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International audience ; Resistance to antibiotics has recently increased dramatically worldwide. The pipeline of new classes of antibiotics is dry for at least the next few years. Therefore antibiotic resistance represents one of the most problematic public health issues of our time. Treatment failures already happen in increasing numbers for common community-acquired infections, such as urinary tract infections or intra-abdominal infections. This is due in particular to Enterobacteriaceae harboring extended-spectrum beta-lactamases (ESBL). Enterobacteriaceae harboring carbapenemases are also highly prevalent in many countries. In the future, difficult surgical procedures, transplants, and other immunosuppressive therapies may become very risky. Resistance is mainly due to an excessive usage of antibiotics, in both humans and animals, and to cross-transmission of resistant bacteria. Action is urgently needed. Therefore, a World Alliance Against Antibiotic Resistance (WAAAR) was created in 2011. It includes healthcare professionals, consumers, health managers, and politicians. We present here the main measures proposed by the Alliance, as a result of a strong consensus between the different stakeholders, including general practitioners and veterinarians.

This work was supported by the Spanish Ministerio de Innovación y Ciencia (AGL2016-75536-P), the Agencia Estatal de Investigación (AEI) and the European regional fund (ERF), the Generalitat de Catalunya (2017SGR170) and the Centre de Referència en Biotecnologia (XeRBa). CERCA Programme from the Generalitat de Catalunya is also acknowledged. M.B.-J. has a grant from COLCIENCIAS (Republic of Colombia). P.B.-P. has a grant from the Spanish Ministry of Economy, Industry and Competitiveness (BES-2017-081296). L.R.-R. is supported by the Beatriu de Pinos postdoctoral programme of the Government of Catalonia's Secretariat for Universities and Research of the Ministry of Economy and Knowledge. ; Altres ajuts: MICITT/AGL2016-75536-P ; Bacteriophages can package part of their host's genetic material, including antibiotic resistance genes (ARGs), contributing to a rapid dissemination of resistances among bacteria. Phage particles containing ARGs were evaluated in meat, pork, beef and chicken minced meat, and ham and mortadella, purchased in local retailer. Ten ARGs (bla, bla, bla, bla, bla, qnrA, qnrS, mecA, armA and sul1) were analyzed by qPCR in the phage DNA fraction. The genes were quantified, before and after propagation experiments in Escherichia coli, to evaluate the ability of ARG-carrying phage particles to infect and propagate in a bacterial host. According to microbiological parameters, all samples were acceptable for consumption. ARGs were detected in most of the samples after particle propagation indicating that at least part of the isolated phage particles were infectious, being sul1the most abundant ARG in all the matrices followed by β-lactamase genes. ARGs were also found in the phage DNA fraction of thirty-seven archive chicken cecal samples, confirming chicken fecal microbiota as an important ARG reservoir and the plausible origin of the particles found in meat. Phages are vehicles for gene transmission in meat that should not be underestimated as a risk factor in the global crisis of antibiotic ...

Antibiotic resistance is a serious global threat to human and animal health. In this study, we explored perceptions of work to contain antibiotic resistance with a focus on the environment. Nine stakeholders from six different areas were interviewed in 2018. A short information update was given by informants from four of the areas in 2021. Interview transcripts were analyzed by conventional content analysis. The stakeholders' perceptions were concluded in three categories: "examples of actions taken to combat antibiotic resistance", "factors influencing work", and "factors hindering work". All informants reported having a role to play. Some of them were very engaged in this issue, whereas among others, antibiotics and resistance were just one part of a general engagement. To be able to act, the policymaker stakeholders asked for more knowledge about antibiotics in the environment and possible actions to take. Actions from the government were requested by several informants. Coordination of the work to combat antibiotic resistance in the environment was not recognized and the One Health approach was known at policy level but not among practitioners. Still, actions seemed to be coordinated, but this was, according to the stakeholders, based on findings from research in their area rather than on strategies developed by national authorities

This is the final version. Available on open access from Nature Research via the DOI in this record ; Data availability: ATLAS is available following website registration*. Data and further information can be downloaded from the following links: Project overview: https://amr.theodi.org/project-overview Project description: https://wellcome.ac.uk/sites/default/files/antimicrobial-resistance-surveillance-sharing-industry-data.pdf Data download*: https://www.synapse.org/#!Synapse:syn17009517/wiki/585653 The same dataset is available from this link: https://s3-eu-west-1.amazonaws.com/amr-prototype-data/Open+Atlas_Reuse_Data.xlsx Data was extracted from the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) report from years 2013-2018. These were downloaded from the following UK government website: https://www.gov.uk/government/publications/english-surveillance-programme-antimicrobial-utilisation-and-resistance-espaur-report ResistanceMap data is published by the Centre for Disease, Dynamics Economics and Policy28, it can be downloaded from https://github.com/gwenknight/empiricprescribing/tree/master/data, Data for the European Centre for Disease Prevention and Control (ECDC) can be downloaded from https://atlas.ecdc.europa.eu/public/index.aspx?Dataset=27#x00026;HealthTopic=4. The file we used in this paper can be downloaded from https://github.com/PabloCatalan/atlas/tree/master/data/europe_resistance_data.csv EUCAST data can only be obtained by contacting individuals named on their website https://www.eucast.org/mic_distributions_and_ecoffs/ and requesting access to MIC histograms, which we were granted. ; Code availability: Analysis codes66 written in Python 3.0 using pandas can be downloaded here: https://github.com/PabloCatalan/atlas or https://doi.org/10.5281/zenodo.6390565. Codes have been written to provide straightforward access to data so that figures from this manuscript can be reproduced and to help facilitate the development of new analyses. Interested readers are ...

Antibiotic resistant bacteria and genes which confer resistance to antibiotics from human/animal sources are currently considered a serious environmental and a public health concern. This problem is still little investigated in aquatic environment of developing countries according to the different climatic conditions. In this research, the total bacterial load, the abundance of relevant bacteria (Escherichia coli (E. coli), Enterococcus (Ent), and Pseudomonas), and antibiotic resistance genes (ARGs: blaOXA-48, blaCTX-M, sul1, sul2, sul3, and tet(B)) were quantified using Quantitative Polymerase Chain Reaction (qPCR) in sediments from two rivers receiving animal farming wastewaters under tropical conditions in Kinshasa, capital city of the Democratic Republic of the Congo. Human and pig host-specific markers were exploited to examine the sources of contamination. The total bacterial load correlated with relevant bacteria and genes blaOXA-48, sul3, and tet(B) (P value<0.01). E. coli strongly correlated with 16s rDNA, Enterococcus, Pseudomonas spp., blaOXA-48, sul3, and tet(B) (P value<0.01) and with blaCTX-M, sul1, and sul2 at a lower magnitude (P value <0.05). The most abundant and most commonly detected ARGs were sul1, and sul2. Our findings confirmed at least two sources of contamination originating from pigs and anthropogenic activities and that animal farm wastewaters didn't exclusively contribute to antibiotic resistance profile. Moreover, our analysis sheds the light on developing countries where less than adequate infrastructure or lack of it adds to the complexity of antibiotic resistance proliferation with potential risks to the human exposure and aquatic living organisms. This research presents useful tools for the evaluation of emerging microbial contaminants in aquatic ecosystems which can be applied in the similar environment.

In this article, we introduce ARES (Antibiotic Resistance Evolution Simulator) a software device that simulates P-system model scenarios with five types of nested computing membranes oriented to emulate a hierarchy of eco-biological compartments, i.e. a) peripheral ecosystem; b) local environment; c) reservoir of supplies; d) animal host; and e) host's associated bacterial organisms (microbiome). Computational objects emulating molecular entities such as plasmids, antibiotic resistance genes, antimicrobials, and/or other substances can be introduced into this framework and may interact and evolve together with the membranes, according to a set of pre-established rules and specifications. ARES has been implemented as an online server and offers additional tools for storage and model editing and downstream analysis ; This work has also been supported by grants BFU2012-39816-C02-01 (co-financed by FEDER funds and the Ministry of Economy and Competitiveness, Spain) to AL and Prometeo/2009/092 (Ministry of Education, Government of Valencia, Spain) and Explora Ciencia y Explora Tecnologia/SAF2013-49788-EXP (Spanish Ministry of Economy and Competitiveness) to AM. IRF is recipient of a "Sara Borrell" postdoctoral fellowship (Ref. CD12/00492) from the Ministry of Economy and Competitiveness (Spain). We are also grateful to the Spanish Network for the Study of Plasmids and Extrachromosomal Elements (REDEEX) for encouraging and funding cooperation among Spanish microbiologists working on the biology of mobile genetic elements (Spanish Ministry of Science and Innovation, reference number BFU2011-14145-E). ; Campos Frances, M.; Llorens, C.; Sempere Luna, JM.; Futami, R.; Rodríguez, I.; Carrasco, P.; Capilla, R. (2015). A membrane computing simulator of trans-hierarchical antibiotic resistance evolution dynamics in nested ecological compartments (ARES). Biology Direct. 10(41):1-13. https://doi.org/10.1186/s13062-015-0070-9 ; S ; 1 ; 13 ; 10 ; 41 ; Baquero F, Coque TM, Canton R. Counteracting antibiotic resistance: breaking ...

There is growing understanding that the environment plays an important role both in the transmission of antibiotic resistant pathogens and in their evolution. Accordingly, researchers and stakeholders world-wide seek to further explore the mechanisms and drivers involved, quantify risks and identify suitable interventions. There is a clear value in establishing research needs and coordinating efforts within and across nations in order to best tackle this global challenge. At an international workshop in late September 2017, scientists from 14 countries with expertise on the environmental dimensions of antibiotic resistance gathered to define critical knowledge gaps. Four key areas were identified where research is urgently needed: 1) the relative contributions of different sources of antibiotics and antibiotic resistant bacteria into the environment; 2) the role of the environment, and particularly anthropogenic inputs, in the evolution of resistance; 3) the overall human and animal health impacts caused by exposure to environmental resistant bacteria; and 4) the efficacy and feasibility of different technological, social, economic and behavioral interventions to mitigate environmental antibiotic resistance. ; The workshop was organized and supported by the Joint Programming Initiative on Antimicrobial Resistance (JPIAMR), the Swedish Research Council (SRC) and the Centre for Antibiotic Resistance Research at University of Gothenburg, Sweden (CARe). This project received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement JPI-EC-AMR No 681055. ; publishedVersion

There is growing understanding that the environment plays an important role both in the transmission of antibiotic resistant pathogens and in their evolution. Accordingly, researchers and stakeholders world-wide seek to further explore the mechanisms and drivers involved, quantify risks and identify suitable interventions. There is a clear value in establishing research needs and coordinating efforts within and across nations in order to best tackle this global challenge. At an international workshop in late September 2017, scientists from 14 countries with expertise on the environmental dimensions of antibiotic resistance gathered to define critical knowledge gaps. Four key areas were identified where research is urgently needed: 1) the relative contributions of different sources of antibiotics and antibiotic resistant bacteria into the environment; 2) the role of the environment, and particularly anthropogenic inputs, in the evolution of resistance; 3) the overall human and animal health impacts caused by exposure to environmental resistant bacteria; and 4) the efficacy and feasibility of different technological, social, economic and behavioral interventions to mitigate environmental antibiotic resistance.1. ; The workshop was organized and supported by the Joint Programming Initiative on Antimicrobial Resistance (JPIAMR), the Swedish Research Council (SRC) and the Centre for Antibiotic Resistance Research at University of Gothenburg, Sweden (CARe). This project received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement JPI-EC-AMR No 681055. Individual member states of the JPIAMR also covered travel costs for participants. ; Sí

Background: Growing rates of antibiotic resistance, caused by increasing antibiotic use, pose a threat by making antibiotics less effective in treating infections. Objective: We aimed to study whether physicians working at privately and publicly owned health centres differed in the likelihood of prescribing antibiotics and choosing broad-spectrum over narrow-spectrum antibiotics. Methods: To estimate the effect of ownership on the probability of a prescribed drug being an antibiotic, we analysed all 4.5 million prescriptions issued from 2011 to 2015 at primary health centres in Västerbotten, Sweden. We controlled for patient age, sex, number of prescriptions per patient, and month of prescription, and used a maximum likelihood logit estimator. We then analysed how ownership affected the likelihood of a prescribed antibiotic being broad spectrum. We also used aggregated data to estimate the impact of the number of private health centres on the number of antibiotic prescriptions per inhabitant and the proportion of broad-spectrum antibiotics. Results: Holding other factors constant, private physicians were 6% more likely to prescribe antibiotics and 9% more likely to choose broad-spectrum antibiotics. An increase by one additional private health centre was positively associated with an increase in the number of antibiotic prescriptions per inhabitant and a higher proportion, although not significant, of broad-spectrum antibiotic prescriptions. Conclusion: Our findings suggest that private physicians prescribe more antibiotics, especially broad-spectrum antibiotics, than public physicians. Therefore, it is crucial to provide health centres with incentives to follow guidelines for antibiotic prescription, especially when the level of private provision of primary healthcare is high.

The potential spreading of antibiotic resistance genes (ARG) into agricultural fields and crops represent a fundamental limitation on the use of organic fertilization in food production systems. We present here a study of the effect of spreading four types of organic soil amendments (raw pig slurry, liquid and solid fractions, and a digested derivative) on demonstrative plots in two consecutive productive cycles of corn harvest (Zea mays), using a mineral fertilizer as a control, following the application of organic amendments at 32-62 T per ha (150 kg total N/ha) and allowing 5-8 months between fertilization and harvest. A combination of qPCR and high-throughput 16S rDNA sequencing methods showed a small, but significant impact of the fertilizers in both ARG loads and microbiomes in soil samples, particularly after the second harvesting cycle. The slurry solid fraction showed the largest impact on both ARG loads and microbiome variation, whereas its digestion derivatives showed a much smaller impact. Soil samples with the highest ARG loads also presented increased levels of tetracyclines, indicating a potential dual hazard by ARG and antibiotic residues linked to some organic amendments. Unlike soils, no accumulation of ARG or antibiotics was observed in corn leaves (used as fodder) or grains, and no grain sample reached detection limits for neither parameter. These results support the use of organic soil amendments in corn crops, while proposing the reduction of the loads of ARGs and antibiotics from the fertilizers to greatly reduce their potential risk. ; This work was supported by grants from the LIFE Program of the European Union (LIFE17 ENV/ES/000439), the Spanish Ministry of Science, Innovation and University (MCIN/AEI/10.13039/501100011033, grant RTI2018-096175-B-I00), and the Generalitat de Catalunya (2017SGR902). CSL was supported by a FI predoctoral fellowship from the Generalitat de Catalunya and the European Social Fund (2018 FI B 00368, ESF Investing in your future). IDAEA-CSIC is a Center of ...

Earl, Chris S. et al. ; Glucocorticosteroids are used as a main treatment to reduce airway inflammation in people with asthma who suffer from neutrophilic airway inflammation, a condition frequently associated with Haemophilus influenzae colonization. Here we show that glucocorticosteroids have a direct influence on the behavior of H. influenzae that may account for associated difficulties with therapy. Using a mouse model of infection, we show that corticosteroid treatment promotes H. influenzae persistence. Transcriptomic analysis of bacteria either isolated from infected mouse airway or grown in laboratory medium identified a number of genes encoding regulatory factors whose expression responded to the presence of glucocorticosteroids. Importantly, a number of these corticosteroid-responsive genes also showed elevated expression in H. influenzae within sputum from asthma patients undergoing steroid treatment. Addition of corticosteroid to H. influenzae led to alteration in biofilm formation and enhanced resistance to azithromycin, and promoted azithromycin resistance in an animal model of respiratory infection. Taken together, these data strongly suggest that H. influenzae can respond directly to corticosteroid treatment in the airway potentially influencing biofilm formation, persistence and the efficacy of antibiotic treatment. ; The work of the authors has been supported in part by grants awarded by the Wellcome Trust (WT100204AIA senior fellowship grant to R.P.R.), European Union's Seventh Framework Programme (Grant No. 603038 to R.P.R.) and the National Institutes of Health (R01 Grant 2 R37 AI83256-06 to G.A.O). ; Peer Reviewed

Septic arthritis is a therapeutic emergency and any delay in diagnosis has a serious impact on the patient's future, both in functional and vitality terms. Objectives: The aim of this study is to determine the epidemiology of septic arthritis, to characterize their bacteriological profiles and to evaluate antibiotic resistance in the Avicenne military hospital in Marrakech. Methods: This is a retrospective descriptive study over a period of 7 years from January 2014 to December 2020, focusing on the bacteriological analysis of articular liquids received in the microbiology laboratory of the Avicenne military hospital in Marrakech. Results: Among the 496 articular liquids studied, only 25 were positive on direct examination and/or culture. The male sex was predominant with a sex ratio of 5.25. The departments involved were: 48% from the rheumatology department, 16% from the trauma department, 8% from the emergency department, 4% from the resuscitation department, and 20% from the outpatient department. A purulent aspect on macroscopic examination is the most frequent finding at 88%. Hyperleukocytosis greater than 10000 elements/mm³ is found in 60% of cases. Direct examination is positive in 60% of cases, of which 44% are gram positive cocci and 16% are gram negative bacilli. Staphylococcus aureus is isolated in 45% of the cultures against 20% for coagulase-negative Staphylococci, 15% for streptococcus spp, 10% for Klebsiella pneumoniae, and 5% for Escherichia. Coli. However, the existence of a germ in the joint fluid is not synonymous with septic arthritis; in fact, we found 3 cases of joint fluid contamination. The study of the resistance of these isolates revealed an absence of resistance to methicillin for Staphylococcus aureus while 33% of coagulase-negative Staphylococcus were resistant. During the study period, out of a total of 20 bacteria isolated, only one multi-resistant bacterium was isolated (ESBL-producing enterobacteria). Conclusion: Septic arthritis is a serious infection. Bacteriological diagnosis ...

The objective of this study is to establish the frequency of multi-drug resistant bacteria (MDR) isolated at the Avicenne Military Hospital as well as their levels of resistance to antibiotics. This is a retrospective study conducted over 7years (2015 to 2021), at the Avicenne Military Hospital. Were collected all bacteriological samples received for diagnostic purposes, from patients hospitalized for at least 48 hours. The identification of the bacterial strains was based on the study of their morphological, cultural, and biochemical characteristics on the BD Phoenix™ i100 Automated System, which also allows susceptibility testing. Detection of resistance phenotypes was completed by the conventional method of disc diffusion in an agar medium. The interpretation was based on CA-SFM/EUCAST guidelines. The overall frequency of MDR bacteria is 14,3% with a large predominance of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (54,1%) followed by Acinetobacter baumannii resistant to ceftazidime and/or imipenem (28,1%), methicillin-resistant Staphylococcus aureus (9,3%), then Enterobacteriaceae resistant to carbapenems (5,2%), and finally Pseudomonas aeruginosa resistant to ceftazidime and/or imipenem which represented 3.3% of the MDR bacteria isolated. Co-resistance levels in MDR bacteria are high. The increasing frequency of multi-drug resistant bacteria highlights the importance of an appropriate antibiotic strategy and the necessity of the implementation of antibiotic resistance monitoring.

This work aims to study the bacteriological profile of Multi drug resistant bacteremia, as well as the current state of their resistance to antibiotics. It is a retrospective, descriptive study, which was spread over 8 years (January 2014-December 2021), relating to hospitalized patients having a positive blood culture, confirmed at microbiological laboratory of the Avicenna Military Hospital of Marrakesh. A total of 1923 blood cultures were performed, 17% of which came back positive. 68 MDRs bacterias were isolated, which is 20% of all isolates. Enterobacteriaceae resistant to third generation cephalosporins and imipenem resistant Acinetobacter baumanii are the most frequently found MDRs bacterias with rates of 47% and 30% respectively. Hospital units are mainly represented by resuscitation-intensive care, followed by medical services. MDR bacteria represent a worrying problem underlining the need for the application of hygiene measures and the rational prescription of antibiotics.

Antimicrobial resistance is a global emerging public health issue whose presence and impact in wildlife are widely unknown. Antimicrobial resistance genes (ARGs) are considered environmental contaminants, suitable to evaluate the degree of anthropic impact on wildlife and the environment. We used a wild felid, the guigna (Leopardus guigna), as a sentinel for the presence of ARGs in anthropized and pristine areas across their entire distribution range in Chile. We evaluated fecal samples from 51 wild guignas, collected between 2009 and 2018. Real-time PCR essays were employed to detect and quantify 22 selected ARGs in their fecal microbiome. All animals (100%) were positive for at least one ARG. The most prevalent ARG families were those that confer resistance to tetracycline (88.2%) and beta-lactamase (68.9%), with tet (Q) (60.8%), tet(W) (60.8%), and bla(TEM) (66.7%) as the most prevalent ARGs. Multi-resistance profiles were observed in 43% of the guignas. Statistically significant differences were found between anthropized and pristine areas for tet(Q) (p = 0.014), tet(W) (p = 0.0037), tetracycline family (p = 0.027), multi-resistance profile prevalence (p = 0.043) and tet(W) quantification (p = 0.004). Two animals from anthropized landscapes were positive for mecA, a gene associated with Staphylococcus aureus and other staphylococci resistant to methicillin, while three animals from anthropized areas were positive for bla(CTX-M), that encodes class A extended-spectrum beta-lactamase. Both genes have been identified in bacteria causing relevant nosocomial infections worldwide. This is the first study on ARGs in wild felids from Chile and the first detection of mecA in South American wild felids. We observed an association between the degree of landscape anthropization and ARG prevalence, confirming that ARGs are important indicators of wildlife exposure to human activity/presence, with a widespread distribution. (C) 2019 Elsevier B.V. All rights reserved. ; Comisión Nacional de Investigación Científica y Tecnológica (CONICYT) CONICYT FONDECYT Morris Animal Foundation (MAF) Fellowship Training Award National Geographic Society Mohamed bin Zayed Species Conservation Fund CONICYT PIA APOYO CCTE Wild Felid Association Fondo Interno UNAB Universidad Andrés Bello, Chile Morris Animal Foundation Comisión Nacional de Investigación Científica y Tecnológica (CONICYT) CONICYT FONDECYT 2018 Endeavour Research Fellowship (Australian government)