Increased carriage of macrolide-resistant fecal<i>E. coli</i>following mass distribution of azithromycin for trachoma control

Seidman, Jessica C.; Coles, Christian; Silbergeld, Ellen K.; Levens, Joshua; Mkocha, Harran; Johnson, Lashaunda Brooke; Muñoz, Beatriz; West, Sheila K.

doi:10.1093/ije/dyu062

Cited by 58 publications

(64 citation statements)

References 36 publications

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“…This finding might be related to the antibacterial activity, the long post-antibiotic effect plus the anti-inflammatory properties of azithromycin, which might break the vicious circle of diarrhea -gut inflammation -nutrient malabsorption -weakened immune status -diarrhea; directly diminishing the number of diarrhea cases due to the good activity of azithromycin against the most relevant diarrheogenic pathogens, but also reducing gut inflammation, thereby favoring nutrient absorption, and consequently, improving the immune status. In the dark size, this mass use of azithromycin will most likely result in the selection of macrolide-resistant microorganisms, as has been described in Tanzania (Seidman et al, 2014). Long-term follow up of these cohorts is needed in order to determine the longterm effect on the general levels of macrolide resistance.…”

Section: Clinical Usementioning

confidence: 99%

“…In this respect, gut-commensal Enterobacteriaceae may play a role as a reservoir of resistance genes that may be transferred to pathogenic microorganisms (Nguyen et al, 2009;Seidman et al, 2014). Some studies have shown a higher prevalence of TMMR among Gram-negative microorganisms compared to Gram-positive recovered from healthy children (Luna et al, 2002;Ojo et al, 2004), reinforcing the relevance of these antibiotic-resistance reservoirs.…”

Section: Mechanisms Of Resistancementioning

confidence: 99%

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Macrolide resistance mechanisms inEnterobacteriaceae: Focus on azithromycin

Gomes

Martínez-Puchol

Palma

et al. 2016

Critical Reviews in Microbiology

119

120

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Section: Clinical Usementioning

confidence: 99%

Section: Mechanisms Of Resistancementioning

confidence: 99%

Macrolide resistance mechanisms inEnterobacteriaceae: Focus on azithromycin

Gomes

Martínez-Puchol

Palma

et al. 2016

Critical Reviews in Microbiology

119

120

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“…(Boumghar-Bourtchai et al, 2008). Breakpoints to discriminate between azithromycin resistant and susceptible populations of E. coli were proposed in a study looking at the epidemiology of mass drug treatment of human patients with azithromycin to control trachoma infection (Seidman et al, 2014). The same cutoff value ( 32 mg/L -which is equivalent to the cut-off value of > 16 mg/L used in this report) has been used in epidemiological studies of E. coli in animals (Schmidt et al, 2015).…”

Section: Azithromycin Newly Inserted In the Harmonised Set Of Antimicmentioning

confidence: 99%

The European Union summary report on antimicrobial resistance in zoonotic and indicator bacteria from humans, animals and food in 2014

2016

EFS2

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The data on antimicrobial resistance in zoonotic and indicator bacteria in 2014, submitted by 28 EU Member States (MSs), were jointly analysed by EFSA and ECDC. Resistance in zoonotic Salmonella and Campylobacter species from humans, animals and food, and resistance in indicator Escherichia coli as well as meticillin‐resistant Staphylococcus aureus in animals and food was assessed. ‘Microbiological’ resistance was assessed using epidemiological cut‐off (ECOFF) values; for some countries, quantitative data on human isolates were interpreted in a way which corresponds closely to the ECOFF‐defined ‘microbiological’ resistance. In Salmonella from humans, high proportions of isolates were resistant to ampicillin, sulfonamides and tetracyclines, whereas resistance to third‐generation cephalosporins and to fluoroquinolones remained generally low, although it was markedly higher in some serovars commonly associated with broilers and turkeys. In Salmonella and Escherichia coli isolates from broilers, fattening turkeys and meat thereof, resistance to ampicillin, (fluoro)quinolones, tetracyclines and sulfonamides was frequently detected, whereas resistance to third‐generation cephalosporins was uncommon. For the first time, presumptive extended spectrum beta‐lactamase (ESBL)‐/AmpC‐/carbapenemase production in Salmonella and Escherichia coli was monitored in poultry. The occurrence of ESBL‐/AmpC‐producers was low, and carbapenemase‐producers were not detected. Resistance to colistin was observed at low levels in Salmonella and Escherichia coli from poultry and meat thereof. In Campylobacter from humans, a high to very high proportion of isolates were resistant to ciprofloxacin and tetracyclines, whereas resistance to erythromycin was low to moderate. Resistance to fluoroquinolones in some MSs was extremely high; in such settings, the effective treatment options for human enteric Campylobacter infection may be significantly reduced. High resistance to ciprofloxacin and tetracyclines was observed in Campylobacter isolates from broilers and broiler meat, whereas much lower levels were recorded for erythromycin. Co‐resistance to critically important antimicrobials in both human and animal isolates was generally uncommon, but very high to extremely high MDR levels were observed in some Salmonella serovars. A minority of Salmonella isolates from animals belonging to a few serovars (notably Kentucky and Infantis) exhibited high‐level resistance to ciprofloxacin.

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“…In Taiwan (19) and other parts of the world, antibiotic prescribing may also be influenced by competition between health care providers and from unsanctioned providers. Mass drug administration of antibiotics for the management of severe acute malnutrition (20) and trachoma control (21) could contribute to resistance at a mass scale if not monitored carefully (22).…”

Section: Conservationmentioning

confidence: 99%

Antibiotic effectiveness: Balancing conservation against innovation

Laxminarayan

2014

Science

155

104

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Antibiotic effectiveness is a natural societal resource that is diminished by antibiotic use. As with other such assets, keeping it available requires both conservation and innovation. Conservation encompasses making the best use of current antibiotic effectiveness by reducing demand through vaccination, infection control, diagnostics, public education, incentives for clinicians to prescribe fewer antibiotics, and restrictions on access to newer, last-resort antibiotics. Innovation includes improving the efficacy of current drugs and replenishing effectiveness by developing new drugs. In this paper, I assess the relative benefits and costs of these two approaches to maintaining our ability to treat infections.

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Increased carriage of macrolide-resistant fecalE. colifollowing mass distribution of azithromycin for trachoma control

Abstract: MDA resulted in significantly increased prevalence of macrolide resistance in E. coli. Although MDA is effective for trachoma elimination, it has costs; it is essential to monitor antimicrobial resistance following MDA.

Cited by 58 publications

References 36 publications

Macrolide resistance mechanisms inEnterobacteriaceae: Focus on azithromycin

Macrolide resistance mechanisms inEnterobacteriaceae: Focus on azithromycin

The European Union summary report on antimicrobial resistance in zoonotic and indicator bacteria from humans, animals and food in 2014

Antibiotic effectiveness: Balancing conservation against innovation

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