Journal of global antimicrobial resistance最新文献

{"title":"Mobilization of an ICEclc-Like Element as a Potential Mechanism for the Spread of IMP-13 Carbapenemase in Pseudomonas aeruginosa","authors":"Léa Bientz ,&nbsp;Ulysse Guyet ,&nbsp;Jennifer Guiraud ,&nbsp;Mathieu Metifiot ,&nbsp;Mikeldi Moulieras ,&nbsp;Sabine Aillerie ,&nbsp;Laure Coulange-Mayonnove ,&nbsp;Bachir Boureima-Abdou ,&nbsp;Alexis Groppi ,&nbsp;Macha Nikolski ,&nbsp;Cécile Bébéar ,&nbsp;Sabine Pereyre ,&nbsp;Véronique Dubois","doi":"10.1016/j.jgar.2024.12.006","DOIUrl":"10.1016/j.jgar.2024.12.006","url":null,"abstract":"<div><div>Carbapenem-resistant <em>Pseudomonas aeruginosa</em> is a global public health concern. IMP-13 is a carbapenemase that was described for the first time in 2001 but is often underestimated due to poor hydrolysis of carbapenems and a lack of molecular detection. The aim of this study was to characterize the genetic support of <em>bla</em>_IMP-13 in <em>P. aeruginosa</em> and to assess the ability of mobile genetic elements to disseminate this resistance. A retrospective analysis conducted between 2010 and 2020 revealed eight multiresistant <em>P. aeruginosa</em> isolates by their production of the carbapenemase IMP-13 in Bordeaux. Additionally, three of the studied isolates exhibited high-level resistance to imipenem and imipenem-relebactam that was linked to an insertion sequence in the <em>oprD</em> gene. Successful mating was achieved, and transconjugants and parental clinical isolate genomes were sequenced. All clinical isolates were found to be ST621 strains. The data revealed that <em>bla</em>_IMP-13 was carried on an Integrative and Conjugative Element (ICE<em>clc</em>-like) of 88,589 bp with a 62% GC content harboring 85 CDSs, and was inserted at the tRNA^Gly locus PA0729.1. The ICE was identical in the eight studied clinical isolates and in all the ST621 strains found in the databases. The conjugation rate was low, at approximately 10^–8 transconjugants per donor and ICE transfer appeared to mobilize some adjacent parental genes located immediately downstream of the ICE. In conclusion, these results suggest that even if the spread of <em>bla</em>_IMP-13 is mainly due to an epidemic ST621 clone, the mobilization of a <em>bla</em>_IMP-13-carrying ICE<em>clc</em>-like element is possible and should not be underestimated.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 44-51"},"PeriodicalIF":3.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acinetobacter indicus Coharboring Tet(X6) and blaNDM-1 Isolated From Slaughterhouse Waste","authors":"Xiaoqian Long ,&nbsp;Feng Lin ,&nbsp;Biao Tang ,&nbsp;Fengcheng Miao ,&nbsp;Zhiyu Li ,&nbsp;Yao Shen ,&nbsp;Hua Yang ,&nbsp;Jiangang Ma","doi":"10.1016/j.jgar.2024.12.004","DOIUrl":"10.1016/j.jgar.2024.12.004","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Acinetobacter indicus</em> is an important pathogen of nosocomial infection. The purpose of this study was to analyze the resistance and transmission of <em>A. indicus</em> strain AIBD14 isolated from slaughterhouse environment.</div></div><div><h3>Methods</h3><div>A total of 96 environmental samples were collected from slaughterhouse. The antimicrobial susceptibility test was carried out by microbroth dilution method and <em>E</em>-test. Whole genome sequencing and bioinformatics analysis of the AIBD14 were performed, then S1-PFGE and southern blot verified the location of <em>bla</em>_NDM-1 and <em>tet</em>(X6).</div></div><div><h3>Results</h3><div>The AIBD14 is resistant to meropenem but susceptibility to tigecycline, and coharboring <em>bla</em>_NDM-1 and <em>tet</em>(X6). The <em>bla</em>_NDM-1 is located on the pAIBD14-NDM-1 that cannot be transferred by conjugation. Specifically, <em>bla</em>_NDM-1 is located on the transposon Tn<em>125</em>, and <em>bla</em>_NDM-1 can be transferred to other species with the help of transposon. The genetic background of <em>bla</em>_NDM-1 is \"IS<em>Aba125</em>-<em>bla</em>_NDM-1-<em>ble</em>_MEL-<em>dsbD</em>-<em>cutA</em>-<em>groES</em>-<em>groEL</em>-<em>insE</em>-IS<em>Aba125</em>\". pAIBD14-NDM-1 is classified into the GR31 plasmid based on the homology of the <em>repB</em>. Meanwhile, there are two XerC/D-like binding sites on the plasmid, which can mediate the transfer of resistance genes. The <em>tet</em>(X6) gene is located on the chromosome of AIBD14, its downstream is accompanied by the neglected macrolide resistance gene <em>estT</em>, and there is a single copy of the insertion element IS<em>CR2</em> around <em>tet</em>(X6) as the genetic background \"IS<em>Aba4</em>-IS<em>3</em>-hp-hp-<em>tet</em>(X6)-<em>estT</em>-<em>guaA</em>-IS<em>CR2</em>\".</div></div><div><h3>Conclusions</h3><div>This is the first report of the coexistence of <em>tet</em>(X6) and <em>bla</em>_NDM-1 in the <em>A. indicus</em>, and it has the risk of horizontal transfer across multiple species. So strict monitoring the multiple-resistant bacteria in the industrial chain is necessary based on the \"One Heath\".</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 1-7"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic Insights into a Multidrug-Resistant Escherichia Coli of sequence type 155: A Ceftazidime-Avibactam Resistant Strain Harboring Four Classes of β-Lactamases","authors":"Mei Han ,&nbsp;Wenjing Liu ,&nbsp;Jia Li ,&nbsp;Lingning Meng ,&nbsp;Yan Zhang ,&nbsp;Zhifeng Zhang ,&nbsp;Danwei Wang ,&nbsp;Zixin Gao ,&nbsp;Wanqing Zhou ,&nbsp;Chang Liu","doi":"10.1016/j.jgar.2024.12.007","DOIUrl":"10.1016/j.jgar.2024.12.007","url":null,"abstract":"<div><h3>Objective</h3><div>The emergence of multidrug-resistant (MDR) <em>Escherichia coli</em> strains has significantly constrained antibiotic treatment options, while the spread of antimicrobial resistance genes (ARGs) and mobile genetic elements exacerbates the situation. This study delves into an MDR <em>E. coli</em> strain, QMM-01, which uniquely co-expresses β-lactamases from all four recognized classes, aiming to uncover the underlying mechanisms of its resistance and assess its potential for global spread.</div></div><div><h3>Methods</h3><div><em>E. coli</em> QMM-01, isolated from a burn patient, underwent antibiotic susceptibility testing through standard automated procedures commonly employed in clinical settings, with further test by immunochromatographic tests for carbapenemases. For genomic insights, whole-genome sequencing (WGS) was performed using both PacBio Sequel and Illumina NovaSeq platforms, supplemented by bioinformatics analyses to predict antimicrobial resistance genes, determining serotypes, performing multilocus sequence typing, and conducting comparative genomic analysis.</div></div><div><h3>Results</h3><div>QMM-01 exhibited resistance to a broad spectrum of β-lactam antibiotics, including carbapenems and ceftazidime-avibactam, with aztreonam being the sole exception. The resistance profile of the strain might primarily be due to the production of class B metallo-β-lactamases. WGS revealed the presence of a chimeric plasmid, pQMM-2-NDM-5, carrying the <em>blaNDM-5</em> gene and exhibiting similarities with plasmids from diverse geographical regions. This plasmid contains 161 predicted coding sequences and harbors resistance genes for 13 different antibiotics, forming a resistance island with a complex genetic environment.</div></div><div><h3>Conclusion</h3><div>This study underscores the global challenge posed by antibiotic resistance and emphasizes the need for international collaboration in antibiotic stewardship to mitigate the spread of resistance genes.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 15-19"},"PeriodicalIF":3.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental mediation of colistin resistance in the African context. A systematic scoping review","authors":"Emmanuel Udochukwu Osisiogu ,&nbsp;Fareeda Ceeta Mahmoud ,&nbsp;Fahad Bin Waqas ,&nbsp;Bhavana Singh ,&nbsp;Patrick K. Feglo ,&nbsp;Kwabena Obeng Duedu","doi":"10.1016/j.jgar.2024.12.002","DOIUrl":"10.1016/j.jgar.2024.12.002","url":null,"abstract":"<div><h3>Objectives</h3><div>The prevalence of antimicrobial resistance (AMR) among Gram-negative bacteria is a major global health concern. Resistance to last-resort antibiotics like colistin is particularly alarming. This study reviews how environmental factors have contributed to colistin resistance in the African context, where reports of colistin-resistant Gram-negative organisms are emerging.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using multiple databases to identify articles on environmental mediation of colistin resistance in Africa. Search terms included “environment,” “colistin,” “mobile colistin resistance gene,” and related keywords. Articles from 2015 to 2021 focusing on Africa were included. Data on country, genes detected, methods used, and bacterial species were extracted.</div></div><div><h3>Results</h3><div>Out of 847 articles identified, 26 were included in the final review. Studies were predominantly from Tunisia, Algeria, South Africa, Egypt, Nigeria, and Congo. The mobile colistin resistance (<em>mcr-1</em>) gene was the most common genetic variant detected. <em>Escherichia coli</em> (<em>E. coli</em>) was the predominant organism spreading <em>mcr</em> genes. Colistin-resistant genes were found in humans, animals, and environmental samples including manure, soil, water bodies, and wildlife.</div></div><div><h3>Conclusions</h3><div>This review confirms the rapid spread of plasmid-mediated colistin-resistant genes in humans, animals, and the environment across Africa. The movement of resistant genes between these reservoirs is alarming. There is a need for more research into colistin resistance mechanisms and implementation of continent-wide antibiotic stewardship programs to address this emerging threat in Africa. © 2024 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 39-43"},"PeriodicalIF":3.7,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence of T4SS-type-ICE-carrying emm28 Streptococcus pyogenes causing invasive infection in Shanghai, China","authors":"Qiong Wu ,&nbsp;Yue Jiang ,&nbsp;PanPan Lv ,&nbsp;Mingliang Chen","doi":"10.1016/j.jgar.2024.12.005","DOIUrl":"10.1016/j.jgar.2024.12.005","url":null,"abstract":"<div><h3>Objective</h3><div>Invasive group A streptococcal (iGAS) infections have been increasing in Europe, Australia, and the USA, but few data from China are available. This study intended to provide local data to highlight the characteristics of iGAS infections in China.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on clinical iGAS infection data from 2014 to 2023 in a tertiary hospital in Shanghai, China. Genomic analysis was conducted to characterize antimicrobial resistance, virulence, prophages, and integrative and conjugative elements (ICEs), as well as phylogenetic clusters.</div></div><div><h3>Results</h3><div>From 2014 to 2023, a total of 21 iGAS cases were discovered, with soft tissue infections accounting for 61.9% (13/21) and 85.7% (18/21) of isolates resistant to erythromycin and clindamycin, respectively. Three iGAS isolates from 2023 underwent genome sequencing, which indicated that two isolates were <em>emm12</em> and one was <em>emm28</em>. Phylogenetic analysis showed that the two <em>emm12</em> isolates were assigned to clade II and closely related to Chinese scarlet fever-causing isolates<em>.</em> The <em>emm28</em> isolate was assigned to subclades of SC1A and discovered to possess a novel ICE (designated as ICE-SHemm28; Tn<em>916</em>-like) that carried both the <em>ermB</em> gene and the type IV secretion system.</div></div><div><h3>Conclusions</h3><div>Emergence of an <em>emm28</em> iGAS strain harboring a novel macrolide resistance-carrying type IV secretion system ICE was identified in invasive infections in Shanghai.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 21-28"},"PeriodicalIF":3.7,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergent Escherichia coli of the highly virulent B2-ST1193 clone producing KPC-2 carbapenemase in ready-to-eat vegetables","authors":"Karine Dantas ,&nbsp;Gregory Melocco ,&nbsp;Fernanda Esposito ,&nbsp;Herrison Fontana ,&nbsp;Brenda Cardoso ,&nbsp;Nilton Lincopan","doi":"10.1016/j.jgar.2024.11.020","DOIUrl":"10.1016/j.jgar.2024.11.020","url":null,"abstract":"<div><h3>Objectives</h3><div>Critical priority carbapenem-resistant pathogens constitute a worldwide public health problem. <em>Escherichia coli</em> (<em>E. coli</em>) ST1193 is an emerging high-risk clone that demonstrates prolonged gut persistence, and association with community-onset urinary and bloodstream infections. The purpose of this study is to report microbiological and genomic data on the emergence of KPC-2-producing <em>E. coli</em> ST1193 in ready-to-eat (RTE) vegetables.</div></div><div><h3>Methods</h3><div>RTE vegetables were purchased from markets in southeastern Brazil. Epiphytic and endophytic Gram-negative bacteria displaying resistance to broad-spectrum beta-lactams were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Whole-genome sequence was conducted using the Illumina NextSeq platform. Antimicrobial susceptibility, conjugation, and acid tolerance assays were performed. Virulence behaviour was evaluated using the <em>Galleria mellonella</em> (<em>G. mellonella</em>) infection model.</div></div><div><h3>Results</h3><div>Epiphytic KPC-2-producing <em>E. coli</em> belonging to pandemic ST1193 was identified in RTE arugula. Genomic analysis predicted clinically relevant genes conferring resistance to β-lactams, fluoroquinolones, hazardous heavy metals, pesticides, disinfectants, and chlorine sanitizer. The <em>bla</em>_KPC-2 gene was carried by a conjugative IncF plasmid. Acid tolerance of <em>E. coli</em> KPC-2/ST1193 during exposure to pH 2.0 was confirmed, being associated with <em>gadWX</em> and <em>ibaG</em> pH tolerance genes, supporting survival to stomach acid prior to reaching the small intestine, and potential for a dietary mode of host colonization. Virulent behaviour was supported by wide virulome of the highly virulent phylogroup B2, whereas single nucleotide polymorphisms of core genes (cgSNP)-based phylogenomics revealed clonal relationship with healthcare-associated lineages circulating in the United States, China, Mexico, France, and Brazil.</div></div><div><h3>Conclusions</h3><div>We report the occurrence of KPC-2-producing <em>E. coli</em> of the highly virulent B2-ST1193 clone in RTE vegetables, highlighting a possible route of dissemination of the World Health Organization (WHO) priority pathogens to humans. © 2024 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 105-110"},"PeriodicalIF":3.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistance to colistin and various antibiotics in non-typhoidal Salmonella","authors":"Rumeysa Bildik,&nbsp;Betigül Öngen","doi":"10.1016/j.jgar.2024.10.066","DOIUrl":"10.1016/j.jgar.2024.10.066","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Non-typhoidal <em>Salmonella</em> has been reported as one of the four major global causes of diarrheal diseases by the World Health Organization. In recent years, <em>Salmonella</em> strains resistant to both antibiotics used in treatment and colistin have been increasing worldwide, and therefore resistance is monitored on a country-by-country basis. In this study, it was aimed to determine the minimal inhibitor concentration (MIC) values of antibiotics frequently used in the treatment and of colistin and to investigate plasmid-mediated <em>mcr</em> genes that play a role in colistin resistance.</div></div><div><h3>METHODS</h3><div>MIC values for colistin (COL), ampicillin (AMP), trimethoprim-sulfamethoxazole (SXT), ciprofloxacin (CIP) and ceftriaxone (CRO) were determined by broth microdilution method in 83 <em>Salmonella</em> (70 <em>S.</em> Enteritidis, 13 <em>S.</em> Typhimurium) isolates from patients with gastroenteritis in accordance with the European Committee on Antimicrobial Susceptibility Testing recommendations and <em>mcr-1</em> and <em>mcr-2</em> genes were investigated by multiplex PCR method.</div></div><div><h3>RESULTS</h3><div>Resistance to COL, CIP and AMP were found 13.25%, 4.81% and 1.2%, respectively. All <em>Salmonella</em> strains were susceptible to SXT and CRO. MIC ranges and MIC50-MIC90 values were found 0.25-8 mg/L and 1-4 mg/L for COL; 1-32 mg/L and 2-2 mg/L for AMP; 0.06-0.5 mg/L and 0.125-0.125 mg/L for SXT; 0.008-0.5 mg/L and 0.016-0.03 mg/L for CIP and 0.03-0.5 mg/L and 0.06-0.125 mg/L for CRO, respectively. The <em>mcr-1</em> and <em>mcr-2</em> genes were not detected in <em>Salmonella</em> isolates.</div></div><div><h3>CONCLUSIONS</h3><div>High-level and multi-resistance were not observed in our isolates. While resistance was generally low, the highest resistance rate was observed against colistin.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Pages 21-22"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics of colistin in patients with multi-drug resistant Gram-negative bacterial infections","authors":"Harivenkatesh Natarajan ,&nbsp;Surya Singaravelu ,&nbsp;Venkateswaran Ramanathan ,&nbsp;Smitha Kayal ,&nbsp;Apurba Sankar Sastry ,&nbsp;Pankaj Kundra","doi":"10.1016/j.jgar.2024.10.084","DOIUrl":"10.1016/j.jgar.2024.10.084","url":null,"abstract":"<div><h3>AIM</h3><div>This study aimed to characterize the first-dose and steady-state pharmacokinetic parameters of colistin in critically-ill patients.</div></div><div><h3>BACKGROUND</h3><div>Increased prevalence of multidrug resistant Gram-negative bacterial infections among critically-ill patients has revived the use of colistin. There is a dire need to characterize the pharmacokinetics of colistin to find out the dosing required to achieve the optimal pharmacokinetic/pharmacodynamic(PK/PD) indices such as Cmax/MIC and AUC/MIC to ensure maximum efficacy and safety.</div></div><div><h3>METHODS</h3><div>In this prospective observational pharmacokinetic study, we studied the first dose and steady state pharmacokinetics of colistin in 16 critically ill patients who received a loading dose of 9 million IU of colistimethate sodium (CMS), followed by maintenance dose of either 4.5 million IU twice daily (n=9) or 3 million IU thrice daily (n=7). Plasma levels of colistin were estimated using LC-MS/MS and pharmacokinetic parameters were estimated using non-compartmental model.</div></div><div><h3>RESULTS</h3><div>We observed a wide inter-individual variability in the pharmacokinetic parameters of colistin. No significant difference was seen in the steady state pharmacokinetic parameters between two different maintenance dosing regimens. Clinical resolution was seen in 8 (50%)patients, nephrotoxicity in 6 (37.5%)patients and bacteriological eradication following repeat culture was seen in 6 (37.5%)patients. PK/PD indices such as AUC/MIC and Cmax/MIC was higher in patients with clinical resolution and bacteriological eradication but this was not statistically significant.</div></div><div><h3>CONCLUSION</h3><div>The lower rates of clinical and microbiological efficacy, and occurrence of adverse events such as nephrotoxicity mandates the need for therapeutic drug monitoring of colistin and individualization of CMS dose for achieving optimal outcome.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Page 27"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing barriers in antimicrobial stewardship: a guide from research to implementation","authors":"Lul Raka ,&nbsp;Arsim Kurti","doi":"10.1016/j.jgar.2024.10.082","DOIUrl":"10.1016/j.jgar.2024.10.082","url":null,"abstract":"<div><h3>AIM</h3><div>This review aimed to identify barriers to the implementing Antimicrobial Stewardship (AMS) programs and recommend solutions to address these challenges.</div></div><div><h3>BACKGROUND</h3><div>Antimicrobial resistance (AMR) is a major global health threat and AMS programs are crucial for optimizing antimicrobial use and reducing resistance.</div></div><div><h3>METHODS</h3><div>A comprehensive literature review was conducted using PubMed, Scopus, and Google Scholar. Studies were selected based on predefined criteria focusing on barriers to AMS implementation.</div></div><div><h3>RESULTS</h3><div>Many countries lack or fail to implement National Action Plans (NAPs) on AMR; regulatory gaps like over-the-counter antibiotic sales have impact on AMS efforts. Preventive measures such as infection prevention and control, vaccination, sanitation and hygiene are often low priorities. Developing countries face resource constraints, including limited human resources, diagnostics, and antibiotic access. The absence of national guidelines and training exacerbates knowledge gaps. Siloed work environments often inhibit interdisciplinary collaboration; cultural habits, prescriber autonomy, self-medication, patient compliance, poor surveillance data, and pharmaceutical industry influence pose additional barriers to AMS.</div><div>To overcome these barriers, governments should enforce NAPs, establish strict regulatory frameworks, and prioritize preventive measures. Strong leadership, integration of AMS into national policies, and resource allocation are crucial. Bridging knowledge gaps through guidelines and training, promoting interdisciplinary collaboration, and raising public awareness are essential. Regulating the pharmaceutical industry, investing in robust surveillance systems, and evaluating principles are also important tools.</div></div><div><h3>CONCLUSIONS</h3><div>Overcoming AMS barriers needs a holistic approach. Addressing these barriers can bridge the gap between scientific evidence and real-world practices, leading to more effective AMR management.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Page 26"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143343773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the distribution and antibiotic resistance rates of Shigella isolates from stool samples: 5-year data","authors":"Betül Ceyhuni,&nbsp;Duygu Öcal","doi":"10.1016/j.jgar.2024.10.050","DOIUrl":"10.1016/j.jgar.2024.10.050","url":null,"abstract":"<div><h3>AIM</h3><div>The study aims to evaluate the distribution of serotypes of Shigella species isolated from stool samples in our hospital and to assess the resistance rates to various antibiotics over the past five years.</div></div><div><h3>BACKGROUND</h3><div>Shigella species are one of the main causes of diarrhea, especially in children, and can cause serious health problems globally. People most commonly become ill through the consumption of contaminated food or water or by coming into contact with an infected person or someone who has recently been infected with Shigella. CDC issued a warning about an observed increase in the number of drug-resistant Shigella cases.</div></div><div><h3>METHODS</h3><div>The study included 50 Shigella spp. isolated from stool cultures sent to laboratory of Ankara University Cebeci Health Practice and Research Hospital between 2019-2024. Isolates were identified using conventional microbiological methods or automated systems [Vitek-2 (bioMérieux, France) and MALDI-TOF MS Bruker Biotyper (BD, Germany)]. Species-level identification was performed using serogroup-specific antisera. EUCAST criteria were used for the application and evaluation of the antibiotic susceptibility. Patient information was obtained from the hospital information system.</div></div><div><h3>RESULTS</h3><div>A total of 50 isolates were evaluated: 32 (64%) were <em>Shigella sonnei</em>, 16 (32%) were <em>Shigella flexneri</em> and 2 (4%) were <em>Shigella boydii</em>. Among the patients, 23 (46%) were male and 27 (54%) were female. Forty-one (82%) of the patients were under the age of 18. The antimicrobial resistance rates are shown in Table.</div></div><div><h3>CONCLUSIONS</h3><div>Increasing antibiotic resistance rates pose a significant risk to our country, as they do worldwide. Preventing fecal-oral transmission is the most effective control strategy.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Page 16"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143343940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}