Antibiotic Resistance
In: Biosecurity and bioterrorism: biodefense strategy, practice and science, Band 7, Heft 4, S. 371-377
ISSN: 1557-850X
In: Biosecurity and bioterrorism: biodefense strategy, practice and science, Band 7, Heft 4, S. 371-377
ISSN: 1557-850X
In: http://dspace.library.uu.nl/handle/1874/21411
Immediately after their introduction in the beginning of the fourties of the previous century, the agents used to combat infectious diseases caused by bacteria were regarded with suspicion, but not long thereafter antibiotics had the status of miracle drugs. For decades mankind has lived under the impression that infectious diseases were no longer a threat to human health. This optimism was so high at a certain moment that antibiotics were also used against viral infections, whereas viruses are not even sensitive to antibiotics. This wrong use, or if one likes, misuse of antibiotics took also place in animal husbandry, where many tons of antibiotics were added to the feed of healthy animals, just because they grew so nicely from these additives. However, also in the use of antibiotics an ancient law in physics, "action equals reaction" turned out to be applicable. Bacteria reacted to the fact that they were attacked by changing their hereditary properties (through mutation) or by taking up parts of the hereditary properties of organisms (bacteria and fungi) able to produce certain antibiotics themselves. As a result of this reaction, already a short while after the introduction of antibiotics, the first bacteria could be isolated that had become insensitive (immune) for particular antibiotics. The bacteria in fact, had even more surprises in store. They turned out to be fanatic collectors of the pieces of hereditary properties that made them immune for antibiotics and like a stamp collector puts his stamps in an album, they also put their collection in an album (an integron). In this way, the best collectors have now become insensitive to more than ten different types of antibiotics. At the moment there are even bacteria that are not sensitive anymore to whatever type of antibiotic and for these bacteria treatment with antimicrobial agents is no longer available. Where, "work together, live together" is the current motto of the Dutch government, "work together to survive together" might be the motto of bacteria. They put this into practice by passing on their album with its integron collection from one bacterial species to the other. In this way a bacterium that used to be sensitive and could very well be treated with antibiotics can in one stroke become resistant to sometimes thirteen different antimicrobial agents, resulting in the fact that an infection with such a bacterium becomes untreatable. In this thesis research with respect to the sensitivity of the bacterium Salmonella, which can cause intestinal infections in human and animals, for antimicrobial agents is described. Since the (wrong) use of antibiotics can influence the development of resistance to antibiotics, in these studies a comparison has been made between Salmonella bacteria isolated from human, pigs, cattle and poultry in Vietnam and The Netherlands. Whereas in The Netherlands antibiotics are only available on prescription by a physician or veterinarian, antibiotics can be purchased over the counter in Vietnam. This leads to a significantly different attitude in both countries with respect to handling antibiotics. Examples are i.e. not taking a course of antibiotics of the correct dose, not taking a course of antibiotics of sufficient duration, not only taking a course of antibiotics in the case of bacterial infections and the continuing use of antibiotics as growth promoters in Vietnam. Resistance to antibiotics in Salmonella bacteria isolated in Vietnam turned out to occur frequently. In the Netherlands where the development of resistance has been monitored and registered for years the problem was hardly less. In Salmonella isolates from some animal species even resistance to antibiotics for which the use of that antibiotic is not allowed in that animal, was observed. In the current studies Salmonella bacteria have been isolated, both in Vietnam and in the Netherlands that have a collection in their integron album which is unique and has not been described before. At the end of the thesis the measures that could be taken to counteract the development of antibiotic resistance are discussed. The necessity of continuously making an inventory of the situation at local, regional, national and global level is accentuated, as is the shared responsibility that the government and civilians have with respect to the improper use of antibiotics.
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In: Regulation: the Cato review of business and government, Band 27, Heft 4, S. 34-37
ISSN: 0147-0590
Argues that current demand-side policy of the Food and Drug Administration and the Centers for Disease Control is the wrong route to address the issue of antibiotic resistance as it reduces the value to a pharmaceutical company of investing in the creation of new antibiotics. In this light, three externalities associated with antibiotic usage are discussed: public health, antibiotic resistance, and supply-side externalities. A cost-benefit analysis of FDA policies related to increased antibiotic scrutiny ensues, finding that requiring additional testing for antibiotics makes little sense with respect to patient welfare. Two harmful effects on antibiotic resistance of this FDA policy are denying the market use of an additional antibiotic, Ketek, and the loss of pharmaceutical company incentive to develop new antibiotics.
This paper provides a United States (US) perspective on the issue of antibiotic resistance as it pertains to the use of antibiotics in animals. A recent National Research Council (NRC, 1999) report concludes that drug residue issues are being effectively addressed in the US. The report also found that antibiotic use in food and animals is related to antibiotic resistance and the development of a set of diseases that exhibit resistance in humans. Although there is an urgent need to find alternatives to the use of antibiotics in animal production, an outright ban is unwarranted, and is likely to come down to a political issue. Scientific risk assessment, impact assessment, and a pragmatic recognition of existing conditions are important inputs in the political process. ; Includes bibliographical references
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1. Definitions and basic concepts -- 2. Have antibiotics and antibiotic resistance genes always been out there? -- 3. Human-related release of antibiotics into the environment -- 4. Spread of resistant organisms from human settlements into the environment -- 5. Impact of antibiotics and resistance in non-clinical settings.
In: info:eu-repo/semantics/altIdentifier/doi/10.2147/IDR.S4899
Beatriz Espinosa Franco1, Marina Altagracia Martínez2, Martha A Sánchez Rodríguez1, Albert I Wertheimer31Facultad de Estudios Superiores Zaragoza (UNAM), Mexico; 2Universidad Autónoma Metropolitana Unidad Xochimilco, Mexico; 3Temple University, Philadelphia, Pennsylvania, USABackground: The use of antibiotic drugs triggers a complex interaction involving many biological, sociological, and psychological determinants. Resistance to antibiotics is a serious worldwide problem which is increasing and has implications for morbidity, mortality, and health care both in hospitals and in the community.Objectives: To analyze current research on the determinants of antibiotic resistance and comprehensively review the main factors in the process of resistance in order to aid our understanding and assessment of this problem.Methods: We conducted a MedLine search using the key words "determinants", "antibiotic", and "antibiotic resistance" to identify publications between 1995 and 2007 on the determinants of antibiotic resistance. Publications that did not address the determinants of antibiotic resistance were excluded.Results: The process and determinants of antibiotic resistance are described, beginning with the development of antibiotics, resistance and the mechanisms of resistance, sociocultural determinants of resistance, the consequences of antibiotic resistance, and alternative measures proposed to combat antibiotic resistance.Conclusions: Analysis of the published literature identified the main determinants of antibiotic resistance as irrational use of antibiotics in humans and animal species, insufficient patient education when antibiotics are prescribed, lack of guidelines for treatment and control of infections, lack of scientific information for physicians on the rational use of antibiotics, and lack of official government policy on the rational use of antibiotics in public and private hospitals.Keywords: antibiotic drug resistance, determinants, social-biological
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INTRODUCTION: Antibiotic-resistant infections have become increasingly prevalent nowadays. As a result, it is essential to examine the key socioeconomic and political factors which contribute to the rise in the prevalence of antibiotic resistance in developing and developed nations. This study aims to identify the various contributors to the development of antibiotic resistance in each type of nation. METHODS: PUBMED was used to identify primary research, systematic reviews, and narrative reviews published before Jan 2017. Search terms included antibiotic resistance, antimicrobial resistance, superbugs, multidrug-resistant organisms, developing countries, developed countries. Publications from different countries were included to ensure generalizability. Publications were excluded if they didn't mention factors causing resistance, focused on the molecular basis of resistance, or if they were case reports. Publicly available reports from national and international health agencies were used. RESULTS: In developing countries, key contributors identified included: (1) Lack of surveillance of resistance development, (2) poor quality of available antibiotics, (3) clinical misuse, and (4) ease of availability of antibiotics. In developed countries, poor hospital-level regulation and excessive antibiotic use in food-producing animals play a major role in leading to antibiotic resistance. Finally, research on novel antibiotics is slow ing down due to the lack of economic incentives for antibiotic research. CONCLUSION: Overall, multiple factors, which are distinct for developing and developed countries, contribute to the increase in the prevalence of antibiotic resistance globally. The results highlight the need to improve the regulatory framework for antibiotic use and research globally.
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Work in our laboratory is supported by grants BIO2008-00090 from the Spanish Ministry of Science and Innovation and KBBE-227258 (BIOHYPO), HEALTH-F3-2011-282004 (EVOTAR), and HEALTH-F3-2010-241476 (PAR) from European Union. ; Peer reviewed ; Peer Reviewed
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A.baumannii is an opportunistic bacterium that has emerged in recent decades as a causative agent of potentially epidemic nosocomial infections. This bacterium has been able to develop an impressive resistance against the majority of antibiotics, which explains the therapeutic difficulties encountered. The objective of this work is to determine, through a retrospective study, the epidemiological profile, and the antibiotic resistance of A.baumannii strains isolated from diagnostic specimens made at Avicenne military hospital of Marrakech, and follow their evolution over 5 years (2012-2017). A.baumannii accounted for 3.75% of all isolated organisms during this period (n = 183). All hospital services were concerned, with a predominance of reanimation units (66% of isolates). The results obtained showed that these pathogens originate in 53% of the protected specimen brush and the main infectious sites were pneumopathies and urinary tract infections. An increase in the resistance of A.baumannii isolates for all antibiotics tested was observed (Ceftazidime 87%, Céfépime98%, Imipenem 84%, Ciprofloxacin 96% and Gentamicin 61%). However, all strains remained sensitive to Colistin. These results confirm the multidrug-resistant nature of A.baumannii and its nosocomial nature. This resistance represents a serious therapeutic and epidemiological problem, hence the need for the establishment of a system for monitoring the microbial environment of the hospital and the strict application of preventive measures.
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In: The handbook of environmental chemistry 91
In: Springer eBook Collection
Antibiotic resistance in the environment: expert perspectives -- Antibiotic resistant bacteria in wildlife -- Genomic surveillance for One Health antimicrobial resistance: understanding human, animal, and environmental reservoirs and transmission -- Antibiotic resistance in pharmaceutical industry effluents and effluent-impacted environments -- Antibiotic resistance in municipal wastewater: A special focus on hospital effluents -- Control strategies to combat dissemination of antibiotic resistance in urban water systems -- Antibiotic resistance, sanitation and public health -- Antibiotic resistance and sanitation in India: current situation and future perspectives -- Mitigating antimicrobial resistance risks when using reclaimed municipal wastewater for agriculture -- Antibiotic resistance in soil -- Religious Mass Gathering (Hajj) and Antimicrobial Resistance: From Challenges to Opportunities -- Human movement and transmission of anti-microbial resistant bacteria.
Policy-makers play a key role in tackling the emerging public health problem of antibiotic resistance. Antibiotic resistance is a result of the misuse, and especially the overuse, of antibiotics. Antibiotic resistance leads to excess morbidity and deaths. The problem is urgent. In the European Union more than 25 000 people die each year from common resistant bacterial infections. Owing to variable diagnostic capacity and a lack of data in countries, including Albania the number for the whole Region is not known. Antibiotic resistance increases health care costs. The estimated total cost to society of antibiotic resistance in the European Union alone is estimated to be € 1.5 billion resistant bacteria or genes that carry this information can spread easily. The use of antibiotics in animals sometimes outweighs their use in humans. Antibiotic resistance could take us back to the pre-antibiotic era. The complexity of the problem and the large number of sectors involved require strong national coordination, surveillance systems, national guidelines and sector-wide action plans. Based on good practices of national coordination of several European countries in many countries serve as reference in the conclusions to develop strategic action plan by the Albanian health institutions that aim to: I. Strengthen national multi sectorial coordination for the containment of antibiotic resistance II. Strengthen national surveillance of antibiotic resistance III. Promote national strategies for the rational use of antibiotics and strengthen national surveillance of antibiotic consumption IV. Strengthen infection control and surveillance of antibiotic resistance in health care settings V. Prevent and control the development and spread of antibiotic resistance in the food chain VII. Improve awareness, patient safety and partnership The complex nature of antibiotic resistance and the use of antibiotics requires the involvement of a wide array of actors:
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The antibiotic resistance (antimicrobial resistance – AMR) and the particular emergence of multi-resistant bacterial strains, is a problem of clinical relevance involving serious threats to public health worldwide. From early this decade, a lot of studies have demonstrated a significant increase in the rates of antibiotic resistance by bacterial pathogens responsible for nosocomial and community infections all over the world. The AMR leads to a reduced drug efficacy in the treatment options available and therefore, to an increase in mortality rates. The original causes of the phenomenon are: environmental factors which favor a mutation of the genetic bacterial inheritance, thereby inhibiting the active ingredient of the antibiotics; unsuitable administering of antibiotics in veterinary, incorrect taking both in hospitals and at home and, lately, lack of investments in the development of new drugs. The alarming epidemiological data prompted the World Health Organization (WHO) in 2011 to coin the slogan "No action today, no cure tomorrow" in order to immediately implement a new strategy to improve the use of available drugs and to accelerate the introduction of new ones through a new phase of research involving private and public institutions. The European Union has stressed that the surveillance is considered an essential factor for an effective response to this problem but it has also highlighted that the results produced have been lower than expectations because of serious shortcomings such as lack of methodological standards, insufficient data sharing and no coordination among European countries. In Italy the situation is much more troubling; in fact, according to the Ministry of Health, 5000-7000 yearly deaths are deemed due to nosocomial infections, with an annual cost of more than 100 million €.These figures explain how the fight against infections is far from being won. The purpose of this review is to analyze the basic causes of the recurrence of the phenomenon, to explain the steps taken by the most important international organizations to face AMR and finally to suggest a possible way to search for new classes of antibiotics.
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The antibiotic resistance (antimicrobial resistance – AMR) and the particular emergence of multi-resistant bacterial strains, is a problem of clinical relevance involving serious threats to public health worldwide. From early this decade, a lot of studies have demonstrated a significant increase in the rates of antibiotic resistance by bacterial pathogens responsible for nosocomial and community infections all over the world. The AMR leads to a reduced drug efficacy in the treatment options available and therefore, to an increase in mortality rates. The original causes of the phenomenon are: environmental factors which favor a mutation of the genetic bacterial inheritance, thereby inhibiting the active ingredient of the antibiotics; unsuitable administering of antibiotics in veterinary, incorrect taking both in hospitals and at home and, lately, lack of investments in the development of new drugs. The alarming epidemiological data prompted the World Health Organization (WHO) in 2011 to coin the slogan "No action today, no cure tomorrow" in order to immediately implement a new strategy to improve the use of available drugs and to accelerate the introduction of new ones through a new phase of research involving private and public institutions. The European Union has stressed that the surveillance is considered an essential factor for an effective response to this problem but it has also highlighted that the results produced have been lower than expectations because of serious shortcomings such as lack of methodological standards, insufficient data sharing and no coordination among European countries. In Italy the situation is much more troubling; in fact, according to the Ministry of Health, 5000-7000 yearly deaths are deemed due to nosocomial infections, with an annual cost of more than 100 million €.These figures explain how the fight against infections is far from being won. The purpose of this review is to analyze the basic causes of the recurrence of the phenomenon, to explain the steps taken by the most important international organizations to face AMR and finally to suggest a possible way to search for new classes of antibiotics.
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In: info:eu-repo/semantics/altIdentifier/doi/10.2147/IDR.S173867
Bilal Aslam,1 Wei Wang,2 Muhammad Imran Arshad,3 Mohsin Khurshid,1,4 Saima Muzammil,1 Muhammad Hidayat Rasool,1 Muhammad Atif Nisar,1 Ruman Farooq Alvi,1 Muhammad Aamir Aslam,2 Muhammad Usman Qamar,1 Muhammad Khalid Farooq Salamat,5 Zulqarnain Baloch6 1Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan; 2NHC Key Laboratory of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment, Beijing, China; 3Institute of Microbiology, University of Agriculture Faisalabad, Faisalabad, Pakistan; 4College of Allied Health Professionals, Directorate of Medical Sciences, Government College University Faisalabad, Faisalabad, Pakistan; 5Neurobiology Division, The Roslin Institute, University of Edinburgh, Edinburgh, UK; 6College of Veterinary Medicine, South China Agricultural University, Guangzhou, China Abstract: The advent of multidrug resistance among pathogenic bacteria is imperiling the worth of antibiotics, which have previously transformed medical sciences. The crisis of antimicrobial resistance has been ascribed to the misuse of these agents and due to unavailability of newer drugs attributable to exigent regulatory requirements and reduced financial inducements. Comprehensive efforts are needed to minimize the pace of resistance by studying emergent microorganisms, resistance mechanisms, and antimicrobial agents. Multidisciplinary approaches are required across health care settings as well as environment and agriculture sectors. Progressive alternate approaches including probiotics, antibodies, and vaccines have shown promising results in trials that suggest the role of these alternatives as preventive or adjunct therapies in future. Keywords: antibiotics, multidrug resistance, evolution, alternative therapies
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