensed at least one antibiotic, with 78.7% dispensed these without a prescription from either independent or franchise pharmacies. Metronidazole (36.1%) and azithromycin (32.7%) were the most dispensed antibiotics. STIs were the most common infectious disease for which an antibiotic was dispensed (60.1%), with 99.6% dispensed without a prescription. Upper respiratory tract infections (URTIs) were the most common infection where antibiotics were dispensed with a prescription (60.0%), with little dispensing without a prescription (7.1%). The most frequently cited reasons for obtaining antibiotics without a prescription were prior use (56.8%), long waiting times at PHC clinics (15.6%), and financial constraints (6.0%). Conclusions: There is an urgent need to review community pharmacists' scope of practice, including allowing them to prescribe antibiotics for infectious diseases such as UTIs, similar to other countries. Concomitantly, utilise trained community pharmacists to engage with prescribers to improve future antibiotic use, especially for URTIs.
Background/Objectives: Antimicrobial Resistance (AMR) is a pressing global animal and public health challenge. There is limited data on AMR prevalence, trends, and drivers in bacterial pathogens from animal sources in Uganda. Thus, this study investigated the occurrence and factors associated with multidrug resistance (MDR) in bacterial isolates recovered from clinical samples of animals submitted to the national veterinary diagnostic laboratory in Uganda. Methods: A retrospective study analyzed antibiogram data of bacteria from animal samples submitted to the Central Diagnostic Laboratory, Makerere University in Uganda between 2014 and 2020. The cleaned dataset comprised 590 cases with antibiogram data. Statistical analyses were conducted using R software version 4.5.2. Results: Gram-negative bacteria were predominant (74.4%) among the samples from clinical cases. The overall MDR proportion in the general bacteria population was 41.7% over the seven-year period. Among the clinically relevant bacteria, MDR was highest in Escherichia coli (57.2%), followed by Staphylococcus aureus (35.8%) and Salmonella (15.5%). Univariable screening of predictors hypothesized that MDR was influenced by year of case submission, animal host type, and bacterial group (p < 0.05). Multivariable logistic regression showed that isolates submitted in 2019 (vs. 2015) had significantly higher odds of MDR (aOR = 4.21; 95% CI: 1.62-13.14), indicating a marked temporal increase in resistance. Gram-negative bacteria (vs. Gram-positives) were also more likely to exhibit MDR (aOR = 1.62; 95% CI: 1.07-2.48). Conclusions: The high occurrence of MDR in bacterial pathogens from animal clinical submissions revealed the need for improved antimicrobial stewardship and integrated AMR surveillance in Uganda, particularly within the central region from which most diagnostic samples originated.
The widespread use of antibiotics in livestock farming has led to the persistent issue of antibiotic residues in meat products, raising significant concerns for food safety and public health. These residues can contribute to the emergence and spread of antimicrobial resistance (AMR), a growing global health threat recognized by the World Health Organization. While some regulatory bodies have imposed restrictions on non-therapeutic antibiotic use in animal agriculture, inconsistent global policies continue to hinder unified efforts to reduce AMR risks. This review explores the role of biotechnology in addressing this challenge by offering innovative tools for the detection, degradation, and removal of antibiotic residues from meat. Biotechnological approaches include the use of biosensors, high-throughput screening, enzymatic degradation, microbial bioremediation, genetically engineered bacteria, phage therapy, and phytoremediation. In addition, enabling technologies such as genomics, metagenomics, bioinformatics, and computational modeling support the rational design of targeted interventions. We further examine the integration of these biotechnological strategies within the broader "One Health" framework, which emphasizes the interconnectedness of human, animal, and environmental health. Case studies and recent applications demonstrate the potential of these methods to ensure safer meat production, reduce public health risks, and enhance consumer trust. By focusing on scalable, science-driven solutions, biotechnology offers a promising path toward mitigating antibiotic residues in the food supply and combating the long-term threat of AMR.
Background: Antibiotic resistance is a pressing public health concern, exacerbated by the prescribing of antibiotics in primary care settings when they are not clinically indicated. Research shows that providers often feel pressured to prescribe antibiotics in response to patients' expectations. To address this challenge, we developed a theory-informed video intervention to enhance antibiotic stewardship communication skills among current and future primary care providers, with emphasis on college health settings. The intervention consisted of five videos targeting core skills: explaining diagnosis and treatment, discussing antibiotic risks, advising on symptom management, offering patient support, and navigating visits with emerging adults. Program effectiveness was assessed immediately and three months post-intervention. Methods: Providers and medical students (N = 135) completed a three-wave study. At baseline, they reported demographics, perceived importance of the five skill sets, as well as self-efficacy, and completed closed- and open-ended skill assessment. Two weeks later, participants viewed the intervention videos, reassessed their skills, and rated their motivation to improve. Three months after video exposure, they completed the same skill assessments. Results: Participants showed improvements in all communication skills immediately post-intervention, except for supporting patients. While some skills showed sustained improvements at three months, the overall long-term effects were less pronounced. Perceived skill importance, baseline self-efficacy, and post-intervention motivation moderated these effects. Conclusions: A brief video-based intervention effectively enhanced current and future providers' antibiotic stewardship communication skills. Sustaining these gains, however, requires ongoing reinforcement. Notably, the intervention was especially beneficial for those with low motivation and self-efficacy, key targets for such programs.
Background/Objectives: Antimicrobial resistance (AMR) is a growing global health challenge, driven in part by how antibiotics are accessed, distributed, and used within complex value chains. In peri-urban India, these supply chains involve a range of formal and informal actors and practices, making them a critical yet underexamined focus for antimicrobial stewardship efforts. While much research has focused on the manufacturing and regulatory end, less is known about how antibiotics reach consumers in rural and peri-urban settings. This study aimed to map the human antibiotic value chain in West Bengal, India, and to analyse how formal and informal governance structures influence antibiotic use and stewardship. Methods: This qualitative study was conducted in two Gram Panchayats in South 24 Parganas district, West Bengal, India. Semi-structured interviews were carried out with 31 key informants, including informal providers, medical representatives, wholesalers, pharmacists, and regulators. Interviews explored the structure of the antibiotic value chain, actor relationships, and regulatory mechanisms. Data were analysed thematically using a value chain governance framework and NVivo 12 for coding. Results: The antibiotic value chain in rural West Bengal is highly fragmented and governed by overlapping formal and informal rules. Multiple actors-many holding dual or unofficial roles-operate across four to five tiers of distribution. Informal providers play a central role in both prescription and dispensing, often without legal licences but with strong community trust. Informal norms, credit systems, and market incentives shape prescribing behaviour, while formal regulatory enforcement is inconsistent or absent. Conclusions: Efforts to promote antibiotic stewardship must move beyond binary formal-informal distinctions and target governance structures across the entire value chain. Greater attention should be paid to actors higher up the chain, including wholesalers and pharmaceutical marketing networks, to improve stewardship and access simultaneously. This study highlights how fragmented governance structures, overlapping actor roles, and uneven regulation within antibiotic value chains create critical gaps that must be addressed to design effective antimicrobial stewardship strategies.
Background: The aim of this study was to evaluate and compare the bacterial colonization, cytotoxicity, immune response, and clinical parameters of three different suture materials: multifilament silk (Silk®), monofilament nylon (Daclon®), and expanded polytetrafluoroethylene monofilament (PTFE®), in surgical extractions of impacted mandibular third molars. Methods: This randomized controlled clinical trial was conducted on twenty-one patients requiring surgical extraction of an impacted third mandibular molar. A bayonet-shaped flap was sutured using all three materials in each patient. Bacterial cell counting and qPCR were assessed for microbiological analysis. In vitro cytotoxicity was studied with the metabolic activity WST-1 assay. Inflammatory response was evaluated through histological analysis. Clinical parameters-healing, handling, slack, pain, swelling and trimus-were recorded. Statistical significance was set at p ≤ 0.05. Results: Monofilament sutures accumulated fewer bacteria and DNA copies than Silk® (p < 0.05). The WST-1 assay revealed non-cytotoxic effects. Silk® presented an immune response with lymphocyte-like cells. The highest values of pain and inflammation were reached at 48 h, with a significant correlation between them (p < 0.05). Silk and nylon were more manageable than PTFE (p < 0.001), and nylon had less slack (p < 0.001). Conclusions: Silk showed the poorest microbiological and histological performance, with higher levels of bacterial colonization and a more pronounced inflammatory response compared to the other types of suture. Clinically, it offered better handling than PTFE (PTFE®), comparable to nylon (Daclon®), but it exhibited greater slack, which could prove less favorable for wound stability. None of the sutures showed in vitro cytotoxicity. Monofilament sutures, particularly nylon (Daclon®), showed better outcomes, acceptable handling, less bacterial colonization, and a milder inflammatory response.
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：