Search Results (260)

Antimicrobial resistance (AMR) has emerged as a planetary health emergency, driven not only by the clinical misuse of antibiotics but also by diverse environmental dissemination pathways. This review critically examines the role of environmental compartments—water, soil, and air—as dynamic reservoirs and transmission routes for antibiotic-resistant bacteria (ARB) and resistance genes (ARGs). Recent metagenomic, epidemiological, and mechanistic evidence demonstrates that anthropogenic pressures—including pharmaceutical effluents, agricultural runoff, untreated sewage, and airborne emissions—amplify resistance evolution and interspecies gene transfer via horizontal gene transfer mechanisms, biofilms, and mobile genetic elements. Importantly, it is not only highly polluted rivers such as the Ganges that contribute to the spread of AMR; even low concentrations of antibiotics and their metabolites, formed during or after treatment, can significantly promote the selection and dissemination of resistance. Environmental hotspots such as European agricultural soils and airborne particulate zones near wastewater treatment plants further illustrate the complexity and global scope of pollution-driven AMR. The synergistic roles of co-selective agents, including heavy metals, disinfectants, and microplastics, are highlighted for their impact in exacerbating resistance gene propagation across ecological and geographical boundaries. The efficacy and limitations of current mitigation strategies, including advanced wastewater treatments, thermophilic composting, biosensor-based surveillance, and emerging regulatory frameworks, are evaluated. By integrating a One Health perspective, this review underscores the imperative of including environmental considerations in global AMR containment policies and proposes a multidisciplinary roadmap to mitigate resistance spread across interconnected human, animal, and environmental domains. Full article

The role of Enterococcus spp. in food is debated since this group of lactic acid bacteria contains opportunistic pathogenic strains, some of which exhibit a multidrug-resistant profile. In livestock farms, the use of antibiotics is the most common practice to deal with mastitis-causing bacteria. However, the heavy usage and/or misuse of antibiotics has led to the emergence of antibiotic resistance. This study aimed to genetically and phenotypically characterize Enterococcus strains isolated from raw sheep milk. Samples were collected over one year from the bulk tank of a dairy sheep farm and cultured on selective media. Isolates were purified and analyzed by whole-genome sequencing and antimicrobial susceptibility testing. The isolates were divided into clusters and the corresponding species were identified along with their genes related to virulence and antibiotic resistance. The pan-, core- and accessory-genomes of the strains were determined. Finally, the antibiotic-resistant profile of selected strains was examined and associated with their genomic characterization. These findings contribute to a better understanding of Enterococci epidemiology, providing comprehensive profiles of their virulence and resistance genes. The presence of antibiotic-resistant bacteria in raw sheep milk destined for the production of cheese should raise awareness. Full article

Vibrio parahaemolyticus is a pathogenic bacterium widely distributed in marine environments, posing significant threats to aquatic organisms and human health. The overuse and misuse of antibiotics has led to the development of multidrug- and pan-resistant V. parahaemolyticus strains. There is an urgent need for novel antibacterial therapies with innovative mechanisms of action. In this work, a genome-scale metabolic network model (GMSN) of V. parahaemolyticus, named VPA2061, was reconstructed to predict the metabolites that can be explored as potential drug targets for eliminating V. parahaemolyticus infections. The model comprises 2061 reactions and 1812 metabolites. Through essential metabolite analysis and pathogen–host association screening with VPA2061, 10 essential metabolites critical for the survival of V. parahaemolyticus were identified, which may serve as key candidates for developing new antimicrobial strategies. Additionally, 39 structural analogs were found for these essential metabolites. The molecular docking analysis of the essential metabolites and structural analogs further investigated the potential value of these metabolites for drug design. The GSMN reconstructed in this work provides a new tool for understanding the pathogenic mechanisms of V. parahaemolyticus. Furthermore, the analysis results regarding the essential metabolites hold profound implications for the development of novel antibacterial therapies for V. parahaemolyticus-related disease. Full article

Background: Antibiotic resistance (AMR) is a critical global and national health challenge, largely driven by the misuse and overuse of antibiotics. Understanding the public′s knowledge and practices regarding antibiotic use is essential for informing effective interventions. This study aimed to assess the levels of knowledge, attitude, and practice (KAP) related to antibiotic use among adults in Saudi Arabia’s Western Region and to identify the demographic and behavioral determinants of these outcomes. Methods: A regional cross-sectional survey was conducted from March to June 2025 using a 40-item self-administered online questionnaire. Adults aged ≥ 18 years residing in the Western Region of Saudi Arabia were recruited via social media using snowball sampling. Descriptive statistics and Chi-square tests were used to examine associations, while multivariate logistic regression was employed to identify determinants of high knowledge and good practices, presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: A total of 891 participants were included; most were female (63.6%) and aged 18–30 years (56.2%). Moderate knowledge of antibiotic use was observed in 54.0% of participants, while 30.8% had high knowledge. In terms of attitude and practice, 55.6% demonstrated good performance and 42.8% average performance. High knowledge was significantly associated with the female gender (aOR = 1.90; 95% CI: 1.34–2.70), age of 41–50 years (aOR = 2.22; 95% CI: 1.42–3.48), and a postgraduate education (aOR = 15.37; 95% CI: 1.84–128.13). Good practices were associated with the female gender (aOR = 2.32; 95% CI: 1.66–3.24) and being married (aOR = 1.99; 95% CI: 1.43–2.77). A moderate positive correlation was found between knowledge and practice scores (r = 0.406, p < 0.001). Conclusions: Significant variability in public KAP regarding antibiotic use was identified. Female gender, older age, and higher education were key determinants of better KAP. These findings emphasize the need for targeted educational strategies focusing on high-risk groups to support rational antibiotic use and mitigate antimicrobial resistance. Full article

Background/Objective: Non-typhoidal Salmonella is a leading cause of foodborne illness worldwide and presents a significant One Health concern due to zoonotic transmission. Although antibiotic therapy remains a standard approach for treating salmonellosis in severe cases in animals, the widespread misuse of antibiotics has contributed to the emergence of multidrug-resistant (MDR) Salmonella strains. This study provides insights into the genotypic and phenotypic characteristics among Salmonella isolates from necropsied cattle. Methods: A total of 1008 samples were collected from necropsied cattle. Salmonella enterica subspecies were identified by MALDI-TOF MS and subsequently confirmed by serotyping. The biofilm-forming ability of the isolated bacteria was assessed using a crystal violet assay. The motility of the isolates was assessed on soft agar plates. Additionally, the antimicrobial resistance genes (ARGs) and virulence genes were investigated. Antimicrobial resistance patterns were investigated against 19 antibiotics representing 9 different classes. Results:Salmonella species were isolated and identified in 27 necropsied cattle. Salmonella Dublin was the most prevalent serotype (29.6%). Additionally, all the isolates were biofilm producers at different levels of intensity, and 96.3% of the isolates exhibited both swarming and swimming motility. Furthermore, virulence genes, including invA, hilA, fimA, and csgA, were detected in all the isolates. The highest resistance was observed to macrolides (azithromycin and clindamycin) (100%), followed by imipenem (92.6%), and chloramphenicol (85.2%). All isolates were multidrug-resistant, with a multiple antibiotic resistance (MAR) index ranging between 0.32 and 0.74. The aminoglycoside resistance gene aac(6′)-Ib was detected in all the isolates (100%), whereas the distribution of other antimicrobial resistance genes (ARGs) varied among the isolates. Conclusions: The increasing prevalence of MDR Salmonella poses a significant public health risk. These resistant strains can reduce the effectiveness of standard treatments and elevate outbreak risks. Strengthening surveillance and regulating antibiotic use in livestock are essential to mitigating these threats. Full article

The intersection of microbial food safety and antimicrobial resistance (AMR) represents a mounting global threat with profound implications for public health, food safety, and sustainable development. This review explores the complex pathways through which foodborne pathogens—such as Salmonella spp., Escherichia coli (E. coli), Listeria monocytogenes (L. monocytogenes), and Campylobacter spp.—acquire and disseminate resistance within human, animal, and environmental ecosystems. Emphasizing a One Health framework, we examine the drivers of AMR across sectors, including the misuse of antibiotics in agriculture, aquaculture, and clinical settings, and assess the role of environmental reservoirs in sustaining and amplifying resistance genes. We further discuss the evolution of surveillance systems, regulatory policies, and antimicrobial stewardship programs (ASPs) designed to mitigate resistance across the food chain. Innovations in next-generation sequencing, metagenomics, and targeted therapeutics such as bacteriophage therapy, antimicrobial peptides (AMPs), and CRISPR-based interventions offer promising alternatives to conventional antibiotics. However, the translation of these advances into practice remains uneven, particularly in low- and middle-income countries (LMICs) facing significant barriers to diagnostic access, laboratory capacity, and equitable treatment availability. Our analysis underscores the urgent need for integrated, cross-sectoral action—anchored in science, policy, and education—to curb the global spread of AMR. Strengthening surveillance, investing in research, promoting responsible antimicrobial use, and fostering global collaboration are essential to preserving the efficacy of existing treatments and ensuring the microbiological safety of food systems worldwide. Full article

Background: Antimicrobial resistance (AMR) poses a critical global health challenge, particularly in resource-limited settings. A hub-and-spoke model, decentralising expertise and distributing resources to peripheral facilities, has been proposed as a strategy to enhance the antimicrobial stewardship (AMS) capacity in low- and middle-income countries. Aim: This study sought to understand healthcare professionals’ experiences of a hub-and-spoke AMS model in the Volta Region of Ghana and its influence on clinical practice, leadership, and collaborative endeavours to address AMR. Methods: A qualitative descriptive design was adopted. In-depth interviews were conducted with 11 healthcare professionals who participated in the AMS program. Thematic analysis was used to identify key themes related to the knowledge and skills that were gained, clinical and leadership practice changes, capacity building, and challenges. Results: Participants reported an increased awareness of AMR, particularly regarding the scale and clinical implications of antimicrobial misuse. The clinical practice improvements included more judicious prescribing and enhanced adherence to infection prevention and control measures. Many respondents highlighted stronger leadership skills and a commitment to capacity building through AMS committees, multidisciplinary collaboration, and cross-organisational knowledge exchange. Despite resource constraints and logistical hurdles, participants expressed optimism, citing data-driven approaches such as point prevalence surveys to track progress and inform policy. Engagement with hospital management and public outreach were viewed as essential to sustaining AMS efforts and curbing over-the-counter antibiotic misuse. Conclusions: The hub-and-spoke model caused observable improvements in AMS knowledge, clinical practice, and leadership capacity among healthcare professionals in Ghana. While challenges remain, particularly in securing sustainable resources and shifting community behaviours, these findings underscore the potential of network-based programs to catalyse systemic changes in tackling AMR. Future research should explore long-term outcomes and strategies for embedding AMS practices more deeply within healthcare systems and communities. Full article

Antimicrobial resistance (AMR) is considered a global healthcare emergency in the 21st century. Although the evolution of microorganisms through Darwinian mechanisms and antibiotic misuse are established drivers, the structural socioeconomic factors of AMR remain insufficiently explored. This review takes on an analytical perspective, drawing upon a wide spectrum of evidence to examine the extent to which socioeconomic factors contribute to the global proliferation of AMR, with an emphasis on low- and middle-income countries (LMICs). The analytical review at hand was carried out through a search for relevant articles and reviews on PubMed, Google Scholar, the Centers for Disease Control and Prevention, and the World Health Organization database using combinations of the keywords “antimicrobial resistance,” “socioeconomic factors,” “low- and middle-income countries,” “surveillance,” “healthcare access,” and “agriculture.” Preference was given to systematic reviews, high-impact primary studies, and policy documents published in peer-reviewed journals or by reputable global health organizations. Our analysis identifies a complex interplay of systemic vulnerabilities that accelerate AMR in resource-limited settings. A lack of regulatory frameworks regarding non-prescription antibiotic use enables the proliferation of multi-drug-resistant microorganisms. Low sewer connectivity facilitates the environmental dissemination of resistance genes. Proper antibiotic selection is hindered by subpar healthcare systems and limited diagnostic capabilities to deliver appropriate treatment. Additionally, gender disparities, forced migration, and climate-driven zoonotic transmission compound the burden. During the COVID-19 pandemic, antimicrobial misuse surged, further amplifying resistance trends. AMR is not solely a biological phenomenon, but a manifestation of global inequity. Mitigation requires a transformation of policy directed toward a “One Health” strategy that incorporates socioeconomic, environmental, and health system reforms. Strengthening surveillance, investing in infrastructure, regulating pharmaceutical practices, and promoting health equity are essential to curb the rising tide of resistance. Full article

Background: The misuse of antibiotics in dental practice significantly contributes to the escalation of antimicrobial resistance. This study aimed to assess the knowledge and attitudes of final-year dental students regarding perioperative antibiotic prophylaxis in oral surgery and to identify potential curricular improvements based on the findings. Methods: A questionnaire was administered to 117 final-year students at Gazi University Faculty of Dentistry in December 2024. The survey presented clinical scenarios related to common oral surgical procedures, evaluating participants’ antibiotic prescribing behaviors. Statistical analyses were performed using descriptive statistics and a One-Sample Chi-Square Test. Results: Students demonstrated a general tendency toward rational antibiotic use in routine clinical scenarios, with statistically significant response patterns favoring the avoidance of unnecessary prescriptions (p < 0.05). However, in complex or borderline cases such as impacted third molar extraction and dental implant placement, response variability was observed. Post hoc analyses revealed no statistically significant differences between closely distributed options, indicating inconsistencies in decision-making in more challenging scenarios. Conclusions: While final-year dental students exhibited a satisfactory level of knowledge regarding appropriate antibiotic use in standard surgical procedures, the variability observed in complex cases underscores the necessity for enhanced educational interventions. Incorporating updated, evidence-based antimicrobial stewardship principles and promoting clinical decision-making through case-based learning are essential to prepare future dental practitioners for responsible antibiotic prescribing, contributing to global efforts to mitigate antimicrobial resistance. Full article

Background/Objectives: Antibiotic resistance or antimicrobial resistance (AMR) in livestock is a growing global concern that threatens both human and animal health. The overuse and misuse of antibiotics in livestock production have led to an increased propensity for the development of AMR bacterial strains in animals, which can be spread to humans through the consumption of contaminated animal products, direct contact, or environmental exposure. This review aims to summarize the development and transmission of AMR in livestock, explore its underlying mechanisms and impact on human and animal health, and discuss current practices and potential strategies for mitigation and prevention. Methods: For this narrative review, we searched articles on PubMed and Google Scholar using the terms antibiotic resistance, livestock, and environment, alone or in combination. Results: The history of antibiotic use in livestock and its link to increased AMR, along with the involved mechanisms, including the enzymatic breakdown of antibiotics, alterations in bacterial targets, horizontal gene transfer, and efflux pumps, are important. Antibiotics in livestock are used for growth promotion, disease prevention and control, and metaphylactic use. The role of livestock and the environment as reservoirs for resistant pathogens, their impact on human health, chronic infections, allergic reactions, toxicity, and the development of untreatable diseases is important to understand AMR. Conclusions: Given the widespread use of antibiotics and the potential consequences of AMR, collaborative global efforts, increased public awareness, coordinated regulations, and advancements in biological technology are required to mitigate the threat AMR poses to human and animal health. Regulatory solutions and the development of new therapeutic alternatives like antimicrobial peptides and bacteriophage therapy, and preventive measures such as DNA and mRNA vaccines, are future perspectives. Full article

The broiler industry is the most developed livestock sector in Cameroon. This study aimed to evaluate the relationship between biosecurity implementation with production performance and antibiotic usage in broiler farms in Cameroon. Data concerning biosecurity, production performance (average daily gain or ADG, mortality rate, feed conversion ratio or FCR, and performance index or PI), and antimicrobial usage (AMU) were collected in 57 farms in the Adamawa and North regions. The average total biosecurity score of broiler farms was 52/100. ADG (46.54 ± 5.18 g versus 43.80 ± 4.16 g), FCR (1.59 ± 0.61 versus 1.75 ± 0.58), mortality rate (2.47% versus 6.65%), and PI (339.21 ± 105.79 versus 268.22 ± 101.09) were statistically better in farms with good biosecurity. The majority of antibiotics used (55.2%) were classified as critically important for human medicine, with 83.9% of antibiotics underdosed/overdosed. No correlation was found between biosecurity and AMU, although there was a trend towards reduced use in farms with good biosecurity. The misuse of antibiotics will result in an increased development of antimicrobial resistance, which can be transmitted to humans. This study highlights the importance of biosecurity in improving poultry performance and reducing AMU. Continuous training and awareness-raising efforts among farmers on the importance of biosecurity are needed to reduce AMU and improve farmers’ profitability. Full article

Background/Objectives: Antimicrobial resistance (AMR) poses a critical global health threat, rendering common bacterial infections increasingly difficult to treat and placing considerable strain on healthcare systems. This study assesses public awareness, perceptions, and behaviors related to antibiotic use and AMR in Kosovo, a country with limited existing data on the topic. Methods: Using a cross-sectional survey design, 568 participants from diverse demographic backgrounds provided insights into their knowledge and practices concerning antibiotic use and antibiotic resistance. Results: The results revealed that although 75% of participants had heard of antibiotic resistance, only a limited proportion understood key terms. Knowledge of appropriate antibiotic use varied, with 67% of respondents correctly recognizing the need to complete a prescribed antibiotic course, while 29% believed it was acceptable to stop treatment once they felt better. Gender and educational level emerged as significant factors, with women and more educated individuals demonstrating greater awareness of proper antibiotic use and the risks of misuse. While 71% of respondents considered it unacceptable to use antibiotics prescribed to others, 41% believed it was acceptable to reuse previously effective antibiotics. Most participants (96%) reported obtaining antibiotics through prescriptions. Public awareness of AMR was generally high, but conceptual understanding remained limited, with misconceptions about the origins of resistance, incorrectly attributing it to the human body rather than bacteria. Conclusions: Targeted public health campaigns, guided by the One Health approach, integrating human, animal, and environmental health, are needed. A multifaceted strategy, including education, policy reforms, and international collaboration, is essential to mitigate AMR and preserve the efficacy of antibiotics for future generations. Full article

The global dissemination of plasmid-mediated mcr genes, which confer resistance to the last-resort antibiotic colistin, represents a critical public health challenge driven by the interplay of clinical, agricultural, and environmental factors. This review examines the genetic and ecological dynamics of mcr-bearing plasmids, focusing on their role in disseminating colistin resistance across diverse bacterial hosts and ecosystems. Key plasmid families demonstrate distinct evolutionary strategies, including IncI2, IncHI2, and IncX4. IncI2 plasmids favor stability in livestock and clinical settings. IncHI2 plasmids, on the other hand, leverage transposons to co-select for multidrug resistance, while IncX4 plasmids achieve global dissemination through streamlined, conjugation-efficient architectures. The pervasive spread of mcr genes is exacerbated by their integration into chromosomes via mobile genetic elements and co-selection with resistance to other antibiotic classes, amplifying multidrug-resistant phenotypes. Environmental reservoirs, food chains, and anthropogenic practices further facilitate cross-niche transmission, underscoring the interconnectedness of resistance under the One Health framework. Addressing this crisis requires coordinated strategies, including reducing colistin misuse in agriculture, enhancing surveillance of high-risk plasmid types, and fostering international collaboration to preserve antimicrobial efficacy and mitigate the threat of untreatable infections. Full article

Antibiotic resistance is increasing at an alarming rate worldwide, in large part due to their misuse and improper disposal. Antibiotics administered to treat human and animal diseases, including feed supplements for the treatment or prevention of disease in farm animals, have contributed greatly to the emergence of a multitude of antibiotic-resistant pathogens. Shewanella is one of many bacteria that have developed antibiotic resistance, and in some species, multiple-antibiotic resistance (MAR). Shewanella is a rod-shaped, Gram-negative, oxidase-positive, and H₂S-producing bacterium that is naturally found in the marine environment. In humans, Shewanella spp. can cause skin and soft tissue infections, septicemia, cellulitis, osteomyelitis, and ear and wound infections. Some Shewanella have been shown to be resistant to a variety of antibiotics, including beta-lactams, aminoglycoside, quinolones, third- or fourth-generation cephalosporins, and carbapenems, due to the presence of genes such as the bla_OXA-class D beta-lactamase-encoding gene, bla_AmpC-class-C beta-lactamase-encoding gene, and the qnr gene. Bacteria can acquire and transmit these genes through different horizontal gene-transmission mechanisms such as transformation, transduction, and conjugation. The genes for antibiotic resistance are present on Shewanella chromosomes and plasmids. Apart from this, heavy metals such as arsenic, mercury, cadmium, and chromium can also increase antibiotic resistance in Shewanella due to co-selection processes such as co-resistance, cross resistance, and co-regulation mechanisms. Antibiotics and drugs enter Shewanella spp. through pores or gates in their cell wall and may be ejected from the bacteria by efflux pumps, which are the first line of bacterial defense against antibiotics. Multiple-drug resistant Shewanella can be particularly difficult to control. This review focuses on the phenotypic and genomic characteristics of Shewanella that are involved in the increase in antimicrobial resistance in this bacterium. Full article

Background: Antimicrobial resistance is a growing global health threat, with antibiotic misuse in pediatric populations being a significant contributing factor. In Romania, antibiotic consumption and resistance rates are among the highest in Europe. Objective: To assess Romanian parents’ knowledge, attitudes, and practices regarding antibiotic use in children, and to identify key misconceptions and behavioral risks contributing to inappropriate antibiotic use. Methods: A cross-sectional survey was conducted among 400 parents of hospitalized children in a pediatric department in Romania. Participants completed a 15 item structured questionnaire. Data were analyzed using descriptive statistics, chi-square tests, and binary logistic regression to examine associations and control for potential confounding effects between education level, residential environment, and parental misconceptions regarding antibiotic use. Results: Among the 400 surveyed caregivers, 86% (n = 344) held at least one misconception regarding antibiotic use. Additionally, 42.5% (n = 170) of participants reported that they had never heard of the concept of antibiotic resistance. Misconceptions were significantly more prevalent among individuals with lower levels of education and those residing in rural areas (p < 0.001). While 89.8% (n = 359) stated that they had never administered antibiotics to their children without a physician’s recommendation, a separate subset of 28% (n = 112) acknowledged that they had asked a doctor to prescribe antibiotics for their child. Moreover, 23.3% (n = 93) reported seeking a second medical opinion when antibiotics were not initially prescribed. Conclusions: Despite high adherence to medical advice, widespread misconceptions persist. These findings highlight the need for targeted, population-specific educational interventions to promote rational antibiotic use and address AMR in high-burden settings like Romania. Full article