Bacterial-Resistant Infections in Resource-Limited Countries

Bartoloni, Alessandro; Gotuzzo, Eduardo

doi:10.1007/978-0-387-89370-9_12

Cited by 12 publications

(7 citation statements)

References 151 publications

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“…Forty-five percent of H. influenzae isolates were resistant to cotrimoxazole, 33% to ampicillin (all of them producing beta-lactamases), and 21% to clarithromycin (Amábile-Cuevas and ArredondoGarcía, unpublished results). None of the strains (150 of each species) were resistant to fluoroquinolones, but there is a report of a 6.5% resistance to ofloxacin in Mexican pneumococci, the highest in the region [17]. An older survey, reporting only MIC values for respiratory pathogens in Latin America, shows that Mexico, Venezuela and Chile have the highest MIC 90 of penicillin for pneumococci (2-4 µg/mL), and Mexico has the highest MIC 90 of clarithromycin (16 µg/mL) and of co-trimoxazole (8 µg/mL) for pneumococci [18].…”

Section: Consequences: More Antibiotic Resistancementioning

confidence: 97%

“…An older survey, reporting only MIC values for respiratory pathogens in Latin America, shows that Mexico, Venezuela and Chile have the highest MIC 90 of penicillin for pneumococci (2-4 µg/mL), and Mexico has the highest MIC 90 of clarithromycin (16 µg/mL) and of co-trimoxazole (8 µg/mL) for pneumococci [18]. With different rates, Mexico is often cited as the Latin American country with the highest prevalence of penicillin-nonsusceptible penumococci: 51.6% (22.2% resistant) in year 2000 [19], and 57% in year 2007 [17].…”

Section: Consequences: More Antibiotic Resistancementioning

confidence: 99%

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Antibiotic resistance in Mexico: a brief overview of the current status and its causes

Amábile-Cuevas¹

2010

J Infect Dev Ctries

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As in many other developing countries, conditions that may foster antibiotic resistance in Mexico differ from developed countries, as does resistance prevalence. Fecal pollution and other characteristics of overcrowded, poor cities might create ideal settings for selecting, exchanging and maintaining resistance traits. Medical abuse of antibiotics, along with low-quality drugs, is also present as in many other developing countries. Self-prescription, a common yet unmeasured practice among the Mexican population, may also contribute to increased resistance rates. Pneumococcal resistance towards penicillin and macrolides are the highest in Latin American countries, as is resistance of Salmonella and uropathogenic Escherichia coli towards ampicillin and sulfamethoxazole-trimethoprim; about one-tenth of isolates of these gram-negative pathogens seem to produce extended-spectrum beta-lactamases (ESBL). High rates of multiple-drug resistant Mycobacterium tuberculosis are also found in Mexico, although there is no report of extensively drug-resistant strains. As to hospital-acquired pathogens, about a third of E. coli and Klebsiella isolates are ESBL-producers, and half of Staphylococcus aureus isolates are resistant to oxacillin (MRSA). Approximately 40% of Pseudomonas aeruginosa isolates are resistant to ceftazidime, imipenem or levofloxacin. Although community-acquired MRSA, vancomycin-resistant enterococci, and other resistance problems found in developed countries are not as common in Mexico, local issues are no small concern, and are disturbingly moving towards outpatients.

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Section: Consequences: More Antibiotic Resistancementioning

confidence: 97%

Section: Consequences: More Antibiotic Resistancementioning

confidence: 99%

Antibiotic resistance in Mexico: a brief overview of the current status and its causes

Amábile-Cuevas¹

2010

J Infect Dev Ctries

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“…The past decade has seen a significant increase in effort to describe and tackle the burden due to drug-resistant infections in the country (6), although overall nationwide surveillance is still at the early stages with AMR data generally remaining patchy (7). Over the years, many studies have demonstrated variable resistance rates in microorganisms that are associated with unfavorable outcomes in hospital and community settings, such as those that cause among others; tuberculosis, meningitis, pneumonia, and gastrointestinal diseases (8)(9)(10)(11)(12)(13)(14). Findings from these studies and other initiatives fighting AMR highlight the need for horizontal (15)(16)(17)(18) as well as vertical (19) strengthening of laboratory capacity to promote widespread detection of resistance and to create strong evidence for optimal AMR response.…”

Section: Introductionmentioning

confidence: 99%

Laboratory-based surveillance of antimicrobial resistance in regions of Kenya: An assessment of capacities, practices, and barriers by means of multi-facility survey

Moirongo

Aglanu²,

Lamshöft³

et al. 2022

Front. Public Health

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BackgroundAdequate laboratory capacity is critical in the implementation of coherent surveillance for antimicrobial resistance (AMR). We describe capacities and deficiencies in laboratory infrastructure and AMR surveillance practices among health facilities in Kenya to support progress toward broader sustainable laboratory-based AMR surveillance.MethodsA convenience sample of health facilities from both public and private sectors across the country were selected. Information was obtained cross-sectionally between 5th October and 8th December 2020 through online surveys of laboratory managers. The assessment covered quality assurance, management and dissemination of AMR data, material and equipment, staffing, microbiology competency, biosafety and certification. A scoring scheme was developed for the evaluation and interpreted as (80% and above) facility is adequate (60–79%) requires some strengthening and (<60%) needing significant strengthening. Average scores were compared across facilities in public and private sectors, rural and urban settings, as well as national, county, and community levels.ResultsAmong the participating facilities (n = 219), the majority (n = 135, 61.6%) did not offer bacterial culture testing, 47 (21.5%) offered culture services only and 37 (16.9%) performed antimicrobial susceptibility testing (AST). The major gaps identified among AST facilities were poor access to laboratory information management technology (LIMT) (score: 45.9%) and low uptake of external quality assessment (EQA) programs for cultures (score 67.7%). Access to laboratory technology was more than two-fold higher in facilities in urban (58.6%) relative to rural (25.0%) areas. Whilst laboratories that lacked culture services were found to have significant infrastructural gaps (average score 59.4%), facilities that performed cultures only (average score: 83.6%) and AST (average score: 82.9%) recorded significantly high scores that were very similar across areas assessed. Lack of equipment was identified as the leading challenge to the implementation of susceptibility testing among 46.8% of laboratories.ConclusionsWe identified key gaps in laboratory information management technology, external quality assurance and material and equipment among the surveyed health facilities in Kenya. Our findings suggest that by investing in equipment, facilities performing cultures can be successfully upgraded to provide additional antimicrobial susceptibility testing, presenting a chance for a major leap toward improved AMR diagnostics and surveillance in the country.

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“…18 Studies of the effect of vaccination on antibiotic use in LMICs are few, and results from HICs may not be generalizable to India, where the underlying burden of infectious diseases is higher, vaccination rates are lower, out-of-pocket expenditure on health is high, and access to antibiotics is often unregulated. [19][20][21] For example, the effect of common vaccines, such as for measles or typhoid, which have been shown to provide additional nonspecific protection against diseases, 22 cannot be determined in HICs where these vaccines are already widely available. To improve understanding of the relationship between vaccines and antibiotic use, we examined the associations between consumption of vaccines and antibiotics from 2009 to 2017 in the private health sector in India.…”

Section: Introductionmentioning

confidence: 99%

Associations between private vaccine and antimicrobial consumption across Indian states, 2009–2017

Schueller

Nandi

Joshi

et al. 2021

Annals of the New York Academy of Sciences

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Vaccines can reduce antibiotic use and, consequently, antimicrobial resistance by averting vaccine-preventable and secondary infections. We estimated the associations between private vaccine and antibiotic consumption across Indian states during 2009-2017 using monthly and annual consumption data from IQVIA and employed fixedeffects regression and the Arellano-Bond Generalized Method of Moments (GMM) model for panel data regression, which controlled for income and public sector vaccine use indicators obtained from other sources. In the annual data fixed-effects model, a 1% increase in private vaccine consumption per 1000 under-5 children was associated with a 0.22% increase in antibiotic consumption per 1000 people (P < 0.001). In the annual data GMM model, a 1% increase in private vaccine consumption per 1000 under-5 children was associated with a 0.2% increase in private antibiotic consumption (P < 0.001). In the monthly data GMM model, private vaccine consumption was negatively associated with antibiotic consumption when 32, 34, 35, and 44-47 months had elapsed after vaccine consumption, with a positive association with lags of fewer than 18 months. These results indicate vaccine-induced longer-term reductions in antibiotic use in India, similar to findings of studies from other low-and middle-income countries.

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Bacterial-Resistant Infections in Resource-Limited Countries

Cited by 12 publications

References 151 publications

Antibiotic resistance in Mexico: a brief overview of the current status and its causes

Antibiotic resistance in Mexico: a brief overview of the current status and its causes

Laboratory-based surveillance of antimicrobial resistance in regions of Kenya: An assessment of capacities, practices, and barriers by means of multi-facility survey

Associations between private vaccine and antimicrobial consumption across Indian states, 2009–2017

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