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Research on Antibiotic Resistance within One Health

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 27206

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Special Issue Editor

Dr. Lucinda J. Bessa

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Guest Editor

Egas Moniz School of Health and Science, Caparica, Portugal
Interests: antimicrobial resistance; bacterial biofilms; antimicrobial susceptibility testing; strategies to fight multidrug-resistant isolates
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Antimicrobial resistance (AMR) is a complex, multifaceted problem that threatens human and animal health, the global economy, and national and global security. The World Health Organization (WHO) has included AMR as one of the top ten threats to global health in 2019. Thus, there is a need for a thorough One Health approach to address AMR that incorporates human, animal, and environmental perspectives and identifies key priorities for research. Research on antibiotic resistance is advancing in a variety of approaches and innovative strategies for tackling multidrug-resistant infections are looked-for. Some of the topics regarding research on antibiotic resistance include characterization of multidrug-resistant isolates from clinical and environmental sources, spread of resistance and antibiotic resistance genes in the environment, study of biofilms and antibiofilm strategies, antibiotic drug discovery, repurposing of existing drugs, innovative technologies for diagnostics or treatment, meta-analysis, and longitudinal studies. Papers addressing these topics are welcome in this Special Issue, especially those providing novel solutions to combat antibiotic resistance. Original research papers, reviews, case reports, methodological papers, and brief reports are invited.

Dr. Lucinda J. Bessa
Guest Editor

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. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

antibiotic resistance
multidrug-resistant bacterial isolates
mechanisms of antibiotic resistance
antibiofilm activity
bacterial infection control
innovative antibacterial strategies
surveillance of antibiotic resistance
One Health perspective to combat antibiotic resistance

Published Papers (7 papers)

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Research

Jump to: Review

18 pages, 11503 KiB

Open AccessArticle

A Rapid Review of Environmental Health Gaps in Antimicrobial Resistance and Water-Related Research from 1990–2020

by Lina Taing, Himesh Bhatia, Rachel A. Kaiser, Manzoor Qadir and Hamid Mehmood

Int. J. Environ. Res. Public Health 2022, 19(11), 6549; https://doi.org/10.3390/ijerph19116549 - 27 May 2022

Cited by 5 | Viewed by 2536

Abstract

Antimicrobial resistance (AMR) is a pervasive global health threat linked to human antimicrobial misuse and abuse, food production, and broader environmental contamination. While global agencies promote a multi-sectoral One Health system approach to equitably combat human, animal, and environmental health AMR risks, it is widely acknowledged that the human and animal sectors dominate discussions. Given this disproportionate focus, identification of critical research gaps is needed to develop stewardship plans that equitably address One Health AMR threats. This review used natural language processing and term frequency algorithms to classify 12,638 records from 1990–2020 thematically in order to highlight sectoral prioritization and gaps. It also specifically assessed water-related gaps as water is recognized as both a primary environmental dissemination pathway and key means of intervention. Drawing from systemic health and integrated water management lenses, this review found that themes related to plant, wildlife, and environmental-related AMR threats—in particular, the role that environmental (ambient) waters play in AMR development, transmission, and spread—are under-prioritized as compared to human and food animal health concerns regardless of geographic region or income level. Further prioritization of these themes is needed to strengthen the environmental dimension of One Health AMR responses and systemically protect global health. Full article

(This article belongs to the Special Issue Research on Antibiotic Resistance within One Health)

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19 pages, 1365 KiB

Open AccessArticle

International Travel as a Risk Factor for Carriage of Extended-Spectrum β-Lactamase-Producing Escherichia coli in a Large Sample of European Individuals—The AWARE Study

by Daloha Rodríguez-Molina, Fanny Berglund, Hetty Blaak, Carl-Fredrik Flach, Merel Kemper, Luminita Marutescu, Gratiela Pircalabioru Gradisteanu, Marcela Popa, Beate Spießberger, Laura Wengenroth, Mariana Carmen Chifiriuc, D. G. Joakim Larsson, Dennis Nowak, Katja Radon, Ana Maria de Roda Husman, Andreas Wieser and Heike Schmitt

Int. J. Environ. Res. Public Health 2022, 19(8), 4758; https://doi.org/10.3390/ijerph19084758 - 14 Apr 2022

Cited by 8 | Viewed by 2320

Abstract

Antibiotic resistance (AR) is currently a major threat to global health, calling for a One Health approach to be properly understood, monitored, tackled, and managed. Potential risk factors for AR are often studied in specific high-risk populations, but are still poorly understood in the general population. Our aim was to explore, describe, and characterize potential risk factors for carriage of Extended-Spectrum Beta-Lactamase-resistant Escherichia coli (ESBL-EC) in a large sample of European individuals aged between 16 and 67 years recruited from the general population in Southern Germany, the Netherlands, and Romania. Questionnaire and stool sample collection for this cross-sectional study took place from September 2018 to March 2020. Selected cultures of participants’ stool samples were analyzed for detection of ESBL-EC. A total of 1183 participants were included in the analyses: 333 from Germany, 689 from the Netherlands, and 161 from Romania. Travels to Northern Africa (adjusted Odds Ratio, aOR 4.03, 95% Confidence Interval, CI 1.67–9.68), Sub-Saharan Africa (aOR 4.60, 95% CI 1.60–13.26), and Asia (aOR 4.08, 95% CI 1.97–8.43) were identified as independent risk factors for carriage of ESBL-EC. Therefore, travel to these regions should continue to be routinely asked about by clinical practitioners as possible risk factors when considering antibiotic therapy. Full article

(This article belongs to the Special Issue Research on Antibiotic Resistance within One Health)

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13 pages, 3123 KiB

Open AccessArticle

Mechanism for Reducing the Horizontal Transfer Risk of the Airborne Antibiotic-Resistant Genes of Escherichia coli Species through Microwave or UV Irradiation

by Azhar Ali Laghari, Liming Liu, Dildar Hussain Kalhoro, Hong Chen and Can Wang

Int. J. Environ. Res. Public Health 2022, 19(7), 4332; https://doi.org/10.3390/ijerph19074332 - 04 Apr 2022

Cited by 4 | Viewed by 2034

Abstract

Antibiotic-resistant bacteria (ARBs) and antibiotic-resistant genes (ARGs) as new types of contaminants are discharged into the environment, increasing the risk of horizontal gene transfer (HGT). However, few researchers have examined the impacts of airborne ARB deactivation on HGT risk. The deactivation of airborne Escherichia coli 10667 (carrying sul genes) and the emission and removal of ARGs were mainly investigated in this study. Moreover, the potential mechanisms of HGT and transfer frequencies under microwave (MW) and ultraviolet (UV) irradiation were investigated using the nonresistant E. coli GMCC 13373 and E. coli DH5α with plasmid RP4 as the recipient and donor, respectively. E. coli CICC 10667 and E. coli DH5α with RP4 plasmid achieve log inactivation values as high as 5.5-log and 5.0-log, respectively, which were quite different from the antibiotic-sensitive strain E. coli CGMCC 13373 (3.4-log) subjected to MW irradiation. For UV disinfection, E. coli DH5α with the RP4 plasmid was reduced at 4.4-log, E. coli CGMCC 13373 was reduced at 2.3-log, and E. coli CICC 10667 was inactivated at 2.1-log. The removal rates of ARGs and HGT frequencies under MW irradiation were compared with those under UV irradiation. The ARGs removal efficiency (85.5%) obtained by MW was higher than that obtained by UV (48.2%). Consequently, the HGT frequency (0.008) of airborne ARGs released to the recipient (forward transfer) decreased and was lower than that under UV irradiation (0.014). Moreover, the plasmid RP4 was transferred from the donor to the surviving damaged E. coli 10667 as cell permeability (reverse transfer) was increased at a high HGT frequency (0.003) by MW, which was close to the value by UV (0.002). Additionally, sul1 and sul2 genes were confirmed to be more resistant to MW than the sul3 gene. These findings reveal the mechanism of HGT between damaged E. coli 10667 and surrounding environmental microbes. Microwave is a promising technology for disinfecting airborne microbes and preventing the spread of antibiotic resistance. Full article

(This article belongs to the Special Issue Research on Antibiotic Resistance within One Health)

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8 pages, 546 KiB

Open AccessArticle

Antimicrobial Usage and Resistance in Makkah Region Hospitals: A Regional Point Prevalence Survey of Public Hospitals

by Abdul Haseeb, Hani Saleh Faidah, Manal Algethamy, Saleh Alghamdi, Ghaidaa Ali Alhazmi, Afnan Owedah Alshomrani, Bashair Rjyan Alqethami, Hind Saeed Alotibi, Maali Zayed Almutiri, Khawlah Saad Almuqati, Amjad Abdullah Albishi, Mahmoud Essam Elrggal, Ahmad Jamal Mahrous, Asim Abdulaziz Khogeer, Zikria Saleem, Muhammad Shahid Iqbal and Aziz Sheikh

Int. J. Environ. Res. Public Health 2022, 19(1), 254; https://doi.org/10.3390/ijerph19010254 - 27 Dec 2021

Cited by 12 | Viewed by 4236

Abstract

(1) Background: Inappropriate use of antimicrobials and subsequently rise of antimicrobial resistance (AMR) remains a major public health priority. Over-prescribing of broad-spectrum antibiotics is one of the main contributing factors for the emergence of AMR. We sought to describe antimicrobial prescribing trends among patients in public hospitals in Makkah hospitals. (2) Method: We undertook a point prevalence survey (PPS) in six hospitals in Makkah, Saudi Arabia, from January 2019 to July 2019. The survey included all the inpatients receiving antimicrobials on the day of PPS. Data was collected using the Global point prevalence survey (PPS) tool developed by the University of Antwerp, Belgium. (3) Results: Of 710 hospitalized patients, 447 patients (61.9%) were treated with one or more antimicrobials during the study period. The average bed occupancy among six hospitals was 74.4%. The majority of patients received antimicrobials parenterally (90.3%). Of the total prescribed antimicrobials, 415 (53.7%) antimicrobials were used in medical departments, 183 (23.7%) in surgical departments, and 175 (22.6%) in ICUs. Pneumonia (17.3%), skin and soft tissue infections (10.9%), and sepsis (6.6.%) were three common clinical indications. Ceftriaxones were the most commonly used antibiotics that were prescribed in 116 (15%) of patients, followed by piperacillin, with an enzyme inhibitor in 84 (10.9%). (4) Conclusion: There was a high prevalence of antibiotic use in the hospitals of Makkah, which could be a potential risk factor for the incidence of resistant strains, particularly MRSA infection. Public health decision-makers should take these findings into consideration to update national policies for antibiotic use in order to reduce the risks of further increases of AMR. Full article

(This article belongs to the Special Issue Research on Antibiotic Resistance within One Health)

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Review

Jump to: Research

17 pages, 944 KiB

Open AccessFeature PaperReview

Managing Oral Health in the Context of Antimicrobial Resistance

by Lucinda J. Bessa, João Botelho, Vanessa Machado, Ricardo Alves and José João Mendes

Int. J. Environ. Res. Public Health 2022, 19(24), 16448; https://doi.org/10.3390/ijerph192416448 - 08 Dec 2022

Cited by 11 | Viewed by 2820

Abstract

The oral microbiome plays a major role in shaping oral health/disease state; thus, a main challenge for dental practitioners is to preserve or restore a balanced oral microbiome. Nonetheless, when pathogenic microorganisms install in the oral cavity and are incorporated into the oral biofilm, oral infections, such as gingivitis, dental caries, periodontitis, and peri-implantitis, can arise. Several prophylactic and treatment approaches are available nowadays, but most of them have been antibiotic-based. Given the actual context of antimicrobial resistance (AMR), antibiotic stewardship in dentistry would be a beneficial approach to optimize and avoid inappropriate or even unnecessary antibiotic use, representing a step towards precision medicine. Furthermore, the development of new effective treatment options to replace the need for antibiotics is being pursued, including the application of photodynamic therapy and the use of probiotics. In this review, we highlight the advances undergoing towards a better understanding of the oral microbiome and oral resistome. We also provide an updated overview of how dentists are adapting to better manage the treatment of oral infections given the problem of AMR. Full article

(This article belongs to the Special Issue Research on Antibiotic Resistance within One Health)

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34 pages, 1228 KiB

Open AccessReview

Clinically Relevant β-Lactam Resistance Genes in Wastewater Treatment Plants

by Izabela Waśko, Aleksandra Kozińska, Ewa Kotlarska and Anna Baraniak

Int. J. Environ. Res. Public Health 2022, 19(21), 13829; https://doi.org/10.3390/ijerph192113829 - 24 Oct 2022

Cited by 12 | Viewed by 2764

Abstract

Antimicrobial resistance (AMR) is one of the largest global concerns due to its influence in multiple areas, which is consistent with One Health’s concept of close interconnections between people, animals, plants, and their shared environments. Antibiotic-resistant bacteria (ARB) and antibiotic-resistance genes (ARGs) circulate constantly in various niches, sediments, water sources, soil, and wastes of the animal and plant sectors, and is linked to human activities. Sewage of different origins gets to the wastewater treatment plants (WWTPs), where ARB and ARG removal efficiency is still insufficient, leading to their transmission to discharge points and further dissemination. Thus, WWTPs are believed to be reservoirs of ARGs and the source of spreading AMR. According to a World Health Organization report, the most critical pathogens for public health include Gram-negative bacteria resistant to third-generation cephalosporins and carbapenems (last-choice drugs), which represent β-lactams, the most widely used antibiotics. Therefore, this paper aimed to present the available research data for ARGs in WWTPs that confer resistance to β-lactam antibiotics, with a particular emphasis on clinically important life-threatening mechanisms of resistance, including extended-spectrum β-lactamases (ESBLs) and carbapenemases (KPC, NDM). Full article

(This article belongs to the Special Issue Research on Antibiotic Resistance within One Health)

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11 pages, 801 KiB

Open AccessReview

Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization in Pneumocystis jirovecii Pneumonia (PCP) Management: A Systematic Review

by Abdul Haseeb, Mohammed A. S. Abourehab, Wesam Abdulghani Almalki, Abdulrahman Mohammed Almontashri, Sultan Ahmed Bajawi, Anas Mohammed Aljoaid, Bahni Mohammed Alsahabi, Manal Algethamy, Abdullmoin AlQarni, Muhammad Shahid Iqbal, Alaa Mutlaq, Saleh Alghamdi, Mahmoud E. Elrggal, Zikria Saleem, Rozan Mohammad Radwan, Ahmad Jamal Mahrous and Hani Saleh Faidah

Int. J. Environ. Res. Public Health 2022, 19(5), 2833; https://doi.org/10.3390/ijerph19052833 - 28 Feb 2022

Cited by 11 | Viewed by 8987

Abstract

(1) Background: Pneumocystis jirovecii pneumonia (PCP) has a substantial impact on the morbidity and mortality of patients, especially those with autoimmune disorders, thus requiring optimal dosing strategies of Trimethoprim–Sulfamethoxazole (TMP-SMX). Therefore, to ensure the safety of TMP-SMX, there is a high demand to review current evidence in PCP patients with a focus on dose optimization strategies; (2) Methods: Various databases were searched from January 2000 to December 2021 for articles in English, focusing on the dose optimization of TMP-SMX. The data were collected in a specific form with predefined inclusion and exclusion criteria. The quality of each article was evaluated using a Newcastle–Ottawa Scale (NOS) for retrospective studies, Joanna Briggs Institute (JBI) critical checklist for case reports, and Cochrane bias tool for randomized clinical trials (RCTs); (3) Results: Thirteen studies met the inclusion criteria for final analysis. Of the 13 selected studies, nine were retrospective cohort studies, two case reports, and two randomized controlled trials (RCT). Most of the studies compared the high-dose with low-dose TMP-SMX therapy for PCP. We have found that a low dose of TMP-SMX provides satisfactory outcomes while reducing the mortality rate and PCP-associated adverse events. This strategy reduces the economic burden of illness and enhances patients’ compliance to daily regimen plan; (4) Conclusions: The large-scale RCTs and cohort studies are required to improve dosing strategies to prevent initial occurrence of PCP or to prevent recurrence of PCP in immune compromised patients. Full article

(This article belongs to the Special Issue Research on Antibiotic Resistance within One Health)

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