Antibiotic resistance is one of the greatest global threats we face today. Human overuse ofantibiotics is a contributing factor and major behaviour change around antibioticconsumption is needed, but several challenges exist in communicating antibiotic resistanceto the public. In 2018 the UK Government relaunched a national television advertisement aspart of the ‘Keep Antibiotics Working’ campaign which aimed to raise awareness of antibioticresistance and reduce public demand for antibiotics. This study evaluates what role theframing of antibiotic resistance in the advertisement played in increasing publicunderstanding of antibiotic resistance and motivating behaviour change. The study isgrounded in behaviour change and health communication theory from the field ofCommunication for Development, and health and social psychology theory, reflecting theneed for multidisciplinary approaches to addressing antibiotic resistance. A textual analysisidentified how the issue was framed in the advertisement and surveys and interviews wereconducted with members of the target audience groups to analyse what effect theadvertisement had on their understanding of, and attitude towards antibiotic resistance.The findings show that the framing of antibiotic resistance in the TV advertisement led to anincrease in misunderstandings of what becomes resistant to antibiotics. The advertisementwas helpful in highlighting the vulnerability of antibiotics and for creating a new social normaround being a responsible antibiotic user, however was interpreted as childish byparticipants. It did not communicate the severity of antibiotic resistance or specific risk ofantibiotic overuse to the audience, or accurately reflect the audience’s existing knowledge ofantibiotic resistance and current behaviours. As the severity of antibiotic resistance was notconveyed, the advertisement did not motivate a change in antibiotic seeking behaviours orattitude amongst the majority of participants. The findings did highlight knowledge gapsamongst study participants including the importance of completing a course of antibiotics asprescribed, and that it is the bacteria itself, not the person, that develops resistance, andhopes this research can inform the development of future campaigns.

Introduktion: Antimikrobiell resistens är en av de stora utmaningarna för folkhälsan i världen. Enligt synsättet One Health är kunskap viktig för att antibiotikaresistens ska kunna bromsas. I Sverige finns en låg men dock tilltagande förekomst av multiresistenta bakterier. Tidigare studier visa att personer som är bärare av multiresistenta bakterier upplever okunskap och otillräckligt och inadekvat bemötande, främst bland hälso- och sjukvårdspersonal. Sår är en riskfaktor för Meticillinresistenta Staphylococcus aureus MRSA, Extended spectrum betalactamase ESBL, Extended spectrum beta-lactamase ESBL-CARBA och Vancomycinresistenta enterokocker VRE. Syfte: Att beskriva hur personer som har sår och som har smittats av någon typ av multiresistent bakterie upplever bemötandet från sin omgivning på grund av smitta. Metod: En kvalitativ intervjustudie med induktiv ansats. Åtta semistrukturerade intervjuer genomfördes med studiedeltagare som hade svårläkta sår och som var bärare av en eller flera multiresistenta bakterier. Resultat: Den kvalitativa innehållsanalysen visade två övergripande teman: Bemötande från omgivningen och Bärarskap av multiresistenta bakterier påverkar omgivningen. Kategorierna för temat Bemötande från omgivningen var: Bemötande av hälso- och sjukvård; Bemötande från familj och vänner och Bemötande från övriga i samhället. Kategorierna till Bärarskap av multiresistenta bakterier påverkar omgivningen var: Överkonsumtion av skyddsutrustning; Personer som är bärare av multiresistenta bakterier har ett eget ansvar mot sin omgivningoch Samhällets ansvar för information om multiresistenta bakterier.  Slutsats: De flesta av studiedeltagarna upplever att de blev bra bemötta eller att reaktion saknades från omgivningen, dock förekom det enstaka situationer där multiresistensen påverkade bemötandet. Det fanns en kunskapsbrist, både hos de personer som är bärare av multiresistenta bakterier och från omgivningen. / Introduction: Antimicrobial resistance is a major challenge for public health globally. Out of a One Health approach, knowledge is important for slowing down spread of antibiotic resistance. In Sweden, the prevalence of multi-resistant bacteria is low but, however, is increasing. Previous studies show that people who are carrier of multi-resistant bacteria perceive lack of knowledge and incompetent and inadequate encountering mainly with health care professionals. Ulcer is risk factor for Methicillin-resistant Staphylococcus aureus, Extended-Spectrum-Beta-Lactamase, Extended-Spectrum-Beta-Lactamase- Carba and Vancomycin-resistant Enterococcus. Aim: To describe how people who have been infected by some type of multi-resistant bacteria experience the treatment from their surroundings due to infection. Method: A qualitative content analysis with inductive approach. Eight semistructured interviews were conducted with patients who had ulcer and were carriers of one och more multi-resistant bacteria. Results: The qualitative content analysis showed two overarching themes: Treatment from the enviroment and Carrier of multi-resistant bacteriaaffect the enviroment. The categories for the theme Treatment from the enviroment were: Treatment from health care; Treatment from family and friends and Treatment from others in the community. The categories for Carrier of multi-resistant bacteria affect the enviroment were Overconsumption of protective equipment; People who are carrier of multi-resistant bacteria have a responsibility for the environment and Society’s responsibility for information on multi-resistant bacteria. Conclusion: Most of the study participants felt that they were treated well or that there was no reaction from the environment, however, there were occasional situations when the multi-resistance affected the treatment. There was at lack of knowledge, both among the people who are carriers of multi-resistant bacteria and from the enviroment.

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No description available.

Thesis (M.Sc.(Medical Sciences)) -- University of Limpopo, 2022 / Background: Wound infections continue to be problematic in clinical practice where empiric treatment of infections is a routine, with non-healing wounds being a burden to the health care system. A gap has been noted between antimicrobial resistance and demographic factors as an existing relationship. This necessitates an investigation of patterns of isolates and susceptibility profiles of microorganisms in wounds to modify the preventative and therapeutic strategies against the resistant strains leading to the stall of wound healing, which could aid in empiric treatment. Objective: The aim of this study was to determine the antimicrobial patterns and their associated demographic determinants in bacteria isolated from patients with non healing wounds at Pietersburg and Mankweng Hospitals, Limpopo Province. Methods: The study was conducted using antimicrobial susceptibility data collected from National Health Laboratory Service through Academic Affairs and Research Management System for the period 2016-2020. A total of 797 Antimicrobial Susceptibility Test results were analysed using Statistical Package for Social Sciences version 27.0. The susceptibility rates for the bacterial isolates by age and gender were calculated. The mean percentages for sensitivity and resistance were also calculated. Pearson’s Chi-square test was used to compare age and gender with drug susceptibility. A p-value of ≤ 0.05 was considered significant. Results: Of the 797 patient Antimicrobial Susceptibility Test results, 372 (46.7%) were males and 425 (53.3%) females, with mean age of 31.42 ± 21.75 years. The most common isolates were, Klebsiella pneumoniae (23%), Pseudomonas aeruginosa (21.7%), Escherichia coli (16%) and Proteus mirabilis (13.5%). Highest percentage of resistance to any antibiotic was amoxicillin, ampicillin (85.15%) then trimethoprim sulfamethoxazole (60.85%), amoxicillin ampicillin (49.1%), tigecycline (46.35%), cefepime (32.7%), gentamycin (25.4%), ciprofloxacin (22.5%), colistin (17.6%), and meropenem (12.3%). Furthermore, the general view of the study is no statistically clinical significance on the effect of age and gender on bacterial resistance although statistical significance was noted on age the resistance Acinetobacter baumannii vi (p=0.018), and gender on K. pneumoniae (p=0.015), P. mirabilis (p=0.024). Major resistance to A. baumannii, K. pneumoniae and P. mirabilis were from female patients. Conclusions: The most effective antibiotics were meropenem, colistin, and ciprofloxacin. The highest number of isolates were K. pneumoniae, E. coli, P. aeruginosa, P. mirabilis and A. baumannii with the most effective antibiotics gentamycin, meropenem, ciprofloxacin, and cefepime. Although the general view of the study is that no statistically clinical significance was noted on the effect of age and gender on bacterial resistance, it is important to note the significant observation that there was an observed relation of age to amoxicillin-clavulanic acid and Ciprofloxacin and gender to amoxicillin ampicillin. As such, there is insufficient evidence that supports the effect of age and gender on antimicrobial susceptibility. The study suggests caution against the use of amoxicillin ampicillin in the treatment of wound infections as it confers low levels of efficacy and high resistance and ultimately the call to revise minimum inhibitory concentrations and critical concentrations of all less effective drugs to increase their efficacy. / National Research Foundation (NRF)

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No description available.

Salmonella est un agent pathogène animal et zoonotique d'importance mondiale. Les infections causées par cette bactérie chez les animaux d’élevage peuvent être asymptomatiques ou se traduire par une gastro-entérite ou une maladie invasive. Chez les humains, les maladies d’origines alimentaires associées à Salmonella sont principalement causées par l'ingestion de produits d'origine animale contaminés. Cependant, aucune étude n’a déterminé la prévalence ou caractérisé le profil de virulence et d’antibiorésistance de Salmonella provenant des fermes ovines du Québec, alors que cette province détient le 2ème plus grand cheptel ovin canadien. Ainsi, cette étude visait à estimer la prévalence des fermes ovines positives à Salmonella dans la province du Québec, à identifier les sérotypes circulant dans ces troupeaux, à caractériser le profil de virulence et de résistance aux antimicrobiens de souches de Salmonella isolées dans ces fermes et à évaluer l'influence de certains facteurs de risque (ex. la saisonnalité, la taille des troupeaux et le type de production) sur la prévalence de fermes ovines positives à Salmonella au Québec. Pour cela, 61 fermes ovines du Québec ont été sélectionnées aléatoirement et ont été échantillonnées. Un pool fécal provenant de 10 animaux a été prélevé par ferme. Des milieux sélectifs ont été utilisés pour isoler Salmonella dans chaque échantillon. La confirmation de Salmonella a été faite par des tests biochimiques suivis par la détection du gène invA par PCR et les sous-espèces ont été identifiées par PCR multiplex. Le rapport de prévalence a été calculé pour évaluer l’association entre les facteurs de risque et la présence de Salmonella dans les fermes. Le séquençage du génome complet de 76 isolats a permis d’identifier les sérotypes et de déterminer le profil de virulence et de résistance génotypique de ces isolats. La confirmation de la résistance phénotypique de différentes souches a été effectuée en utilisant la méthode de diffusion en milieu solide (antibiogramme) et la méthode de dilution en milieu liquide. Les résultats indiquent que 83,6% (95% CI 74,3%-92,9%) des troupeaux sont porteurs de Salmonella. Le sérotype Salmonella enterica sous-espèce diarizonae 61 k:1, 5, (7) (Sheep associated Salmonella diarizonae (SASd) a été le seul sérotype identifié dans tous les isolats qui ont été séquencés. Aucun des facteurs de risque évalués n’était associée à la présence de Salmonella. En outre, aucun gène de résistance aux antimicrobiens n’a été identifié à partir de l’analyse des génomes séquencés et toutes les souches ont été révélées comme étant phénotypiquement sensibles aux différents antimicrobiens testés. De plus, des facteurs de virulence, comme les ilots de pathogénicité (SPI-1, SPI-2, SPI-3, SPI-5, SPI-9 et SPI-13) et le plasmide (IncX1), ont été identifiés chez les 84 SASd. Cette étude est la première à rapporter que la prévalence des fermes ovines positives à Salmonella est élevée au Québec (83,6%). Seule la présence du sérotype 61 k:1, 5, (7) a été détectée. Finalement, toutes les souches de Salmonella isolées dans le cadre de cette étude étaient sensibles aux antimicrobiens testés. / Salmonella is a world-known animal and zoonotic pathogen. Infections caused by this bacterium in livestock can be asymptomatic or result in gastroenteritis or an invasive disease. In humans, food-related diseases associated with Salmonella are mainly caused by the ingestion of contaminated products of animal origin. However, no studies have determined the prevalence or characterized the virulence and antimicrobial resistance (AMR) profiles of Salmonella from sheep farms in Quebec, where the province holds the second largest sheep population in Canada. This study aimed to estimate the prevalence of Salmonella-positive sheep farms in the province of Quebec, to identify the serotypes circulating in these flocks, to characterize the virulence and AMR profiles of Salmonella strains isolated from these farms and to assess the influence of some potential risk factors on the prevalence of Salmonella-positive sheep farms in the province of Quebec. For this purpose, 61 sheep farms in Quebec were randomly selected and sampled. A fecal pool including samples from 10 animals was collected per farm. Selective culture media were used to isolate Salmonella in each sample. Salmonella was confirmed by biochemical tests followed by the detection of invA gene by PCR and the subspecies were identified by multiplex PCR. The prevalence ratio was calculated to assess the association between risk factors and the presence of Salmonella in farms. The Whole genome sequencing (WGS) of 76 isolates was used to determine the serotypes, the virulence and the AMR profile of these isolates. The confirmation of the phenotypic AMR of these isolates (n=76) was carried out using the Kirby–Bauer disk diffusion method (antibiogram) or the broth microdilution method. The results indicated that 83.6% (95% CI 74.3%-92.9%) of the flocks are carrier of Salmonella and only the Salmonella enterica subspecies diarizonae serotype 61: k: 1, 5, (7) (sheep associated S. diarizonae, SASd) was identified. None of the tested risk factors was associated with Salmonella positivity at the flock level. In addition, no AMR genes were identified from the WGS data, and all strains were phenotypically sensitive to the various antimicrobials tested. In addition, virulence factors such as pathogenicity islands (SPI-1, SPI-2, SPI-3, SPI-5, SPI-9 and SPI-13) and plasmid (IncX1) have been identified in the sequenced strains. This study was the first to report a high prevalence of Salmonella-positive sheep farms in Quebec (83.6%). Only the presence of serotype 61 k:1, 5, (7) was detected. Interestingly, all Salmonella strains isolated in this study were sensitive to the tested antimicrobials.

No / Whole genome sequencing (WGS) of Mycobacterium tuberculosis has rapidly progressed from a research tool to a clinical application for the diagnosis and management of tuberculosis and in public health surveillance. This development has been facilitated by drastic drops in cost, advances in technology and concerted efforts to translate sequencing data into actionable information. There is, however, a risk that, in the absence of a consensus and international standards, the widespread use of WGS technology may result in data and processes that lack harmonization, comparability and validation. In this Review, we outline the current landscape of WGS pipelines and applications, and set out best practices for M. tuberculosis WGS, including standards for bioinformatics pipelines, curated repositories of resistance-causing variants, phylogenetic analyses, quality control and standardized reporting. / European Research Council grant (INTERRUPTB; no. 311725), European Research Council grant (TB-ACCELERATE; no. 638553), Foundation for Innovative New Diagnostics, German Center for Infection Research (DZIF), Deutsche Forschungsgemeinschaft (German Research Foundation) under Germany’s Excellence Strategy (EXC 22167–390884018), FWO Odysseus G0F8316N, US National Institutes of Health BD2K K01 (MRF ES026835), Agence Nationale de la Recherche (ANR-16-CD35-0009)

La pollution microbienne des eaux récréatives peut engendrer un risque pour la santé des populations exposées. La contamination fécale de ces eaux représente une composante importante de ce risque, notamment par la présence possible d’agents pathogènes et par l’exposition à des micro-organismes résistants aux antimicrobiens. Les sources de pollution fécale sont multiples et incluent entre autres les activités agricoles et les productions animales. Ce projet visait donc à mieux comprendre les facteurs influençant la qualité microbiologique des eaux récréatives du Québec méridional, en ciblant le rôle possible des activités agricoles, ainsi qu`à proposer et évaluer de nouvelles sources de données pouvant contribuer à l’identification de ces facteurs. Dans un premier temps, une évaluation de la présence d’Escherichia coli résistants aux antimicrobiens dans les eaux récréatives à l’étude a été effectuée. À la lumière des résultats de cette première étude, ces eaux représenteraient une source de micro-organismes résistants aux antimicrobiens pour les personnes pratiquant des activités aquatiques, mais l’impact en santé publique d’une telle exposition demeure à déterminer. Les déterminants agroenvironnementaux associés à la présence de micro-organismes résistants aux antimicrobiens ont par la suite été explorés. Les résultats de ce chapitre suggèrent que les activités agricoles, et plus spécifiquement l’épandage de fumier liquide, seraient reliées à la contamination des eaux récréatives par des bactéries résistantes aux antimicrobiens. Le chapitre suivant visait à identifier des déterminants agroenvironnementaux temps-indépendants d’importance associés à la contamination fécale des eaux à l’étude. Différentes variables, regroupées en trois classes (activités agricoles, humaines et caractéristiques géohydrologiques), ont été explorées à travers un modèle de régression logistique multivarié. Il en est ressorti que les eaux récréatives ayant des sites de productions de ruminants à proximité, et en particulier à l’intérieur d’un rayon de 2 km, possédaient un risque plus élevé de contamination fécale. Une association positive a également été notée entre le niveau de contamination fécale et le fait que les plages soient situées à l’intérieur d’une zone urbaine. Cette composante nous permet donc de conclure qu’en regard à la santé publique, les eaux récréatives pourraient être contaminées par des sources de pollution fécale tant animales qu’humaines, et que celles-ci pourraient représenter un risque pour la santé des utilisateurs. Pour terminer, un modèle de régression logistique construit à l’aide de données issues de la télédétection et mettant en association un groupe de déterminants agroenvironnementaux et la contamination fécale des eaux récréatives a été mis au point. Ce chapitre visait à évaluer l’utilité de telles données dans l’identification de ces déterminants, de même qu`à discuter des avantages et contraintes associées à leur emploi dans le contexte de la surveillance de la qualité microbiologique des eaux récréatives. À travers cette étude, des associations positives ont été mises en évidence entre le niveau de contamination fécale des eaux et la superficie des terres agricoles adjacentes, de même qu’avec la présence de surfaces imperméables. Les données issues des images d’observation de la Terre pourraient donc constituer une valeur ajoutée pour les programmes de suivi de la qualité microbiologique de ces eaux en permettant une surveillance des déterminants y étant associés. / Microbial pollution of recreational waters may constitute a health risk for exposed populations. Fecal contamination of these waters represents an important component of this risk, especially due to the possible presence of pathogens and exposure to antimicrobial resistant microorganisms. Sources of fecal pollution are many and include agricultural activities and animal production. This project aims to better understand agroenvironmental factors influencing the microbiological quality of recreational waters of Southern Quebec and also suggests and assesses new sources of data which may contribute to the identification of these factors. An evaluation of the presence of antimicrobial resistant Escherichia coli in the recreational waters studied was first performed. Given the positive results found, certain bodies of waters may represent a source of antimicrobial resistant microorganisms for people engaged in water activities. However the public health impact of such exposure is still unknown. Agroenvironmental determinants associated with the presence of antimicrobial resistant microorganisms were investigated. Results of this chapter suggest that agricultural activities, especially liquid manure spreading, may be associated with the contamination of recreational waters with antimicrobial resistant microorganisms. The next chapter assesses key time-independent agroenvironmental determinants associated with the fecal contamination of studied recreational waters. Various variables – classified as either agricultural activities, human activities or geo-hydrological characteristics – are explored through a multivariate logistic regression model. It appears that recreational waters with ruminant productions in their proximal environment, especially when they are within a radius of 2 km, may present a higher risk of fecal contamination. A positive association was also noticed between the level of fecal contamination of a beach and its presence in an urban area. From a public health perspective, recreational waters may be contaminated by animal and human sources and these sources may represent a risk for bathers’ health. Finally, association between fecal contamination of recreational waters and agroenvironment determinants was studied through a logistic regression model built from remote sensing data. This chapter assesses the utility of such data in the identification of these determinants and discusses the strengths and the limitations of their use in the context of the monitoring of the microbiological quality of recreational waters. In this study, positive associations were found between the level of fecal contamination and both the proximity of agricultural lands and the presence of impervious surfaces. Earth observation data may constitute an added value for the water quality monitoring program in allowing the surveillance of the determinants associated with this quality.