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Antimicrobial use in animals is known to contribute to the global burden of antimicrobial resistance. Therefore, it is critical to monitor antimicrobial sales for livestock and pets. Despite the availability of veterinary antimicr...
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Antimicrobial use in animals is known to contribute to the global burden of antimicrobial resistance. Therefore, it is critical to monitor antimicrobial sales for livestock and pets. Despite the availability of veterinary antimicrobial sales data in most European countries, surveillance currently lacks consumption monitoring at the animal species level. In this study, alternative methods were investigated for stratifying antimicrobial sales per species using Swiss data (2006?2013). Three approaches were considered: (i) Equal Distribution (ED) allocated antimicrobial sales evenly across all species each product was licensed for; (ii) Biomass Distribution (BMD) stratified antimicrobial consumption, weighting the representativeness of each species' total biomass; and (iii) Longitudinal Study Extrapolation (LSE) assigned antimicrobial sales per species based on a field study describing prescription patterns in Switzerland. LSE is expected to provide the best estimates because it relies on field data. Given the Swiss example, BMD appears to be a reliable method when prescription data are not available, whereas ED seems to underestimate consumption in species with larger populations and higher treatment intensity. These methods represent a valuable tool for improving the monitoring systems of veterinary antimicrobial consumption across Europe. Keywords: antibiotic use, public health policy, surveillance, livestock, antimicrobial resistanceIntroductionAntimicrobial resistance has been gaining momentum as one of the most important topics within the public health sphere [1]. Part of the antimicrobial resistance burden for public health lies on the use of antimicrobials for veterinary purposes. Results from several studies have suggested that antimicrobial exposure in livestock is contributing to the emergence, selection and spread of antimicrobial resistant bacteria [2-4]. In addition, it is known that the use of antimicrobials in pets influences the resistance patterns found in those animals [5]. The subsequent spread of resistant bacteria from animals to humans can occur through multiple potential routes.Monitoring systems in veterinary medicine can provide useful insights into temporal trends of antimicrobial consumption and ensure compliance with prudent usage practices, programmes or regulations. Furthermore, they can assist in identifying the most efficient interventions for optimising antimicrobial usage. When combined with antimicrobial resistance data, quantification of antimicrobial usage can be useful not only in identifying risk factors for the emergence of resistance, but also in describing temporal associations between antimicrobial usage and resistance [6,7]. Finally, monitoring systems can be a source of highly informative data for boosting research on the complex topic of emergence, selection and spread of antimicrobial resistance. Thus, monitoring antimicrobial consumption in livestock and companion animals is undoubtedly an important tool in the battle against antimicrobial resistance.Research on the veterinary use of antimicrobials has focused on livestock species because their populations are larger and their antimicrobial consumption is higher than that of pet animals. Recognition of the importance of quantifying antimicrobial use in livestock emerged more than a decade ago [8] and the European Commission and the European Medicines Agency (EMA) have also emphasised the importance of monitoring antimicrobial use [9-11]. There is no binding European Union (EU) legislation with respect to the implementation of such monitoring programmes at national level and it is up to each country to define its strategy. In Switzerland, a non-EU country, the legal basis for sales data collection was defined in Article 35 of the Federal Ordinance on Veterinary Medicinal Products, enacted in September 2004 [12].The European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) project, initiated in 2010 by the EMA, has contributed considerably to the collection of standardised data on veterinary consumption in Europe [13]. ESVAC reports are published annually and are currently based on data provided by 26 countries, including Switzerland [14].Prompted by the European Commission’s Action plan against the rising threats from Antimicrobial Resistance [10], ESVAC published guidance for data collection on antimicrobial consumption at the species level [15]. Furthermore, international guidelines such as the World Organisation for Animal Health’s Terrestrial Animal Health Code [7] and Integrated Surveillance of Antimicrobial Resistance: Guidance from a WHO Advisory Group [16], mention usage data at the species level as an important aspect that should be considered in monitoring systems. Data at the species and the production type level (such as dairy or beef cattle; broilers or laying hens; breeding, farrowing or fattening units) provide a better estimate of the antimicrobial exposure in each population and are t
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Over the past 20?years, excessive antibiotic use has led to serious antimicrobial resistance (AMR) worldwide, and the phenomenon is particularly serious in China. To this end, the Chinese health sector took a series of measures to...
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Over the past 20?years, excessive antibiotic use has led to serious antimicrobial resistance (AMR) worldwide, and the phenomenon is particularly serious in China. To this end, the Chinese health sector took a series of measures to promote rational antibiotic use. In this study, to reveal the impact of policies on antibiotic use, we explored the long-term trend and patterns of antibiotic use at public health care institutions from 2012 to 2020 in northwest China, taking Gansu Province as an example. Antibiotic procurement data were obtained from the provincial centralized bidding procurement (CBP) platform between 2012 and 2020. Antibiotic use was quantified using the Anatomical Therapeutic Chemical (ATC)/defined daily doses (DDD) methodology and standardized using the DDD per 1000 inhabitants per day (DID). Twelve relevant quality indicators were calculated for comparison with the European Surveillance of Antimicrobial Consumption (ESAC) project monitoring results. Total antibiotic use increased from 18.75 DID to 57.07 DID and then decreased to 19.11 DID, a turning point in 2014. The top three antibiotics used were J01C (beta-lactam antibacterials, penicillins), J01F (macrolides, lincosamides and streptogramins), and J01D (other beta-lactam antibacterials, cephalosporins), accounting for 45.15%, 31.40%, and 11.99% respectively. The oral antibiotics used were approximately 2.5 times the parenteral antibiotics, accounting for 71.81% and 28.19%, respectively. Different use preferences were shown in public hospitals and primary health care centres (PHCs), and the latter accounted for more than half of total use. The absolute use of all classes of antibiotics in Gansu is almost higher than any of the 31 European countries included in the ESAC, but the relative use of some focused antibiotics is lower than theirs. The intervention policies of the health department reduced antibiotic use in Gansu Province, but the proportion of broad-spectrum and parenteral antibiotics was still high. It is necessary to further improve the quality of antibiotic prescriptions and pay more attention to the rationality of antibiotic use in PHCs.
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Antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) have been globally considered environmental contaminants that pose a serious problem to the health of humans, animals and the ecosystem. The primary object...
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Antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) have been globally considered environmental contaminants that pose a serious problem to the health of humans, animals and the ecosystem. The primary objective of the study was to characterize the antibiotic resistance phenotypes and genotypes of bacterial isolates from Gaborone wastewater treatment plant (GWWTP) and the downstream environment receiving effluent wastewater. Culture dependent and independent approaches were used to determine occurrence and diversity of ARGs in viable and potentially pathogenic bacteria from samples of wastewater influent, effluent and downstream environment. Higher frequencies of potentially pathogenic ARB; Staphylococcus species, Escherichia coli, Enterobacter aerogenes, Pseudomonas species, Brucella species, Salmonella species, Listeria species and Campylobacter species, and ARGs to clinically relevant antibiotics; tetA (tetracycline), mphA (macrolides), strB (streptomycin), sul1 (sulphonamide), dfr (trimethoprim) and int1 (mobile ARG cassette) were detected from the samples. Taken together, the results suggest accumulation of these antibiotic resistance determinants in wastewater treatment facilities and subsequent release into the water ecosystems downstream of the WWTP. This research is critical in Botswana because of lack of data and awareness on the threat posed by antibiotic resistance, poor wastewater treatment infrastructure, and lack of policies/guidelines on the safe use/handling of effluent wastewater for agricultural purposes. Data from this research will help sensitize relevant government health officials to carefully consider the environment contamination and spread of antibiotic resistance. This study further advocates for development of new water quality monitoring schemes and implementation of locally relevant policies on the safe and sustainable use of effluent contaminated water particularly for irrigation purposes in many developing countries.
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Antimicrobial resistance is a significant public health issue and a major threat to global health. The solutions are multifactorial, and include: a reduction in the unnecessary use of antibiotics; public health campaigns; the use ...
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Antimicrobial resistance is a significant public health issue and a major threat to global health. The solutions are multifactorial, and include: a reduction in the unnecessary use of antibiotics; public health campaigns; the use of systems approaches by healthcare organisations; and involving the knowledge and responsibilities of individual nurses. This article examines the challenge of antimicrobial resistance and explores the concept of antimicrobial stewardship in addressing this issue. It also discusses how nurses can contribute to a systems approach in primary and secondary care to support antimicrobial stewardship initiatives.
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Purpose Antibiotics are growing environmental contaminants leading to public health concern. Antibiotics are commonly used as growth promoters and therapeutic agents in poultry feed that are not completely metabolized in the body ...
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Purpose Antibiotics are growing environmental contaminants leading to public health concern. Antibiotics are commonly used as growth promoters and therapeutic agents in poultry feed that are not completely metabolized in the body tissues of chicken, get deposited in meat as parent compounds, and ultimately excreted via poultry droppings into the environment. These antibiotics in the soil result into the creation of antibiotic resistance in bacteria via activation of antibiotic resistance genes (ARGs). The development of ARGs and antibiotic-resistant bacteria (ARB) lead to huge physical and economic losses, as these bacteria cannot be treated with commonly used antibiotics. Moreover, these antibiotics after entering into food chains seriously affect the human immune system, growth, and metabolism of the body. Therefore, to reduce the future health risks of antibiotics, there is a dire need to understand the fate of poultry antibiotics and spread of ARGs in the soil environment.Materials and methods In this manuscript, we reviewed the existing literature about the antibiotics used in the poultry sector, soil contamination through application of poultry manures, and development of ARB in environment. An attempt has been done to present a better understanding of emerging contaminants (ARGs, ARB) in the soil environment and their associated human health effects.Results and discussion In this paper, we summarized the use of antibiotics in the poultry sector, persistence of antibiotics in animal body, and their release into environment. Transfer mechanism of antibiotics and their metabolites to the human body and their fatal effects have been investigated. Developments of ARB and ARGs in the soil due to excessive use of veterinary antibiotics have been highlighted.Conclusions Poultry antibiotics are causing human health risks by development of ARGs and ARB. Such antibiotic resistance cannot be treated with common antibiotics. Therefore, effective measures are needed to control this emerging problem by improving the efficiency of antibiotics, reducing the spread of resistance genes, and proper monitoring of antibiotics in poultry feed and manure. Manure composting and biochar application are the possible ways to reduce the risk and spread of ARGs in environment due to manure application in agriculture field. The pathways that allow antibiotic, ARGs, and ARB to move through the environment are not fully understood and there is a need for further research to make clear the reservoirs and routes of antibiotic-related contaminants in the ecosystem.
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This study aimed to assess understanding of antibiotic resistance and evaluate antibiotic use themes among the general public. In March 2018, respondents that were ≥21 years old and residing in the United States were recruited fr...
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This study aimed to assess understanding of antibiotic resistance and evaluate antibiotic use themes among the general public. In March 2018, respondents that were ≥21 years old and residing in the United States were recruited from ResearchMatch.org and surveyed to collect data on respondent expectations, knowledge, and opinions regarding prescribing antibiotics and antibiotic resistance. Content analysis was used to code open-ended definitions of antibiotic resistance into central themes. Chi-square tests were used to assess differences between the definitions of antibiotic resistance and antibiotic use. Among the 657 respondents, nearly all (99%) had taken an antibiotic previously. When asked to define antibiotic resistance, the definitions provided were inductively coded into six central themes: 35% bacteria adaptation, 22% misuse/overuse, 22% resistant bacteria, 10% antibiotic ineffectiveness, 7% body immunity, and 3% provided an incorrect definition with no consistent theme. Themes that were identified in respondent definitions of resistance significantly differed between those who reported having shared an antibiotic versus those who had not (p = 0.03). Public health campaigns remain a central component in the fight to combat antibiotic resistance. Future campaigns should address the public’s understanding of antibiotic resistance and modifiable behaviors that may contribute to resistance.
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Introduction: Antibiotic resistance is a substantial cause of mortality, morbidity burden in Bangladesh. In this perspective piece, the problem of antibiotic resistance has been analyzed by critically evaluating literature data, a...
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Introduction: Antibiotic resistance is a substantial cause of mortality, morbidity burden in Bangladesh. In this perspective piece, the problem of antibiotic resistance has been analyzed by critically evaluating literature data, and based on the author’s experience. Areas covered: The underlying causes of this resistance are numerous including irrational and inappropriate use of antibiotics aggravated by aggressive marketing, over-the-counter dispensing, prescribing by the unqualified providers, lack of awareness in the general population, and inadequate implementation of relevant regulations. Expert opinion: Although Bangladesh is making some progress toward containing antibiotic resistance, the pace of this progress is insufficient. Public awareness is crucial for the full implementation of the regulations. Given that it is more a social than a medical problem, the health sector is unable to tackle the problem on its own. An integrated approach is required that identifies the roles and relative importance of each sector (human, animal, and environment). A set of recommendations has been provided for the government to act.
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Current use, misuse, and overuse of antibiotics raise dangers and ethical dilemmas that cannot be solved in isolation, exclusively within a health system building block or even within the health sector only. There is a need to tac...
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Current use, misuse, and overuse of antibiotics raise dangers and ethical dilemmas that cannot be solved in isolation, exclusively within a health system building block or even within the health sector only. There is a need to tackle antibiotic resistance emergence and containment on levels ranging from individuals, households, and the communities, to health care facilities, the entire health sector, and finally to national and global levels. We analyse emergence of antibiotic resistance based on interdependencies between health systems resources. We further go beyond the health system building blocks, to look at determinants of antibiotic resistance referring to wider global dynamics. Multi-level governance is the key for successful action in containment strategies. This will involve, in a comprehensive way, patients, health facilities where they receive care, health systems to which these facilities pertain, and the wider national context as well as the global community that influences the functioning of these health systems. In order to be effective and sustainable in both high and low-resource settings, implementation of containment interventions at all these levels needs to be managed based on existing theories and models of change. Although ministries of health and the global community must provide vision and support, it is important to keep in mind that containment interventions for antibiotic resistance will target individuals, consumers as well as providers.
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The prevalence of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in the microbiome is a major public health concern globally. Many habitats in the environment are under threat due to excessive use of an...
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The prevalence of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in the microbiome is a major public health concern globally. Many habitats in the environment are under threat due to excessive use of antibiotics and evolutionary changes occurring in the resistome. ARB and ARGs from farms, cities and hospitals, wastewater treatment plants (WWTPs) or as water runoffs, may accumulate in water, soil, and air. We present a global picture of the resistome by examining ARG-related papers retrieved from PubMed and published in the last 30 years (1990-2020). Natural Language Processing (NLP) was used to retrieve 496,640 papers, out of which 9374 passed the filtering test and were further analyzed to determine the distribution and diversity of ARG subtypes. The papers revealed seven major antibiotic families together with their respective ARG subtypes in different habitats on six continents. Asia, especially China, had the highest number of ARGs related papers compared to other countries/regions/continents. ARGs belonging to multidrug, glycopeptide, and beta-lactam families were the most common in reports from hospitals and sulfonamide and tetracycline families were common in reports from farms, WWTPs, water and soil. We also highlight the 'omics' tools used in resistome research, describe some factors that shape the development of resistome, and suggest future work needed to better understand the resistome. The goal was to show the global nature of ARB and ARGs in order to encourage collaborate research efforts aimed at reducing the negative impacts of antibiotic resistance on the One Health concept.
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ObjectiveTo identify and compare the factors affecting the knowledge of, attitude towards and use of antibiotics between urban and rural residents in China.
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