Cause Of Antibiotic Resistance Research Articles

Sports and sustainable development: the troubling absence of meat sourcing policies in the sports sector.

The excessive use of antibiotics in industrial meat production in the U.S. incurs severe health implications for animals, humans, and the environment, thereby threatening the integrated health of the ecosystem and sustainable development. While the consumption of meat, including hot dogs, chicken wings, and hamburgers, is a hallmark of attending professional sports events in North America, the sourcing policies for meat in the realm of professional sports remain relatively obscure. We conducted a content analysis case study on the four major sports leagues in North America, their teams and stadium practices. Our objective was twofold: first, to investigate existing sustainability initiatives at the league, team, and stadium levels; and second, to examine whether there are any food sourcing programs, specifically meat sourcing policies that might encourage the consumption of meat produced without the use of antibiotics, in the sports sector that are designed to mitigate ecological ramifications of meat consumption within sports contexts. Results show that existing sustainability initiatives at the three levels are focused primarily on reducing carbon emissions and waste. There is, however, a notable neglect of food sourcing policies, which is concerning given that industrial animal agriculture is a leading cause of antibiotic resistance and environmental degradation. This suggests that meat sourcing policy is a missing piece in current sustainability initiatives. The major sports leagues should therefore consider incorporating pertinent policies, such as procuring meat-based products produced without the use of antibiotics to help strengthen their existing efforts in achieving their sustainable development goals.

Determining the potential targets of silybin by molecular docking and its antibacterial functions on efflux pumps and porins in uropathogenic E. coli.

One of the causes of antibiotic resistance is the reduced accumulation of antibiotics in bacterial cells through pumping out the drugs. Silybin, a key component of the Silybum marianum plant, exhibits various beneficial properties, including anti-bacterial, anti-inflammatory, antioxidant, and hepatoprotective effects. Clinical isolates of E. coli were procured from 17 Shahrivar Children's Hospital in Rasht, Guilan, located in northern Iran. Their susceptibility to six antibiotics was assessed using disc diffusion and broth dilution (MIC) methods. The antibacterial effects of silybin-loaded polymersome nanoparticles (SPNs) were investigated with broth dilution (MIC) and biofilm assays. Molecular docking was utilized to evaluate silybin's (the antibacterial component) binding affinity to efflux pumps, porins, and their regulatory elements. Additionally, qRT-PCR analysis explored the expression patterns of acrA, acrB, tolC, ompC, and ompF genes in both SPNs (sub-MIC) and ciprofloxacin (sub-MIC)-treated and untreated E. coli isolates. The combined use of SPNs and ciprofloxacin exhibited a notable reduction in bacterial growth and biofilm formation, in ciprofloxacin-resistant isolates. The study identified eight overlapping binding sites of the AcrABZ-TolC efflux pump in association with silybin, demonstrating a binding affinity ranging from -7.688 to -10.33 Kcal/mol. Furthermore, the qRT-PCR analysis showed that silybin upregulated AcrAB-TolC efflux pump genes and downregulated ompC and ompF porin genes in combination with ciprofloxacin in transcriptional level in uropathogenic E. coli. Silybin, a safe herbal compound, exhibits potential in inhibiting antibiotic resistance within bacterial isolates, potentially through the regulation of gene expression and plausible binding to target proteins.

Social and biological evaluation of antimicrobial resistance (SOBEAR) in rural India: a study protocol.

Antimicrobial resistance (AMR) has been one of the biggest global health threats in recent years, mostly in low- and middle-income countries, which requires urgent research using a multidisciplinary research approach. The use of large quantities of antimicrobial drugs inappropriately for humans, poultry and agriculture has been recognized as a leading cause of antibiotic resistance and the predominance of drug-resistance pathogens in the environment. This protocol aims to describe the use/misuse of antibiotics (ABs) in the community and evaluate clinical samples from healthcare settings to detect genes associated with antimicrobial resistance. We will conduct a community-level survey in different villages of the Tigiria block to assess knowledge and awareness on ABs and AMR. We will conduct in-depth interviews (IDIs) with doctors, pharmacists, nurses and drug sellers, as well as focus group discussions (FGDs) with ASHA and ANM workers who are involved in antibiotic supplies to the community. Quantitative data from the community survey and qualitative data of IDIs and FGDs will be linked and analyzed using statistical modeling and iterative thematic content analysis. Specimens (stool, urine, blood and wound/pus) will be collected from clinically diagnosed patients of different healthcare centers of Tigiria block. The samples will be cultured for bacterial isolation and antibiotic sensitivity testing. Genomic DNA will be isolated from positive bacterial cultures and sequenced using PCR to evaluate high-threat multi-drug resistance organisms (MDROs), screening of plasmid-mediated quinolone resistance (PMQR) genes, antimicrobial genes responsible for MDR and quinolone resistance-determining regions (QRDRs). This is the community-based protocol to evaluate the knowledge, attitudes, awareness and practices regarding ABs and AMR. The study protocol establishes a foundation for evaluating population-based prevalence and risk factors for AMR and MDROs in rural areas of the Odisha state, India.

Libyan community pharmacists' knowledge, attitude, and practice concerning non-prescription dispensing of antibiotics

Antibiotics are prescription only medications, but their dispensing as over the counter drugs constitutes one of the main causes of antibiotic resistance. Antibiotic resistance threatens the life of people around the world, as indicated by world and Health Organization. Therefore, a global effort and collaboration are required to decrease and control the development and spread of antibiotic resistance. The purpose of this study is to evaluate the knowledge, attitude, and practice of community pharmacists regarding dispensing of antibiotics without prescription (DAWP) in Libya. Self- administered questionnaire has been created with a cross sectional design and statistical package for social sciences(SPSS) version 27.0 was used for descriptive statistics analysis. The vast majority of respondents were female (82.2%) and (79.4%) of respondents were less than 30 years old. About 43% of community pharmacists reported that they dispense antibiotics without prescription. Feeling competent to dispense antibiotics as over the counter drug was the most common reason for antibiotic dispensing without prescription. Amoxicillin, Azithromycin and Metronidazole were the most commonly dispensed antibiotics without a prescription respectively. In summary, dispensing antibiotics without a prescription is widespread in Libya, especially When patient asks for a particular antibiotic.

Libyan community pharmacists' knowledge, attitude, and practice concerning non-prescription dispensing of antibiotics

Antibiotics are prescription only medications, but their dispensing as over the counter drugs constitutes one of the main causes of antibiotic resistance. Antibiotic resistance threatens the life of people around the world, as indicated by world and Health Organization. Therefore, a global effort and collaboration are required to decrease and control the development and spread of antibiotic resistance. The purpose of this study is to evaluate the knowledge, attitude, and practice of community pharmacists regarding dispensing of antibiotics without prescription (DAWP) in Libya. Self- administered questionnaire has been created with a cross sectional design and statistical package for social sciences(SPSS) version 27.0 was used for descriptive statistics analysis. The vast majority of respondents were female (82.2%) and (79.4%) of respondents were less than 30 years old. About 43% of community pharmacists reported that they dispense antibiotics without prescription. Feeling competent to dispense antibiotics as over the counter drug was the most common reason for antibiotic dispensing without prescription. Amoxicillin, Azithromycin and Metronidazole were the most commonly dispensed antibiotics without a prescription respectively. In summary, dispensing antibiotics without a prescription is widespread in Libya, especiallyWhen patient asks for a particular antibiotic.

Development of quality indicators for antimicrobial stewardship in Belgian hospitals: a RAND – modified Delphi procedure

ABSTRACT Introduction Inappropriate antibiotic use is a major cause of antibiotic resistance. Therefore, optimizing antibiotic usage is essential. In Belgium, optimization of antimicrobials for the fight against multidrug resistant organisms (MDROs) is followed up by national surveillance by public health authorities. To improve appropriate antimicrobial use in hospitals, an effective national Antimicrobial Stewardship (AMS) program should include indicators for measuring both the quantity and quality of antibiotic use. Objectives The aim of this study was to develop a set of process quality indicators (QIs) to evaluate and improve AMS in hospitals. Methods A RAND-modified Delphi procedure was used. The procedure consisted of a structured narrative literature review to select the QIs, followed by two online questionnaires and an intermediate multidisciplinary panel discussion with experts in infectious diseases from general and teaching hospitals in Belgium. Results A total of 38 QIs were selected after the RAND-modified Delphi procedure, from which 11 QIs were selected unanimously. These QIs address compliancy of antibiotic therapy and prophylaxis with local guidelines, documentation of the rationale for antibiotic treatment in the medical record, the availability of AMS Programs and Outpatient Parenteral Antibiotic Therapy, resistance patterns and antimicrobial prescribing during focused ward rounds. Conclusion Our study selected 38 relevant process QIs, from which 11 were unanimously selected. The QIs can contribute to the improvement of quality of antibiotic use by stimulating hospitals to present better outcomes and by providing a focus on how to intervene and to improve prescribing of antimicrobials.

Antimicrobial Effects of Propolis Ethanol Extract Tetragonula laeviceps Against Bacteria Methicillin Resistant Staphylococcus aureus

Staphylococcus aureus bacteria, especially Methicillin Resistant Staphylococcus aureus (MRSA), is one of the main causes of antibiotic resistance. MRSA is a bacteria that is resistant to the ?-lactam class of penicillin antibiotics. MRSA infections can cause a variety of health problems, including skin infections, pneumonia, and bacteremia. This problem requires alternative resources that can be an option. Propolis from the stingless bee species Tetragonula laeviceps can be a potential alternative for treating MRSA infections. This research is classified as a true experiment with a posttest control group design. The concentration of propolis ethanol extract tested was 20%; 10%; 5%; 2.5%; 1.25%; and 0.625% in the diffusion and dilution methods. These two methods provide assessment output in the form of inhibition zone diameter, minimum inhibition concentration, and minimum bactericidal concentration. The data obtained will be tested statistically using One-way Anova and Fisher's exact tests. Test results show that the ethanol extract of Tetragonula laeviceps propolis has an antimicrobial effect against MRSA bacteria. The diffusion test showed that the average diameter of the inhibition zone formed by the ethanol extract of propolis successively from a concentration of 20% to 1,25% with six repetitions was 12.7 ± 1.23 mm; 11.36 ± 0.67 mm; 10.24 ± 0.61 mm; 7.59 ± 1.69 mm; and 6.5 ± 1.14 mm. From these averages, the One-Way Anova test revealed a statistically significant difference in the diameter of the inhibition zone (F(7,40) = [ 192.79], p = 0.000).

The Global Impact on Health of Dental Infections and Antibiotic Resistance:A mini Reveiw

Dental abscesses are a common infectious process that medical professionals are aware of. The aggressiveness of the bacteria, host resistance mechanisms, and local anatomy all influence how the infection turns out. A dental abscess that spreads can have serious implications that result in a high rate of morbidity and death. Acute dental abscesses are composed of a variety of microorganisms, including facultative anaerobes like _Streptococcus anginosus_ group and _viridans_ group _streptococci_, as well as stringent anaerobes such anaerobic _cocci_, _Prevotella_, and _Fusobacterium_ species. Antibiotics are commonly prescribed to treat dental infections. The benefits of antibiotics are that they can help resolve symptoms quickly, reduce pain, and prevent systemic infections. However, antibiotics can also have negative impacts on health, such as promoting antibiotic resistance. Antibiotic resistance refers to the phenomenon where bacteria evolve to become immune to antibiotics, making them harder to treat. Bacteria can develop resistance through mutations or by acquiring resistance genes from other bacteria. The overuse and misuse of antibiotics are one of the primary causes of antibiotic resistance. Inappropriate prescribing of antibiotics for illnesses such as the common cold and flu has led to the development of antibiotic resistance. In addition, patients who do not finish a full course of antibiotics can also contribute to the evolution of resistant bacteria. This has resulted in health risks that are not just confined to treating dental infections, but also pose a significant threat to global health. MATERIALS AND METHODS: This review is based on a thorough analysis of freely accessible literature from reputable sources such as Google, Google Scholar, and PubMed. The terms used in this review include dental, oral, maxillofacial infection, resistance pattern, epidemiology, common microorganisms, nutrition components, biofilm formation, morbidity, mortality, and increased healthcare costs. Overall, this review highlights the significant impact of dental infections and resistance on global health, including increased morbidity and mortality rates and rising healthcare costs. By understanding the epidemiology and resistance patterns of common microorganisms, as well as the role of nutrition and biofilm formation in infection prevention, we can work towards developing effective strategies for managing and preventing dental infections. In CONCLUSION, the epidemiology of dental infections is an important area of study that helps us understand the prevalence, incidence, and risk factors associated with these infections. By understanding these factors, we can develop effective prevention and treatment strategies to improve oral health and overall well-being.

Pengaruh Video Edukasi Berbahasa Banjar terhadap Pengetahuan dan Sikap terkait Antibitoik pada Perempuan

Inappropriate use of antibiotics due to lack of understanding and public knowledge is one of the causes of antibiotic resistance. Providing education via video to the public is a strategy that can be used to increase knowledge about the use of antibiotics. This study aims to assess the effect of providing local language educational videos about antibiotics and their use on increasing the knowledge and attitudes of women living in the Banjar Regency area, South Kalimantan. This research is Quasi-experimental research with a pretest posttest intervention with a control group research design using a purposive sampling technique and an intervention in the form of educational videos in the Banjar language. A valid and reliable questionnaire was used to assess knowledge and behavior in using antibiotics. Analysis of changes in knowledge and behavior scores between the control and intervention groups was carried out with the Mann-Whitney test. The number of respondents involved in the study was 80 women who were divided into a control group (40 people) and an intervention group (40 people). The results showed that the average pre-test and post-test knowledge scores in the control group (7.58 ± 1.81 and 7.85 ± 2.11) and the intervention group (7.33 ± 2.30 and 8.78 ± 2.93) with a significance value of p = 0.026. The mean scores of pre-test and post-test behavior in the control group (6.03 ± 2.60 and 6.15 ± 2.70) and the intervention group (6.33 ± 2.37 and 7.50 ± 2.05) with a significance value of p = 0.016. It can be concluded that providing educational videos in Banjar language can increase Females knowledge and behavior in using antibiotics in Banjar Regency.

Skewed perception of personal behaviour as a contributor to antibiotic resistance and underestimation of the risks.

The increasing prevalence of antibiotic-resistant bacteria poses a significant threat to global human health. Countering this threat requires the public to understand the causes of, and risks posed by, antibiotic resistance (AR) to support changing healthcare and societal approaches to antibiotic use. To gauge public knowledge, we designed a questionnaire to assess awareness of causes of AR (both personal and societal) and knowledge of absolute and relative risks posed by antibiotic-resistant bacteria. Our findings reveal that while >90% respondents recognized personal behaviours as limiting AR, few individuals recognized the importance of societal factors e.g. the use of antibiotics in livestock. Furthermore, more respondents named viruses (either by name or as a group) than bacteria as reasons to take antibiotics, indicating lack of understanding. The absolute numbers of current and predicted future deaths attributed to antibiotic-resistant bacteria were under-estimated and respondents were more concerned about climate change and cancer than AR across all age groups and educational backgrounds. Our data reveal that despite heightened public awareness of infection-control measures following the COVID-19 pandemic, there remains a knowledge gap related to contributors and impacts of increasing numbers of antibiotic-resistant bacteria.

ANTIBIOTIC RESISTANCE, RATIONAL ANTIBIOTIC THERAPY AND PROBIOTICS IN THE COMPLEX TREATMENT OF PERITONITIS

Resume. The aim of the study was to highlight the causes of antibiotic resistance, rational antibiotic therapy and the role of probiotics in the complex treatment of peritonitis.
 Matherials and methods. In 2021, surgical interventions were performed on 360 patients with acute peritonitis of various genesis in the surgical department of the Brovary Multidisciplinary Clinical Hospital. The distribution of patients by gender was as follows: 174 (48.3%) men and 186 (51.7%) women.
 Results. 391 strains of microorganisms belonging to facultatively anaerobic and aerobic gram-negative and gram-positive pathogens were isolated from the patients, including: Escherichia coli – 144 (36.8%) strains, Enterococcus faecalis – 47 (12.0%), Streptococcus spp. – 52 (13.3%), Staphylococcus aureus – 37 (9.5%), Staphylocooccus haemolyticus – 23 (5.9%), Klebsiella pneumoniae – 31 (7.9%), Citrobacter – 25 (6.4% ), Acinetobacter baumannii – 13 (3.3%), Pseudomonas aeruginosa – 14 (3.6%), Proteus mirabilis – 5 (1.3%) strains. In most cases, microbial associations of two, three, and four microorganisms that showed high antibiotic resistance were sown.
 Conclusions. In order to overcome antibiotic resistance, it is necessary to clearly define the indications and follow the principles of rational antibiotic therapy. Probiotic solutions are effective for the rehabilitation of the abdominal cavity with peritonitis, which has been proven by experimental research and opens a new era in the treatment of peritonitis.

Assessment of Awareness and Approach Regarding Antibiotic Prescription and Resistance among Different Level of Dental Students in a Tertiary Care Dental College, Karachi

OBJECTIVE: To evaluate the awareness and approach of dental students regarding antibiotic prescription and its resistance due to irrational use of antibiotics. Antibiotic resistance is spreading alarmingly throughout the world, including developed countries. The common causes of antibiotic resistance include over prescription, incomplete treatment and inappropriate self medication.Among different causes of antimicrobial resistance, irrational use of antibiotic is the most prominent one. METHODOLOGY: After approved by the Institutional Ethics Committee of Ziauddin University this cross-sectional study was conducted from 1st April, 2020 to 30th July,2020 at Ziauddin University. Third and final year dental students as well as house officers were enrolled and the computed sample size was 133 to which 5% non-response rate was added, therefore total 139 dental students were approached. Non-probability convenience sampling technique was used. A self- designed, self administered questionnaire was prepared to collect the demographic data and information regarding the prescription pattern of antibiotics amongst study subjects. All questions in the questionnaire were close ended. The questionnaire comprised information pertaining to demographic characteristics, standard guideline for antibiotic prescriptions, antibiotic stewardship and resistance, improper prescription and its consequences. The dental students were briefed about the purpose of the study and the significance of participation and a written informed consent was obtained from them. The awareness of dental students regarding antibiotics was the outcome factor. The data was analyzed by using SPSS version 22. RESULTS: Out of total 139 dental students majority (79.1%)were familiar to standard antibiotic prescription guidelines .(87.8%) responded amoxicillin is beta lactam, for probability of antibiotic abuse and antibiotics aid in recovery of infections majority showed awareness (92.1% and 84.9% respectively). Almost equal students inquire recent antibiotic course prior to prescription (90.6%) as well as take extra caution prescribing antibiotic in immune compromised patients (89.9%). CONCLUSION: This study concluded that majority of the dental students had good awareness regarding antibiotics and factors related to it, as participants responded positively to the 70% of awareness - based questions. KEYWORDS: Awareness. Antibiotics, Resistance, Prescription, Dental Students

Antibiotics Knowledge, Attitudes and Behaviours among the Population Living in Greece and Turkey.

Antimicrobial resistance is one of the largest threats to public health worldwide. As the inappropriate use of antibiotics is one of the leading causes of antibiotic resistance, it is important to have an understanding of the public's knowledge, attitudes and behaviours towards antibiotics and antimicrobial resistance. The present study investigated the knowledge, attitudes and behaviours towards antibiotics among the public living in Greece and Turkey using an online cross-sectional survey, with social media advertising (e.g., Facebook) and snowball sampling. In total, 709 individuals completed the survey (Greece n = 309, Turkey n = 400), with an average age of 34.2 (SD = 13.1) and 40.5 (SD = 14.7), respectively. In Greece, 49.4% of the participants were female, and in Turkey, this figure was 62.4%. The Greek respondents reported that obtaining antibiotics without a prescription was easier (52.6% reported "easy or very easy") than the Turkish (35.6% reported "easy or very easy") respondents did. This study reveals that Greek citizens were more educated and knowledgeable about antibiotics (58.5% of Greeks and 44.2% of Turks identified antibiotics correctly), their effects (20.9% of Greeks and 26.3% of Turks agreed with wrong statements about antibiotics) and the risks of antibiotic resistance, compared to those from Turkey. On the other hand, the Greek respondents were more prone to use leftover antibiotics or to give them to someone else later (p < 0.001). The findings of this study indicate that Greece and Turkey, both countries with high rates of antibiotic usage, exhibit distinct variations in their knowledge, attitudes, and perceptions concerning antibiotic use and antibiotic resistance. Effective countermeasures such as public campaigns should be targeted according to the population and those areas of knowledge, attitudes and behaviours in which the main shortcomings lie.

Application of solidified floating organic droplet dispersive liquid–liquid microextraction for determination of veterinary antibiotic residues in milk samples with greenness assessment

Antibiotics are the most commonly used veterinary drug category worldwide. The extensive utilization of antibiotics in animal farming is one of the main causes of antibiotic resistance, thus posing a hazard to human health. In the current study, solidification of floating organic droplet dispersive liquid–liquid microextraction (SFO-DLLME) was developed as a green sample preparation step for extracting three widely used veterinary antibiotics; enrofloxacin, ciprofloxacin and oxytetracycline in milk samples present in the Egyptian market. SFO-DLLME was based on using 1-undecanol as a low-toxicity extracting solvent. As several effective parameters are required to be optimized in SFO-DLLME, Box–Behnken experimental design was utilized to obtain the best possible extraction results. The analysis of the analytes was performed through the development of two eco-friendly chromatographic techniques. The first method was based on HPLC-UV where the separation was achieved using C18 column with isocratic elution of mobile phase composed of 0.025 M phosphate buffer (pH 3.2): acetonitrile (85: 15 v/v) and UV detection at 278 nm. The second was UPLC-MS/MS method utilizing BEH shield C18 column acetonitrile: 0.1% formic acid in a ratio of 80:20 (v/v) as mobile phase. The two developed methods were validated it was found that they had high recoveries (88.50 %- 94%), enrichment factors(106.2 %- 112.93 %), low limit of detection (0.077 µg/kg − 29 µg/kg), and satisfactory precision RSD ≤ 2. Different brands of market milk samples were analyzed showing no residues of the studied antibiotics, while enrofloxacin was detected in a concentration of 3.74 µg/kg in raw cow milk samples. Finally, the greenness profile of the developed chromatographic methods was evaluated by the Green Analytical Procedure Index, Analytical GREEnness Metric Approach, and White Analytical Chemistry principles confirming their safety on the environment.

3-Hydroxy coumarin demonstrates anti-biofilm and anti-hyphal efficacy against Candida albicans via inhibition of cell-adhesion, morphogenesis, and virulent genes regulation

Candida albicans, a common fungus of human flora, can become an opportunistic pathogen and causes invasive candidiasis in immunocompromised individuals. Biofilm formation is the prime cause of antibiotic resistance during C. albicans infections and treating biofilm-forming cells is challenging due to their intractable and persistent nature. The study intends to explore the therapeutic potential of naturally produced compounds by competitive marine bacteria residing in marine biofilms against C. albicans biofilm. To this end, 3-hydroxy coumarin (3HC), a compound identified from the cell-free culture supernatant of the marine bacterium Brevundimonas abyssalis, was found to exhibit anti-biofilm and anti-hyphal activity against both reference and clinical isolates of C. albicans. The compound demonstrated significant inhibitory effects on biofilms and impaired the yeast-to-hyphal transition, wrinkle, and filament morphology at the minimal biofilm inhibitory concentration (MBIC) of 250 µg mL−1. Intriguingly, quantitative PCR analysis of 3HC-treated C. albicans biofilm revealed significant downregulation of virulence genes (hst7, ume6, efg1, cph1, ras1, als1) associated with adhesion and morphogenesis. Moreover, 3HC displayed non-fungicidal and non-toxic characteristics against human erythrocytes and buccal cells. In conclusion, this study showed that marine biofilms are a hidden source of diverse therapeutic drugs, and 3HC could be a potent drug to treat C. albicans infections.

Antibiotic resistance in healthcare associated infections: An Empirical Study causes and consequences

Antimicrobial resistance has arisen as a considerable worldwide health predicament, especially in the framework of healthcare-connected infections (HAIs). HAIs occur during medical treatment and frequently affect vulnerable patient populations, resulting in elevated morbidity, mortality, and healthcare expenses. This abridgment scrutinizes the roots and repercussions of antibiotic resistance in HAIs. The leading cause of antibiotic resistance in HAIs is the superfluous and erroneous use of antibiotics. The broad and indiscriminate application of these medications has resulted in selective pressure on bacteria, advancing the endurance and propagation of resistant strains. Additionally, the spread of resistance genes between bacteria compounds the issue. Poor infection control methodologies, substandard hygiene, and unsatisfactory antimicrobial stewardship programs within healthcare centers also contribute to the generation and dissemination of antibiotic resistance. The aftermath of antibiotic resistance in HAIs is profound. Patients affected by antibiotic-resistant infections experience protracted hospital stays, heightened treatment shortcomings, and elevated mortality rates contrasted with those infected by susceptible pathogens. Moreover, the restricted availability of effective antibiotics obstructs treatment alternatives, leading to the use of last-resort antibiotics with latent toxicities and greater costs

Prevalence of Self-Medication with Antibiotics in Europe: A Scoping Review

Summary The most common cause of antibiotic resistance is the irrational use of antibiotics. Most of the irrational use of antibiotics is related to use in the community and the prevalence of self-medication in different populations. This review aimed to explore the prevalence of self-medication with antibiotics in European countries and the main sources of antibiotics. An online search of Pubmed and Scopus was conducted to identify relevant studies. A two-phase mapping approach was used. All steps in this scoping review were carried out using the Covidence® software. A total of 22 studies were included. The prevalence of self-medication with antibiotics is greater in Southern European countries than in Northern and Western European countries. The main sources of over-the-counter antibiotics are community pharmacies and leftovers from previous courses. Targeted communication strategies and interventions are needed to reduce the overuse of antibiotics and to slow down the spread of antibiotic resistance until new classes of effective antibiotics are developed.

SURGICAL ORTHOPEDIC PATIENTS’ PERCEPTION OF ANTIBIOTIC USE AND ANTIBIOTIC RESISTANCE

Objective: The aim of the study was to evaluate orthopedic patients' knowledge of antibiotics and antibiotic resistance. Material and Method: Patients admitted to the hospital for orthopedic surgery were given a questionnaire containing a total of 26 questions, 7 multiple choices, nine true and false questions and ten likert scale questions adapted from a survey which has been published by World Health Organization and translated to Albanian to assess their knowledge and attitude toward antibiotics and antibiotic resistance. Result and Discussion: Sixty-two percent of the patients misunderstood the definition of antibiotic resistance and answered yes to the question "Antibiotic resistance occurs when your body becomes resistant to antibiotics and the antibiotic is no longer effective." 62.4% of the patient strongly agreed that ‘antibiotic resistance is one of the biggest problems facing the world”. Although participants are aware of antibiotic resistance and the potential threats it may pose, their knowledge of the causes of antibiotic resistance and how to prevent it is limited. In conclusion, attempts need to be made to raise antibiotic resistance awareness and knowledge among the Kosovo population.

Detection of blaNDM−1,mcr-1 and MexB in multidrug resistant Pseudomonas aeruginosa isolated from clinical specimens in a tertiary care hospital of Nepal

IntroductionPseudomonas aeruginosa is an opportunistic pathogen, which causes healthcare-associated infections in immunosuppressed patients. They exhibit resistance to multiple classes of antibiotics via various mechanisms such as the over-expression of efflux pumps, decreased production of the outer membrane protein (D2 porin), over-expression of the chromosomally encoded AmpC cephalosporinase, modification of drugs, and mutation(s) at the target site of the drug. The bacteria also develop antibiotic resistance through the acquisition of resistance genes carried on mobile genetic elements. Limited data on phenotypic as well as genotypic characterization of MDR P. aeruginosa in Nepal infers the needs for this study. This study was carried out to determine the prevalence rate of metallo-β-lactamase (MBL-producer) as well as colistin resistant multidrug resistant (MDR) P. aeruginosa in Nepal and also to detect MBL, colistin resistance, and efflux pump encoding genes i.e. blaNDM−1, mcr-1 and MexB respectively in MDR P. aeruginosa isolated from clinical samples.Methods/methodologyA total of 36 clinical isolates of P. aeruginosa were collected. All bacterial isolates were phenotypically screened for antibiotic susceptibility using Kirby Bauer Disc Diffusion method. All the multidrug resistant P. aeruginosa were phenotypically screened for MBL producer by Imipenem-EDTA combined disc diffusion test (CDDT). Similarly, MIC value for colistin was also determined by broth microdilution method. Genes encoding carbapenemase (blaNDM−1), colistin resistant (mcr-1) and efflux pump activity (MexB) were assayed by PCR.ResultsAmong 36 P. aeruginosa, 50% were found to be MDR among which 66.7% were found to be MBL producer and 11.2% were found to be colistin resistant. Among MDR P. aeruginosa, 16.7%, 11.2% and 94.4% were found to be harbouring blaNDM−1, mcr-1 and MexB genes respectively.ConclusionIn our study, carbapenemase production (encoded by blaNDM−1), colistin resistant enzyme production (encoded by mcr-1), and expression of efflux pump (encoded by MexB) are found to be one of the major causes of antibiotic resistance in P. aeruginosa. Therefore, periodic phenotypic as well as genotypic study in Nepal on P. aeruginosa would provide the scenario of resistance pattern or mechanisms in P. aeruginosa. Furthermore, new policies or rules can be implemented in order to control the P. aeruginosa infections.

Antibiotic Resistance Profiling of Pathogenic Staphylococcus Species from Urinary Tract Infection Patients in Benin.

Staphylococci can cause urinary tract infections (UTIs). These UTIs are among the significant causes of antibiotic resistance and the spread of antibiotic-resistant diseases. The current study is aimed at establishing a resistance profile and determining the pathogenicity of Staphylococcus strains isolated from UTI samples collected in Benin. For this purpose, urine samples (one hundred and seventy) that were collected from clinics and hospitals showed UTI in patients admitted/visited in Benin. The biochemical assay method was used to identify Staphylococcus spp., and the disk diffusion method tested the antimicrobial susceptibility. The biofilm formation ability of the isolates of Staphylococcus spp. was investigated by the colorimetric method. The presence of mecA, edinB, edinC, cna, bbp, and ebp genes was examined by multiplex polymerase chain reaction (PCR). The results showed that Staphylococcus species were identified in 15.29% of all infected individuals and that 58% of these strains formed biofilms. Most Staphylococcus strains (80.76%) were isolated in female samples, and the age group below 30 years appeared to be the most affected, with a rate of 50%. All Staphylococcus strains isolated were 100% resistant to penicillin and oxacillin. The lowest resistance rates were seen with ciprofloxacin (30.8%), gentamicin, and amikacin (26.90%). Amikacin was the best antibiotic against Staphylococcus strains isolated from UTIs. The isolates carried mecA (42.31%), bbp (19.23%), and ebp (26.92%) genes in varying proportions. This study provides new information on the risks posed to the population by the overuse of antibiotics. In addition, it will play an essential role in restoring people's public health and controlling the spread of antibiotic resistance in urinary tract infections in Benin.