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"The COVID-19 pandemic has taught us the terrible cost of being unprepared for global health emergencies. The lack of treatments, vaccines, and sufficiently coordinated responses resulted in many unprecedented challenges that must now be analyzed and tackled rapidly. The crisis has raised awareness of the urgent need to improve the design of health systems, as well as the practical implementation of new strategies and technical solutions to better prepare for future pandemics. These preparations must also consider harms secondary to the pandemic, including the resulting effects on antimicrobial resistance (AMR). While drug-resistant infections pose a well-known and severe threat to human and animal health, the COVID-19 pandemic is compounding this already problematic situation. Although often considered only a medical problem, antimicrobial resistance is an evolutionary challenge accelerated by social, cultural and economic factors that lead to the misuse, overuse and abuse of life-saving antimicrobial medicines. The antimicrobial resistance challenge is compounded by inadequate attention to disease prevention and response, global circulation of people and products, differences in industry and market regulations across countries, and a fragile pipeline of new antibiotics and their alternatives. While the discovery of new antimicrobials will provide temporary solutions, sustainable success requires rigorous social science research that explores the drivers of antimicrobial resistance. These solutions should promote balance between equitable access to, conservation of, and innovation for antimicrobials, adapted to local conditions across the globe. To encourage collaboration and to address this challenge, we have created the International Network for Antimicrobial Resistance Social Science (INAMRSS).12 The network is an open consortium of social science researchers focused on addressing the global challenge of antimicrobial resistance. We believe antimicrobial resistance is only surmountable through efforts that consider social, political and economic factors. We intend to champion social science as part of a broadly defined One Health perspective to inform global initiatives. INAMRSS is a member of the Global AMR R&D Hub stakeholder group, which has built a system to track antimicrobial resistance research investment, but has not yet started monitoring relevant social science research funding. We endorse the recommendation of the United Nations Interagency Coordination Group on Antimicrobial Resistance for creating an Independent Panel on Evidence for Action against such resistance, with appropriate expertise across disciplines including the social sciences, and with a focus on the ways that humans are driving this problem and can contribute to solutions"

The steam distillation method was used to obtain samples of essential oil of Pseudotsuga menziesii introduced in Republic of Belarus. More than 20 components have been identified and determined in the essential oil of Pseudotsuga menziesii by gas liquid chromatography. The dominant components are bornylacetate (~25–30 %), camphene (~14–15 %), α-pinene (~7–8 %), β-pinene (~8–10 %). Distribution of the enantiomers of the main components of Pseudotsuga menziesii essential oil are shown. It was determined the optical purity of oil to (–)-bornylacetate. The antimicrobial activity of Pseudotsuga menziesii essential oil was detected in relation to test cultures of gram-positive and gram-negative bacteria. Gram-positive bacterial cultures were more sensitive to the inhibitory effect of essential oil. The effect of the optical activity of essential oil dominant components on antimicrobial properties is shown.

The agricultural industry utilizes antibiotic growth promoters to promote livestock growth and health. However, the World Health Organization has raised concerns over the ongoing spread of antibiotic resistance transmission in the populace, leading to its subsequent ban in several countries, especially in the European Union. These restrictions have translated into an increase in pathogenic outbreaks in the agricultural industry, highlighting the need for an economically viable, non-toxic, and renewable alternative to antibiotics in livestock. Probiotics inhibit pathogen growth, promote a beneficial microbiota, regulate the immune response of its host, enhance feed conversion to nutrients, and form biofilms that block further infection. Commonly used lactic acid bacteria probiotics are vulnerable to the harsh conditions of the upper gastrointestinal system, leading to novel research using spore-forming bacteria from the genus Bacillus. However, the exact mechanisms behind Bacillus probiotics remain unexplored. This review tackles this issue, by reporting antimicrobial compounds produced from Bacillus strains, their proposed mechanisms of action, and any gaps in the mechanism studies of these compounds. Lastly, this paper explores omics approaches to clarify the mechanisms behind Bacillus probiotics.

In 2001, the Task Force developed an initial Action Plan, outlining specific issues, goals, and actions important for addressing the problem of AR. This document, entitled A Public Health Action Plan to Combat Antimicrobial Resistance, Part I: Domestic Issues, reflected a broad- based consensus of participating federal agencies, which was reached with individual input from state and local health agencies, universities, professional societies, pharmaceutical companies, healthcare delivery organizations, agricultural producers, consumer groups, and other members of the public. Continued collaboration with these partners has been vital to achieving successful implementation of the Action Plan. The 2011 revision of the Action Plan was based in part on individual input obtained at a consultants' meeting held in Atlanta, Georgia, in December 2007. Present at the public meeting were consultants with wide-ranging expertise in areas such as human and veterinary medicine, pharmaceutical and diagnostics manufacturing, animal husbandry, clinical microbiology, epidemiology, infectious diseases and infection control, and state and local public health officials. The Action Plan includes action items organized into four focus areas: Surveillance, Prevention and Control, Research, and Product Development. ; Executive summary -- Introduction and overview -- The Focus Areas -- Focus Area I: Surveillance -- Focus Area II: Prevention and Control -- Focus Area III: Research -- Focus Area IV: Product Development -- Acronyms and abbreviations ; Interagency Task Force on Antimicrobial Resistance ; co-chairs: Centers for Disease Control and Prevention, Food and Drug Administration. ; Title from caption (viewed on October 1, 2012). ; The Interagency Task Force on Antimicrobial Resistance (hereafter referred to as the Task Force) was created in 1999 to coordinate the activities of federal agencies in addressing antimicrobiala resistance (AR) in recognition of the increasing importance of AR as a public health threat. The Task Force is co-chaired by the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the National Institutes of Health (NIH) and also includes the Agency for Healthcare Research and Quality (AHRQ), the Centers for Medicare and Medicaid Services (CMS), the Department of Agriculture (USDA), the Department of Defense (DoD), the Department of Veterans Affairs (VA), the Environmental Protection Agency (EPA), the Health Resources and Services Administration (HRSA), the Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response (HHS/ASPR), and the Department of Health and Human Services Office of the Assistant Secretary for Health (HHS/OASH). ; Mode of access: Internet; PDF reader (Acrobat .pdf file: 459 KB, 69 p.). ; Text (electronic publication)

Background: Post-operative surgical site infections (SSIs) are among the leading cause of morbidity and increased medical expense. The aim of this study is to isolate identify and study antimicrobial susceptibility pattern of microorganism from surgical wound of admitted patients.Methods: This retrospective study was carried at the Microbiology Laboratory of Bharatpur hospital, Nepal, from May 2015 to October 2015. The pus samples were cultured and antibiotic susceptibility determined in vitro by Kirby Bauer's disc diffusion method following clinical and Laboratory Standards Institute (CLSI) 2014 recommendation.Results: Of the total 250 samples, 194 (77.6%) showed bacterial growth. Staphylococcus aureus was 47.4% and Escherichia coli 20.60 %. Of 194 isolates 39.2% were multi drug resistant. Amikacin was sensitive in 93.1% of Gram positive isolates and 81.8% of gram negative isolates.Conclusions: Bacterial growth is common in surgical site. Staphylococcus aureus and Escherichia coli were multidrug resistant. Grampositive and gram negative isolates were commonly sensitive to Amikacin.

Abstract Antimicrobial resistance (AMR) has the potential to threaten tens of millions of lives and poses major global economic and development challenges. As the AMR threat grows, it is increasingly important to strengthen the scientific evidence base on AMR policy interventions, to learn from existing policies and programmes, and to integrate scientific evidence into the global AMR response. While rigorous evaluations of AMR policy interventions are the ideal, they are far from the current reality. To strengthen this evidence base, we describe a framework for planning, conducting and disseminating research on AMR policy interventions. The framework identifies challenges in AMR research, areas for enhanced coordination and cooperation with decision-makers, and best practices in the design of impact evaluations for AMR policies. This framework offers a path forward, enabling increased local and global cooperation, and overcoming common limitations in existing research on AMR policy interventions.

Antimicrobial resistance (AMR) is a rapidly developing and alarming global threat which has been highlighted by national governments and public health bodies including the World Health Organization. The spectre of a 'post-antibiotic era' is a real possibility unless curtailing the development and spread of these organisms is given high priority. Numerous studies have shown that AMR is associated with worse outcomes for patients and higher healthcare costs. While clinical data from low and middle income countries is lacking, there is increasing evidence that the problem in these areas is as great, or even greater, than in high income nations. Of the many drivers behind the development of AMR, the most significant is selection pressure caused by antibiotic use. Antimicrobial stewardship programmes are a set of interventions that aim to ensure the judicious use of antimicrobials by preventing their unnecessary use, and by providing targeted and limited therapy in situations where they are warranted. The ultimate goal of these programmes is to provide effective antimicrobial therapy whilst safeguarding their effectiveness for future generations. Whilst they do require an initial investment, they have been shown to be an effective way of controlling antimicrobial use, and have been associated with improved patient outcomes and reduced healthcare costs.

Increasing antimicrobial resistance has necessitated an approach to guide the use of antibiotics. The necessity to guide antimicrobial use via stewardship has never been more urgent. The decline in anti-infective innovation and the failure of currently available antimicrobials to treat some serious infections forces clinicians to change those behaviors that drive antimicrobial resistance. The majority of antimicrobial stewardship (AMS) programs function in acute-care hospitals, however, hospitals are only one setting where antibiotics are prescribed. Antimicrobial use is also high in residential aged care facilities and in the community. Prescribing in aged care is influenced by the fact that elderly residents have lowered immunity, are susceptible to infection and are frequently colonized with multi-resistant organisms. While in the community, prescribers are faced with public misconceptions about the effectiveness of antibiotics for many upper respiratory tract illnesses. AMS programs in all of these locations must be sustainable over a long period of time in order to be effective. A future with effective antimicrobials to treat bacterial infection will depend on AMS covering all of these bases. This review discusses AMS in acute care hospitals, aged care and the community and emphasizes that AMS is critical to patient safety and relies on government, clinician and community engagement.

Despite global awareness of the key factors surrounding antimicrobial resistance (AMR), designing and implementing policies to address the critical issues around the drivers of AMR remains complex to put into practice. We identified prevalent narratives and framing used by epistemological communities involved in the response to AMR in Tanzania, interrogated how this framing may inform policymaking, and identified interventions that could be tailored to the groups believed responsible for AMR. We interviewed 114 key informants from three districts and analysed transcripts line by line. Our results suggest that many different groups help drive the spread of AMR in Tanzania and need to be involved in any effective response. Human health is currently perceived as driving the response, while other domains lag behind in their efforts. For AMR programmes to be successful, all sectors need to be involved, including civil society groups, community representatives, and those working in communities (e.g., primary care physicians). However, current plans and programmes largely fail to include these viewpoints. The perceived presence of political will in Tanzania is a significant step towards such a response. Any strategies to tackle AMR need to be tailored to the context-specific realities, taking into account constraints, beliefs, and power dynamics within countries.

Effective antimicrobials are essential for adequate healthcare, but unfortunately, worldwide antimicrobial resistance (AMR) threatens this effectiveness, caused by antimicrobial use (AMU). The possibilities for development of antimicrobials are limited, and new antimicrobials will not become widely available. This leaves prudent AMU and other interventions to limit existing AMR as an important strategy and therefore, AMR must be monitored. Production animals are a relevant reservoir to monitor, because AMR may be transmitted to humans directly, or indirectly via food or the environment. This thesis is about monitoring of AMR in livestock as public health hazard in indicator organism Escherichia coli. In the European Union, monitoring of AMR in animals as public health hazard is performed by European legislation in commensal E. coli and food-borne pathogens Salmonella and Campylobacter. The international legislation has led to harmonisation and standardisation of the sampling and the microbiological methods. Elements not prescribed create room for improvement. The evaluation and interpretation by statistical analysis of AMR monitoring results is not prescribed, but is challenging and will be more complex when the amount of data increases. The updated EU legislation in 2020 has allowed whole-genome sequencing (WGS) as alternative method to culture-based antimicrobial susceptibility testing in AMR monitoring. So far, no statistical approaches were described to evaluate WGS versus culture-based methods. Analyses can be improved for optimal evaluation and interpretation of AMR monitoring data. Therefore, the first aim of this thesis is to evaluate AMR monitoring results with statistical methods. The second aim is to improve the interpretation of AMR monitoring in commensal E. coli. The third aim is to assess WGS versus culture-based methods to monitor AMR. The conclusions from this thesis are that E. coli is a useful indicator to monitor AMR in livestock, provided that bias in the sampling is prevented, and that proper statistical methods are used for the evaluation and interpretation. As we show, the randomized sample from healthy animals is well suited to analyse AMR trends over time. Other types of samples such as risk-based sampling (for example from diseased animals) are useful to detect rare or emerging resistance, but should be used next to a random sample to ensure representativeness for the whole animal population. To improve interpretation of AMR monitoring data, quantitative analyses should be incorporated in routine monitoring, because in the future the amount and complexity of data will further increase. The validity of the statistical approaches in this thesis should be further investigated in data with more variation, from different countries. We promote further evaluation of AMR surveillance systems, and the analysis of AMR monitoring outcomes should be harmonized, next to already existing harmonization of laboratory methods.

Since 2002, the Interagency Task Force on Antimicrobial Resistance has released an annual report on the progress towards implementation of the 2001 Action Plan to Combat Antimicrobial Resistance. The Task Force has now revised the 2001 Action Plan and a draft of the revised Action Plan was recently released and published in the Federal Register for public comment. The revised draft is available at (http://www.cdc.gov/drugresistance/index.html). Although the revised Action Plan is not final, the participating agencies are releasing this annual progress report, to provide information on Federal activities during calendar years 2009 and 2010. The revised Action Plan maintains the same four Focus Areas as the previous plan: Surveillance, Prevention and Control, Research and Product Development. Within these Focus Areas, there are a total of 11 goals: two for Surveillance, two for Prevention and Control, four for Research and three for Product Development. Further, each of the goals lists one or more Action Items that constitute the Federal government's commitment to targeted efforts to address the public health burden of antimicrobial resistance; there are a total of 53 such Action Items. Many of the Action Items also list implementation steps representing specific activities that one or more of the participating agencies will undertake to accomplish the Action Item. Most of these implementation steps are time-delimited; the planned completion date is given in parentheses as the year by which this step will be completed (indicating December 31 of that year). For example, (2011) means that the work is expected to be completed by the end of the 2011 calendar year. Other activities constitute continuing work of the agencies and are noted as "ongoing" with no set end date. The format of this report is new, and differs from updates of the previous Action Plan by providing progress descriptions that are embedded into the Action Plan. The Task Force hopes that this format is useful for the reader in understanding the Federal agencies' activities as we move toward accomplishment of the Action Plans goals. The Task Force plans to continue to provide annual updates on these Action Items and implementation steps as was done in the past. The goals, action items, and implementation steps represent current priorities based on today's science and threats to public health. Because of the rapidly evolving nature of AR, there will likely be new or emerging challenges in antimicrobial resistance subsequent to the publication of this Action Plan. The Task Force is committed to identifying and responding to these issues as they arise. Thus, the Action Items and implementation steps will be updated at least every two years and more often if circumstances require. ; Introduction -- The Focus Areas -- Focus Area I: Surveillance -- Focus Area II: Prevention and control -- Focus Area III: Research -- Focus Area IV: Product development -- Acronyms and abbreviations. ; Interagency Task Force on Antimicrobial Resistance ; co-chairs: Centers for Disease Control and Prevention, Food and Drug Administration, National Institutes of Health. ; 6/16/11 - date from document properites ; Participating agencies: Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services, Department of Agriculture, Department of Defense, Department of Veterans Affairs, Environmental Protection Agency, Health Resources and Services Administration, Health and Human Services/Office of the Assistant Secretary for Health, Health and Human Services/ Office of the Assistant Secretary for Preparedness and Response. ; Mode of access: Internet; PDF reader (Acrobat .pdf file: 345 KB, 54 p.). ; Text (electronic publication)

Despite global awareness of the key factors surrounding antimicrobial resistance (AMR), designing and implementing policies to address the critical issues around the drivers of AMR remains complex to put into practice. We identified prevalent narratives and framing used by epistemological communities involved in the response to AMR in Tanzania, interrogated how this framing may inform policymaking, and identified interventions that could be tailored to the groups believed responsible for AMR. We interviewed 114 key informants from three districts and analysed transcripts line by line. Our results suggest that many different groups help drive the spread of AMR in Tanzania and need to be involved in any effective response. Human health is currently perceived as driving the response, while other domains lag behind in their efforts. For AMR programmes to be successful, all sectors need to be involved, including civil society groups, community representatives, and those working in communities (e.g., primary care physicians). However, current plans and programmes largely fail to include these viewpoints. The perceived presence of political will in Tanzania is a significant step towards such a response. Any strategies to tackle AMR need to be tailored to the context-specific realities, taking into account constraints, beliefs, and power dynamics within countries.