Misuse, overuse, and missed prescription of antimicrobials are the driving factors to antimicrobial resistance (AMR) leading to a globally increasing public health concern. This study was conducted to assess the curre...Misuse, overuse, and missed prescription of antimicrobials are the driving factors to antimicrobial resistance (AMR) leading to a globally increasing public health concern. This study was conducted to assess the current knowledge, attitudes, and practices (KAP) of village animal health workers (VAHWs) and veterinary drug retailers (VDRs) on antimicrobial use (AMU) and antimicrobial resistance (AMR). The sample size was calculated following [1]. KAP data were scored and categorized following Bloom’s cut-off score. A total of 108 study populations (66 VAHWs and 42 VDRs) were purposively surveyed using a validated KAP questionnaire in 5 provinces across Cambodia. This study found that VAHWs and VDRs have moderate levels of knowledge (61% to 65%) and good attitudes towards AMU (83% to 84%) but employed moderate practices (59% to 74%) on AMU. VAHWs had moderate (66%);while DVRs had poor knowledge (58%) on AMR. Thus, regular awareness education specifically on proper use, prudent use, and stewardships on AMU and AMR in the form of refresher training or awareness events must be provided to VAHWs and VDRs to avoid inappropriate use of antimicrobials and spreading the AMR knowledge across Cambodia.展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"></span><b> </b><span style="font-family:Verdan...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"></span><b> </b><span style="font-family:Verdana;">Antibiotic resistance is putting the commercial poultry production systems across the globe at risk of losses due to the failure of treatments for animals and human health which has been associated with overuse and misuse of antibiotics in poultry farming. One possible approach to the resistance problem is ensuring adequate knowledge, attitudes, and practices on antimicrobial use by farmers on commercial production systems across the globe are applied. Therefore, the current study was carried out to determine factors that could promote antimicrobial use in commercial poultry production systems of Kiambu County, Kenya. </span><b><b><span style="font-family:Verdana;">Materials</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Methods:</span></b><span></span></b><span style="font-family:Verdana;"> A descriptive cross-sectional survey was conducted on commercial poultry production systems of Kiambu County to determine the level of knowledge, attitudes, and practices on antimicrobial use. One hundred and fifty-six (n = 156) semi-structured questionnaires imprinted in a mobile Open data kit were administered to capture the level of knowledge, attitudes, and practices on antimicrobial usage in commercial poultry production systems of Kiambu County. </span><b><b><span style="font-family:Verdana;">Results:</span></b><span></span></b><span style="font-family:Verdana;"> Out of the 156 commercial poultry farmers who participated in this study, females accounted for (64%) with 51% of them keeping layers between 50 - 500 birds as medium scale farmers. In the study</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> most of the farmers were 45 years and above (61%) and they had obtained a secondary level of education (34%). We further noted that 67% of the farmers obtain antibiotics through self-prescription/personal experience. Additional lack of veterinary officers (77%) and consultation services (72%) was also mentioned as</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">key challenges in poultry production. The majority of the respondents (63%), indicated Tetracycline as the most commonly used antibiotic in their farms, with the most preferred subtypes of tetracycline and Amoxicillin being Oxytetracyclines (85%) and Amoxi (88%) respectively. Nearness to veterinary services significantly (P < 0.05) contributed to the use of antibiotics agents. Additionally, the area of residence, type of production, number of years in farming, and average number of birds kept also significantly (P < 0.05) influenced the level of knowledge and practice on antimicrobial usage. </span><b><b><span style="font-family:Verdana;">Conclusion:</span></b><span></span></b> <span style="font-family:Verdana;">Generally, the level of knowledge and practice on antibiotic use among commercial poultry farmers in Kiambu County is still lacking. This was witne</span></span><span style="font-family:Verdana;">ssed</span><span style="font-family:Verdana;"> with continued use of antibiotics without a prescription from veterinary/</span><span style="font-family:Verdana;">livestock extension offices, which is inconsis</span><span style="font-family:Verdana;">tent with the general recommendation on antimicrobial stewardship. Therefore, the current research calls for intervention measures such as extensive education to farmers on the rat</span><span style="font-family:Verdana;">ional use of antimicrobial agents in commercial poultry disease management, observance of withdraw</span><span style="font-family:Verdana;">al</span><span style="font-family:Verdana;"> periods, and the impacts of residues on public health.</span>展开更多
Background:Antimicrobial resistance(AMR)poses a global threat to both human and animal health,associated with widespread use of antimicrobials across sectors.In low-and middle-income countries(LMICs)such as Malawi,wea...Background:Antimicrobial resistance(AMR)poses a global threat to both human and animal health,associated with widespread use of antimicrobials across sectors.In low-and middle-income countries(LMICs)such as Malawi,weak regulatory frameworks and limited enforcement capacity contribute to inappropriate use of antibiotics.This study examined the governance and regulatory frameworks for antimicrobial use(AMU)in Malawi's agricultural sector,identified regulatory gaps,and offers recommendations to antimicrobial stewardship.Methods:A qualitative approach was used,combining a review of policy and legal documents with semi-structured stakeholder interviews.Relevant policies and laws were sourced from government databases,the Food and Agricultural Organisation of the United Nations'(FAO)FAOLEX and AMR-LEX databases,and other publicly available resources.The FAO's legal assessment methodology was used to evaluate the policy landscape across nine key thematic areas:(1)veterinary medicinal products,(2)animal health and production practices to prevent animal diseases in terrestrial and aquatic animals,(3)feed registration,(4)pesticides,(5)food safety,(6)environment,soil and waste,(7)water quality,(8)plant health,and(9)institutional coordination.Stakeholder interviews with representatives from relevant government ministries and regulatory bodies validated findings from the document review and provided additional insight into governance challenges.A One Health governance mapping exercise was conducted to identify key institutional actors,assess their role in AMR/AMU governance,and evaluate inter-institutional relationships using social network analysis.Results:The analysis identified 522 policies relevant to AMU in agriculture,with most addressing aquatic animal health(11.3%,n=59),food safety(10.9%,n=57)and animal feed(10.9%,n=57).Several critical regulatory gaps were identified,including the absence of a legal definition for“antimicrobials,”a national essential veterinary medicines list,and standardized veterinary treatment guidelines.Additionally,there are no restrictions on the use of critically important antimicrobials for human health in veterinary settings,minimal oversight of antimicrobial-medicated feed,and no established protocols for on-farm antimicrobial disposal.Stakeholder mapping revealed limited knowledge sharing among institutions and a dependence on international donors for AMR/AMU-related activities,raising concerns about the sustainability of current initiatives.Malawi also lacks an integrated AMR and AMU monitoring system,a national prioritised AMR research agenda,and clear targets for reducing AMU in animals.Conclusion:To address these gaps,we recommend that Malawi:(1)establish a comprehensive AMR and AMU monitoring program,(2)update existing regulations to provide clear definitions and classification of veterinary antimicrobials,(3)develop and implement national veterinary treatment guidelines,(4)restrict non-therapeutic AMU,(5)enhance regulatory oversight of medicated feed,(6)strengthen One Health coordination mechanisms,(7)promote stakeholder collaboration,and(8)secure sustainable,nationally driven funding.Implemention of these measures will enhance antimicrobial stewardship,reduce AMU,mitigate the spread of AMR,and support the long-term sustainability of agricultural production in Malawi.展开更多
By measuring the quantity and ways in which antimicrobials are used, and reviewing different technical and socioeconomic factors influencing antimicrobial use at farm level, this study discusses the main knowledge gap...By measuring the quantity and ways in which antimicrobials are used, and reviewing different technical and socioeconomic factors influencing antimicrobial use at farm level, this study discusses the main knowledge gaps in antimicrobial use in food animal production and provides recommendations for future research and policy development. The review reveals that antimicrobial use in food animals exhibit strong regional and species differences, and there are still large information gaps concerning the current state of antimicrobial use. Factors associated with animal health(including antimicrobial resistance),animal health improvement, economic costs and benefits relevant to animal diseases, and potential technological alternatives or alternative systems all have an impact on antimicrobial use on the farm. There is a clear need to resolve the data gap by monitoring antimicrobial use and developing an analytical framework to better understand farmer behaviors under different technical, economic and environmental circumstances.展开更多
Antimicrobial resistance poses a significant threat to global public health,and excessive antimicrobial use(AMU)in animals is a major contributing factor.We used national AMU data for food animals to examine the curre...Antimicrobial resistance poses a significant threat to global public health,and excessive antimicrobial use(AMU)in animals is a major contributing factor.We used national AMU data for food animals to examine the current status and trends for AMU in food animals in China from 2018-2020.In 2020,China used 32,776.30 tons of antimicrobials in food animals,amounting to 165 g of antimicrobials per ton of animal products.AMU in China increased throughout the 2018-2020 study period;however,the data still showed a consistent and notable reduction from those of 2017,coinciding with the implementation of the China National Action Plan for Combating Animal Antimicrobial Resistance.Among the antimicrobials used,tetracyclines,macrolides andβ-lactams(includingβ-lactam inhibitors)were the most commonly used in food animals.Analysis by antimicrobial class revealed shifts in usage patterns,such as decreased tetracycline use and increased macrolide andβ-lactam use.Furthermore,the use of antimicrobial growth promoters decreased sharply,from 51.78%in 2018 to 28.7%in 2020.Compared with AMU data from other countries,China used more antimicrobials,but the values were relatively lower when adjusted for population correction units.These findings highlight China’s remarkable efforts in combating antimicrobial resistance and promoting antimicrobial stewardship,thus contributing significantly to global initiatives.展开更多
Peritoneal dialysis （PD） is a well-established renal replacement therapy （RRT） for end-stage renal failure （ESRF） and offers certain clear advantages over hemodialysis. However, PD is often associated with a hig...Peritoneal dialysis （PD） is a well-established renal replacement therapy （RRT） for end-stage renal failure （ESRF） and offers certain clear advantages over hemodialysis. However, PD is often associated with a high risk of infection of the intraperitoneal cavity, subcutaneous tunnel and catheter exit site, which may subsequently form microbial biofilms.展开更多
The present study sought to assess the rational use of antimicrobial agents in a Brazilian intensive care unit (ICU) and its association with antimicrobial resistance in elderly patients admitted to the unit. Results:...The present study sought to assess the rational use of antimicrobial agents in a Brazilian intensive care unit (ICU) and its association with antimicrobial resistance in elderly patients admitted to the unit. Results: Choice of empiric and sensitivity-guided therapy was inadequate in > 80% and 59% of cases respectively. Inadequate antimicrobial therapy, whether empiric or sensitivity-guided, was positively correlated with bacterial resistance (r = 0.316;p = 0.001). Sensitivity testing revealed a 46.5% resistance rate to eight out of the ten most commonly used antibiotics. Multiple drug-resistant organisms were found in 40.8% of patients. A significant increase was observed in the number of multidrug-resistant samples between 2006/2007 and 2008 (r = 0.41, p = 0.006), (r = 0.598, p = 0.001), (r = 0.688, p = 0.00). Conclusion: We found a high rate of antibiotic misuse in the study sample. Inadequate therapy was correlated with resistance to antimicrobial agents.展开更多
In a world of increasing resistance to current antibiotics,search of novel therapeutic options is urgently needed.The aim of this work was to screen plant crude extracts for direct or indirect(inhibition of resistance...In a world of increasing resistance to current antibiotics,search of novel therapeutic options is urgently needed.The aim of this work was to screen plant crude extracts for direct or indirect(inhibition of resistance)antimicrobial activity.Four crude extracts from 12 plants traditionally used in Benin for the treatment of infections were展开更多
文摘Misuse, overuse, and missed prescription of antimicrobials are the driving factors to antimicrobial resistance (AMR) leading to a globally increasing public health concern. This study was conducted to assess the current knowledge, attitudes, and practices (KAP) of village animal health workers (VAHWs) and veterinary drug retailers (VDRs) on antimicrobial use (AMU) and antimicrobial resistance (AMR). The sample size was calculated following [1]. KAP data were scored and categorized following Bloom’s cut-off score. A total of 108 study populations (66 VAHWs and 42 VDRs) were purposively surveyed using a validated KAP questionnaire in 5 provinces across Cambodia. This study found that VAHWs and VDRs have moderate levels of knowledge (61% to 65%) and good attitudes towards AMU (83% to 84%) but employed moderate practices (59% to 74%) on AMU. VAHWs had moderate (66%);while DVRs had poor knowledge (58%) on AMR. Thus, regular awareness education specifically on proper use, prudent use, and stewardships on AMU and AMR in the form of refresher training or awareness events must be provided to VAHWs and VDRs to avoid inappropriate use of antimicrobials and spreading the AMR knowledge across Cambodia.
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"></span><b> </b><span style="font-family:Verdana;">Antibiotic resistance is putting the commercial poultry production systems across the globe at risk of losses due to the failure of treatments for animals and human health which has been associated with overuse and misuse of antibiotics in poultry farming. One possible approach to the resistance problem is ensuring adequate knowledge, attitudes, and practices on antimicrobial use by farmers on commercial production systems across the globe are applied. Therefore, the current study was carried out to determine factors that could promote antimicrobial use in commercial poultry production systems of Kiambu County, Kenya. </span><b><b><span style="font-family:Verdana;">Materials</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Methods:</span></b><span></span></b><span style="font-family:Verdana;"> A descriptive cross-sectional survey was conducted on commercial poultry production systems of Kiambu County to determine the level of knowledge, attitudes, and practices on antimicrobial use. One hundred and fifty-six (n = 156) semi-structured questionnaires imprinted in a mobile Open data kit were administered to capture the level of knowledge, attitudes, and practices on antimicrobial usage in commercial poultry production systems of Kiambu County. </span><b><b><span style="font-family:Verdana;">Results:</span></b><span></span></b><span style="font-family:Verdana;"> Out of the 156 commercial poultry farmers who participated in this study, females accounted for (64%) with 51% of them keeping layers between 50 - 500 birds as medium scale farmers. In the study</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> most of the farmers were 45 years and above (61%) and they had obtained a secondary level of education (34%). We further noted that 67% of the farmers obtain antibiotics through self-prescription/personal experience. Additional lack of veterinary officers (77%) and consultation services (72%) was also mentioned as</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">key challenges in poultry production. The majority of the respondents (63%), indicated Tetracycline as the most commonly used antibiotic in their farms, with the most preferred subtypes of tetracycline and Amoxicillin being Oxytetracyclines (85%) and Amoxi (88%) respectively. Nearness to veterinary services significantly (P < 0.05) contributed to the use of antibiotics agents. Additionally, the area of residence, type of production, number of years in farming, and average number of birds kept also significantly (P < 0.05) influenced the level of knowledge and practice on antimicrobial usage. </span><b><b><span style="font-family:Verdana;">Conclusion:</span></b><span></span></b> <span style="font-family:Verdana;">Generally, the level of knowledge and practice on antibiotic use among commercial poultry farmers in Kiambu County is still lacking. This was witne</span></span><span style="font-family:Verdana;">ssed</span><span style="font-family:Verdana;"> with continued use of antibiotics without a prescription from veterinary/</span><span style="font-family:Verdana;">livestock extension offices, which is inconsis</span><span style="font-family:Verdana;">tent with the general recommendation on antimicrobial stewardship. Therefore, the current research calls for intervention measures such as extensive education to farmers on the rat</span><span style="font-family:Verdana;">ional use of antimicrobial agents in commercial poultry disease management, observance of withdraw</span><span style="font-family:Verdana;">al</span><span style="font-family:Verdana;"> periods, and the impacts of residues on public health.</span>
基金supported by the CGIAR One Health initiative“Protecting Human Health Through a One Health Approach”the CGIAR Science Programme“Sustainable Animal and Aquatic Foods(SAAF)”,which are supported by contributors to the CGIAR Trust Fund(https://www.cgiar.org/funders/).
文摘Background:Antimicrobial resistance(AMR)poses a global threat to both human and animal health,associated with widespread use of antimicrobials across sectors.In low-and middle-income countries(LMICs)such as Malawi,weak regulatory frameworks and limited enforcement capacity contribute to inappropriate use of antibiotics.This study examined the governance and regulatory frameworks for antimicrobial use(AMU)in Malawi's agricultural sector,identified regulatory gaps,and offers recommendations to antimicrobial stewardship.Methods:A qualitative approach was used,combining a review of policy and legal documents with semi-structured stakeholder interviews.Relevant policies and laws were sourced from government databases,the Food and Agricultural Organisation of the United Nations'(FAO)FAOLEX and AMR-LEX databases,and other publicly available resources.The FAO's legal assessment methodology was used to evaluate the policy landscape across nine key thematic areas:(1)veterinary medicinal products,(2)animal health and production practices to prevent animal diseases in terrestrial and aquatic animals,(3)feed registration,(4)pesticides,(5)food safety,(6)environment,soil and waste,(7)water quality,(8)plant health,and(9)institutional coordination.Stakeholder interviews with representatives from relevant government ministries and regulatory bodies validated findings from the document review and provided additional insight into governance challenges.A One Health governance mapping exercise was conducted to identify key institutional actors,assess their role in AMR/AMU governance,and evaluate inter-institutional relationships using social network analysis.Results:The analysis identified 522 policies relevant to AMU in agriculture,with most addressing aquatic animal health(11.3%,n=59),food safety(10.9%,n=57)and animal feed(10.9%,n=57).Several critical regulatory gaps were identified,including the absence of a legal definition for“antimicrobials,”a national essential veterinary medicines list,and standardized veterinary treatment guidelines.Additionally,there are no restrictions on the use of critically important antimicrobials for human health in veterinary settings,minimal oversight of antimicrobial-medicated feed,and no established protocols for on-farm antimicrobial disposal.Stakeholder mapping revealed limited knowledge sharing among institutions and a dependence on international donors for AMR/AMU-related activities,raising concerns about the sustainability of current initiatives.Malawi also lacks an integrated AMR and AMU monitoring system,a national prioritised AMR research agenda,and clear targets for reducing AMU in animals.Conclusion:To address these gaps,we recommend that Malawi:(1)establish a comprehensive AMR and AMU monitoring program,(2)update existing regulations to provide clear definitions and classification of veterinary antimicrobials,(3)develop and implement national veterinary treatment guidelines,(4)restrict non-therapeutic AMU,(5)enhance regulatory oversight of medicated feed,(6)strengthen One Health coordination mechanisms,(7)promote stakeholder collaboration,and(8)secure sustainable,nationally driven funding.Implemention of these measures will enhance antimicrobial stewardship,reduce AMU,mitigate the spread of AMR,and support the long-term sustainability of agricultural production in Malawi.
文摘By measuring the quantity and ways in which antimicrobials are used, and reviewing different technical and socioeconomic factors influencing antimicrobial use at farm level, this study discusses the main knowledge gaps in antimicrobial use in food animal production and provides recommendations for future research and policy development. The review reveals that antimicrobial use in food animals exhibit strong regional and species differences, and there are still large information gaps concerning the current state of antimicrobial use. Factors associated with animal health(including antimicrobial resistance),animal health improvement, economic costs and benefits relevant to animal diseases, and potential technological alternatives or alternative systems all have an impact on antimicrobial use on the farm. There is a clear need to resolve the data gap by monitoring antimicrobial use and developing an analytical framework to better understand farmer behaviors under different technical, economic and environmental circumstances.
基金supported by a grant from the National Key Research and Development Program of China(grant number 2022YFD1800400).
文摘Antimicrobial resistance poses a significant threat to global public health,and excessive antimicrobial use(AMU)in animals is a major contributing factor.We used national AMU data for food animals to examine the current status and trends for AMU in food animals in China from 2018-2020.In 2020,China used 32,776.30 tons of antimicrobials in food animals,amounting to 165 g of antimicrobials per ton of animal products.AMU in China increased throughout the 2018-2020 study period;however,the data still showed a consistent and notable reduction from those of 2017,coinciding with the implementation of the China National Action Plan for Combating Animal Antimicrobial Resistance.Among the antimicrobials used,tetracyclines,macrolides andβ-lactams(includingβ-lactam inhibitors)were the most commonly used in food animals.Analysis by antimicrobial class revealed shifts in usage patterns,such as decreased tetracycline use and increased macrolide andβ-lactam use.Furthermore,the use of antimicrobial growth promoters decreased sharply,from 51.78%in 2018 to 28.7%in 2020.Compared with AMU data from other countries,China used more antimicrobials,but the values were relatively lower when adjusted for population correction units.These findings highlight China’s remarkable efforts in combating antimicrobial resistance and promoting antimicrobial stewardship,thus contributing significantly to global initiatives.
文摘Peritoneal dialysis （PD） is a well-established renal replacement therapy （RRT） for end-stage renal failure （ESRF） and offers certain clear advantages over hemodialysis. However, PD is often associated with a high risk of infection of the intraperitoneal cavity, subcutaneous tunnel and catheter exit site, which may subsequently form microbial biofilms.
文摘The present study sought to assess the rational use of antimicrobial agents in a Brazilian intensive care unit (ICU) and its association with antimicrobial resistance in elderly patients admitted to the unit. Results: Choice of empiric and sensitivity-guided therapy was inadequate in > 80% and 59% of cases respectively. Inadequate antimicrobial therapy, whether empiric or sensitivity-guided, was positively correlated with bacterial resistance (r = 0.316;p = 0.001). Sensitivity testing revealed a 46.5% resistance rate to eight out of the ten most commonly used antibiotics. Multiple drug-resistant organisms were found in 40.8% of patients. A significant increase was observed in the number of multidrug-resistant samples between 2006/2007 and 2008 (r = 0.41, p = 0.006), (r = 0.598, p = 0.001), (r = 0.688, p = 0.00). Conclusion: We found a high rate of antibiotic misuse in the study sample. Inadequate therapy was correlated with resistance to antimicrobial agents.
文摘In a world of increasing resistance to current antibiotics,search of novel therapeutic options is urgently needed.The aim of this work was to screen plant crude extracts for direct or indirect(inhibition of resistance)antimicrobial activity.Four crude extracts from 12 plants traditionally used in Benin for the treatment of infections were
