Burden of bacterial antimicrobial resistance in low-income and middle-income countries avertible by existing interventions: an evidence review and modelling analysis

Lewnard, Joseph A; Charani, Esmita; Gleason, Alec; Hsu, Li Yang; Khan, Wasif Ali; Karkey, Abhilasha; Chandler, Clare I R; Mashe, Tapfumanei; Khan, Ejaz Ahmed; Bulabula, Andre N H; Donado-Godoy, Pilar; Laxminarayan, Ramanan

doi:10.1016/s0140-6736(24)00862-6

Cited by 29 publications

(4 citation statements)

References 148 publications

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“…The results of bacterial enumerations are expressed as log Colony Forming Unit (CFU)/metal sample and calculated using Equation (1).…”

Section: Antimicrobial Efficacy Testingmentioning

confidence: 99%

“…Hospital acquired infections (HAIs), also known as healthcare associated infections, have become a major concern for healthcare facilities over the last few decades. This is especially true for HAIs caused by multi-drug resistant (MDR) pathogens, which are common [1]. Amongst the preventative measures proposed to mitigate the risk of HAIs, frequent biocleaning of surfaces to achieve the lowest possible bioburden and avoid persistence/transmission of antibiotic resistant pathogenic organisms through this route is recommended [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

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Antibacterial Activity of Brass against Antibiotic Resistant Bacteria Following Repeated Exposure to Hydrogen Peroxide/Peracetic Acid and Quaternary Ammonium Compounds

Dauvergne,

Lacquemant,

Mullié

2024

Preprint

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Copper-containing materials are attracting attention as self-desinfecting surfaces, suitable for helping healthcare settings in reducing healthcare associated infections. However, the impact of repeated exposure to disinfectants frequently used in biocleaning protocols on their antibacterial activity remains insufficiently characterized. This study aimed at evaluating the antibacterial effi-ciency of copper (positive control), a brass alloy (AB+®) and stainless steel (negative control) after repeated exposure to a quaternary ammonium compound and/or a mix of peracetic acid/hydrogen peroxide routinely used in healthcare settings. A panel of 6 antibiotic-resistant strains (clinical isolates) was selected for this assessment. After a short (5 min) exposure time, the copper and brass materials retained significantly better antibacterial efficiencies than stainless steel, whatever the bacterial strain or disinfectant treatment considered. Moreover, post-treatment with both disinfectant products, copper-containing materials still reached similar levels of antibacterial efficiency as those obtained before treatment. Antibiotic resistance mechanisms such as efflux pump overexpression did not impair the antibacterial efficiency of copper-containing materials, neither did the presence of one or several genes related to copper homeostasis/resistance. In light of those results, surfaces made out of copper and brass remain interesting tools in the fight against dissemination of antibiotic-resistant strains that might cause healthcare associated infections.

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“…The results of bacterial enumerations are expressed as log Colony Forming Unit (CFU)/metal sample and calculated using Equation (1).…”

Section: Antimicrobial Efficacy Testingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Antibacterial Activity of Brass against Antibiotic Resistant Bacteria Following Repeated Exposure to Hydrogen Peroxide/Peracetic Acid and Quaternary Ammonium Compounds

Dauvergne,

Lacquemant,

Mullié

2024

Preprint

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“…Antimicrobial resistance (AMR) is regarded as one of the most pressing public health concerns. Evidence suggests that inappropriate use of antibiotics is associated with rising resistance, which has selectively pressured microorganisms to develop resistance mechanisms ( 1 , 2 ). The resistant strains can no longer be controlled with standard treatments, leading to prolonged illnesses, increased mortality rates, and higher healthcare expenditures ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Multiple impacts of the COVID-19 pandemic and antimicrobial stewardship on antimicrobial resistance in nosocomial infections: an interrupted time series analysis

Li,

Yang,

Liu

et al. 2024

Front. Public Health

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ObjectivesThe emergency response to the COVID-19 pandemic may disrupt hospital management activities of antimicrobial resistance (AMR). This study aimed to determine the changing AMR trend over the period in China when stringent COVID-19 response measures were implemented.MethodsThis retrospective study was conducted in a designated hospital for COVID-19 patients in Guangzhou, China from April 2018 to September 2021. The prevalence of 13 antimicrobial-resistant bacteria was compared before and after the COVID-19 responses through Chi-square tests. Interrupted time series (ITS) models on the weekly prevalence of AMR were established to determine the changing trend. Controlled ITS models were performed to compare the differences between subgroups.ResultsA total of 10,134 isolates over 1,265 days were collected. And antimicrobial-resistant strains presented in 38.6% of the testing isolates. The weekly AMR prevalence decreased by 0.29 percentage point (95% CI [0.05–0.80]) after antimicrobial stewardship (AMS) policy, despite an increase in the prevalence of penicillin-resistant Streptococcus pneumoniae (from 0/43 to 15/43, p < 0.001), carbapenem-resistant Escherichia coli (from 20/1254 to 41/1184, p = 0.005), and carbapenem-resistant Klebsiella pneumoniae (from 93/889 to 114/828, p = 0.042). And the changing trend did not vary by gender (male vs. female), age (<65 vs. ≥65 years), service setting (outpatient vs. inpatient), care unit (ICU vs. non-ICU), the primary site of infection (Lung vs. others), and Gram type of bacteria (positive vs. negative).ConclusionThe response to COVID-19 did not lead to an increase in overall AMR; however, it appears that management strategy on the prudent use of antimicrobials likely contributed to a sizable long-term drop. The frequency of several multidrug-resistant bacteria continues to increase after the COVID-19 epidemic. It is crucial to continue to monitor AMR when COVID-19 cases have surged in China after the relaxation of restriction measures.

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“…The performance and effects of AMS programs in low- and middle-income countries (LMICs) have not been extensively studied [ 1 ], and few studies have focused on patients with cancer [ 2–4 ]. In response to the urgent global need to combat antimicrobial misuse [ 5 , 6 ] and the worldwide rise in antimicrobial resistance, particularly in LMICs [ 7 ], we implemented an ambitious AMS program. However, we faced unique challenges: 1 significant challenge was that most of our medical staff worked part-time in the public sector, where they had adopted antimicrobial prescription practices that deviated from the regimens recommended in our center according to our microbiological profile.…”

mentioning

confidence: 99%

Implementing an Antimicrobial Stewardship Program in an Oncology Center in Lima, Peru: A Model for Low- and Middle-Income Countries

Seas,

Legua,

Delfin

et al. 2024

Open Forum Infectious Diseases

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Burden of bacterial antimicrobial resistance in low-income and middle-income countries avertible by existing interventions: an evidence review and modelling analysis

Cited by 29 publications

References 148 publications

Antibacterial Activity of Brass against Antibiotic Resistant Bacteria Following Repeated Exposure to Hydrogen Peroxide/Peracetic Acid and Quaternary Ammonium Compounds

Antibacterial Activity of Brass against Antibiotic Resistant Bacteria Following Repeated Exposure to Hydrogen Peroxide/Peracetic Acid and Quaternary Ammonium Compounds

Multiple impacts of the COVID-19 pandemic and antimicrobial stewardship on antimicrobial resistance in nosocomial infections: an interrupted time series analysis

Implementing an Antimicrobial Stewardship Program in an Oncology Center in Lima, Peru: A Model for Low- and Middle-Income Countries

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