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Author: Cristin Cowles Weekley Young Publisher: ISBN: 9781658412988 Category : Languages : en Pages :
Book Description
While the discovery and subsequent availability of antimicrobials revolutionized modern healthcare in humans and animals, growing resistance to antimicrobials by bacterial pathogens threatens to undermine one of the greatest scientific advances of the 20th century, as the discovery of new antimicrobials has slowed while antibiotic use and subsequent resistance (AMR) is rising globally (1-4). Current human mortality rates due to AMR are already over half a million deaths annually worldwide, and recent reports have estimated that if AMR is not controlled, the mortality rate will exceed 10 million per year by 2050, with an economic burden of over $100 trillion USD in lost output (4). These impacts will be felt globally, with low- and middle-income countries being hardest hit, as AMR can spread easily in humans and agricultural settings in these countries due to large variation in healthcare infection-control practices, high rates of infectious diseases, high population densities with poor water, sanitation, and hygiene regulations, and suboptimal agricultural regulations in place for biosecurity and use of veterinary antimicrobials (5-7). Despite evidence indicating that many countries face particularly high-risk conditions for AMR, there remain substantial data gaps characterizing the prevalence and abundance of AMR in humans, animals, and the surrounding environment, especially for community-acquired infections (7). This paucity of One Health-focused research on AMR in low-income and underserved settings worldwide highlights the need for transdisciplinary research to elucidate drivers of antimicrobial resistance and to characterize AMR transmission across One Health domains (7-9). This dissertation seeks to address these gaps in evidence by focusing on an urban, informal settlement with intensifying livestock production in Kathmandu, Nepal. Chapter 1 illustrated a One Health framework that can be used to investigate co-occurrence of resistance genes within and between species and to inform on environmental reservoirs of resistance genes in a densely populated, urban community in Nepal. We concurrently sampled humans, chickens, ducks, swine, and water, as well as rodents and shrews near dwellings. Sixty-nine resistance genes were identified, and detection of the same gene among different species was widespread. The highest prevalence of resistance genes were detected in ducks and gene prevalence varied markedly by species and sample type. Overall, ermB, tetA, mefA, and tetB were most commonly detected; antibiotics associated with these resistance genes, including doxycycline, azithromycin, and gentamicin, are widely used in Nepal in both humans and animals (10). Chapter 2 evaluated putative risk factors relating to the occurrence of specific resistance genes associated with antibiotics of global health importance for both humans and animals as prioritized by the World Health Organization (WHO) and the Organisation for Animal Health (OiE), respectively. Seven genes were chosen based on prevalence in the community and were evaluated independently in multivariate analyses in order to characterize potential reservoirs and transmission pathways for each gene in this urban, informal settlement setting. By assessing which species and sample types were associated with the detection of a gene, this study was able to more fully characterize the genetic resistome in this community and provide guidance for prioritization of prevention and intervention efforts for disrupting AMR transmission of critically important antibiotics for humans and animals in Nepal. Finally, to better understand the sociodemographic and human behavioral drivers of AMR gene burden in low-income community settings, Chapter 3 assessed individual- and household-level risk factors associated with the carriage and burden of AMR genes found in humans. Resistance genes were found in all samples tested with an average of 7 resistance genes from 10 antibiotic classification groups found per participant (n=67). Age and having animals inside the dwelling in the past year were both risk factors for resistance gene carriage and burden, while having a dedicated location for trash and animal waste was protective. Predictors were similar across multivariate and antibiotic resistance classification group-specific models, signifying that activities that generally mitigate risk factors for gene carriage in humans will aid in reducing overall resistance gene burden across antibiotic resistance classification groupings in this community. The conclusions drawn from this body of work help further the understanding of the antibiotic resistome in low-income, urban settings. The concurrent sampling design combined with broad screening for AMR genes offers a unique framework on which to base further efforts to characterize the community resistome, evaluate reservoirs of AMR, and better inform policy for combating the spread of resistance among and between animals, humans, and the environment. References 1. Blair JMA, Webber MA, Baylay AJ, Ogbolu DO, Piddock LJV. Molecular mechanisms of antibiotic resistance. Nature Publishing Group. Nature Publishing Group; 2014 Dec 1;13(1):42-51. 2. World Health Organization. WHO global strategy for containment of antimicrobial resistance. 2001. 3. Yao X, Doi Y, Zeng L, Lv L, Liu J-H. Carbapenem-resistant and colistin-resistant Escherichia coli co-producing NDM-9 and MCR-1. The Lancet Infectious Diseases. Elsevier Ltd; 2016 Jan 28;:1-2. 4. O'Neill J. Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations. UK Government; 2014 Dec. 5. Holmes AH, Moore L, Sundsfjord A, Steinbakk M, Regmi S, Karkey A, et al. Understanding the mechanisms and drivers of antimicrobial resistance. The Lancet. 2015 Nov 18;387(10014):176-87. 6. Bhattacharya S, Khanal B, Bhattarai NR, Das ML. Prevalence of Shigella species and Their Antimicrobial Resistance Patterns in Eastern Nepal. J Health Popul Nutr. 2005 Mar 12;23(4):339-42. 7. Rousham EK, Unicomb L, Islam MA. Human, animal and environmental contributors to antibiotic resistance in low-resource settings: integrating behavioural, epidemiological and One Health approaches. Proceedings of the Royal Society B: Biological Sciences. 2018 Apr 11;285(1876):20180332. 8. Thakur S, Gray GC. The Mandate for a Global "One Health" Approach to Antimicrobial Resistance Surveillance. American Journal of Tropical Medicine and Hygiene. 2019;100(2):227-8. 9. Ogawa VA, Shah CM, Hughes JM, King LJ. Prioritizing a One Health Approach in the Immediate Fight Against Antimicrobial Resistance. EcoHealth. 2018 Mar 9. 10. Administration DOD. NATIONAL LIST OF ESSENTIAL MEDICINES NEPAL (FIFTH REVISION) [Internet]. Fifth Revision. Ministry of Health. Available from: http://www.dda.gov.np/content/essential-drug-list
Author: Cristin Cowles Weekley Young Publisher: ISBN: 9781658412988 Category : Languages : en Pages :
Book Description
While the discovery and subsequent availability of antimicrobials revolutionized modern healthcare in humans and animals, growing resistance to antimicrobials by bacterial pathogens threatens to undermine one of the greatest scientific advances of the 20th century, as the discovery of new antimicrobials has slowed while antibiotic use and subsequent resistance (AMR) is rising globally (1-4). Current human mortality rates due to AMR are already over half a million deaths annually worldwide, and recent reports have estimated that if AMR is not controlled, the mortality rate will exceed 10 million per year by 2050, with an economic burden of over $100 trillion USD in lost output (4). These impacts will be felt globally, with low- and middle-income countries being hardest hit, as AMR can spread easily in humans and agricultural settings in these countries due to large variation in healthcare infection-control practices, high rates of infectious diseases, high population densities with poor water, sanitation, and hygiene regulations, and suboptimal agricultural regulations in place for biosecurity and use of veterinary antimicrobials (5-7). Despite evidence indicating that many countries face particularly high-risk conditions for AMR, there remain substantial data gaps characterizing the prevalence and abundance of AMR in humans, animals, and the surrounding environment, especially for community-acquired infections (7). This paucity of One Health-focused research on AMR in low-income and underserved settings worldwide highlights the need for transdisciplinary research to elucidate drivers of antimicrobial resistance and to characterize AMR transmission across One Health domains (7-9). This dissertation seeks to address these gaps in evidence by focusing on an urban, informal settlement with intensifying livestock production in Kathmandu, Nepal. Chapter 1 illustrated a One Health framework that can be used to investigate co-occurrence of resistance genes within and between species and to inform on environmental reservoirs of resistance genes in a densely populated, urban community in Nepal. We concurrently sampled humans, chickens, ducks, swine, and water, as well as rodents and shrews near dwellings. Sixty-nine resistance genes were identified, and detection of the same gene among different species was widespread. The highest prevalence of resistance genes were detected in ducks and gene prevalence varied markedly by species and sample type. Overall, ermB, tetA, mefA, and tetB were most commonly detected; antibiotics associated with these resistance genes, including doxycycline, azithromycin, and gentamicin, are widely used in Nepal in both humans and animals (10). Chapter 2 evaluated putative risk factors relating to the occurrence of specific resistance genes associated with antibiotics of global health importance for both humans and animals as prioritized by the World Health Organization (WHO) and the Organisation for Animal Health (OiE), respectively. Seven genes were chosen based on prevalence in the community and were evaluated independently in multivariate analyses in order to characterize potential reservoirs and transmission pathways for each gene in this urban, informal settlement setting. By assessing which species and sample types were associated with the detection of a gene, this study was able to more fully characterize the genetic resistome in this community and provide guidance for prioritization of prevention and intervention efforts for disrupting AMR transmission of critically important antibiotics for humans and animals in Nepal. Finally, to better understand the sociodemographic and human behavioral drivers of AMR gene burden in low-income community settings, Chapter 3 assessed individual- and household-level risk factors associated with the carriage and burden of AMR genes found in humans. Resistance genes were found in all samples tested with an average of 7 resistance genes from 10 antibiotic classification groups found per participant (n=67). Age and having animals inside the dwelling in the past year were both risk factors for resistance gene carriage and burden, while having a dedicated location for trash and animal waste was protective. Predictors were similar across multivariate and antibiotic resistance classification group-specific models, signifying that activities that generally mitigate risk factors for gene carriage in humans will aid in reducing overall resistance gene burden across antibiotic resistance classification groupings in this community. The conclusions drawn from this body of work help further the understanding of the antibiotic resistome in low-income, urban settings. The concurrent sampling design combined with broad screening for AMR genes offers a unique framework on which to base further efforts to characterize the community resistome, evaluate reservoirs of AMR, and better inform policy for combating the spread of resistance among and between animals, humans, and the environment. References 1. Blair JMA, Webber MA, Baylay AJ, Ogbolu DO, Piddock LJV. Molecular mechanisms of antibiotic resistance. Nature Publishing Group. Nature Publishing Group; 2014 Dec 1;13(1):42-51. 2. World Health Organization. WHO global strategy for containment of antimicrobial resistance. 2001. 3. Yao X, Doi Y, Zeng L, Lv L, Liu J-H. Carbapenem-resistant and colistin-resistant Escherichia coli co-producing NDM-9 and MCR-1. The Lancet Infectious Diseases. Elsevier Ltd; 2016 Jan 28;:1-2. 4. O'Neill J. Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations. UK Government; 2014 Dec. 5. Holmes AH, Moore L, Sundsfjord A, Steinbakk M, Regmi S, Karkey A, et al. Understanding the mechanisms and drivers of antimicrobial resistance. The Lancet. 2015 Nov 18;387(10014):176-87. 6. Bhattacharya S, Khanal B, Bhattarai NR, Das ML. Prevalence of Shigella species and Their Antimicrobial Resistance Patterns in Eastern Nepal. J Health Popul Nutr. 2005 Mar 12;23(4):339-42. 7. Rousham EK, Unicomb L, Islam MA. Human, animal and environmental contributors to antibiotic resistance in low-resource settings: integrating behavioural, epidemiological and One Health approaches. Proceedings of the Royal Society B: Biological Sciences. 2018 Apr 11;285(1876):20180332. 8. Thakur S, Gray GC. The Mandate for a Global "One Health" Approach to Antimicrobial Resistance Surveillance. American Journal of Tropical Medicine and Hygiene. 2019;100(2):227-8. 9. Ogawa VA, Shah CM, Hughes JM, King LJ. Prioritizing a One Health Approach in the Immediate Fight Against Antimicrobial Resistance. EcoHealth. 2018 Mar 9. 10. Administration DOD. NATIONAL LIST OF ESSENTIAL MEDICINES NEPAL (FIFTH REVISION) [Internet]. Fifth Revision. Ministry of Health. Available from: http://www.dda.gov.np/content/essential-drug-list
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309675332 Category : Medical Languages : en Pages : 179
Book Description
On December 4â€"5, 2019, the National Academies of Sciences, Engineering, and Medicine held a 1.5-day public workshop titled Exploring the Frontiers of Innovation to Tackle Microbial Threats. The workshop participants examined major advances in scientific, technological, and social innovations against microbial threats. Such innovations include diagnostics, vaccines (both development and production), and antimicrobials, as well as nonpharmaceutical interventions and changes in surveillance. This publication summarizes the presentations and discussions from the workshop.
Author: Aníbal de J. Sosa Publisher: Springer Science & Business Media ISBN: 0387893709 Category : Science Languages : en Pages : 553
Book Description
Avoiding infection has always been expensive. Some human populations escaped tropical infections by migrating into cold climates but then had to procure fuel, warm clothing, durable housing, and crops from a short growing season. Waterborne infections were averted by owning your own well or supporting a community reservoir. Everyone got vaccines in rich countries, while people in others got them later if at all. Antimicrobial agents seemed at first to be an exception. They did not need to be delivered through a cold chain and to everyone, as vaccines did. They had to be given only to infected patients and often then as relatively cheap injectables or pills off a shelf for only a few days to get astonishing cures. Antimicrobials not only were better than most other innovations but also reached more of the world’s people sooner. The problem appeared later. After each new antimicrobial became widely used, genes expressing resistance to it began to emerge and spread through bacterial populations. Patients infected with bacteria expressing such resistance genes then failed treatment and remained infected or died. Growing resistance to antimicrobial agents began to take away more and more of the cures that the agents had brought.
Author: Michael Anderson Publisher: Cambridge University Press ISBN: 1108799450 Category : Health & Fitness Languages : en Pages : 273
Book Description
An accessible overview of the challenges in tackling AMR, and the economic and policy responses of the 'One Health' approach. It will appeal to policy-makers seeking to strengthen national and local polices tackling AMR, as well as students and academics who want an overview of the latest scientific evidence regarding effective AMR policies.
Author: John S. Mackenzie Publisher: MDPI ISBN: 3039212958 Category : Medical Languages : en Pages : 140
Book Description
The One Health concept recognizes that the health of humans, animals, and their ecosystems are interconnected, and that a coordinated, collaborative, multidisciplinary, and cross-sectoral approach is necessary to fully understand and respond to potential or existing risks that originate at the animal–human–ecosystems interfaces. Thus, the One Health concept represents a holistic vision for addressing some of the complex challenges that threaten human and animal health, food safety, and the environments in which diseases flourish. There are many examples showing how the health of humans is related to the health of animals and the environment. Diseases shared between humans and animals are zoonoses. Some zoonoses have been known for many years, whereas others have emerged suddenly and unexpectedly. Over 70% of all new emerging diseases over the past few decades have been zoonoses that have emerged from wildlife, most often from bats, rodents, or birds. Examples of zoonoses are many and varied, ranging from rabies to bovine tuberculosis, and from Japanese encephalitis to SARS. Clearly, a One Health approach is essential for understanding their ecology, and for outbreak response and the development of control strategies. However, the One Health concept and approach is much broader than zoonoses; it extends to including antimicrobial resistance, food safety, and environmental health and, consequently, impacts on global health security, economic wellbeing, and international trade. It is this breadth of One Health that connects the papers in this Special Issue.
Author: King K. Holmes Publisher: World Bank Publications ISBN: 1464805253 Category : Medical Languages : en Pages : 1027
Book Description
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
Author: Jun Lin Publisher: Frontiers Media SA ISBN: 2889195260 Category : Antibiotics Languages : en Pages : 226
Book Description
Antibiotics represent one of the most successful forms of therapy in medicine. But the efficiency of antibiotics is compromised by the growing number of antibiotic-resistant pathogens. Antibiotic resistance, which is implicated in elevated morbidity and mortality rates as well as in the increased treatment costs, is considered to be one of the major global public health threats (www.who.int/drugresistance/en/) and the magnitude of the problem recently prompted a number of international and national bodies to take actions to protect the public (http://ec.europa.eu/dgs/health_consumer/docs/road-map-amr_en.pdf: http://www.who.int/drugresistance/amr_global_action_plan/en/; http://www.whitehouse.gov/sites/default/files/docs/carb_national_strategy.pdf). Understanding the mechanisms by which bacteria successfully defend themselves against the antibiotic assault represent the main theme of this eBook published as a Research Topic in Frontiers in Microbiology, section of Antimicrobials, Resistance, and Chemotherapy. The articles in the eBook update the reader on various aspects and mechanisms of antibiotic resistance. A better understanding of these mechanisms should facilitate the development of means to potentiate the efficacy and increase the lifespan of antibiotics while minimizing the emergence of antibiotic resistance among pathogens.
Author: Cristin Cowles Weekley Young
Author: Cristin Cowles Weekley Young
Author: National Academies of Sciences, Engineering, and Medicine
Author: Ghassan M. Matar
Author: Aníbal de J. Sosa
Author: Michael Anderson
Author: World Health Organization
Author: John S. Mackenzie
Author: Mirza Alas
Author: King K. Holmes
Author: Jun Lin