The aim of this study was to determine quantities of antibiotics used mainly or exclusively for urinary tract infections in Croatia between 2005 and 2014, to describe utilisation trends, and general ...consequences of antibiotic consumption on antimicrobial resistance.
Antibiotic utilisation data were obtained from annual reports of both the Croatian Drug Agency and Croatian Academy of Medical Sciences. Antibiotic consumption was expressed in DDD/1000 inhabitants/day (DDD TID). Antimicrobial resistance was analysed for E. coli, E. faecalis, E. faecium, P. aeruginosa, Klebsiella spp., P. mirabilis. Descriptive statistics were used to process data and calculate trends.
Overall, utilisation of antibacterials decreased by 4.8% (from 3,35 to 3,19 DDD TID), while trends of individual agents varied substantially - from 87% decline for ceftibuten to 160% rise for levofloxacin. The consumption of quinolones increased by 32.3%. This was mostly due to increased ciprofloxacin consumption (144% raise). Sulfamethoxazole-trimethoprim declined by 57%, while nitrofurantoin increased by 86%. The use of fosfomycin was marginal. Antimicrobial resistance of E. coli increased against quinolones by 54.5%, and against nitrofurantoin by 2-3%. Quinolone resistance of other pathogens (Klebiella spp, Proteus mirabilis), increased variably - between 17.2% (Klebsiella) and 90% (Proteus), while for P. aeruginosa remained the same at 22%.
High rates of antimicrobial utilisation require prescribing restrictions and educational interventions. The increased use of fluoroquinolones is a potentially serious public health threat due to the rapid development of resistance among uropathogens. This threat can be avoided by greater use of nitrofurantoin and fosfomycin.
This edition is intended to provide better understanding of antibacterial drugs and their mechanism, the role of a few metal drug complexes as antibacterials, cross-checking of a few compounds and ...biomaterials against drug-resistant bacterial strains as well as a few alternative approaches using medicinal plant based formulations in the control of antibiotic-resistant bacteria. The information in this book provides clues for upcoming trends in treating antibiotic resistance problems with which one can explore new approaches in the treatment of common infections with drug-resistant strains.
In the last decade antibiotic usage in animal production systems has received a considerable public attention. The use, overuse and misuse of antibiotics provided an excellent environment for the ...selection and dissemination of antibiotic resistant bacteria and resistance genes across a wide diversity of bacteria, mainly through horizontal gene transfer. Resistance genes move between animal and human bacteria mainly through the food chain. Thus resistance generated in animal production environments could result in the loss of effectiveness of antibiotics used for the treatment of human diseases. The increasing threat of emerging bacterial pathogens resistant to a variety of antibiotics and the economic and human burden have moved the legislators in EU to ban antibiotic usage in animal food production as growth promoters in 2006 and recently proposed further non-binding recommendations to ban antibiotics for prophylactic use too. The costs for such actions will presumably be much lower in comparison to the costs of leaving the issue as it is. However, in non EU countries such measures have not been adopted yet. The mechanisms and examples of antibiotic resistance development and dissemination are described, focusing on antibiotics used both in human and veterinary medicine and animal food production.
V zadnjem desetletju je uporaba antibiotikov v živinoreji pritegnila pozornost širše javnosti. Nenadzorovana, prekomerna in nenamenska uporaba antibiotikov je, predvsem preko mehanizma horizontalnega prenosa genov, omogočila selekcijo in širjenje proti antibiotikom odpornih bakterij in genov z zapisi za odpornost. Prenos odpornih bakterij oziroma genov z zapisi za odpornost med človekom in živalmi poteka predvsem preko prehranjevalne verige. Posledično lahko odporne bakterije ali geni z zapisom za odpornost, ki izvirajo iz živinorejskega okolja, zmanjšajo učinkovitost zdravljenja bakterijskih okužb z antibiotiki pri človeku. Vse večja grožnja pojavljanja novih večkratno odpornih patogenih bakterij, ter kot posledica vpliv na zdravje ljudi in tudi ekonomska škoda, so pripeljali do odločitve Evropske skupnosti, da od leta 2006 prepove uporabo antibiotikov kot pospeševalcev rasti v živinoreji. Nedavno pa so sprejeli tudi priporočilo, po katerem naj se antibiotikov v živinoreji ne bi uporabljalo več niti za profilakso. V večini držav izven EU podobne zakonodaje še niso sprejeli. V tem preglednem članku so opisani primeri razvoja in pojavljanja odpornosti proti antibiotikom, ki se uporabljajo tako v humani medicini in veterini, kot posledica množične uporabe v živinoreji.
In this study, low-carbon soils collected from an altitude transect from 5000 m to 6000 m were adopted as a simple model system with lower interaction complexity. This could help disentangle the ...basic environmental factors shaping the abundance and distribution of expressed resistance traits in culturable portion of fast growing heterotrophic strains. Improved plate counts were performed at 4 °C using 0.01 diluted nutrient broth supplemented with cold soil extract as a general media and additionally supplemented with antibiotics Ampicillin, Erythromycin, Kanamycin and Tetracyclin. A number of colonies (500) isolated from six locations were also tested separately for their antibiotic resistance. The results show that these high-altitude cold soils contained bacterial populations culturable at 4 °C in the range of 106 cells / g that were resistant to the four antibiotics and their various combinations tested in this study. The highest prevalence of resistance was observed in vegetated soils, whereas almost two orders of magnitude lower abundance of resistant cells was cultured from barren soils. Redundancy analysis showed that vegetation, soil carbon and pH were successful in explaining the interaction between environmental parameters and various culturable fractions of cold soil bacteria used in this study.
V študiji sem uporabil vzorce tal z nizko vsebnostjo organskega ogljika iz višinskega transekta 5000 m-6000 m kot poenostavljen modelni sistem z nizko kompleksnostjo interakcij. Ta bi lahko pomagal razumeti osnovne okoljske dejavnike, ki uravnavajo porazdelitev in obseg izraženih rezistenčnih lastnosti gojljivega dela hitro rastočih heterotrofnih sevov. Izboljšano štetje na ploščah sem izvedel pri 4 °C na 0,01 koncentriranem hranilnem bujonu, dopolnjenim s hladnim ekstraktom tal, kot splošnim gojiščem, ki sem ga dopolnil z posameznimi antibiotiki (ampicilin, eritromicin, kanamicin in tetraciklin). Večje število izolatov (500) iz šestih lokacij sem prav tako testiral ločeno na njihovo odpornost na antibiotike. Ugotavljal sem tudi povezavo med okoljskimi dejavniki ter porazdelitvijo odpornih sevov in splošnega gojljivega deleža talnih bakterij. Rezultati kažejo, da visokogorska hladna tla vsebujejo pri nizkih temperaturah gojljive bakterijske populacije (106 / g), ki so odporni na posamezne antibiotike in razne njihove kombinacije, uporabljene v tej študiji. Poraščena tla imajo največji delež odpornih bakterij, skoraj dva reda manjši pa je prisoten v golih tleh. Statistična analiza je pokazala, da vegetacija, organski ogljik ter pH uspešno razložijo interakcijo med okoljskimi dejavniki in posameznimi gojenimi deleži bakterij, izoliranih iz hladnih tal.
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