AMR in low-resource settings: Médecins Sans Frontières bridges surveillance gaps by developing a turnkey solution, the Mini-Lab

Ronat, Jean-Baptiste; Natale, Alessandra; Kesteman, Thomas; Antoine, Andremont; Elamin, Wael; Hardy, Liselotte; Kanapathipillai, Rupa; Michel, J.; Langendorf, Céline; Vandenberg, Olivier; Naas, Thierry

doi:10.1016/j.cmi.2021.04.015

Cited by 14 publications

(8 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, on a broader scale, there is a need to establish a robust national surveillance system in order to understand local resistance profiles, that should guide national guidelines for the management of infectious diseases. It would also be essential to adopt novel solutions for ABR testing, such as innovative accessible laboratories as the Mini-Lab designed by MSF [ 53 ], in order to expand the capacity of ABR testing, and ultimately reporting.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic resistance among bacteria isolated from war-wounded patients at the Weapon Traumatology Training Center of the International Committee of the Red Cross from 2016 to 2019: a secondary analysis of WHONET surveillance data

Yaacoub

Truppa²,

Pedersen

et al. 2022

BMC Infect Dis

View full text Add to dashboard Cite

Background A substantial body of evidence has recently emphasized the risks associated with antibiotic resistance (ABR) in conflicts in the Middle East. War-related, and more specifically weapon-related wounds can be an important breeding ground for multidrug resistant (MDR) organisms. However, the majority of available evidence comes from the military literature focused on risks and patterns of ABR in infections from combat-related injuries among military personnel. The overall aim of this study is to contribute to the scarce existing evidence on the burden of ABR among patients, including civilians with war-related wounds in the Middle East, in order to help inform the revision of empirical antibiotic prophylaxis and treatment protocols adopted in these settings. The primary objectives of this study are to: 1) describe the microbiology and the corresponding resistance profiles of the clinically relevant bacteria most commonly isolated from skin, soft tissue and bone biopsies in patients admitted to the WTTC; and 2) describe the association of the identified bacteria and corresponding resistance profiles with sociodemographic and specimen characteristics. Methods We retrospectively evaluated the antibiograms of all consecutive, non-duplicate isolates from samples taken from patients admitted to the ICRC WTTC between 2016 and 2019, limited to skin and soft tissue samples and bone biopsies. We collected data on socio-demographic characteristics from patient files and data on specimens from the WHONET database. We ran univariate and multivariable logistic regression models to test the association between bacterial and resistance profiles with sociodemographic and specimen characteristics. Results Patients who were admitted with war-related trauma to the ICRC reconstructive surgical project in Tripoli, Lebanon, from 2016 to 2019, presented with high proportion of MDR in the samples taken from skin and soft tissues and bones, particularly Enterobacterales (44.6%), MRSA (44.6%) and P. aeruginosa (7.6%). The multivariable analysis shows that the odds of MDR isolates were higher in Iraqi patients (compared to Syrian patients) and in Enterobacterales isolates (compared to S. aureus isolates). Conclusions Our findings stress the importance of regularly screening patients who present with complex war-related injuries for colonization with MDR bacteria, and of ensuring an antibiotic-sensitivity testing-guided antimicrobial therapeutic approach.

show abstract

Section: Discussionmentioning

confidence: 99%

Antibiotic resistance among bacteria isolated from war-wounded patients at the Weapon Traumatology Training Center of the International Committee of the Red Cross from 2016 to 2019: a secondary analysis of WHONET surveillance data

Yaacoub

Truppa²,

Pedersen

et al. 2022

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…Within the context of the Mini-Lab project, an MSF initiative to realise a small-scale, transportable, clinical microbiology laboratory adapted to low-resource settings [12,13], we tested whether an alternative subculturing solution, the InTray™ cassettes (BioMed Diagnostics, Inc., White City, OR, USA), could be used for bloodstream infection diagnosis directly from blood cultures. These in-vitro culture-media cassettes have several advantages: FDA and CE-marked, ready-to-use, small size for easy transport and storage and long shelf-life even with blood-containing media (12 months for most agar formulations).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of InTray Cassettes Directly from Blood Cultures for the Diagnosis of Sepsis in Clinical Bacteriology Laboratories as an Alternative to Classic Culture Media

et al. 2023

Self Cite

View full text Add to dashboard Cite

Culture media is fundamental in clinical bacteriology for the detection and isolation of bacterial pathogens. However, in-house media preparation could be challenging in low-resource settings. InTray® cassettes (Biomed Diagnostics) could be a valid alternative as they are compact, ready-to-use media preparations. In this study, we evaluate the use of two InTray media as a subculture alternative for the diagnosis of bloodstream infections: the InTray® Müller-Hinton (MH) chocolate and the InTray® Colorex™ Screen. The InTray MH chocolate was evaluated in 2 steps: firstly, using simulated positive blood cultures (reference evaluation study), and secondly, using positive blood cultures from a routine clinical laboratory (clinical evaluation study). The Colorex Screen was tested using simulated poly-microbial blood cultures. The sensitivity and specificity of the InTray MH chocolate were respectively 99.2% and 90% in the reference evaluation study and 97.1% and 88.2% in the clinical evaluation study. The time to detection (TTD) was ≤20 h in most positive blood cultures (99.8% and 97% in the two studies, respectively). The InTray® MH Chocolate agar showed good performance when used directly from clinical blood cultures for single bacterial infections. However, mixed flora is more challenging to interpret on this media than on Colorex™ Screen, even for an experienced microbiologist.

show abstract

“…AMR hinders the fight against infectious diseases [ 8 ], and the development of new antibiotics is slower than the emergence and spread of resistant organisms [ 9 ]. Their dissemination has obvious health impacts, but also economic effects in high- as well as in low- and middle-income countries [ 6 , 10 , 11 ]. Indeed, actions have to be taken, and the One Heath approach aims to ensure that antimicrobials are optimally used in both human and animal health, but also in agriculture.…”

Section: Introductionmentioning

confidence: 99%

The Revolution of Lateral Flow Assay in the Field of AMR Detection

et al. 2022

View full text Add to dashboard Cite

The global spread of antimicrobial resistant (AMR) bacteria represents a considerable public health concern, yet their detection and identification of their resistance mechanisms remain challenging. Optimal diagnostic tests should provide rapid results at low cost to enable implementation in any microbiology laboratory. Lateral flow assays (LFA) meet these requirements and have become essential tools to combat AMR. This review presents the versatility of LFA developed for the AMR detection field, with particular attention to those directly triggering β-lactamases, their performances, and specific limitations. It considers how LFA can be modified by detecting not only the enzyme, but also its β-lactamase activity for a broader clinical sensitivity. Moreover, although LFA allow a short time-to-result, they are generally only implemented after fastidious and time-consuming techniques. We present a sample processing device that shortens and simplifies the handling of clinical samples before the use of LFA. Finally, the capacity of LFA to detect amplified genetic determinants of AMR by isothermal PCR will be discussed. LFA are inexpensive, rapid, and efficient tools that are easy to implement in the routine workflow of laboratories as new first-line tests against AMR with bacterial colonies, and in the near future directly with biological media.

show abstract

AMR in low-resource settings: Médecins Sans Frontières bridges surveillance gaps by developing a turnkey solution, the Mini-Lab

Cited by 14 publications

References 33 publications

Antibiotic resistance among bacteria isolated from war-wounded patients at the Weapon Traumatology Training Center of the International Committee of the Red Cross from 2016 to 2019: a secondary analysis of WHONET surveillance data

Antibiotic resistance among bacteria isolated from war-wounded patients at the Weapon Traumatology Training Center of the International Committee of the Red Cross from 2016 to 2019: a secondary analysis of WHONET surveillance data

Evaluation of InTray Cassettes Directly from Blood Cultures for the Diagnosis of Sepsis in Clinical Bacteriology Laboratories as an Alternative to Classic Culture Media

The Revolution of Lateral Flow Assay in the Field of AMR Detection

Contact Info

Product

Resources

About