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Expert Review of Anti-infective Therapy 2023Antibiotic consumption rates are high in both high and low-income countries, but addressing antibiotic practices in low- and middle-income countries (LMICs) is crucial...
INTRODUCTION
Antibiotic consumption rates are high in both high and low-income countries, but addressing antibiotic practices in low- and middle-income countries (LMICs) is crucial to combatting antibiotic resistance (AR).
AREA COVERED
This editorial examines the current landscape of antibiotic practices in LMICs, investigate the factors driving such trends including lack of resource equity and shared global responsibility, and explore (AR) global implications, with particular emphasis placed on swift measures to combat its spread.
EXPERT OPINION
LMICs face three key obstacles that exacerbate AR: inadequate WASH services, climate factors, and misuse of antibiotics. A lack of sanitation and clean water promotes infections, while poor hygiene exacerbates resistant pathogen spread. Global strategies should go beyond simply educating LMICs about antibiotic misuse; they must also understand its repercussions, such as prolonged illnesses and drug-resistant bacteria like MRSA. Addressing this challenge requires multifaceted strategies, including improving WASH services, acknowledging climate impacts, and tightening regulations. Prioritizing WASH requires significant funding, community participation, technology solutions, and partnerships with NGOs. Utilizing social media influencers can boost AR awareness. Antibiotic regulation reforms, manufacturing quality, and seeking antibiotic alternatives are vital. Antimicrobial Stewardship Programs and AI's potential in managing resistant infections are notable.
Topics: Humans; Developing Countries; Drug Resistance, Microbial; Bacteria; Anti-Bacterial Agents; Antimicrobial Stewardship
PubMed: 37804134
DOI: 10.1080/14787210.2023.2268835 -
The Science of the Total Environment Sep 2023Antibiotic resistant bacteria (ARB) are a major health risk caused particularly by anthropogenic activities. Acquisition of antibiotic resistances by bacteria is known...
Antibiotic resistant bacteria (ARB) are a major health risk caused particularly by anthropogenic activities. Acquisition of antibiotic resistances by bacteria is known to have happened before the discovery of antibiotics and can occur through different routes. Bacteriophages are thought to have an important contribution to the dissemination of antibiotic resistance genes (ARGs) in the environment. In this study, seven ARGs (bla, bla, bla, bla, mecA, vanA, and mcr-1) were investigated, in the bacteriophage fraction, in raw urban and hospital wastewaters. The genes were quantified in 58 raw wastewater samples collected at five WWTPs (n = 38) and hospitals (n = 20). All genes were detected in the phage DNA fraction, with the bla genes found in higher frequency. On the other hand, mecA and mcr-1 were the least frequently detected genes. Concentrations varied between 10 copies/L and 10 copies/L. The gene coding for the resistance to colistin (mcr-1), a last-resort antibiotic for the treatment of multidrug-resistant Gram-negative infections, was identified in raw urban and hospital wastewaters with positivity rates of 19 % and 10 %, respectively. ARGs patterns varied between hospital and raw urban wastewaters, and within hospitals and WWTP. This study suggests that phages are reservoirs of ARGs, and that ARGs (with particularly emphasis on resistance to colistin and vancomycin) in the phage fraction are already widely widespread in the environment with potential large implications for public health.
Topics: Wastewater; Anti-Bacterial Agents; Genes, Bacterial; Colistin; Bacteriophages; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Drug Resistance, Microbial; Bacteria; Hospitals
PubMed: 37315610
DOI: 10.1016/j.scitotenv.2023.164708 -
Water Research Oct 2023Oceans serve as global reservoirs of antibiotic-resistant bacteria and antibiotic resistance genes (ARGs). However, little is known about the traits and expression of...
Oceans serve as global reservoirs of antibiotic-resistant bacteria and antibiotic resistance genes (ARGs). However, little is known about the traits and expression of ARGs in response to environmental factors. We analyzed 347 metagenomes and 182 metatranscriptomes to determine the distribution, hosts, and expression of ARGs in oceans. Our study found that the diversity and abundance of ARGs varied with latitude and depth. The core marine resistome mainly conferred glycopeptide and multidrug resistance. The hosts of this resistome were mainly limited to the core marine microbiome, with phylogenetic barriers to the horizontal transfer of ARGs, transfers being more frequent within species than between species. Sixty-five percent of the marine ARGs identified were expressed. More than 90% of high-risk ARGs were more likely to be expressed. Anthropogenic activity might affect the expression of ARGs by altering nitrate and phosphate concentrations and ocean temperature. Machine-learning models predict >97% of marine ARGs will change expression by 2100. High-risk ARGs will shift to low latitudes and regions with high anthropogenic activity, such as the Pacific and Atlantic Oceans. Certain ARGs serve a dual role in antibiotic resistance and potentially participate in element cycling, along with other unknown functions. Determining whether changes in ARG expression are beneficial to ecosystems and human health is challenging without comprehensive understanding of their functions. Our study identified a core resistome in the oceans and quantified the expression of ARGs for the development of future control strategies under global change.
Topics: Humans; Genes, Bacterial; Anti-Bacterial Agents; Phylogeny; Drug Resistance, Microbial; Microbiota
PubMed: 37604017
DOI: 10.1016/j.watres.2023.120488 -
Bioresource Technology Dec 2023Fate of antibiotics and antibiotic resistance genes (ARGs) during composting of antibiotic fermentation waste (AFW) is a major concern. This review article focuses on... (Review)
Review
Fate of antibiotics and antibiotic resistance genes (ARGs) during composting of antibiotic fermentation waste (AFW) is a major concern. This review article focuses on recent literature published on this subject. The key findings are that antibiotics can be removed effectively during AFW composting, with higher temperatures, appropriate bulking agents, and suitable pretreatments improving their degradation. ARGs dynamics during composting are related to bacteria and mobile genetic elements (MGEs). Higher temperatures, suitable bulking agents and an appropriate C/N ratio (30:1) lead to more efficient removal of ARGs/MGEs by shaping the bacterial composition. Keeping materials dry (moisture less than 30%) and maintaining pH stable around 7.5 after composting could inhibit the rebound of ARGs. Overall, safer utilization of AFW can be realized by optimizing composting conditions. However, further removal of antibiotics and ARGs at low levels, degradation mechanism of antibiotics, and spread mechanism of ARGs during AFW composting require further investigation.
Topics: Anti-Bacterial Agents; Genes, Bacterial; Composting; Fermentation; Bacteria; Drug Resistance, Microbial; Manure
PubMed: 37863331
DOI: 10.1016/j.biortech.2023.129861 -
Journal of Infection and Public Health Dec 2023The emergence and re-emergence of tick-borne bacteria (TBB) as a public health problem raises the uncertainty of antibiotic resistance in these pathogens, which could be... (Review)
Review
The emergence and re-emergence of tick-borne bacteria (TBB) as a public health problem raises the uncertainty of antibiotic resistance in these pathogens, which could be dispersed to other pathogens. The impact of global warming has led to the emergence of pathogenic TBB in areas where they were not previously present and is another risk that must be taken into account under the One Health guides. This review aimed to analyze the existing information regarding antibiotic-resistant TBB and antibiotic-resistance genes (ARG) present in the tick microbiome, considering the potential to be transmitted to pathogenic microorganisms. Several Ehrlichia species have been reported to exhibit natural resistance to fluoroquinolones and typhus group Rickettsiae are naturally susceptible to erythromycin. TBB have a lower risk of acquiring ARG due to their natural habitat, but there is still a probability of acquiring them; furthermore, studies of these pathogens are limited. Pathogenic and commensal bacteria coexist within the tick microbiome along with ARGs for antibiotic deactivation, cellular protection, and efflux pumps; these ARGs confer resistance to antibiotics such as aminoglycosides, beta-lactamase, diaminopyrimidines, fluoroquinolones, glycopeptides, sulfonamides, and tetracyclines. Although with low probability, TBB can be a reservoir of ARGs.
Topics: Humans; One Health; Bacteria; Anti-Bacterial Agents; Drug Resistance, Microbial; Genes, Bacterial; Fluoroquinolones
PubMed: 37945496
DOI: 10.1016/j.jiph.2023.10.027 -
Revue de L'infirmiere Oct 2023Antibiotic resistance is a threat to human medicine. Preventing the risk of infection and participating in the proper use of antibiotics are part of nurses' mission to...
Antibiotic resistance is a threat to human medicine. Preventing the risk of infection and participating in the proper use of antibiotics are part of nurses' mission to combat this phenomenon, in partnership with their colleagues who are experts in hygiene and infectiology.
Topics: Humans; Drug Resistance, Microbial; Hygiene; Nurses
PubMed: 37838367
DOI: 10.1016/j.revinf.2023.08.007 -
MBio Aug 2023Conjugative plasmids play a vital role in bacterial evolution and promote the spread of antibiotic resistance. They usually cause fitness costs that diminish the growth...
Conjugative plasmids play a vital role in bacterial evolution and promote the spread of antibiotic resistance. They usually cause fitness costs that diminish the growth rates of the host bacteria. Compensatory mutations are known as an effective evolutionary solution to reduce the fitness cost and improve plasmid persistence. However, whether the plasmid transmission by conjugation is sufficient to improve plasmid persistence is debated since it is an inherently costly process. Here, we experimentally evolved an unstable and costly plasmid pHNSHP24 under laboratory conditions and assessed the effects of plasmid cost and transmission on the plasmid maintenance by the plasmid population dynamics model and a plasmid invasion experiment designed to measure the plasmid's ability to invade a plasmid-free bacterial population. The persistence of pHNSHP24 improved after 36 days evolution due to the plasmid-borne mutation A51G in the 5'UTR of gene . This mutation largely increased the infectious transmission of the evolved plasmid, presumably by impairing the inhibitory effect of FinP on the expression of . We showed that increased conjugation rate of the evolved plasmid could compensate for the plasmid loss. Furthermore, we determined that the evolved high transmissibility had little effect on the -deficient ancestral plasmid, implying that high conjugation transfer is vital for maintaining the -bearing plasmid. Altogether, our findings emphasized that, besides compensatory evolution that reduces fitness costs, the evolution of infectious transmission can improve the persistence of antibiotic-resistant plasmids, indicating that inhibition of the conjugation process could be useful to combat the spread of antibiotic-resistant plasmids. IMPORTANCE Conjugative plasmids play a key role in the spread of antibiotic resistance, and they are well-adapted to the host bacteria. However, the evolutionary adaptation of plasmid-bacteria associations is not well understood. In this study, we experimentally evolved an unstable colistin resistance () plasmid under laboratory conditions and found that increased conjugation rate was crucial for the persistence of this plasmid. Interestingly, the evolved conjugation was caused by a single-base mutation, which could rescue the unstable plasmid from extinction in bacterial populations. Our findings imply that inhibition of the conjugation process could be necessary for combating the persistence of antibiotic-resistance plasmids.
Topics: Plasmids; Drug Resistance, Microbial; Bacteria; Mutation; Anti-Bacterial Agents
PubMed: 37314200
DOI: 10.1128/mbio.00442-23 -
Cell Reports Methods Dec 2023We created a generalizable pipeline for antibiotic-resistance-gene-free plasmid (ARGFP)-based cloning using a dual auxotrophic- and essential-gene-based selection...
We created a generalizable pipeline for antibiotic-resistance-gene-free plasmid (ARGFP)-based cloning using a dual auxotrophic- and essential-gene-based selection strategy. We use auxotrophic selection to construct plasmids in engineered E. coli DH10B cloning strains and both auxotrophic- and essential-gene-based selection to (1) select for recombinant strains and (2) maintain a plasmid in E. coli Nissle 1917, a common chassis for engineered probiotic applications, and E. coli MG1655, the laboratory "wild-type" E. coli strain. We show that our approach has comparable efficiency to that of antibiotic-resistance-gene-based cloning. We also show that the double-knockout Nissle and MG1655 strains are simple to transform with plasmids of interest. Notably, we show that the engineered Nissle strains are amenable to long-term plasmid maintenance in repeated culturing as well as in the mouse gut, demonstrating the potential for broad applications while minimizing the risk of antibiotic resistance spread via horizontal gene transfer.
Topics: Animals; Mice; Anti-Bacterial Agents; Escherichia coli; Plasmids; Drug Resistance, Microbial; Cloning, Molecular
PubMed: 38086386
DOI: 10.1016/j.crmeth.2023.100669 -
BMC Microbiology Jul 2023Group B Streptococcus (GBS) is a causative agent of various infections in newborns, immunocompromised (especially diabetic) non-pregnant adults, and pregnant women....
BACKGROUND
Group B Streptococcus (GBS) is a causative agent of various infections in newborns, immunocompromised (especially diabetic) non-pregnant adults, and pregnant women. Antibiotic resistance profiling can provide insights into the use of antibiotic prophylaxis against potential GBS infections. Virulence factors are responsible for host-bacteria interactions, pathogenesis, and biofilm development strategies. The aim of this study was to determine the biofilm formation capacity, presence of virulence genes, and antibiotic susceptibility patterns of clinical GBS isolates.
RESULTS
The resistance rate was highest for penicillin (27%; n = 8 strains) among all the tested antibiotics, which indicates the emergence of penicillin resistance among GBS strains. The susceptibility rate was highest for ofloxacin (93%; n = 28), followed by azithromycin (90%; n = 27). Most GBS strains (70%; n = 21) were strong biofilm producers and the rest (30%; n = 9) were moderate biofilm producers. The most common virulence genes were cylE (97%), pavA (97%), cfb (93%), and lmb (90%). There was a negative association between having a strong biofilm formation phenotype and penicillin susceptibility, according to Spearman's rank correlation analysis.
CONCLUSION
About a third of GBS strains exhibited penicillin resistance and there was a negative association between having a strong biofilm formation phenotype and penicillin susceptibility. Further, both the strong and moderate biofilm producers carried most of the virulence genes tested for, and the strong biofilm formation phenotype was not associated with the presence of any virulence genes.
Topics: Female; Pregnancy; Humans; Streptococcus agalactiae; Serogroup; Virulence; Anti-Bacterial Agents; Drug Resistance, Microbial; Streptococcal Infections; Penicillins; Biofilms; Drug Resistance, Bacterial; Microbial Sensitivity Tests
PubMed: 37407919
DOI: 10.1186/s12866-023-02877-y -
Natural Product Research 2023Bacterial resistance to antibiotics poses a high level of danger worldwide. Bacterial resistance mechanisms are spreading globally, impeding our ability to treat common... (Review)
Review
Bacterial resistance to antibiotics poses a high level of danger worldwide. Bacterial resistance mechanisms are spreading globally, impeding our ability to treat common infectious diseases. Misuse and overuse of antibiotics accelerate microbial resistance to antibiotics. Despite the exerted efforts, none of the newly developed antibiotics are expected to be effective against the dangerous forms of antibiotic-resistant bacteria. Since many plants have been shown to contain powerful antimicrobial compounds that can act synergistically or alternatively to antibiotics, the demand for herbal medicines has recently increased to co-treat microbes that are resistant to antibiotics. Maximum benefit can be achieved when the pharmacokinetics and pharmacodynamics of natural products match the antibiotic. This review article refers to nine highly effective and key herbs to use alongside antibiotics to overcome crises of antibiotic resistance. Their unique molecular mechanisms of action have been highlighted.
Topics: Anti-Bacterial Agents; Drug Resistance, Microbial; Anti-Infective Agents; Bacteria; Plant Extracts
PubMed: 36719419
DOI: 10.1080/14786419.2023.2172009