August 14, 2023
OHT’s ResistanceMap data was used to link global air pollution and antibiotic resistance.
Using antibiotic use and resistance data from One Health Trust’s ResistanceMap, researchers aimed to provide the first global estimates of the contributions of particulate matter, or PM2.5, to the transmission of antibiotic resistance and associated premature deaths. There was a robust correlation between PM2.5 and antibiotic resistance upon multivariate and univariate analyses across various geographic regions and bacterial species. The magnitude of PM2.5’s contribution to aggregate antibiotic resistance (10.9 percent) was greater than that of antibiotic use (2.4 percent), access to drinking-water services (2.7 percent), and current health expenditures (10.1 percent). For nearly all of the pathogens investigated, PM2.5 contributed to an increase in resistance rates. With antibiotic use predicted to increase in low- and middle-income countries in the next three decades, there is a need for policy changes and air quality interventions to reduce air pollution and help mitigate the burden of antibiotic resistance worldwide. [The Lancet Planetary Health]
Inadequate access to modern energy services drives indoor air pollution.
Household and ambient air pollution (HAAP) accounts for nearly seven million premature deaths per year globally. HAAP consists of fine particulate matter, carbon monoxide, nitrogen oxides, black carbon, and methane, primarily produced by the incomplete combustion of biomass fuels in open fires and inefficient cookstoves. Exposure to HAAP has been linked to cardiovascular disease, stroke, lung cancer, and adverse pregnancy outcomes. A mixed methods study conducted in rural Malawi revealed HAAP levels that far exceed the World Health Organization’s recommended safe levels. A lack of access to modern energy services along with economic constraints were a driver of HAAP. Lack of information on the dangers of HAAP exposure and cultural factors played a role in cooking, heating, and waste management practices as well. [Journal of Public Health]
Inappropriate antibiotic use and low awareness are associated with rising rates of resistant Salmonella typhi in Pakistan.
A narrative review analyzed the state of AMR in Pakistan in the context of rising rates of drug-resistant Salmonella typhi by highlighting antibiotic use in the community and healthcare workers’ awareness of antimicrobial stewardship (AMS). Inappropriate empirical use of antibiotics like ceftriaxone and cefixime to treat typhoid fever has led to the emergence of extended-spectrum beta-lactamase (ESBL)-producing bacteria, including S. typhi. Acquiring antibiotics over the counter and self-medicating are common practices because pharmacies often do not adhere to the regulation of antibiotic sales. The authors note limited access to healthcare facilities, economic difficulties to pay for consultations with specialists, and the reuse of old prescriptions as hurdles for appropriate antibiotic use for patients as well. Gaps in physicians’ knowledge and awareness of AMR and related therapeutic guidelines necessitate educational campaigns among doctors and patients in the country. [Journal of Infection and Public Health]
The stability of antimicrobials in storage conditions can affect the efficacy of wastewater surveillance.
An investigation into the stability of 32 antimicrobial agents in wastewater following storage in freezing conditions for up to one year revealed varying degrees of stability of antimicrobials: 38, 22, and 40 percent displayed low, moderate, and high degradation. The antimicrobials that were most significantly affected by freezer storage included beta-lactams, tuberculosis drugs, and clindamycin. Beta-lactams in plasma samples exhibited up to 30 percent degradation when kept at -20°C for 4 days. These findings suggest that experts must account for varying degrees of stability among antimicrobials and consider storage conditions when analyzing wastewater samples, particularly when measuring antimicrobial concentrations. [Analytical and Bioanalytical Chemistry]
Preventing short-term immune degradation and instability with nanovaccines
Nanovaccines are a novel formulation composed of nanomaterials with an immunogenic component which trigger a protective immune response in human hosts. While they remain in the early stages of innovation, their potential to combat multidrug-resistant pathogens demands further development and exploration of their capacity to prevent infections. The nanosized particles in nanovaccines help enhance the subsequent immune response and prevent their self-degradation. Developing nanovaccines also requires minimal formulation, lending greater stability and other long-term advantages over conventional vaccines. Bacterial targets of nanovaccines include methicillin-resistant Staphylococcus aureus, Vibrio cholerae, and resistant Escherichia coli. [Future Journal of Pharmaceutical Sciences]
Urban primary care facilities in Brazil lack in-unit leprosy diagnostics and treatment.
An ecological study assessed the geographical distribution of facilities that diagnose and treat of leprosy and tuberculosis (TB) in primary care settings in five regions in Brazil: urban, intermediate adjacent, remote intermediary, adjacent rural, and rural remote. Despite having an established leprosy control program, barriers still prevent effective mitigation of the disease. Only two-thirds of primary healthcare teams in urban municipalities in Brazil carry out in-unit leprosy diagnosis and treatment, suggesting delays in early detection of the disease. In contrast, active actions related to the care and monitoring of TB patients were carried out most frequently by urban facilities. [BMC Health Services Research]
A novel online diagnostic calculator may help physicians rule out bacterial pneumonia.
A new diagnostic calculator for estimating the probability of bacterial pneumonia was developed using disease-specific indicators from previously published literature. With this tool, developers aim to inform clinical decision-making and support physicians in their care of patients with suspected bacterial pneumonia. While the calculator cannot provide a definitive diagnosis, it provides a quantitative assessment of the probability of community-acquired pneumonia and help reduce patients’ exposure to inappropriate empirical antibiotic prescriptions and associated poor health outcomes. [Antimicrobial Stewardship & Healthcare Epidemiology]
Improved tuberculosis diagnostics and screening programs are needed to improve treatment regimens globally.
The 1/4/6×24 Campaign aims to provide the shortest and best tuberculosis (TB) treatment regimens worldwide by the end of 2024. Achievement of this goal requires addressing gaps in screening and diagnosis. In 2021, an estimated 40 percent of people believed to develop active TB, and 70 percent of young children were not diagnosed or reported to the health system. Half of people with confirmed TB are asymptomatic and transmit the disease before symptoms arise. Drug-resistant TB is a growing threat, yet in 2021, only one-third of people with drug-resistant TB received appropriate treatment, demonstrating the need for improved access to susceptibility testing. [The Lancet Microbe]
Image from Canva
