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Fulltext Stepwise evolution of pandrug-resistance in Klebsiella pneumoniae

Zowawi HM, Forde BM, Alfaresi M, Alzarouni A, Farahat Y, Chong TM, et al.

Sci Rep, 2015;5:15082.
PMID: 26478520 DOI: 10.1038/srep15082

Carbapenem resistant Enterobacteriaceae (CRE) pose an urgent risk to global human health. CRE that are non-susceptible to all commercially available antibiotics threaten to return us to the pre-antibiotic era. Using Single Molecule Real Time (SMRT) sequencing we determined the complete genome of a pandrug-resistant Klebsiella pneumoniae isolate, representing the first complete genome sequence of CRE resistant to all commercially available antibiotics. The precise location of acquired antibiotic resistance elements, including mobile elements carrying genes for the OXA-181 carbapenemase, were defined. Intriguingly, we identified three chromosomal copies of an ISEcp1-bla(OXA-181) mobile element, one of which has disrupted the mgrB regulatory gene, accounting for resistance to colistin. Our findings provide the first description of pandrug-resistant CRE at the genomic level, and reveal the critical role of mobile resistance elements in accelerating the emergence of resistance to other last resort antibiotics.

Matched MeSH terms: Drug Resistance, Microbial
Comparison of knowledge and attitudes about antibiotics and resistance, and antibiotics self-practicing between Bachelor of Pharmacy and Doctor of Pharmacy students in Southern India

Ahmad A, Khan MU, Moorthy J, Jamshed SQ, Patel I

Pharm Pract (Granada), 2015 03 15;13(1):523.
PMID: 25883690

BACKGROUND: There is limited research on pharmacy specialization based differences with regards to usage of antibiotics.
OBJECTIVE: To compare the knowledge, attitude and practice of Bachelor of Pharmacy (BPharm) and Doctor of Pharmacy (PharmD) students about usage and resistance of antibiotics in Southern India.
METHODS: This was a cross sectional study involving final year BPharm and PharmD students studying in two private institutions located in Andra Pradesh, India. The study was conducted for the period of 3 months. The questionnaire was divided into 5 components: demographics, knowledge about antibiotic use, attitude towards antibiotic use and resistance, self-antibiotic usage, and possible causes of antibiotic resistance. The study questionnaire was assessed for reliability. Data were analysed by employing Mann Whitney and chi square tests using SPSS version 19.
RESULTS: The sample size comprised of 137 students. The response rate was 76.11% for the study. There was a significant difference in the knowledge of antibiotic use in BPharm and PharmD students (Mean score: 5.09 vs 6.18, p<0.001). The overall attitude of PharmD students about antibiotic use and resistance was positive compared to BPharm students (Mean score: 3.05 vs 2.23, p<0.05). The self-antibiotic practices was higher in BPharm students than PharmD students (36.4% vs 20%, p<0.05). A significantly high number of PharmD students believed that empirical antibiotic therapy led to antibiotic resistance (19.5% versus 48%, P<0.05).
CONCLUSION: PharmD students were more knowledgeable about antibiotic usage and resistance compared to BPharm students who did not have accurate and the much needed information about the same. Future interventions should be targeted towards educating the BPharm students so that they can implement the acquired knowledge in their practice.

Matched MeSH terms: Drug Resistance, Microbial
Emerging problems of antibiotic resistance in community medicine

Parasakthi N

Malays J Pathol, 1996 Jun;18(1):9-13.
PMID: 10879217

Emergence of antimicrobial resistance in bacteria associated with community acquired infections has made the choice of empirical therapy more difficult and more expensive. The problems due to possible spread of MRSA to the community, emergence of penicillin resistance in S. pneumoniae, ampicillin resistance in H. influenzae, and multiresistance among common enteric pathogens are highlighted. Bacteria have a remarkable ability to develop resistance to many of the newly synthesized antimicrobial agents but the appropriate use of antibiotics will delay and in many cases prevent the emergence of resistance.

Matched MeSH terms: Drug Resistance, Microbial*
Fulltext Susceptibility of 57 strains Ps. pseudomallei to some new B-lactams and other antibiotics

Puthucheary SD, Parasakthi N

Med J Malaysia, 1987 Dec;42(4):248-51.
PMID: 3454397

Fifty seven strains of Pseudomonas pseudomallei were tested for in vitro susceptibility to 15 antimicrobial agents. Amongst the generally recommended antibiotics for therapy of melioidosis, only 86%, 84% and 58% of the strains were found to be sensitive to trimethoprim-sulphamethoxazole, chloramphenicol and tetracycline respectively. Of the newer B-Iactams, in descending order of activity were, ceftazidime, ceftriaxone, cefotaxime, cefoperazone and cefuroxime. But on a weight for weight basis, ceftazidime was the most active agent and as such, may be considered in the therapy of acute septicaemic melioidosis."

Matched MeSH terms: Drug Resistance, Microbial
Multidrug-resistant strains of Salmonella enterica serotype typhi are genetically homogenous and coexist with antibiotic-sensitive strains as distinct, independent clones

Thong KL, Bhutta ZA, Pang T

Int J Infect Dis, 2000;4(4):194-7.
PMID: 11231181

OBJECTIVE: The goal of this study was to report the molecular analysis of antibiotic-sensitive and multidrug-resistant (MDR) strains of Salmonella typhi, using pulsed-field gel electrophoresis (PFGE), with a particular emphasis on the coexistence of these strains in a typhoid-endemic region of Karachi, Pakistan.
METHODS: One hundred isolates of S. typhi in humans (50 MDR and 50 antibiotic-sensitive isolates) from sporadic cases of typhoid fever were analyzed by Vi-phage typing, antibiograms and PFGE.
RESULTS: The MDR S. typhi strains were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole. Analysis by PFGE showed that 50 MDR isolates of S. typhi had a single, homogenous PFGE profile, which was distinctly different from that of 50 antibiotic-sensitive isolates obtained in the same time frame from the same area. This latter group of isolates showed much greater diversity of PFGE profiles, as has been observed in other endemic regions.
CONCLUSIONS: Multidrug-resistant and antibiotic-susceptible strains of S. typhi can coexist in endemic areas as epidemiologically independent pathogens and are not in competition for continued persistence and transmission.

Matched MeSH terms: Drug Resistance, Microbial/genetics
Spread of drug-resistant Streptococcus pneumoniae in Asian countries: Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

Song JH, Lee NY, Ichiyama S, Yoshida R, Hirakata Y, Fu W, et al.

Clin Infect Dis, 1999 Jun;28(6):1206-11.
PMID: 10451154

Antimicrobial susceptibility of 996 isolates of Streptococcus pneumoniae from clinical specimens was investigated in 11 Asian countries from September 1996 to June 1997. Korea had the greatest frequency of nonsusceptible strains to penicillin with 79.7%, followed by Japan (65.3%), Vietnam (60.8%), Thailand (57.9%), Sri Lanka (41.2%), Taiwan (38.7%), Singapore (23.1%), Indonesia (21.0%), China (9.8%), Malaysia (9.0%), and India (3.8%). Serotypes 23F and 19F were the most common. Pulsed-field gel electrophoresis (PFGE) of 154 isolates from Asian countries showed several major PFGE patterns. The serotype 23F Spanish clone shared the same PFGE pattern with strains from Korea, Japan, Singapore, Taiwan, Thailand, and Malaysia. Fingerprinting analysis of pbp1a, pbp2x, and pbp2b genes of 12 strains from six countries also showed identical fingerprints of penicillin-binding protein genes in most strains. These data suggest the possible introduction and spread of international epidemic clones into Asian countries and the increasing problems of pneumococcal drug resistance in Asian countries for the first time.

Matched MeSH terms: Drug Resistance, Microbial
Fulltext Recent Approaches for Downplaying Antibiotic Resistance: Molecular Mechanisms

Ahmed S, Ahmed MZ, Rafique S, Almasoudi SE, Shah M, Jalil NAC, et al.

Biomed Res Int, 2023;2023:5250040.
PMID: 36726844 DOI: 10.1155/2023/5250040

Antimicrobial resistance (AMR) is a ubiquitous public health menace. AMR emergence causes complications in treating infections contributing to an upsurge in the mortality rate. The epidemic of AMR in sync with a high utilization rate of antimicrobial drugs signifies an alarming situation for the fleet recovery of both animals and humans. The emergence of resistant species calls for new treatments and therapeutics. Current records propose that health drug dependency, veterinary medicine, agricultural application, and vaccination reluctance are the primary etymology of AMR gene emergence and spread. Recently, several encouraging avenues have been presented to contest resistance, such as antivirulent therapy, passive immunization, antimicrobial peptides, vaccines, phage therapy, and botanical and liposomal nanoparticles. Most of these therapies are used as cutting-edge methodologies to downplay antibacterial drugs to subdue the resistance pressure, which is a featured motive of discussion in this review article. AMR can fade away through the potential use of current cutting-edge therapeutics, advancement in antimicrobial susceptibility testing, new diagnostic testing, prompt clinical response, and probing of new pharmacodynamic properties of antimicrobials. It also needs to promote future research on contemporary methods to maintain host homeostasis after infections caused by AMR. Referable to the microbial ability to break resistance, there is a great ultimatum for using not only appropriate and advanced antimicrobial drugs but also other neoteric diverse cutting-edge therapeutics.

Matched MeSH terms: Drug Resistance, Microbial
Increased frequency of chloroquine resistant P. falciparum on a rubber estate in Peninsular Malaysia during two years of systematic chloroquine treatment

Dondero TJ, Parsons RE, O'Holohan DR

Southeast Asian J. Trop. Med. Public Health, 1975 Dec;6(4):488-94.
PMID: 775652

Chloroquine pressure was applied over a 22 month period on a somewhat isolated, malarious rubber estate by examination of residents at 4-week intervals and treatment of parasitaemias with chloroquine. During this time the monthly attack rate for P. falciparum rose four-fold to an average of nearly 18% per month, while that of P. vivax remained relatively constant at about 8%. Eight in vivo chloroquine resistance studies, which allowed both detection of late recrudescing R-I resistance and estimation of the risk of reinfection, showed an apparent rise in the drug resistance rate, from 12% to 20% prior to the study to the range of 40-50%. Virtually all resistance encountered was R-I in nature. There was no convincing evidence of chloroquine resistance among 148 tested P. vivax infections.

Matched MeSH terms: Drug Resistance, Microbial
Detection of blaoxa genes and identification of biofilm-producing capacity of Acinetobacter baumannii in a tertiary teaching hospital, Klaten, Indonesia

Nirwati H, Hakim MS, Darma S, Mustafa M, Nuryastuti T

Med J Malaysia, 2018 10;73(5):291-296.
PMID: 30350807

INTRODUCTION: Acinetobacter baumannii (A. baumannii) is commonly found as an agent of nosocomial infections and demonstrates a high antibiotic resistance due to its carbapenemase production. The objectives of this study were to explore the antibiotic resistance pattern, the presence of OXAs genes and the biofilm-producing capacity of A. baumannii isolated from clinical specimens.
METHODS: Antibiotics susceptibility testing, detection of OXAs genes and the biofilm-producing capacity were performed using the Kirby Bauer method, polymerase chain reaction (PCR) and adherence quantitative assays, respectively.
RESULTS: A total of 80 A. baumannii isolates were mainly obtained from sputum and most of them were resistant to antibiotics. All A. baumannii carried blaOXA-51 gene, yet no blaOXA-24 and blaOXA-58 genes were detected. Fourteen (82.4%) of the 17 meropenem resistant isolates carried blaOXA-23 gene, but it was not found in meropenem sensitive isolates. In addition, sixty (75.0%) of 80 isolates were biofilm producers with 2 (2.5%), 16 (20.0%), and 42 (52.5%) isolates were identified as strong, moderate and weak biofilm producers, respectively.
CONCLUSION: Most of A. baumannii isolates had a high level of antibiotic resistance and had a capacity to produce biofilm.

Matched MeSH terms: Drug Resistance, Microbial
Fulltext Tetracycline resistant cholera in Kelantan

Ranjit K, Nurahan M

Med J Malaysia, 2000 Mar;55(1):143-5.
PMID: 11072502 MyJurnal

Sensitivity testing on Vibrio cholerae isolates during an epidemic in 1998 in Kelantan identified strains resistant to tetracycline. This prompted a change in the usual management of cholera in Kelantan. The antibiotic of choice was changed from tetracycline to erythromycin.

Matched MeSH terms: Drug Resistance, Microbial
Fulltext Identification and occurrence of antibiotic resistance of staphylococcus aureus and escherichia coli isolated from recreational parks around Kota Kinabalu, SabahRajeena Sugumaran

Rajeena Sugumaran, Pamela David Jocksing, Nur Athirah Yusof

Borneo International Journal of Biotechnology, 2020;1(1):55-75.
MyJurnal

Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) are contributors to infection cases among the Asian population. S. aureus is found in the mucous lining of noses and is mainly non-pathogenic while E. coli, mostly harmless bacteria, are found in the intestine. Pathogenic strains of both bacteria have adverse effects on the elderly and younger age group of the population. Samples were collected from recreational parks around Kota Kinabalu as they are hotspots frequently visited by families with both age groups. The bacterial samples were isolated and cultured on selective media such as Baird-Parker agar (BPA), Brain Heart Infusion (BHI) agar, MacConkey agar and Eosin-Methylene Blue (EMB) agar. Morphological characteristics of bacterial growth were observed, where S. aureus had black-shiny growth in BPA and E. coli had a metallic-green sheen in EMB agar. The suspected bacteria samples were then stained and viewed under a light microscope. S. aureus was identified as gram-positive, stained violet with a circular shape and clustered appearance. E. coli was identified as gram-negative, stained red, rod-shaped with 2 – 3 bacterial alignment. Antibiotic resistance test resulted in S. aureus and E. coli samples did not display 100% resistance among 4 antibiotics tested (ampicillin, penicillin, tetracycline and chloramphenicol). Most of the bacteria samples were a minimum inhibitory of 0.1 mg/mL of antibiotic concentration. These results provide a foundation for further research on identifying bacterial strains using molecular methods. The findings can then be used to disseminate information to the public to create awareness of potential disease outbreaks in the city.

Matched MeSH terms: Drug Resistance, Microbial
Fulltext Knowledge and attitudes concerning antibiotic use and resistance among the public in Pulau Pinang, Malaysia

Halim NAAA, Chang CT, Chan HK, Hassali MA, Nouri A

Malays J Med Sci, 2018 Nov;25(6):141-147.
PMID: 30914888 MyJurnal DOI: 10.21315/mjms2018.25.6.15

The aim of this cross-sectional study was to evaluate the knowledge and attitudes concerning antibiotic use and resistance among members of the local community in Pulau Pinang, Malaysia. The study was conducted among 326 residents of the Jelutong district, Pulau Pinang state, from August to October 2013. A self-administered five-part questionnaire was used for the data collection. The respondents exhibited inadequate knowledge of antibiotics in general. Approximately 80% of them did not know the indications for antibiotic use, while 76% believed that antibiotics were useful in terms of resolving viral fever. Additionally, 52.6% believed that antibiotics could be used to treat all types of infections. Inadequate knowledge of antibiotic resistance was also evident among the respondents, since 72.9% of them did not agree that resistant bacteria can spread from human or animal to human, while 32% were unaware that bacteria can develop resistance to antibiotics. More than 60% of respondents admitted that they took antibiotics in order to accelerate their recovery from illness, while 34.8% claimed that they only stopped taking antibiotics when they felt better. The findings hence indicate that most respondents had poor knowledge and attitudes concerning antibiotic use and resistance, which suggests the need for more community-based educational campaigns designed to improve the public's knowledge and attitudes regarding antibiotics.
Study site: General public, Jelutong district, Pulau Pinang, Malaysia

Matched MeSH terms: Drug Resistance, Microbial
Fulltext Antibiotic resistance and plasmid profiling of Vibrio parahaemolyticus isolated from cockles in Padang, Indonesia

Zulkifli, Y., Alitheen, N.B., Raha, A.R., Yeap, S.K., Marlina, Son, R., et al.

International Food Research Journal, 2009;16(1):53-58.
MyJurnal

Vibrio parahaemolyticus is one of the most widely recognized pathogenic Vibrio species due to numerous outbreaks and its’ wide occurrence in marine environment. In this study, 32 isolates of V. parahaemolyticus isolated from cockles were tested for sensitivity to 16 antibiotics and the presence of plasmids. All the isolates were multi-resistance, defined as resistant to atleast three different antibiotics with multiple antibiotic resistance indexes ranging from 0.31 to 0.69, indicating the isolates originate from high risk sources of contamination where antibiotics are often used. In the plasmid profiling test, only 15 isolates (47%) harbored plasmid DNA, which ranged in size from 2.7 to 56.2 kb, separating the isolates into 14 plasmid profiles. Hence, food contaminated with antibiotic resistant V. parahaemolyticus could be a major threat to public health due to the distinct possibility that they can be a significant reservoir of genes encoding antibiotic resistance determinants that can be transferred intra or interspecies. As in many developing countries, raw food hygiene and antimicrobial resistance epidemiology is still in the infancy stage in the locality of the study and thus our data provide a current baseline profile of antimicrobial resistance and plasmid of V. parahaemolyticusfrom cockles in Padang, Indonesia.

Matched MeSH terms: Drug Resistance, Microbial
Detection of Escherichia coli O157:H7 by multiplex PCR and their characterization by plasmid profiling, antimicrobial resistance, RAPD and PFGE analyses

Radu S, Ling OW, Rusul G, Karim MI, Nishibuchi M

J Microbiol Methods, 2001 Aug;46(2):131-9.
PMID: 11412923

Twenty-five and three strains of Escherichia coli O157:H7 were identified from 25 tenderloin beef and three chicken meat burger samples, respectively. The bacteria were recovered using the immunomagnetic separation procedure followed by selective plating on sorbitol MacConkey agar and were identified as E. coli serotype O157:H7 with three primer pairs that amplified fragments of the SLT-I, SLT-II and H7 genes in PCR assays. Susceptibility testing to 14 antibiotics showed that all were resistant to two or more antibiotics tested. Although all 28 strains contained plasmid, there was very little variation in the plasmid sizes observed. The most common plasmid of 60 MDa was detected in all strains. We used DNA fingerprinting by randomly amplified polymorphic DNA (RAPD) and pulsed-field gel electrophoresis (PFGE) to compare the 28 E. coli O157:H7 strains. At a similarity level of 90%, the results of PFGE after restriction with XbaI separated the E. coli O157:H7 strains into 28 single isolates, whereas RAPD using a single 10-mer oligonucleotides separated the E. coli O157:H7 strains into two clusters and 22 single isolates. These typing methods should aid in the epidemiological clarification of the E. coli O157:H7 in the study area.

Matched MeSH terms: Drug Resistance, Microbial
Detection and molecular characterization of Vibrio vulnificus from coastal waters of Malaysia

Radu S, Yuherman, Rusul G, Yeang LK, Nishibuchi M

Southeast Asian J. Trop. Med. Public Health, 2000 Dec;31(4):668-73.
PMID: 11414409

A total of 57 Vibrio vulnificus isolates from coastal water were characterized for their antimicrobial resistance, plasmid profiles and were typed by the PCR-based techniques: a random amplification of polymorphic DNA (RAPD) method and the enterobacterial repetitive intergenic consensus sequence (ERIC) method. All isolates were susceptible to chloramphenicol, nalidixic acid, tetracycline and trimethoprim-sulfamethoxazole. Fifty-one isolates were resistant to one or more of the other antibiotics tested. Plasmid analysis indicated that only 18 isolates carried small plasmids of 1.6 to 16 megadaltons. Analysis of the RAPD and ERIC DNA fingerprints of the V. vulnificus isolates with Gel Compare and cluster analysis software revealed significant genetic heterogeneity among these isolates. The combination of RAPD and ERIC analysis allowed us to distinguish all isolates. Thus, the combination of the two techniques is recommended for epidemiological investigation.

Matched MeSH terms: Drug Resistance, Microbial
Occurrence of the vanA and vanC2/C3 genes in Enterococcus species isolated from poultry sources in Malaysia

Radu S, Toosa H, Rahim RA, Reezal A, Ahmad M, Hamid AN, et al.

Diagn Microbiol Infect Dis, 2001 Mar;39(3):145-53.
PMID: 11337180

Enterococcus species isolated from poultry sources were characterized for their resistance to antibiotics, plasmid content, presence of van genes and their diversity by randomly amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR). The results showed that all isolates were multi-resistance to the antibiotics tested. Ampicillin (15/70) followed by chloramphenicol (37/70) were the most active antibiotics tested against the Enterococcus spp. isolates, while the overall resistant rates against the other antibiotics were between 64.3% to 100%. All vancomycin-resistant E. faecalis, E. durans, E. hirae and E. faecium isolates tested by the disk diffusion assay were positive in PCR detection for presence of vanA gene. All E. casseliflavus isolates were positive for vanC2/C3 gene. However, none of the Enterococcus spp. isolates were positive for vanB and vanC1 genes. Plasmids ranging in sizes between 1.1 to ca. 35.8 MDa were detected in 38/70 of the Enterococcus isolates. When the genetic relationship among all isolates of the individual species were tested by RAPD-PCR, genetic differences detected suggested a high genetic polymorphisms of isolates in each individual species. Our results indicates that further epidemiological studies are necessary to elucidate the role of food animals as reservoir of VRE and the public health significance of infections caused by Enterococcus spp.

Matched MeSH terms: Drug Resistance, Microbial
Isolation and molecular characterization of vancomycin-resistant Enterococcus faecium in Malaysia

Son R, Nimita F, Rusul G, Nasreldin E, Samuel L, Nishibuchi M

Lett Appl Microbiol, 1999 Aug;29(2):118-22.
PMID: 10499300

Nineteen strains of vancomycin-resistant Enterococcus faecium isolated from 10 of 75 (13.3%) tenderloin beef samples were examined for resistance to selected antibiotics, presence of plasmids, and genetic diversity by random amplification of polymorphic DNA analysis. All strains showed multiple resistant to the antibiotics tested. Multiple antibiotic indexing of the vancomycin-resistant E. faecium strains showed that all (100%) originated from high risk contamination environments where antibiotics were often used. Plasmids ranging in size from 1.5 to 36 megadalton were detected in 15 of 19 (79%) strains. Thus, three plasmid profiles and eight antibiotypes were observed among the E. faecium strains. A high degree of polymorphism was obtained by combining the results of the two primers used; with the 19 E. faecium strains being differentiated into 19 RAPD-types. These preliminary results suggest that RAPD-PCR has application for epidemiologic studies and that resistance patterns and plasmid profiling could be used as an adjunct to RAPD for the typing of E. faecium in the study area.

Matched MeSH terms: Drug Resistance, Microbial
Antibiotic usage and resistance in animal production in Vietnam: a review of existing literature

Di KN, Pham DT, Tee TS, Binh QA, Nguyen TC

Trop Anim Health Prod, 2021 Jun 05;53(3):340.
PMID: 34089130 DOI: 10.1007/s11250-021-02780-6

Inappropriate use of antibiotics in animal production system is one of the major factors leading to the antibiotic resistance (ABR) development. In Vietnam, the ABR situation is crucial as antibiotics have been used indiscriminately for disease prevention and as growth promoters in animals. Thus, a thorough understanding on the ABR in veterinary settings would be beneficial to the Vietnam public health authority in formulating timely interventions. This review aimed to provide information on the current status of antibiotic usage in animal husbandry in Vietnam, identified gaps in research, and suggested possible solutions to tackle ABR. To this end, data on ABR in animals were extracted from 3 major electronic databases (PubMed, Web of Science, and ScienceDirect) in the period of January 2013-December 2020. The review findings were reported according to PRISMA, which highlighted the emergence and persistence of ABR in bacterial isolates, including Escherichia coli, Enterococcus spp., and Salmonella species, obtained from pigs and poultry. The lack of awareness of Vietnamese farmers on the antibiotic utilization guidelines was one of the main causes driving the animal ABR. Hence, this paper calls for interventions to restrict antibiotics use in food-producing animals by national action plan and antibiotics control programs. Additionally, studies to evaluate knowledge, attitude, and practice (KAP) of the community are required to promote rational use of antibiotics in all sectors.

Matched MeSH terms: Drug Resistance, Microbial
Infrequent occurrence of vancomycin-resistant enterococci in poultry from Malaysian wet markets

Ong CH, Asaad M, Lim KC, Ngeow YF

Malays J Pathol, 2002 Dec;24(2):91-4.
PMID: 12887166

Fifty samples of chicken, duck and geese faeces were obtained from 13 wet markets in Kuala Lumpur to study the prevalence of vancomycin-resistant enterococci (VRE) among local market poultry. Biotyping of colonies grown on azide agar incubated at 45 degrees C yielded E. pseudoavium, E. faecalis, E. faecium and E. gallinarum from chicken faeces and E. malodoratus, E. faecalis, E. faecium, E. gallinarum, E. hirae/dispar, and E. durans from goose and duck faeces. On agar containing 6 mg/ l of vancomycin, one strain of E. flavescens was identified, giving a VRE detection rate of 2.0%. This isolate had a vancomycin M.I.C. of 8 mg/l as determined by the Etest, and the van C-3 gene that was identified by PCR followed by sequence analysis. The prevalence of VRE among poultry sold in local markets appears to be low, and may reflect the infrequent use of antimicrobials in our poultry farms. Nevertheless, the possibility of human acquisition of microbes via the food chain cautions against the use of antimicrobials in animal husbandry that may encourage the emergence and spread of multi-drug resistant organisms like the VRE among animal microbial flora.

Matched MeSH terms: Drug Resistance, Microbial
Fulltext Perception and practices of public hospital pharmacists towards the antimicrobial stewardship programme in the State of Selangor, Malaysia

Saleh MS, Hong YH, Muda MR, Dali AF, Hassali MA, Khan TM, et al.

Eur J Hosp Pharm, 2020 05;27(3):173-177.
PMID: 32419939 DOI: 10.1136/ejhpharm-2018-001679

Objective: The increase in antimicrobial resistance and the lack of new antimicrobial agents in drug discovery pipelines have called for global attention to mitigate the problem of antimicrobial misuse. While an antimicrobial stewardship (AMS) programme has been implemented in Malaysia, the perception and practices of public hospital pharmacists remain unknown. The aim of this study was to determine the perception and practices of Malaysian public hospital pharmacists towards the AMS programme in the state of Selangor, Malaysia.
Methods: A cross-sectional study, using a validated 23-item self-administered questionnaire, was conducted among pharmacists from 11 public hospitals in the State of Selangor, Malaysia, from December 2016 to January 2017. All public hospital pharmacists (n=432) were invited to participate in the survey. A 5-point Likert scale was employed in the questionnaire; the perception section was scored from 1 (strongly disagree) to 5 (strongly agree) while the practice section was scored from 1 (never) to 5 (always). Both descriptive and inferential statistical analyses were used to analyse data.
Results: Of the 432 pharmacists surveyed, 199 responded, giving a response rate of 46.0%. The majority of the respondents agreed (n=190, 95.5%) that the AMS programme improves patient care at their hospitals (median=5; IQR=1). Slightly less than half of the respondents indicated that a local antibiotic guideline was established in their hospitals (median=3, IQR=2.5), and had taken part in antimicrobial awareness campaigns to promote optimal use of antimicrobials in hospitals (median=3, IQR=1).
Conclusions: Overall, the perception and practices of the surveyed hospital pharmacists towards AMS programme were positive. National antibiotic guidelines, which take into consideration local antimicrobial resistance patterns, should be used fully to improve antimicrobial usage and to reduce practice variation. Collaboration among healthcare professionals should be strengthened to minimise the unfavourable consequences of unintended use of antimicrobial agents while optimising clinical outcomes.

Matched MeSH terms: Drug Resistance, Microbial

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