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Search Results (410)

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Keywords = antimicrobial resistance (AMR) data

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12 pages, 388 KiB  
Article
Evolution of Respiratory Pathogens and Antimicrobial Resistance over the COVID-19 Timeline: A Study of Hospitalized and Ambulatory Patient Populations
by Luigi Regenburgh De La Motte, Loredana Deflorio, Erika Stefano, Matteo Covi, Angela Uslenghi, Carmen Sommese and Lorenzo Drago
Antibiotics 2025, 14(8), 796; https://doi.org/10.3390/antibiotics14080796 (registering DOI) - 5 Aug 2025
Abstract
Background: The COVID-19 pandemic has profoundly altered the clinical and microbiological landscape of respiratory tract infections (RTIs), potentially reshaping pathogen distribution and antimicrobial resistance (AMR) profiles across care settings. Objectives: The objective of this study was to assess temporal trends in respiratory bacterial [...] Read more.
Background: The COVID-19 pandemic has profoundly altered the clinical and microbiological landscape of respiratory tract infections (RTIs), potentially reshaping pathogen distribution and antimicrobial resistance (AMR) profiles across care settings. Objectives: The objective of this study was to assess temporal trends in respiratory bacterial pathogens, antimicrobial resistance, and polymicrobial infections across three pandemic phases—pre-COVID (2018–2019), COVID (2020–2022), and post-COVID (2022–2024)—in hospitalized and ambulatory patients. Methods: We retrospectively analyzed 1827 respiratory bacterial isolates (hospitalized patients, n = 1032; ambulatory patients, n = 795) collected at a tertiary care center in Northern Italy. Data were stratified by care setting, anatomical site, and pandemic phase. Species identification and susceptibility testing followed EUCAST guidelines. Statistical analysis included chi-square and Fisher’s exact tests. Results: In hospitalized patients, a significant increase in Pseudomonas aeruginosa (from 45.5% pre-COVID to 58.6% post-COVID, p < 0.0001) and Acinetobacter baumannii (from 1.2% to 11.1% during COVID, p < 0.0001) was observed, with 100% extensively drug-resistant (XDR) rates for A. baumannii during the pandemic. Conversely, Staphylococcus aureus significantly declined from 23.6% pre-COVID to 13.7% post-COVID (p = 0.0012). In ambulatory patients, polymicrobial infections peaked at 41.2% during COVID, frequently involving co-isolation of Candida spp. Notably, resistance to benzylpenicillin in Streptococcus pneumoniae reached 80% (4/5 isolates) in hospitalized patients during COVID, and carbapenem-resistant P. aeruginosa (CRPA) significantly increased post-pandemic in ambulatory patients (0% pre-COVID vs. 23.5% post-COVID, p = 0.0014). Conclusions: The pandemic markedly shifted respiratory pathogen dynamics and resistance profiles, with distinct trends observed in hospital and community settings. Persistent resistance phenotypes and frequent polymicrobial infections, particularly involving Candida spp. in outpatients, underscore the need for targeted surveillance and antimicrobial stewardship strategies. Full article
(This article belongs to the Section Antibiotic Therapy in Infectious Diseases)
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7 pages, 1045 KiB  
Proceeding Paper
Surveillance of Antimicrobial Use in Animal Production: A Cross-Sectional Study of Kaduna Metropolis, Nigeria
by Aliyu Abdulkadir, Marvelous Oluwashina Ajayi and Halima Abubakar Kusfa
Med. Sci. Forum 2025, 35(1), 4; https://doi.org/10.3390/msf2025035004 - 4 Aug 2025
Abstract
Measuring antimicrobial use (AMU) in animal production can provide useful data for monitoring AMU over time, which will promote antimicrobial resistance (AMR) reduction. This study involved the daily collation and validation of active primary drug sales and prescription data from veterinary outlets and [...] Read more.
Measuring antimicrobial use (AMU) in animal production can provide useful data for monitoring AMU over time, which will promote antimicrobial resistance (AMR) reduction. This study involved the daily collation and validation of active primary drug sales and prescription data from veterinary outlets and clinics of the Kaduna metropolis. In total, 83.7% of the identified antimicrobials were in the form of oral medication, and most were registered antibiotics (52.8%). Parenteral and topical forms were also identified, with 94% also being antibiotics. The estimated AMU was 282 mg/kg population correction unit (PCU). Poultry represented the most significant population, constituting 99% (31,502,004) of the study population. The class-specific AMU was antibiotics, with 274 mg/kg PCU. The antiprotozoal AMU was 418 mg/kg PCU. The anthelminthic AMU was the highest at 576 mg/kg PCU. This study has provided useful and practical information on the trends in antimicrobial use in animals, with poultry being the most important animal population involved in AMU and oxytetracycline being the most abused antibiotic in animal production. Antimicrobial stewardship (AMS) should be targeted at poultry populations, with an emphasis on reducing antibiotic use/consumption. Full article
(This article belongs to the Proceedings of The 4th International Electronic Conference on Antibiotics)
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20 pages, 519 KiB  
Article
Bridging the Capacity Building Gap for Antimicrobial Stewardship Implementation: Evidence from Virtual Communities of Practice in Kenya, Ghana, and Malawi
by Ana C. Barbosa de Lima, Kwame Ohene Buabeng, Mavis Sakyi, Hope Michael Chadwala, Nicole Devereaux, Collins Mitambo, Christine Mugo-Sitati, Jennifer Njuhigu, Gunturu Revathi, Emmanuel Tanui, Jutta Lehmer, Jorge Mera and Amy V. Groom
Antibiotics 2025, 14(8), 794; https://doi.org/10.3390/antibiotics14080794 (registering DOI) - 4 Aug 2025
Abstract
Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through [...] Read more.
Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi. Methods: A mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions. Results: Between September 2023 and February 2025, 77 virtual learning sessions were conducted, engaging 2445 unique participants from hospital-based AMS committees and health professionals across the three countries. Participants reported significant knowledge gain, and data showed facility improvements in two core AMS areas, including the implementation of multidisciplinary ward-based interventions/communications and enhanced monitoring of antibiotic resistance patterns. Along those lines, participants reported that the program assisted them in improving prescribing and culture-based treatments, and also evidence-informed antibiotic selection. The evidence of implementing ward-based interventions was further stressed in focus group discussions, as well as other strengthened practices like point-prevalence surveys, and development or revision of stewardship policies. Substantial improvements in microbiology services were also shared by participants, particularly in Malawi. Other practices mentioned were strengthened multidisciplinary communication, infection prevention efforts, and education of patients and the community. Conclusion: Our findings suggest that a virtual case-based learning educational intervention, providing structured and tailored AMS capacity building, can drive behavior change and strengthen healthcare systems in low resource settings. Future efforts should aim to scale up the engagements and sustain improvements to further strengthen AMS capacity. Full article
12 pages, 284 KiB  
Communication
Raw Sheep Milk as a Reservoir of Multidrug-Resistant Staphylococcus aureus: Evidence from Traditional Farming Systems in Romania
by Răzvan-Dragoș Roșu, Adriana Morar, Alexandra Ban-Cucerzan, Mirela Imre, Sebastian Alexandru Popa, Răzvan-Tudor Pătrînjan, Alexandra Pocinoc and Kálmán Imre
Antibiotics 2025, 14(8), 787; https://doi.org/10.3390/antibiotics14080787 (registering DOI) - 2 Aug 2025
Viewed by 127
Abstract
Background/Objectives: Staphylococcus aureus is a major pathogen of concern in raw milk due to its potential to cause foodborne illness and its increasing antimicrobial resistance (AMR). In Romania, data on the occurrence and resistance patterns of S. aureus in raw sheep milk [...] Read more.
Background/Objectives: Staphylococcus aureus is a major pathogen of concern in raw milk due to its potential to cause foodborne illness and its increasing antimicrobial resistance (AMR). In Romania, data on the occurrence and resistance patterns of S. aureus in raw sheep milk from traditional farming systems remain limited. This study investigated the presence and antimicrobial resistance of S. aureus in 106 raw sheep milk samples collected from traditional farms in the Banat region of western Romania. Methods: Coagulase-positive staphylococci (CPS) were enumerated using ISO 6888-1:2021 protocols. Isolates were identified at the species level using the Vitek 2 system and molecularly confirmed via PCR targeting the 16S rDNA and nuc genes. Methicillin resistance was assessed by detecting the mecA gene. Antimicrobial susceptibility was determined using the Vitek 2 AST-GP79 card. Results: CPS were detected in 69 samples, with S. aureus confirmed in 34.9%. The mecA gene was identified in 13.5% of S. aureus isolates, indicating the presence of methicillin-resistant S. aureus (MRSA). Resistance to at least two antimicrobials was observed in 97.3% of isolates, and 33 strains (89.2%) met the criteria for multidrug resistance (MDR). The most frequent MDR phenotype involved resistance to lincomycin, macrolides, β-lactams, tetracyclines, and aminoglycosides. Conclusions: The high prevalence of S. aureus, including MRSA and MDR strains, in raw sheep milk from traditional farms represents a potential public health risk, particularly in regions where unpasteurized dairy consumption persists. These findings underscore the need for enhanced hygiene practices, prudent antimicrobial use, and AMR monitoring in small-scale dairy systems. Full article
14 pages, 841 KiB  
Article
Enhanced Deep Learning for Robust Stress Classification in Sows from Facial Images
by Syed U. Yunas, Ajmal Shahbaz, Emma M. Baxter, Mark F. Hansen, Melvyn L. Smith and Lyndon N. Smith
Agriculture 2025, 15(15), 1675; https://doi.org/10.3390/agriculture15151675 - 2 Aug 2025
Viewed by 113
Abstract
Stress in pigs poses significant challenges to animal welfare and productivity in modern pig farming, contributing to increased antimicrobial use and the rise of antimicrobial resistance (AMR). This study involves stress classification in pregnant sows by exploring five deep learning models: ConvNeXt, EfficientNet_V2, [...] Read more.
Stress in pigs poses significant challenges to animal welfare and productivity in modern pig farming, contributing to increased antimicrobial use and the rise of antimicrobial resistance (AMR). This study involves stress classification in pregnant sows by exploring five deep learning models: ConvNeXt, EfficientNet_V2, MobileNet_V3, RegNet, and Vision Transformer (ViT). These models are used for stress detection from facial images, leveraging an expanded dataset. A facial image dataset of sows was collected at Scotland’s Rural College (SRUC) and the images were categorized into primiparous Low-Stressed (LS) and High-Stress (HS) groups based on expert behavioural assessments and cortisol level analysis. The selected deep learning models were then trained on this enriched dataset and their performance was evaluated using cross-validation on unseen data. The Vision Transformer (ViT) model outperformed the others across the dataset of annotated facial images, achieving an average accuracy of 0.75, an F1 score of 0.78 for high-stress detection, and consistent batch-level performance (up to 0.88 F1 score). These findings highlight the efficacy of transformer-based models for automated stress detection in sows, supporting early intervention strategies to enhance welfare, optimize productivity, and mitigate AMR risks in livestock production. Full article
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13 pages, 292 KiB  
Article
Molecular Detection of Multiple Antimicrobial Resistance Genes in Helicobacter pylori-Positive Gastric Samples from Patients Undergoing Upper Gastrointestinal Endoscopy with Gastric Biopsy in Algarve, Portugal
by Francisco Cortez Nunes, Catarina Aguieiras, Mauro Calhindro, Ricardo Louro, Bruno Peixe, Patrícia Queirós, Pedro Castelo-Branco and Teresa Letra Mateus
Antibiotics 2025, 14(8), 780; https://doi.org/10.3390/antibiotics14080780 (registering DOI) - 1 Aug 2025
Viewed by 299
Abstract
Background/Objectives: Helicobacter pylori (H. pylori) is a common gastric pathogen linked to gastritis, gastroduodenal ulcers, and gastric cancer. Rising antimicrobial resistance (AMR) poses challenges for effective treatment and has prompted the WHO to classify H. pylori as a high-priority pathogen. [...] Read more.
Background/Objectives: Helicobacter pylori (H. pylori) is a common gastric pathogen linked to gastritis, gastroduodenal ulcers, and gastric cancer. Rising antimicrobial resistance (AMR) poses challenges for effective treatment and has prompted the WHO to classify H. pylori as a high-priority pathogen. This study aimed to detect the prevalence of AMR genes in H. pylori-positive gastric samples from patients in Algarve, Portugal, where regional data is scarce. Methods: Eighteen H. pylori-positive gastric biopsy samples from patients undergoing upper gastrointestinal endoscopy were analyzed. PCR and sequencing were used to identify genes associated with resistance to amoxicillin (Pbp1A), metronidazole (rdxA, frxA), tetracycline (16S rRNA mutation) and clarithromycin (23S rRNA). Sequence identity and homologies were verified using tBLASTx and the Comprehensive Antibiotic Resistance Database (CARD). Results: Out of the 18 H. pylori-positive samples, 16 (88.9%) contained at least one AMR gene. The most frequent genes were rdxA (83.3%) and frxA (66.7%) for metronidazole resistance, and the 16S rRNA mutation (66.7%) for tetracycline. Resistance to amoxicillin and clarithromycin was detected in 27.8% and 16.7% of cases, respectively. Most samples (72.2%) had multiple resistance genes. A significantly strong association was found between female sex and the presence of the rdxA gene (p = 0.043). Conclusions: The study reveals a high prevalence of H. pylori resistance genes in Algarve, particularly against metronidazole and tetracycline. These findings highlight the need for local surveillance and tailored treatment strategies. Further research with larger populations is warranted to assess regional resistance patterns and improve eradication efforts. Full article
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28 pages, 1387 KiB  
Article
Metagenomic Analysis of Ready-to-Eat Foods on Retail Sale in the UK Identifies Diverse Genes Related to Antimicrobial Resistance
by Edward Haynes, Roy Macarthur, Marc Kennedy, Chris Conyers, Hollie Pufal, Sam McGreig and John Walshaw
Microorganisms 2025, 13(8), 1766; https://doi.org/10.3390/microorganisms13081766 - 29 Jul 2025
Viewed by 128
Abstract
Antimicrobial Resistance (AMR), i.e., the evolution of microbes to become resistant to chemicals used to control them, is a global public health concern that can make bacterial diseases untreatable. Inputs including antibiotics, metals, and biocides can create an environment in the agrifood chain [...] Read more.
Antimicrobial Resistance (AMR), i.e., the evolution of microbes to become resistant to chemicals used to control them, is a global public health concern that can make bacterial diseases untreatable. Inputs including antibiotics, metals, and biocides can create an environment in the agrifood chain that selects for AMR. Consumption of food represents a potential exposure route to AMR microbes and AMR genes (ARGs), which may be present in viable bacteria or on free DNA. Ready-to-eat (RTE) foods are of particular interest because they are eaten without further cooking, so AMR bacteria or ARGs that are present may be consumed intact. They also represent varied production systems (fresh produce, cooked meat, dairy, etc.). An evidence gap exists regarding the diversity and consumption of ARGs in RTE food, which this study begins to address. We sampled 1001 RTE products at retail sale in the UK, in proportion to their consumption by the UK population, using National Diet and Nutrition Survey data. Bacterial DNA content of sample extracts was assessed by 16S metabarcoding, and 256 samples were selected for metagenomic sequencing for identification of ARGs based on consumption and likely bacterial DNA content. A total of 477 unique ARGs were identified in the samples, including ARGs that may be involved in resistance to important antibiotics, such as colistin, fluoroquinolones, and carbapenems, although phenotypic AMR was not measured. Based on the incidence of ARGs in food types, ARGs are estimated to be present in a high proportion of average diets. ARGs were detected on almost all RTE food types tested (48 of 52), and some efflux pump genes are consumed in 97% of UK diets. Full article
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13 pages, 748 KiB  
Article
Characterization of Antimicrobial Resistance in Campylobacter Species from Broiler Chicken Litter
by Tam T. Tran, Sylvia Checkley, Niamh Caffrey, Chunu Mainali, Sheryl Gow, Agnes Agunos and Karen Liljebjelke
Antibiotics 2025, 14(8), 759; https://doi.org/10.3390/antibiotics14080759 - 28 Jul 2025
Viewed by 305
Abstract
Background/Objectives: Campylobacteriosis in human populations is an ongoing issue in both developed and developing countries. Poultry production is recognized as a reservoir for antimicrobial resistance and main source of human Campylobacter infection. Methods: In this study, sixty-five Campylobacter isolates were cultured from [...] Read more.
Background/Objectives: Campylobacteriosis in human populations is an ongoing issue in both developed and developing countries. Poultry production is recognized as a reservoir for antimicrobial resistance and main source of human Campylobacter infection. Methods: In this study, sixty-five Campylobacter isolates were cultured from fecal samples collected from 17 flocks of broiler chickens in Alberta, Canada over two years (2015–2016). Susceptibility assays and PCR assays were performed to characterize resistance phenotypes and resistance genes. Conjugation assays were used to examine the mobility of AMR phenotypes. Results: Campylobacter jejuni was the predominant species recovered during both years of sampling. There were no Campylobacter coli isolates found in 2015; however, approximately 33% (8/24) of isolates collected in 2016 were Campylobacter coli. The two most frequent antimicrobial resistance patterns in C. jejuni collected in 2015 were tetracycline (39%) and azithromycin/clindamycin/erythromycin/telithromycin resistance (29%). One isolate collected in 2015 has resistance pattern ciprofloxacin/nalidixic acid/tetracycline. The tetO gene was detected in all tetracycline resistant isolates from 2015. The cmeB gene was detected in all species isolates with resistance to azithromycin/clindamycin/erythromycin/telithromycin, and from two isolates with tetracycline resistance. Alignment of the nucleotide sequences of the cmeB gene from C. jejuni isolates with different resistance patterns revealed several single nucleotide polymorphisms. A variety of multi-drug resistance patterns were observed through conjugation experiments. Conclusions: These data suggest that poultry production may serve as a potential reservoir for and source of transmission of multi-drug resistant Campylobacter jejuni and supports the need for continued surveillance. Full article
(This article belongs to the Special Issue Antimicrobial Resistance Genes: Spread and Evolution)
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15 pages, 943 KiB  
Systematic Review
The Implementation of Antimicrobial Consumption Surveillance and Stewardship in Human Healthcare in Post-Soviet States: A Systematic Review
by Zhanar Kosherova, Dariga Zhazykhbayeva, Ainur Aimurziyeva, Dinagul Bayesheva and Yuliya Semenova
Antibiotics 2025, 14(8), 749; https://doi.org/10.3390/antibiotics14080749 - 25 Jul 2025
Viewed by 353
Abstract
Background/Objectives: Antimicrobial consumption (AMC) surveillance and antimicrobial stewardship (AMS) constitute effective strategies to combat the increasing antimicrobial resistance rates worldwide. Post-Soviet countries (Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan) implemented various elements [...] Read more.
Background/Objectives: Antimicrobial consumption (AMC) surveillance and antimicrobial stewardship (AMS) constitute effective strategies to combat the increasing antimicrobial resistance rates worldwide. Post-Soviet countries (Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan) implemented various elements of AMC surveillance and AMS to different extents. The limited quantity and quality of data from post-Soviet countries make it difficult to assess health system performance; therefore, this region is a blind spot in global AMR monitoring. This systematic review assesses and characterises AMC surveillance and AMS implementation in post-Soviet countries. Methods: Evidence was compiled via a search in PubMed, Google Scholar, Embase, CyberLeninka, and Scopus. The eligibility criteria included AMC surveillance- and AMS-related papers in human health within defined regions and timelines. Some literature from the official websites of international and national health organisations was included in the search. Results: As a result of the searches, screening, and critical appraisal, three peer-reviewed publications and 31 documents were selected for analysis. Eleven out of fifteen countries with updated national action plans for combating antimicrobial resistance have defined AMC surveillance and AMS as strategic objectives. All 15 examined countries submitted antimicrobial consumption data to international networks and reported the existence of approved laws and regulations on antibiotic sales. However, disparities exist in the complexity of monitoring systems and AMS implementation between high-income and low-income countries in the region. Conclusions: This review provides key insights into the existing AMC surveillance and AMS implementation in former Soviet countries. Although the approach of this review lacks quantitative comparability, it provides a comprehensive qualitative framework for national-level AMC surveillance and AMS system assessment. Full article
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17 pages, 432 KiB  
Article
Internal Validation of a Machine Learning-Based CDSS for Antimicrobial Stewardship
by Ari Frenkel, Alicia Rendon, Carlos Chavez-Lencinas, Juan Carlos Gomez De la Torre, Jen MacDermott, Collen Gross, Stephanie Allman, Sheri Lundblad, Ivanna Zavala, Dave Gross, Jessica Siegel, Soojung Choi and Miguel Hueda-Zavaleta
Life 2025, 15(7), 1123; https://doi.org/10.3390/life15071123 - 17 Jul 2025
Viewed by 391
Abstract
Background: Antimicrobial stewardship programs (ASPs) are essential in combating antimicrobial resistance (AMR); however, limited resources hinder their implementation. Arkstone, a biotechnology company, developed a machine learning (ML)-driven clinical decision support system (CDSS) to guide antimicrobial prescribing. While AI (artificial intelligence) applications are increasingly [...] Read more.
Background: Antimicrobial stewardship programs (ASPs) are essential in combating antimicrobial resistance (AMR); however, limited resources hinder their implementation. Arkstone, a biotechnology company, developed a machine learning (ML)-driven clinical decision support system (CDSS) to guide antimicrobial prescribing. While AI (artificial intelligence) applications are increasingly used, each model must be carefully validated. Methods: Three components of the ML system were assessed: (1) A prospective observational study tested its ability to distinguish trained from novel data using various validation techniques and BioFire molecular panel inputs. (2) An anonymous retrospective analysis of internal infectious disease lab results evaluated the recognition of novel versus trained complex datasets. (3) A prospective observational validation study reviewed clinical recommendations against standard guidelines by independent clinicians. Results: The system achieved 100% accuracy (F1 = 1) in identifying 111 unique novel data points across 1110 tests over nine training sessions. It correctly identified all 519 fully trained and 644 novel complex datasets. Among 644 clinician-trained reports, there were no major discrepancies in recommendations, with only 100 showing minor differences. Conclusions: This novel ML system demonstrated high accuracy in distinguishing trained from novel data and produced recommendations consistent with clinical guidelines. These results support its value in strengthening CDSS and ASP efforts. Full article
(This article belongs to the Section Medical Research)
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19 pages, 368 KiB  
Article
Barriers to Compliance with National Guidelines Among Children Hospitalized with Community-Acquired Pneumonia in Vietnam and the Implications
by Thuy Thi Phuong Nguyen, Huong Thi Thu Vu, Anh Minh Hoang, An Minh Ho, Israel Abebrese Sefah, Brian Godman and Johanna C. Meyer
Antibiotics 2025, 14(7), 709; https://doi.org/10.3390/antibiotics14070709 - 15 Jul 2025
Viewed by 564
Abstract
Background: Community-acquired pneumonia (CAP) is the leading cause of death in infants aged 1–59 months. Concurrent with this, there is a need to prescribe antibiotics wisely in Vietnam due to concerns with rising antimicrobial resistance (AMR). Consequently, an urgent need has arisen [...] Read more.
Background: Community-acquired pneumonia (CAP) is the leading cause of death in infants aged 1–59 months. Concurrent with this, there is a need to prescribe antibiotics wisely in Vietnam due to concerns with rising antimicrobial resistance (AMR). Consequently, an urgent need has arisen to treat patients according to agreed guidelines. The aim of this study was to investigate the current management of infants under five years old with CAP in Vietnam as well as identify possible obstacles to adhering to national guidelines. Methods: A mixed-method approach was used incorporating both quantitative and qualitative data analysis in a leading hospital in Vietnam, which influences others. Data from 108 pediatric patient records were collected and analyzed. Subsequently, in-depth interviews were conducted with pediatric doctors treating these patients to ascertain possible reasons for non-adherence to guidelines. Results: The mean age of children diagnosed with CAP was 27.94 ± 12.99 months, with 82.4% having non-severe CAP, and 41.7% of children had previously used antibiotics before hospitalization. The median length of hospital stay was 7 days. All children were prescribed antibiotics, 91.4% of children received these initially intravenously, with third-generation cephalosporins being the most (91.7%) commonly prescribed. Cefoperazone/sulbactam was the most frequently prescribed (48.2%) antibiotic. However, on 96.1% of occasions cefoperazone/sulbactam was given at higher doses than the label instructions. Overall, 73.3% of antibiotics prescribed were “Watch” antibiotics. In addition, the proportion of initial antibiotic regimens that were consistent with current national guidelines was only 4.63%. Conclusions: There were considerable concerns with low adherence rates to current guidelines alongside high rates of prescribing of injectable third-generation cephalosporins due to various internal and external barriers. Antimicrobial stewardship programs with updated national guidelines are urgently needed in Vietnamese hospitals to treat CAP in children as part of ongoing measures to reduce increasing AMR rates. Such activities should also help improve antibiotic use in the community following improved education of trainee ambulatory care physicians regarding appropriate management of children with CAP. Full article
(This article belongs to the Special Issue Antibiotic Resistance: From the Bench to Patients, 2nd Edition)
14 pages, 355 KiB  
Article
Distribution and Determinants of Antibiotic Self-Medication: A Cross-Sectional Study in Chinese Residents
by Guo Huang, Pu Ge, Mengyun Sui, He Zhu, Sheng Han and Luwen Shi
Antibiotics 2025, 14(7), 701; https://doi.org/10.3390/antibiotics14070701 - 12 Jul 2025
Viewed by 461
Abstract
Antimicrobial resistance (AMR) represents a critical global health threat, with inappropriate antibiotic self-medication (ASM) being a key contributor. China—as the world’s largest antibiotic consumer—faces significant challenges despite regulatory efforts, compounded by limited contemporary data during the COVID-19 pandemic. A nationwide cross-sectional study was [...] Read more.
Antimicrobial resistance (AMR) represents a critical global health threat, with inappropriate antibiotic self-medication (ASM) being a key contributor. China—as the world’s largest antibiotic consumer—faces significant challenges despite regulatory efforts, compounded by limited contemporary data during the COVID-19 pandemic. A nationwide cross-sectional study was conducted using the 2021 China Family Health Index Survey (n = 11,031 participants across 120 cities). Trained investigators administered face-to-face questionnaires assessing ASM practices, decision-making factors, and sociodemographic characteristics. Multivariate logistic regression identified determinants of ASM. Overall, ASM prevalence was 33.7% (n = 3717), with no urban-rural difference (p > 0.05). Physician advice (78.2%), drug safety (67.1%), and efficacy (64.2%) were primary selection criteria; rural residents prioritized drug price and salesperson recommendations more than their urban counterparts (p < 0.01). Key predictors included higher ASM odds among females (OR = 1.30, 95%CI:1.18–1.43), middle-aged adults (46–59 years; OR = 1.20, 95%CI:1.02–1.42), those with health insurance (resident: OR = 1.33; commercial: OR = 1.62), and individuals with drinking histories (OR = 1.20, 95%CI:1.10–1.31). Lower odds were associated with primary education (OR = 0.69, 95%CI:0.58–0.81), unemployment (OR = 0.88, 95%CI:0.79–0.98), and absence of chronic diseases (OR = 0.56, 95%CI:0.47–0.67). One-third of Chinese residents engaged in ASM during the pandemic, driven by intersecting demographic and behavioral factors. Despite converging urban-rural prevalence rates, distinct decision-making drivers necessitate context-specific interventions, including strengthened pharmacy regulation in rural areas, tailored education programs for high-risk groups, and insurance system reforms to disincentivize self-medication. Full article
(This article belongs to the Special Issue Antibiotic Use in the Communities—2nd Edition)
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13 pages, 2433 KiB  
Article
Distribution and Antimicrobial Resistance Patterns of Aerobic Bacterial Isolates from Clinically Ill Pet Guinea Pigs (Cavia porcellus) in Hong Kong
by Desiree Hung, Ibrahim Elsohaby, Fraser Hill, Andrew Ferguson and Colin T. McDermott
Animals 2025, 15(14), 2042; https://doi.org/10.3390/ani15142042 - 11 Jul 2025
Viewed by 292
Abstract
With the increase in keeping exotic companion mammals as pets, concerns about antimicrobial resistance (AMR) and its impact on animal and human health are growing. Guinea pigs, a popular pet in Hong Kong and globally, have limited studies regarding antimicrobial culture and sensitivity [...] Read more.
With the increase in keeping exotic companion mammals as pets, concerns about antimicrobial resistance (AMR) and its impact on animal and human health are growing. Guinea pigs, a popular pet in Hong Kong and globally, have limited studies regarding antimicrobial culture and sensitivity results. We reviewed bacteriologic and antimicrobial sensitivity results from clinically ill pet guinea pigs from 2019 to 2023 using data from the City University Veterinary Diagnostic Laboratory. Of the 234 clinical samples from 22 veterinary clinics in Hong Kong, 134 (57.3%) showed positive bacterial growth, of which 23 (17.2%) showed mixed bacterial growth. In total, 156 bacterial isolates were identified. Gram-positive bacteria (n = 104, 66.7%) were most commonly recovered, representing 25 bacterial species, most commonly Streptococcus spp., Staphylococcus spp., and Corynebacterium spp. The majority of positive samples were from the integument (43.6%) and urinary tract (33.8%). A total of 85.9% of all isolates were resistant to at least one antimicrobial agent, with over 40% of isolates exhibiting resistance to three or more antimicrobial agents, and 27.6% were multidrug resistant (resistant to at least one agent in three or more antimicrobial classes). High resistance rates were observed for penicillin (45.6%), gentamicin (43.7%), doxycycline (42.1%), and azithromycin (36.3%). In contrast, isolates were highly susceptible to ceftazidime (84.1%), chloramphenicol (82.6%), ciprofloxacin (72.7%), and marbofloxacin (72.2%). These findings highlight the high frequency of AMR in this population of clinically ill pet guinea pigs in Hong Kong and the need for informed and judicious antimicrobial use. Full article
(This article belongs to the Special Issue Exotic Mammal Care and Medicine)
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13 pages, 233 KiB  
Article
Policy Makers’ Perceptions on Implementation of National Action Plans on Antimicrobial Resistance in South Africa and Eswatini Using Coordination, Accountability, Resourcing, Regulation and Ownership Framework (2018–2019)
by Kholiwe Shabangu, Sabiha Yusuf Essack and Sinegugu Evidence Duma
Antibiotics 2025, 14(7), 696; https://doi.org/10.3390/antibiotics14070696 - 11 Jul 2025
Viewed by 367
Abstract
Background: Antimicrobial resistance (AMR) is a global threat that affects humans, animals, plants, the environment, societies, and economies—requiring urgent coordinated action. In May 2015, the World Health Assembly (WHA) adopted the Global Action Plan (GAP) on AMR, urging member states to develop [...] Read more.
Background: Antimicrobial resistance (AMR) is a global threat that affects humans, animals, plants, the environment, societies, and economies—requiring urgent coordinated action. In May 2015, the World Health Assembly (WHA) adopted the Global Action Plan (GAP) on AMR, urging member states to develop and implement their own National Action Plans (NAPs) using a One Health approach. Objective: Both South Africa and Eswatini have developed NAPs and are currently in the implementation phase. However, no study has explored policymakers’ perceptions regarding NAP implementation particularly concerning coordination, accountability, resourcing, regulation and ownership. Methods: This qualitative study employed a narrative approach to explore these perceptions in South Africa and Eswatini. A total of 36 key informants were recruited using purposive and snowball sampling methods. Data was collected between November 2018 and March 2019 and transcribed verbatim. Results: Findings revealed that while governance structures for implementing NAPs exist in South Africa and Eswatini, several critical areas require urgent attention. These include limited accountability across One Health sectors, the absence of dedicated national budgets for NAP implementation, poor intra- and inter- ministerial coordination, weak medicine regulation and enforcement, and delayed multisectoral ownership of the NAPs. Conclusions: To address AMR effectively, both countries must allocate dedicated budgets, improve multisectoral integration, and strengthen regulatory frameworks regarding antimicrobial access and use across all One Health sectors. A firm commitment from all sectors is required—not just formal endorsement of the NAPs—to ensure sustainable implementation and ownership. Full article
(This article belongs to the Special Issue A One Health Approach to Antimicrobial Resistance, 2nd Edition)
14 pages, 840 KiB  
Article
Veterinary Prescriptions of Antibiotics Approved for Human Use: A Five-Year Analysis of Companion Animal Use and Regulatory Gaps in Brazil
by Rana Zahi Rached, Regina Albanese Pose, Érika Leão Ajala Caetano, Joana Garrossino Magalhães and Denise Grotto
Vet. Sci. 2025, 12(7), 652; https://doi.org/10.3390/vetsci12070652 - 9 Jul 2025
Viewed by 590
Abstract
Antimicrobial resistance (AMR) is a growing global concern, influenced by antibiotic use in both human and veterinary medicine, especially in companion animals. In low- and middle-income countries, regulatory oversight on veterinary prescriptions is often limited, creating gaps that can accelerate AMR. This study [...] Read more.
Antimicrobial resistance (AMR) is a growing global concern, influenced by antibiotic use in both human and veterinary medicine, especially in companion animals. In low- and middle-income countries, regulatory oversight on veterinary prescriptions is often limited, creating gaps that can accelerate AMR. This study aimed to characterize the use of antibiotics approved for human use that are prescribed by veterinarians for companion animals in Brazil, a country representative of broader regulatory challenges. We conducted a retrospective analysis of five years (2017–2021) of national sales data recorded by the National System for the Management of Controlled Products (SNGPC), maintained by the Brazilian Health Regulatory Agency (ANVISA). A total of 789,893 veterinary antibiotic prescriptions were analyzed over the five-year period, providing a comprehensive overview of prescribing patterns. The dataset included all oral and injectable antibiotics purchased in human pharmacies with veterinary prescriptions. Data wrangling and cleaning procedures were applied to extract information on volume, antibiotic classes, seasonal variation, and regional distribution. The results revealed a predominance of penicillins, first- and second-generation cephalosporins, and a marked increase in macrolide use, especially azithromycin. Notable regional disparities were observed, with the southeastern region leading in prescription volume. The findings, particularly the disproportionate use of azithromycin and the marked regional disparities, highlight the need for targeted monitoring policies and a stricter regulation of off-label antibiotic use in veterinary medicine. They also offer insights applicable to other countries facing similar AMR threats due to limited surveillance and regulatory frameworks. Full article
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