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A One Health Approach to Antimicrobial Resistance

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A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (15 June 2024) | Viewed by 16800

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Dr. Beatriz Robredo

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Guest Editor

Área Didáctica de las Ciencias Experimentales, OneHealth-UR Research Group, Universidad de La Rioja, 26006 Logroño, Spain
Interests: one health; education; antibiotics; microbiology

Dr. Belén Fouz

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Guest Editor

Instituto Universitario BIOTECMED/Departamento Microbiología y Ecología, Universitat de València, 46100 Burjassot, Spain
Interests: microbiology; bacterial pathogens; health in Aquaculture; antibiotic resistance; vaccines; education

Dr. Rosa Alduina

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Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90133 Palermo, Italy
Interests: antibiotic biosynthesis and Actinomycetes; antibiotic resistance; microbiome; resistome; glycopeptides; regulation
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Special Issue Information

Dear Colleagues,

To address the problem of antibiotic resistance, we have conceived of six strategic or action lines based on the One Health concept, which recognizes that human health, animal health and environment are intertwined. This strategy is necessary because the isolated efforts of different sectors are not sufficient to tackle the problem of resistance. The contribution of health and environmental professionals in the different work areas is a key element.

SURVEILLANCE of the use of antibiotics is a fundamental pillar in the fight against resistance because it allows information to be gathered regarding prescription habits and behaviors related to the consumption of antibiotics.

CONTROL of the diffusion of resistance to antibiotics. It is crucial to design and disseminate tools that facilitate the promotion of good practices for their use in healthcare, at home, among animals and in the environment.

PREVENTION of disease to reduce the need for antibiotics. In this context, strategies for the improvement of hygiene measures, the development of susceptibility tests and rapid diagnostic methods, as well as the development of standards to reduce the risk of infection and transmission of resistant organisms in different settings, are key.

INVESTIGATION of the channels of antimicrobial resistance and of the search for antimicrobial alternatives.

TRAINING of healthcare professionals at all stages of their professional lives to improve their knowledge on the prudent use of antibiotics and infection prevention.

COMMUNICATION aimed at the general public and specific population groups to make everyone aware of the problem of antibiotic resistance and contribute to the prudent use of antibiotics.

This Special Issue seeks manuscript submissions that further our understanding of antimicrobial resistance from a One Health approach.

Dr. Beatriz Robredo
Dr. Belén Fouz
Dr. Rosa Alduina
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

one health
antibiotic
antimicrobial resistance
animal
food
environment

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Published Papers (9 papers)

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Research

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18 pages, 1879 KiB

Open AccessArticle

Phylogenetic Diversity, Antibiotic Resistance, and Virulence of Escherichia coli Strains from Urinary Tract Infections in Algeria

by Anfal Kara, Chiara Massaro, Giovanni M. Giammanco, Rosa Alduina and Naouel Boussoualim

Antibiotics 2024, 13(8), 773; https://doi.org/10.3390/antibiotics13080773 - 15 Aug 2024

Cited by 1 | Viewed by 1255

Abstract

Urinary tract infections (UTIs) caused by Escherichia coli represent a significant public health concern due to the high virulence and antimicrobial resistance exhibited by these pathogens. This study aimed to analyze the phylogenetic diversity and antibiotic resistance profiles of Uropathogenic E. coli (UPEC) strains isolated from UTI patients in Algeria, focusing on virulence factors such as extended β-lactamase (ESBL) production, biofilm formation, and hemolytic activity. Phylogenetic grouping of 86 clinical imipenem resistant E. coli isolates showed the prevalence of group B2 (48.9%), followed by groups E (22.1%), unknown (12.8%), A (8.1%), and B1 (4.7%), and Clade I, D, Clade I, or Clade II (1.2%). The highest resistance rates were observed towards amoxicillin (86.04%), ticarcillin (82.55%), piperacillin (73.25%), nitrofurantoin (84.88%), and trimethoprim-sulfamethoxazole (51.16%). Notably, 69.8% of UPEC strains were multidrug-resistant (MDR) and 23.2% were extensively drug-resistant (XDR). Additionally, 48.9%, 42%, and 71% of strains demonstrated ESBL production, hemolytic activity, and weak biofilm production, respectively. Continuous monitoring and characterization of UPEC strains are essential to track the spread of the most resistant and virulent phylogenetic groups over time, facilitating rapid therapeutic decisions to treat infections and prevent the emergence of new resistant organisms, helping choose the most effective antibiotics and reducing treatment failure. Full article

(This article belongs to the Special Issue A One Health Approach to Antimicrobial Resistance)

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16 pages, 1286 KiB

Open AccessArticle

Genetic Characterization of Antibiotic-Resistant Staphylococcus spp. and Mammaliicoccus sciuri from Healthy Humans and Poultry in Nigeria

by Christiana Jesumirhewe, Tolulope Oluwadamilola Odufuye, Juliana Ukinebo Ariri, Amdallat Arike Adebiyi, Amina Tanko Sanusi, Anna Stöger, Beatriz Daza-Prieto, Franz Allerberger, Adriana Cabal-Rosel and Werner Ruppitsch

Antibiotics 2024, 13(8), 733; https://doi.org/10.3390/antibiotics13080733 - 5 Aug 2024

Viewed by 1071

Abstract

Staphylococcus spp. poses a significant threat to human and animal health due to their capacity to cause a wide range of infections in both. In this study, resistance genes conferring antibiotic resistance in Staphylococcus spp. and Mammaliicoccus sciuri isolates from humans and poultry in Edo state, Nigeria, were investigated. In April 2017, 61 Staphylococcus spp. isolates were obtained from urine, wounds, nasal and chicken fecal samples. Species identification was carried out by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Antimicrobial susceptibility testing was performed using the Kirby-Bauer method for 16 antibiotics. Whole-genome sequencing was used for characterization of the isolates. The 61 investigated isolates included Staphylococcus aureus, S. arlettae, M. sciuri, S. haemolyticus, and S. epidermidis. A total of 47 isolates (77%) belonged to human samples and 14 (23%) isolates were collected from poultry samples. All were phenotypically resistant to at least three antimicrobial(s). Multiple resistance determinants were detected in the human and poultry isolates analyzed. Phylogenetic analysis revealed close relatedness among the isolates within each species for S. arlettae, M. sciuri, and S. haemolyticus, respectively. This study delivered comprehensive genomic insights into antibiotic-resistant Staphylococcus species and M. sciuri isolates from human and poultry sources in Edo state, Nigeria, from a One Health perspective. Full article

(This article belongs to the Special Issue A One Health Approach to Antimicrobial Resistance)

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18 pages, 520 KiB

Open AccessArticle

Antimicrobial Resistance Surveillance: Data Harmonisation and Data Selection within Secondary Data Use

by Sinja Bleischwitz, Tristan Salomon Winkelmann, Yvonne Pfeifer, Martin Alexander Fischer, Niels Pfennigwerth, Jens André Hammerl, Ulrike Binsker, Jörg B. Hans, Sören Gatermann, Annemarie Käsbohrer, Guido Werner and Lothar Kreienbrock

Antibiotics 2024, 13(7), 656; https://doi.org/10.3390/antibiotics13070656 - 16 Jul 2024

Viewed by 1078

Abstract

Resistance to last-resort antibiotics is a global threat to public health. Therefore, surveillance and monitoring systems for antimicrobial resistance should be established on a national and international scale. For the development of a One Health surveillance system, we collected exemplary data on carbapenem and colistin-resistant bacterial isolates from human, animal, food, and environmental sources. We pooled secondary data from routine screenings, hospital outbreak investigations, and studies on antimicrobial resistance. For a joint One Health evaluation, this study incorporates epidemiological metadata with phenotypic resistance information and molecular data on the isolate level. To harmonise the heterogeneous original information for the intended use, we developed a generic strategy. By defining and categorising variables, followed by plausibility checks, we created a catalogue for prospective data collections and applied it to our dataset, enabling us to perform preliminary descriptive statistical analyses. This study shows the complexity of data management using heterogeneous secondary data pools and gives an insight into the early stages of the development of an AMR surveillance programme using secondary data. Full article

(This article belongs to the Special Issue A One Health Approach to Antimicrobial Resistance)

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11 pages, 687 KiB

Open AccessArticle

One Health Landscape of Antimicrobial Resistance in Bacteria Isolated from Virginia between 2007–2021

by Jimin Kim and Eunice Ndegwa

Antibiotics 2024, 13(6), 504; https://doi.org/10.3390/antibiotics13060504 - 29 May 2024

Viewed by 1040

Abstract

The emergence of antimicrobial-resistant (AMR) bacteria has become a critical global One Health issue, mainly attributed to the extensive use of antimicrobial agents in human and agricultural settings. Regional and local AMR surveillance data is essential for implementing awareness and mitigation strategies. This article assesses AMR frequency in 1604 bacterial isolates consisting of Escherichia coli (E. coli) and Salmonella spp. isolated from diverse sources in Virginia, including farm animals, wildlife, environment, and food samples from 2007 to 2021. The results are based on the Kirby–Bauer disc diffusion assessment method of susceptibility to select antimicrobial agents, spanning nine distinct categories approved by the US Food and Drug Administration for clinical use. Streptomycin (STR) and tetracycline (TCY) exhibited the highest frequency of resistance in E. coli (39.1%) and Salmonella (25.2%), respectively. Multidrug resistance (MDR) was evident in 6.6% of E. coli and 10.9% of Salmonella isolates. Notably, 51% of E. coli and 36% of Salmonella isolates demonstrated resistance to more than one antimicrobial. None of the tested antimicrobials guaranteed effectiveness against the bacteria isolated from the surveyed sources and regions. The study found heightened MDR and distinct AMR patterns in bacteria isolated from food products compared to other sampled sources. These findings are vital for comprehending the current AMR landscape, prompting the development of strategies to mitigate the emergence of AMR bacteria, and advocating prudent antimicrobial use from a One Health perspective. Full article

(This article belongs to the Special Issue A One Health Approach to Antimicrobial Resistance)

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13 pages, 1492 KiB

Open AccessEditor’s ChoiceArticle

Searching for Antimicrobial-Producing Bacteria from Soils through an Educational Project and Their Evaluation as Potential Biocontrol Agents

by Mario Sergio Pino-Hurtado, Rosa Fernández-Fernández, Carmen Torres and Beatriz Robredo

Antibiotics 2024, 13(1), 29; https://doi.org/10.3390/antibiotics13010029 - 28 Dec 2023

Cited by 2 | Viewed by 3374

Abstract

Antimicrobial resistance (AMR) is a serious threat to public health due to the lack of effective drugs to combat infectious diseases, which generates the need to search for new antimicrobial substances. In this study, the potential of soil as a source of antimicrobial-producing bacteria (APB) was investigated and the importance of the connection between education and science was emphasized, using service-learning methodologies. Sixty-one soil samples were collected, and 1220 bacterial isolates were recovered. Eighteen of these isolates showed antimicrobial activity against at least 1 of the 12 indicator bacteria tested (including multidrug-resistant and relevant pathogens). The 18 APB were identified by MALDI-TOF and 6 different genera (Bacillus, Brevibacillus, Lysinobacillus, Peribacillus, Streptomyces, and Advenella) and 10 species were identified. The 18 APB were tested for antifungal activity against four phytopathogenic fungi (Botritis cynerea, Lecanicillium fungicola, Trichoderma harzianum, and Cladobotryum mycophilum). Moreover, the antibiotic susceptibility of APB was tested using the disk-diffusion method as well as their β-hemolytic activity (important safety criteria for potential future applications). A total of 10 of the 18 APB were able to inhibit at least 50% of indicator bacteria tested, including methicillin-resistant Staphylococcus aureus (MRSA), among others. A total of 4 of the 18 APB (3 Bacillus pumilus and 1 Bacillus altitudinis) showed inhibitory activity against two of the four fungal pathogens tested (B. cinerea and L. fungicola), as well as against 5–7 of the 12 bacterial pathogen indicators; these 4 isolates showed susceptibility to the antibiotics tested and lacked β-hemolytic activity and were considered promising APB for use as potential biocontrol agents. In addition, one Brevibacillus laterosporus strain had activity against 83% of indicator bacteria tested including Escherichia coli, MRSA and other methicillin-resistant staphylococci, as well as vancomycin-resistant enterococci (but not against fungi). These results show that soil is a source of APB with relevant antibacterial and antifungal activities, and also emphasize the importance of education and science to raise public awareness of the AMR problem and the strategies to control it. Full article

(This article belongs to the Special Issue A One Health Approach to Antimicrobial Resistance)

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11 pages, 600 KiB

Open AccessArticle

Bloodstream Infections in Intensive Care Unit during Four Consecutive SARS-CoV-2 Pandemic Waves

by Giacomo Pozza, Giacomo Casalini, Cosmin Lucian Ciubotariu, Andrea Giacomelli, Miriam Galimberti, Martina Zacheo, Andrea Rabbione, Margherita Pieruzzi, Letizia Oreni, Laura Galimberti, Riccardo Colombo, Giuliano Rizzardini, Cristina Pagani, Sara Giordana Rimoldi, Cecilia Bonazzetti, Anna Lisa Ridolfo and Spinello Antinori

Antibiotics 2023, 12(9), 1448; https://doi.org/10.3390/antibiotics12091448 - 14 Sep 2023

Cited by 2 | Viewed by 1351

Abstract

Critically ill COVID-19 patients are at an increased risk of bloodstream infections (BSIs). We performed a retrospective observational single-center study on COVID-19 patients admitted to intensive care unit (ICU) to assess the incidence of BSIs in four consecutive periods: 21 February–31 July 2020 (W1), 1 August 2020–31 January 2021 (W2), 1 February–30 September 2021 (W3) and 1 October 2021 and 30 April 2022 (W4). BSIs that occurred 48 h after ICU admission were included. The crude incidence of BSIs was estimated by means of Poisson distribution normalized to 1000 patient-days. A total of 404 critically ill COVID-19 patients were admitted to ICU, of whom 284 (61%) developed at least one episode of BSI with an overall crude incidence of 87 events every 1000 patient-days (95% CI 77–98) without a significant difference in consecutive epidemic periods (p = 0.357). Gram-positive bacteria were the most frequent etiological agents of BSIs, contributing to 74.6% episodes. A progressive decrease in BSIs due to Enterococcus spp. was observed (W1 57.4%, W2 43.7%, W3 35.7% and W4 32.7%; p = 0.004). The incidence of BSIs remained stable during different epidemic periods. Enterococcus spp. prevalence was significantly reduced, although still accounted for one third of BSIs in more recent epidemic periods. Full article

(This article belongs to the Special Issue A One Health Approach to Antimicrobial Resistance)

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13 pages, 2407 KiB

Open AccessArticle

Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in Italy

by Zaira Maraia, Tony Mazzoni, Miriana Pia Turtora, Alessandra Tempera, Marco Spinosi, Anita Vagnoni and Isidoro Mazzoni

Antibiotics 2023, 12(5), 912; https://doi.org/10.3390/antibiotics12050912 - 15 May 2023

Cited by 2 | Viewed by 1841

Abstract

The increased incidence of antimicrobial resistance during coronavirus disease 2019 (COVID-19) is a very important collateral damage of global concern. The cause is multifactorial and is particularly related to the high rates of antibiotic use in COVID-19 patients with a relatively low rate of secondary co-infection. To this end, we conducted a retrospective observational study of 1269 COVID-19 patients admitted during the years 2020, 2021 and 2022 in two Italian hospitals, with a focus on bacterial co-infections and antimicrobial therapy. Multivariate logistic regression was used to analyze the association between bacterial co-infection, antibiotic use and hospital death after adjustment for age and comorbidity. Bacterial co-infection was detected in 185 patients. The overall mortality rate was 25% (n = 317). Concomitant bacterial infections were associated with increased hospital mortality (β = 1.002, p < 0.001). A total of 83.7% (n = 1062) of patients received antibiotic therapy, but only 14.6% of these patients had an obvious source of bacterial infection. There was a significantly higher rate of hospital mortality in patients who received antibiotics than in those who did not (χ² = 6.22, p = 0.012). Appropriate prescribing and the rational use of antimicrobials according to the principles of antimicrobial stewardship can help prevent the emergence of antibiotic resistance. Full article

(This article belongs to the Special Issue A One Health Approach to Antimicrobial Resistance)

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18 pages, 328 KiB

Open AccessReview

The Role of Wastewater Treatment Plants in Dissemination of Antibiotic Resistance: Source, Measurement, Removal and Risk Assessment

by Kezia Drane, Madoc Sheehan, Anna Whelan, Ellen Ariel and Robert Kinobe

Antibiotics 2024, 13(7), 668; https://doi.org/10.3390/antibiotics13070668 - 18 Jul 2024

Cited by 5 | Viewed by 2201

Abstract

Antibiotic Resistance Genes (ARGs) are contaminants of emerging concern with marked potential to impact public and environmental health. This review focusses on factors that influence the presence, abundance, and dissemination of ARGs within Wastewater Treatment Plants (WWTPs) and associated effluents. Antibiotic-Resistant Bacteria (ARB) and ARGs have been detected in the influent and the effluent of WWTPs worldwide. Different levels of wastewater treatment (primary, secondary, and tertiary) show different degrees of removal efficiency of ARGs, with further differences being observed when ARGs are captured as intracellular or extracellular forms. Furthermore, routinely used molecular methodologies such as quantitative polymerase chain reaction or whole genome sequencing may also vary in resistome identification and in quantifying ARG removal efficiencies from WWTP effluents. Additionally, we provide an overview of the One Health risk assessment framework, as well as future strategies on how WWTPs can be assessed for environmental and public health impact. Full article

(This article belongs to the Special Issue A One Health Approach to Antimicrobial Resistance)

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20 pages, 1207 KiB

Open AccessSystematic Review

Antibiotic-Resistant Bacteria Isolated from Street Foods: A Systematic Review

by Carmine Fusaro, Valentina Miranda-Madera, Nancy Serrano-Silva, Jaime E. Bernal, Karina Ríos-Montes, Francisco Erik González-Jiménez, Dennys Ojeda-Juárez and Yohanna Sarria-Guzmán

Antibiotics 2024, 13(6), 481; https://doi.org/10.3390/antibiotics13060481 - 23 May 2024

Viewed by 2352

Abstract

Street food may be a vehicle of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) to humans. Foods contaminated with ARB entail serious problems or challenges in the fields of medical care, animal husbandry, food industry, and public health worldwide. The objectives of this systematic review were to identify and evaluate scientific reports associated with ARB isolated from various street foods. “Preferred reporting items for systematic reviews and meta-analysis” (PRISMA) guidelines were followed. The bibliographic material covers a period from January 2015 to April 2024. Six electronic scientific databases were searched individually for full-text articles; only those papers that met the inclusion and exclusion criteria were selected. Seventeen papers were included in this systematic review. This study highlighted the wide distribution of ARB resistant to β-lactams and other antibiotics, posing significant health risks to consumers. High resistance levels were observed for antibiotics such as ampicillin, ceftriaxone, and tetracycline, while some antibiotics, such as ceftazidime, clavulanic acid, cefoperazone, cotrimoxazole, doxycycline, doripenem, fosfomycin, vancomycin, and piperacillin-tazobactam, demonstrated 100% susceptibility. The prevalence of ARB in street foods varied between 5.2% and 70.8% among different countries. The multiple resistance of various bacteria, including Escherichia coli, Staphylococcus, Salmonella, and Klebsiella, to multiple classes of antibiotics, as well as environmental factors contributing to the spread of antibiotic resistance (AR), emphasize the urgent need for comprehensive approaches and coordinated efforts to confront antimicrobial resistance (AMR) under the “One Health” paradigm. Full article

(This article belongs to the Special Issue A One Health Approach to Antimicrobial Resistance)

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