Challenge Of Antimicrobial Resistance Research Articles

Genomic Characterization of Mobile Genetic Elements Associated with Multidrug-Resistant Acinetobacter Non-baumannii Species from Southern Thailand.

This study investigated the genetic diversity, antimicrobial resistance profiles, and virulence characteristics of Acinetobacter non-baumannii isolates obtained from four hospitals in southern Thailand. Clinical data, genome information, and average nucleotide identity (ANI) were analyzed for eight isolates, revealing diverse genetic profiles and novel sequence types (STs). Minimum spanning tree analysis indicated potential clonal spread of certain STs across different geographic regions. Antimicrobial resistance genes (ARGs) were detected in all isolates, with a high prevalence of genes conferring resistance to carbapenems, highlighting the challenge of antimicrobial resistance in Acinetobacter spp. infections. Mobile genetic elements (MGEs) carrying ARGs were also identified, emphasizing the role of horizontal gene transfer in spreading resistance. Evaluation of virulence-associated genes revealed a diverse range of virulence factors, including those related to biofilm formation and antibiotic resistance. However, no direct correlation was found between virulence-associated genes in Acinetobacter spp. and specific clinical outcomes, such as infection severity or patient mortality. This complexity suggests that factors beyond gene presence may influence disease progression and outcomes. This study emphasizes the importance of continued surveillance and molecular epidemiological studies to combat the spread of multidrug-resistant (MDR) Acinetobacter non-baumannii strains. The findings provide valuable insights into the epidemiology and genetic characteristics of this bacteria in southern Thailand, with implications for infection control and antimicrobial management efforts.

Social Dimensions of Antimicrobial Resistance and an Anthropological Approach: Analytic Review

Purpose: The objective of this paper is to devise a comprehensive and layered framework to tackle antimicrobial resistance (AMR). It aims to weave together the strands of ethnomedicine, healthcare system analysis, and anthropological perspectives on illness, aligning with universal healthcare principles to encourage community participation and address the societal roots of health inequalities. The framework seeks to address AMR through a lens that views health disparities not merely as medical issues, but as complex phenomena shaped by cultural, social, and structural factors.
 Methodology: The research employs a single-case study design to synthesize and analyse interdisciplinary insights into AMR. This approach facilitates an in-depth understanding of how various elements, such as cultural beliefs, healthcare practices, and community dynamics, interact and influence the spread and management of AMR. By focusing on a single case, the study intends to meticulously document and interpret the nuanced interactions between these factors, providing a detailed narrative that captures the essence of the AMR challenge in a global health context. The study utilizes 66 varied references, such as journal articles, book excerpts, theses, reports, and websites, sourced from academic venues and the internet, published between 1946 and 2023.
 Findings: Through its investigation, the study presents a healthcare approach that marries the traditional wisdom of ethnomedicine with the precision of biomedicine, underscoring the significance of cultural competence in formulating AMR mitigation strategies. It dissects the intricate relationship between the three primary health sectors—popular, professional, and folk—and disentangles the sociocultural concepts of 'disease' and 'illness' as distinguished by medical anthropologists. The research calls for a reconceptualization of healthcare systems that goes beyond the biomedical model, advocating for an integration of the sociocultural, economic, and political dimensions that influence health and illness manifestations.
 Unique contribution to theory: This study's unique theoretical contribution lies in its interdisciplinary approach to health disparities and AMR. It proposes a model that balances the rigor of scientific research with the insights gleaned from traditional health practices, placing a premium on the dynamics of community involvement and the myriad influences on health. By doing so, it offers a more equitable, sustainable, and contextually relevant paradigm for health practices and policies. This paradigm shift is intended to provide actionable insights for policymakers and health practitioners, enabling them to devise strategies that are not only scientifically sound but also culturally sensitive and broadly applicable. The framework envisages a future where health interventions are tailored to the lived experiences of diverse populations, potentially transforming the landscape of global health and AMR strategy.

Emergence of carbapenem resistant gram-negative pathogens with high rate of colistin resistance in Egypt: A cross sectional study to assess resistance trends during the COVID-19 pandemic

The current study investigated the temporal phenotypic and genotypic antimicrobial resistance (AMR) trends among multi-drug resistant and carbapenem-resistant Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa recovered from Egyptian clinical settings between 2020 and 2021. Bacterial identification and antimicrobial sensitivity of 111 clinical isolates against a panel of antibiotics were performed. Molecular screening for antibiotic resistance determinants along with integrons and associated gene cassettes was implemented. An alarming rate (98.2%) of these isolates were found to be phenotypically resistant to carbapenem. Although 23.9 % K. pneumoniae isolates were phenotypically resistant to colistin, no mobile colistin resistance (mcr) genes were detected. Among carbapenem-resistant isolates, blaNDM and blaOXA-48-like were the most prevalent genetic determinants and were significantly overrepresented among K. pneumoniae. Furthermore, 84.78% of K. pneumoniae isolates co-produced these two carbapenemase genes. The plasmid-mediated quinolone resistance genes (qnrS and qnrB) were detected among the bacterial species and were significantly more prevalent among K. pneumoniae. Moreover, Class 1 integron was detected in 82% of the bacterial isolates. This study alarmingly reveals elevated resistance to last-resort antibiotics such as carbapenems as well as colistin which impose a considerable burden in the health care settings in Egypt. Our future work will implement high throughput sequencing-based antimicrobial resistance surveillance analysis for characterization of novel AMR determinants. This information could be applied as a step forward to establish a robust antibiotic stewardship program in Egyptian clinical settings, thereby addressing the rising challenges of AMR.

The challenges experts face during creeping crises: the curse of complacency

The policy literature has generally conceptualised crises as urgent public threats with clearly demarcated ‘focusing events’. Consequently, most studies have identified the main challenges faced by expert agencies involved in evidence-based policymaking as managing uncertainty, time pressure and communication. However, less focus has been devoted to analysing the concrete challenges faced by expert agencies during creeping crises. Creeping crises are characterised by spatial and temporal fragmentation and elusiveness, which create an additional challenge for expert agencies: placing the crises on the political agenda. Comparing two global creeping crises: climate change (CC) and antimicrobial resistance (AMR), this article highlights two distinct strategies for influencing policymaking. The analysis shows how two expert agencies, the World Health Organization (WHO) and the United Nations Framework Convention on Climate Change (UNFCCC), pursue different strategies when setting the global agenda and influencing policymaking. The findings show that the WHO’s approach to policymaking regarding AMR has been mostly guided by top-down, science-led, formal engagements and strategies. This approach has successfully increased the salience of the global challenge of AMR, providing strong, evidence-based solutions, but it has been less successful in promoting the challenge onto the global political agenda. In contrast, the UNFCCC’s approach to policymaking has relied more on horizontal, bottom-up, multidisciplinary, informal strategies. This approach has enabled a broader coalition of advocacy actors and placed CC persistently on the global political agenda. In this way, the article enhances our understanding of the role experts play in drawing attention to creeping crises.

Bayesian Calibration to Address the Challenge of Antimicrobial Resistance: A Review

Bayesian Calibration to Address the Challenge of Antimicrobial Resistance: A Review

Visualization of Engineered M13 Phages Bound to Bacterial Targets by Transmission Electron Microscopy.

The filamentous phage M13 is one of the most well-studied and characterized phages, particularly since it was introduced as a scaffold for phage display, a technique to express and evolve fusion proteins on the M13 phage's coat to study protein or peptide binding interactions. Since phages can be engineered or evolved to specifically bind to a variety of targets, engineered M13 phages have been explored for applications such as drug delivery, biosensing, and cancer therapy, among others. Specifically, with the rising challenge of antimicrobial resistance among bacteria, chimeric M13 phages have been explored both as detection and therapeutic agents due to the flexibility in tuning target specificity. Transmission electron microscopy (TEM) is a powerful tool enabling researchers to directly visualize and characterize binding of phages to bacterial surfaces. However, the filamentous phage structure poses a challenge for this technique, as the phages have similar morphology to bacterial structures such as pili. In order to differentiate between bacterial structures and the filamentous phages, here we describe a protocol to prepare TEM samples of engineered M13 phages bound to bacterial cells, in which the phage virions have been specifically labeled by decoration of the major capsid proteins with gold nanoparticles. This protocol enables clear visualization and unambiguous identification of attached filamentous phages within the context of bacterial cells expressing numerous pili.

Antimicrobial Resistance Challenge to Sustainable Development Goals and Targets: A One-Health Perspective

Abstract Antimicrobial resistance (AMR) is one of the biggest challenges to Sustainable Development Goal (SDG). Antimicrobial resistance is primarily associated with misuse, abuse, or overuse of antimicrobials, resulting in no effect of antibiotics on microorganisms in humans, animals, and the environment in the domain of One Health. AMR directly affects Sustainable Development (SDG) Goals 1,3, and 4 related to wellbeing considered the inner component, SDG Goals 2, 6, 8, 9, and 12 the infrastructural middle component, and SDG Goal 17 the related component of cooperation and coordination. AMR indirectly affects SDG Goals 5, 7, 10, 11, 13, 14, 15, and 16. This interpretation is based on the dynamic interaction of various components that leads to direct or indirect tradeoff in achieving SDG goals based on the One-Health approach. Thus, understanding this dynamic interaction among various components of One Health is important to underscore the importance of AMR challenging Sustainable Development Goals (SDG). Antimicrobial resistance extends beyond misuse, abuse, or overuse in healthcare settings, encompassing inadequate access to clean water, substandard practices in human and animal sanitation and hygiene, limited availability of early diagnostic tools, and insufficient legislation addressing the issue. Notably, a widespread lack of awareness and understanding regarding the issue poses a potential threat to SDGs. Hence, efforts must encompass strategic and synchronized actions across various tiers of the systems, coupled with evidence-based policy formulation, to yield sustainable outcomes on a global scale with the transdisciplinary approach of One Heath.

Antibacterial Activity of Crude Aqueous Extracts of Tithonia Diversifolia from Chichiri Area in Blantyre District, Malawi.

Background: The global challenge of antimicrobial resistance has spurred scientific research efforts to find alternative sources of new antibiotics. The ethnopharmacological importance of Tithonia diversifolia is well-known. Objective: The present study’s aim was to evaluate the in vitro activity of crude aqueous leaf, stem and root extracts of locally growing Tithonia diversifolia against the clinical bacterial isolates: E. coli, K. pneumoniae, and P. mirabilis. Methods: To obtain antibacterial activity data, the Broth macrodilution testing and Zone of inhibition Kirby-Bauer approaches were used. Results: Estimated diameters of zone of inhibition showed leaf extracts of Tithonia diversifolia had significantly greater antibacterial activity (19.5 ± 3.9 mm, 95% CI: 15.4 - 23.6 mm) than stem (15.2 ± 2.0 mm, 95% CI: 13.0 - 17.3 mm, p = 0.021) or root extracts (15.0 ± 2.1 mm, 95% CI: 12.8 - 17.2 mm, p=0.019). K. pneumoniae was the most susceptible isolate to growth inhibition by extracts from all plant parts. In broth macrodilution testing, leaf extracts exhibited greater potency on all study isolates compared to stem and root extracts. Conclusion: These findings support the traditional use of Tithonia diversifolia decoctions and infusions in infectious processes that are due to these pathogens and further strengthens recommendations for additional work to isolate and characterize the bioactive chemical compounds responsible for the observed antibacterial properties of the plant.

The occurrence of the carbapenemase gene, blaNDM-5, on a transmissible IncX3 plasmid in multidrug-resistant Escherichia coli isolated from a farm dog

In-depth phenotypic and genomic analyses on a carbapenem-resistant Escherichia coli isolate, recovered from the faeces of a farm dog in Lebanon, focusing on its antimicrobial resistance (AMR) patterns and the underlying resistome. E. coli strain EC-106 was identified using MALDI-TOF-MS. Analyses using Carba NP, immunochromatographic assay NG Carba5, and other antimicrobial susceptibility testing were performed. Whole-genome sequencing (WGS) using the Illumina technology and different software available at the Center of Genomic Epidemiology wwere used to predict the resistome, sequence type (ST), plasmid types, and virulence genes. Susceptibility testing revealed that E. coli EC-106 was multi-drug resistant, including against newer antimicrobials such as imipenem-relebactam (MIC = 16 µg/mL), meropenem-vaborbactam (MIC = 16 µg/mL), and ceftazidime-avibactam (MIC > 32 µg/mL), but remained susceptible to aztreonam (MIC = 0.12 µg/mL), aztreonam-avibactam (MIC = 0.06 µg/mL), and cefiderocol (MIC = 0.5 µg/mL). WGS analyses showed that E. coli EC-106 carried 13 acquired resistance genes associated with resistance to β-lactams (blaNDM-5 and blaTEM-1B), aminoglycosides (aac(3)-IId, aph(3')-Ia, aadA1, and aadA2), tetracyclines (tetA), amphenicols (partial catA1), macrolides (mphA), sulphonamides (sul1 and sul3), trimethoprim (dfrA12), and quaternary ammonium compounds (partial qacE). The blaNDM-5 was located on an IncX3 plasmid. The isolate was predicted to be a human pathogen (92.9%) and belonged to ST1011. To our knowledge, this is the first report of the detection of an IncX3 plasmid carrying the blaNDM-5 gene in animals in Lebanon, highlighting the severe AMR challenges in the country. Taken together, our current and previous findings suggest that blaNDM-5 might be spreading in different hosts and genetic backgrounds across clinical and non-clinical settings.

WHO AWaRe classification for antibiotic stewardship: tackling antimicrobial resistance - a descriptive study from an English NHS Foundation Trust prior to and during the COVID-19 pandemic.

Antimicrobial resistance (AMR) is a silent and rapidly escalating pandemic, presenting a critical challenge to global health security. During the pandemic, this study was undertaken at a NHS Foundation Trust in the United Kingdom to explore antibiotic prescribing trends for respiratory tract infections (RTIs), including pneumonia, and the COVID-19 pandemic across the years 2019 and 2020. This study, guided by the WHO's AWaRe classification, sought to understand the impact of the pandemic on antibiotic prescribing and antimicrobial stewardship (AMS). The research methodology involved a retrospective review of medical records from adults aged 25 and older admitted with RTIs, including pneumonia, in 2019 and 2020. The application of the AWaRe classification enabled a structured description of antibiotic use. The study evaluated antibiotic use in 640 patients with RTIs. Notably, it observed a slight increase in the use of amoxicillin/clavulanic acid and a substantial rise in azithromycin prescriptions, highlighting shifts in prescribing trends. Despite these changes, some antibiotics displayed steady consumption rates. These findings highlight the importance of understanding antibiotic use patterns during the AMR threat. The increase in the usage of "Watch" category antibiotics during the pandemic emphasises the urgency of robust AMS measures. The research confirms that incorporating the AWaRe classification in prescribing decisions is crucial for patient safety and combating antibiotic misuse. This study provides essential insights into the changing landscape of antibiotic prescribing during a global health crisis, reinforcing the necessity for ongoing AMS vigilance to effectively address AMR challenges.

Chalcones As Broad‐Spectrum Antimicrobial Agents: A Comprehensive Review And Analysis Of Their Antimicrobial Activities

AbstractThe rise of drug‐resistant microbes necessitates the development of new antimicrobial agents. Increasing resistance among multidrug‐resistant microbes has spurred research efforts to overcome drug resistance through novel scaffolds and strategies. Chalcones, distinguished by their chemical structure of 1,3‐diphenylprop‐2‐en‐1‐one, have exhibited a multifaceted array of biological activities, prominently including antimicrobial and antiviral properties. Modifying the structure by adding substituent groups to the aromatic ring enhances potency, reduces toxicity, and expands pharmacological effects. This review highlights the potential of chalcones and analogues in preventing diseases affected by diverse antibiotic resistance genes, including viruses, bacteria, fungal spores, and Plasmodiidae. Our analysis underscores the fact that a multitude of chalcone compounds effectively obstruct various molecular targets pivotal in the development of antibiotic resistance, thus rendering bacteria vulnerable to conventional antibacterial agents and potentially obliterating resistance mechanisms. Certain chalcone compounds exhibit higher activity levels compared to traditional antibiotics like vancomycin and tetracycline. Additionally, Docking and SAR studies of chalcones summarize their role in developing novel drugs. Chalcones and their derivatives demonstrate promising broad‐spectrum antimicrobial activities. Investigating structure‐activity relationships (SAR) enhances our understanding of chalcone‐based drug design, enabling the development of more effective therapeutic interventions against the pressing global health challenge of antimicrobial resistance.

Enterococcus species: insights into antimicrobial resistance and whole-genome features of isolates recovered from livestock and raw meat in Ghana.

Enterococcus spp. have gradually evolved from commensals to causing life-threatening hospital-acquired infections globally due to their inherent antimicrobial resistance ability and virulence potential. Enterococcus spp. recovered from livestock and raw meat samples were characterized using antimicrobial susceptibility testing and whole-genome sequencing. Isolates were confirmed using the MALDI-ToF mass spectrometer, and antimicrobial susceptibility was determined using the Kirby-Bauer disk diffusion method. Whole genome sequencing was performed on isolates resistant to two or more antibiotics. Bioinformatics analysis was performed to determine sequence types, resistance and virulence gene content and evolutionary relationships between isolates from meat and livestock samples, and other enterococci genomes curated by PATRIC. eBURST analysis was used to assign genomes to clonal complexes. Enterococcus spp. were predominantly E. faecalis (96/236; 41%) and E. faecium (89/236; 38%). Overall, isolates showed resistance to erythromycin (78/236; 33%), tetracycline (71/236; 30%), ciprofloxacin (20/236; 8%), chloramphenicol (12/236; 5%), linezolid (7/236; 3%), ampicillin (4/236; 2%) and vancomycin (1/236, 0.4%). Resistance to two or more antimicrobial agents was detected among 17% (n = 40) Enterococcus spp. Resistance genes for streptogramins [lsa(A), lsa(E), msr(C)], aminoglycosides [aac(6')-Ii, aph(3')-III, ant(6)-Ia, aac(6')-aph(2″), str], amphenicol [cat], macrolides [erm(B), erm(T), msr(C)], tetracyclines [tet(M), tet(L), tet(S)] and lincosamides [lsa(A), lsa(E), lnu(B)] were detected among the isolates. Genes for biofilm formation, adhesins, sex pheromones, cytolysins, hyaluronidase, oxidative stress resistance, quorum-sensing and anti-phagocytic activity were also identified. Potential plasmids with replicon sequences (rep1, rep2, repUS43, repUS47, rep9a, rep9b) and other mobile genetic elements (Tn917, cn_5536_ISEnfa1, Tn6009, ISEnfa1, ISEfa10) were detected. Clinically relevant E. faecium ST32 and ST416 clones were identified in meat samples. The occurrence of antimicrobial-resistant Enterococcus spp. in livestock and raw meat samples, carrying multiple resistance and virulence genes, including known clones associated with hospital-acquired infections, underscores the critical need for employing robust tools like whole genome sequencing. Such tools provide detailed data essential for ongoing surveillance efforts aimed at addressing the challenge of antimicrobial resistance with a focus on one health.

Five Rights of Antibiotic Safety: Antimicrobial Stewardship at One NHS Foundation Trust in England Before and During the COVID-19 Pandemic

Abstract Introduction The study highlights the urgency of combating rising multi-drug-resistant infections, projecting 10 million deaths annually by 2050. With over 1.2 million deaths in 2019, Antimicrobial Resistance (AMR) has become a significant public health issue. Antimicrobial Stewardship (AMS) promotes judicious antibiotic use1. 'The Five Rights of Antibiotic Safety' ensure appropriate usage. It encompasses the right patient, drug, dose, time, and duration2. The COVID-19 pandemic, causing around 6 million deaths by 2023, has intensified AMR challenges. The Royal Pharmaceutical Society's AMS policy advocates for maximising the use of pharmacists' expertise to promote prudent antibiotic use, strengthen stewardship, and reduce AMR3. Aim This study aimed to evaluate AMS and adherence to the 'Five Rights of Antibiotic Safety' in antibiotic prescribing at an NHS Foundation Trust during 2019 and 2020 amidst the COVID-19 pandemic. Methods This research study was conducted using a cross-sectional retrospective design and undertook an in-depth analysis of 640 patient records in 2019 and 2020. The study included adult patients aged 25 and above, immunocompromised and pregnant individuals, and those prescribed antibiotics for respiratory tract infections or pneumonia during 2019 and 2020. A validated data extraction tool facilitated data collection. This study was registered under ISRCTN number 14825813, receiving ethical approval from the University of Hertfordshire Ethics and Health Research Authority (HRA) (REC Reference number 22/EM/0161). The Citizens Senate reviewed the study protocol, ensuring public and patient involvement. Results The study evaluated inappropriate antibiotic prescribing, identifying a rise in inappropriate antibiotic prescribing with no indication from 16% in 2019 to 20% in 2020. Inappropriate routes of administration also increased from 33% to 36%. While inappropriate drug choice remained steady around 63-64%, inappropriate dosing rose from 13% to 18%. Interestingly, inappropriate duration reduced slightly from 70% to 66%. The study assessed AMS champions, pharmacists' participation increased from 19% to 21%, and doctors decreased from 19% to 12%. However, combined collaboration jumped from 58% to 71%. Discussion/Conclusion This study highlights the surge in incorrect antibiotic prescribing during the 2020 COVID-19 pandemic, stressing the necessity of the 'Five Rights of Antibiotic Safety.' Strict guideline adherence and increased professional education are pivotal. Progress in reducing improper duration was seen, indicating the significance of refining prescribing practices. This research highlights the critical role of pharmacists and doctors as AMS champions. It demonstrates that their collaborative efforts during the pandemic positively impacted patient outcomes, thus reaffirming the Royal Pharmaceutical Society's AMS policy on the importance of a multidisciplinary team in ensuring appropriate antibiotic use. This study reveals a worrying increase in incorrect antibiotic use during 2020, calling for stricter compliance with the five safety rules and enhancing professional education. Reduced inappropriate duration of use suggests improvements in prescribing practices. The critical role of pharmacists and doctors in AMS, with heightened collaboration yielding prudent antibiotic use and better patient outcomes. Despite these insights, limitations like potential reporting bias, not exploring the causes of inappropriate prescribing in-depth, and a limited focus on doctors and pharmacists in AMS need future research.

Addressing Antimicrobial Resistance (AMR) on Dairy Farms: A One Health Case Study from Punjab, India

Abstract This case study explores the antimicrobial usage (AMU) practices on Punjab’s dairy farms, aiming to address the challenge of antimicrobial resistance (AMR) through collaborative efforts. It uncovers diverse AMU practices contributing to misuse, particularly on farm management-related diseases, such as mastitis, reproductive disorders, diarrhoeal diseases, and blood parasite infections. Some animal farms displayed high AMU levels of ‘critical importance’ category antibiotics, as per the World Health Organization. Additionally, some farmers exhibited inadequate knowledge and understanding of the importance of completing adequate antimicrobial therapy courses. The key risk factors for incorrect AMU include lack of awareness among the informal animal health service providers (without formal education/qualification), over-the-counter access of antibiotics, self-treatment practices by the farmers, and limited understanding of AMR’s public health implications. The study undertook a series of initiatives to combat AMR, including subject awareness workshops, biosecurity awareness activities comprising proper disposal of farm waste, and workshops for veterinarians, para-veterinarians, and farmers, sensitizing about AMR’s adverse consequences. Recommendations include enhancing access to qualified veterinarians, discouraging reliance on unauthorized practitioners, enhancing diagnostic capabilities, and providing technical support for disease prevention. Establishing AMU and AMR surveillance systems is essential for informed decision-making. Collaborative efforts are vital to raise awareness, promote responsible AMU, and ensure animal and public health security. These joint actions among dairy chain stakeholders are imperative to combat AMR and foster sustainable dairy production while protecting animal and human health. Information © The Authors 2023

Trends of feline Escherichia coli minimum inhibitory concentrations over 14 years illustrate the need for judicious antimicrobial use in cats.

This study aims to assess the antimicrobial resistance (AMR) trends among Escherichia coli isolated from cats between 2008 and 2022, utilizing MIC data, within a one-health framework. The study analyzed MIC results from 1,477 feline E coli isolates that were obtained from samples submitted to the Cornell University Animal Health Diagnostic Center, primarily from the northeastern US. MIC values were categorized as susceptible or not susceptible using the Clinical and Laboratory Standards Institute breakpoints. Multidrug resistance (MDR) was analyzed using a Poisson regression model. Additionally, accelerated failure time models were employed to analyze MIC values. Out of the 1,477 E coli isolates examined, 739 (50%) showed susceptibility to all tested antimicrobials. Among the tested antimicrobials, cefazolin (69%) and ampicillin (74% for urinary tract isolates) exhibited the lowest susceptibility. Overall, 15% of isolates were not susceptible to cefovecin. E coli isolates were highly susceptible (> 95%) to antibiotics typically reserved for human use. Almost one-third of the isolates were classified as MDR, with nonurinary isolates more likely to exhibit an MDR pattern. A decrease in MICs for fluoroquinolones and gentamicin in recent years was identified. However, MICs for cephalexin increased from 2016 to 2022 and cefovecin from 2012 to 2019. This study highlights the challenge of AMR in feline medicine, emphasizing the importance of responsible antimicrobial use and surveillance to address E coli AMR. The related Currents in One Health by Cazer et al, JAVMA, December 2023, addresses additional feline antimicrobial stewardship topics.

Carotane sesquiterpenes from Peperomia pellucida and their anti-infective activities

Owing to the challenges of antimicrobial resistance, investigations of new antibiotics from medicinal plants are continuously being conducted. Peperomia pellucida is a pantropical plant used in traditional medicine for the treatment of various disorders. From the ethanol extract of a whole P. pellucida plant, one previously undescribed carotane sesquiterpene (pellucarotine), one known carotane sesquiterpene (daucol), and one phenylpropanoid (dillapiol) were isolated and structurally elucidated. Their structures were determined based on 1D and 2D NMR, HR-ESI-Mass, experimental, and computational electronic circular dichroism spectroscopic data and compared with those reported in the literature. Antimicrobial assay results showed that pellucarotine had an anti-infective effect on Candida albicans with an MIC of 512 µg/mL.

Health communication for AMR behaviour change: Zimbabwean students’ relationships with the microbial world

Abstract Background Microbes have a global impact on health; microbial relationships benefit and impair quality of life. Negative health impacts of antimicrobial resistance (AMR) in our relationships with the microbial world are primarily borne by the Global South Objectives To study experiences, understandings and practices of Zimbabwean students regarding health, food and microbes. Methods Using purposive sampling, Zimbabwean school students were recruited as participants in group interviews supported by participant observation, exploring the relationships between health, food and microbes. Results The study included 120 students from six upper secondary schools in the Midland Region and Gweru District. Findings identify two categories: microbial relationships and microbial encounters, each with three subcategories. Food emerged as both mediating artefacts and mediating experiences, enabling the students to link biomedical explanations of AMR and their everyday lives with friends and family. The necessity for health communication to explore and engage with participants’ contextual preferences and motivations is highlighted. When discussing food choices and practices, students considered the beneficial relationships with the microbial world. Conclusions A contextually relevant approach is outlined, where food mediates the relationship between student health and the microbial world, supporting health communication for AMR behaviour change. Expanding AMR education to include the everyday experiences of food enables students to link the pressing sustainability challenge of AMR to their health goals. The study showcases how the exploration of microbial relationships and food practices as a ubiquitous feature of community life can form a basis for AMR prevention and control.

Consumer Preferences and Attitudes towards Antibiotic Use in Food Animals.

Antimicrobial resistance (AMR) is one of the major challenges faced by society, with the real threat of the failure of many medical procedures. Antibiotics are also used in livestock production and provide a potential pathway to increasing AMR. The central challenge involves ensuring animal health and welfare while securing the long-term effectiveness of antibiotics. This paper reports the results of a survey of 5693 respondents from the customer panels of four major UK supermarkets regarding preferences and attitudes towards antibiotic use in food animals, and their perspectives on how the balance between animal welfare and human benefit can be achieved. The results of these surveys are consistent with those from other countries that found that consumers generally have limited knowledge about antibiotic use in agriculture and AMR, with around 50% responding "don't know" to many questions. There was agreement about the benefits of antibiotics outweighing harm, with 40% agreeing that, overall, the use of antibiotics to treat disease in farm animals delivers more benefit than harm. However, 44% neither agreed nor disagreed, indicating a high level of uncertainty and a situation that is potentially unstable. The seriousness of the AMR challenge is such that continued action for the more discriminating use of antibiotics must continue.

Urgent imperatives and perspectives of Antimicrobial resistance

Antimicrobial resistance (AMR) is a pressing global health issue that threatens the effectiveness of antibiotics in treating infectious diseases. This study examines the current landscape of AMR with a specific focus on the emergence and spread of multidrug-resistant bacteria. The factors contributing to the development and spread of AMR including the overuse and misuse of antibiotics in human and animal health sectors are discussed. The mutations of bacterial genes causing AMR, highlighting their role in promoting the survival and proliferation of drug-resistant bacteria are analyzed. The consequences of AMR are far-reaching and include increased morbidity, mortality and healthcare costs. The assessment highlights the impact of medical wastes such as patient samples, clinical and drug wastes and agro-based wastes such as surface runoff of poultry and cattle medication on AMR. To address the challenge of AMR, the analysis emphasizes the need for novel antimicrobial agents. The importance of public awareness, awareness among decision makers and appropriate attention and schemes is also discussed as a promising approach to combat AMR. In conclusion, this appraisal sheds light on the escalating problem of AMR and the urgent need for effective strategies to wrestle it. The findings underscore the importance of a multidisciplinary approach involving healthcare professionals, researchers, policymakers and the public to mitigate the impact of AMR and to ensure the availability of effective treatments for infectious diseases in the future. By addressing the challenges posed by AMR, we can safeguard public health and promote sustainable use of antibiotics.

Antimicrobial resistance (AMR) as a form of human-wildlife conflict: Why and how nondomesticated species should be incorporated into AMR guidance.

The challenge of antimicrobial resistance (AMR) continues to receive significant global attention as common infections become increasingly resistant to the drugs used to treat them. Once an infectious microbe has developed a mechanism of resistance, it can cause longer, more damaging infections which are more costly, time-consuming, and sometimes impossible to treat. Such impacts occur across the health of humans, animals, plants, and the environment. Thus, AMR is considered a One Health issue. However, current narratives on AMR focus on humans, food-producing animals, crops, and their immediate environments. Very little attention is given to wildlife in terms of the impact of AMR on their health, nor their role in the evolution and spread of AMR. This article (1) discusses an absence of wildlife in current AMR guidance, (2) suggests how this absence of wildlife could limit understanding of, and action on, AMR, (3) proposes that considering AMR as a form of human-wildlife conflict could enable AMR guidance to better incorporate wildlife into action planning and create a truly One Health approach to tackle AMR.