Fecal pollution of surface water is a significant environmental health issue. Indicator organisms are used to monitor microbial water quality, but often their presence does not coincide with the presence of pathogens. Bacterial source tracking is a term describing methods to determine the origin of fecal pollution based on bacterial traits. The objective of this research is to evaluate the use of 2 bacterial source tracking techniques, antibiotic resistance analysis (ARA) and ribotyping, to determine the sources of bacteria isolated from Sinking Creek. Based on the results of this study, ARA and ribotyping are not useful techniques for identifying sources of fecal pollution in Sinking Creek. ARA classification rates were low, and ribotype pattern generation success was 37%. The results of this study bring into question the reliability and reproducibility of these 2 source tracking methods for routine use in small watersheds.

Background There has been an increase in antibiotic consumption in the last decades in lower income countries, still, it is insufficient to meet everyone’s needs. Ensuring access to them is essential to lower the burden of disease and mortality, as well as to accomplish the Sustainable Developmental Goals. However, this consumption needs to be responsible to avoid faster spreading of antibiotic resistances. The recent COVID-19 pandemic has threatened the healthcare systems everywhere, both directly and indirectly. Nevertheless, there is a lack of research on how it has impacted antibiotics’ stock.  Methods This study used secondary data of a cross-sectional cohort design to follow the impact of the pandemic on the stock of three commonly used antibiotics in healthcare facilities of Uganda. The data was compared between three time periods: before the pandemic started (January 2019-February 2020), during the first months of the pandemic and coinciding with the harshest restrictions (March 2020-May 2020), and the second period of the pandemic (June 2020-December 2020). Results An increase in stock of the antibiotics was observed as the restrictions hardened, followed by a decrease when they were lifted. Likewise, this rise happened both in the consumption and arrival of antibiotics. Stratified analysis was preformed grouping by healthcare level and by region, seeing that the strongest change happened in facilities at level II and III in the Eastern region of Uganda. Conclusions  This suggests that the pandemic influenced the antibiotics stocks and consumption. Further research needs to be done to better understand this effect.

Infections caused by antibiotic resistant pathogenic bacteria is an increasing issue inhealthcare, and development of new antimicrobial substances could contribute to combat the continued spread. Plants have historically been used in traditional medicine, have intrinsic defense mechanisms against microbes, and could therefore be a source for new antimicrobial agents. At the Department of Chemistry and Biomedicine at Linnaeus University, Kalmar, a total of 18 extracts made from 9 different combinations of Swedish-growing plants were available.The purpose of the current thesis was to investigate possible antimicrobial effects of the plant extracts in vitro, on a selection of Gram-positive (n=3) and Gram-negative (n=4) bacterial strains. Initial screening of all 18 extracts was performed with agar-based methods including agar well diffusion and direct application on inoculated agar. Detection of concentration-dependent antimicrobial effects was performed with four extracts on Staphylococcus aureus and Enterococcus faecalis. At inhibitory concentrations, viability was estimated as colony forming units/ml (CFU/ml).Screening showed that 11 of 18 extracts affected the growth of at least one of the strains tested. Gram-positive species were affected to a greater extent than Gram-negatives. Estimation of concentration dependency showed inhibitory effects at 50 mg/l in the most potent extracts. Viability estimation revealed an average reduction for both S. aureus and E. faecalis, as compared to the positive control. In conclusion, the study showed possible antimicrobial effects of several extract-bacteria combinations, disclosing potential substances for further investigations.

Inledning: Konsumtionen av antibiotika skiljer sig mellan länder i världen. På lokal nivå sker överföring av antibiotikaresistens mellan de olika ekosystemen såsom gårdar, sjukhus, avloppsvatten, reningsverk och naturliga miljöer. Detta är det enda problem där hälsoläget i ett ekosystem kan påverka motsvarande område i andra system, inklusive människors hälsa. Internationella resenärer och migrerande djur kan bära på antibiotikaresistenta bakterier. Mål 3 av genda 2030 är att säkerställa hälsosamma liv och främja välbefinnande för alla i alla åldrar. Antibiotikaresistens är en av de stora utmaningarna för folkhälsan i världen. Genom att öka människors kunskaper och hälsokunskaper i synnerhet kan medvetenheten om antibiotikaresistens ökas avsevärt, vilket kommer att ha en positiv inverkan på åtgärder som irrationell antibiotikadispensering och självmedicinering. Syfte: Arbetets syfte var att undersöka kunskap och uppfattning om antibiotikaanvändning, självmedicinering med antibiotika och antibiotikaresistenta bakterier bland vuxna invandrare i Sverige. Metoder: En kvalitativ intervjustudie med nio deltagare som har genomförts med induktivt tillvägagångssätt. Datamaterial samlades in via en semistrukturerad intervju och analyserades med hjälp av en kvalitativ innehållsanalys. Resultat: Resultatet av studien visar deltagarnas hälsokunskaper gällande; allmän kunskap om antibiotika, självmedicinering med antibiotika, användning av antibiotika i andra länder och antibiotikaresistens. Slutsats: Okunskap om antibiotika- och antibiotikaresistens utgör ett allvarligt folkhälsoproblem. / Introduction: Consumption of antibiotics differs between countries in the world. At the local level, antibiotic resistance transmission occurs across borders of different ecosystems such as farms, hospitals, wastewater, treatment plants, and natural environments. This is the one area of public health in which the health problem of one ecosystem may affect the health of an other ecosystems, including human health. International travelers and migrating animals may carry antibiotic-resistant bacteria. Goal 3 of the Agenda 2030 ensures healthy lives and advocates promotion of well-being for everyone of all ages. Antibiotic resistance is one of the significant challenges to public health in the world. By improving people's knowledge and health literacy, antibiotic resistance awareness can be considerably increased, which will have a health-promoting impact on actions such as irrational dispense of antibiotics and self-medication. Aim: The aim was to investigate the knowledge and perception of antibiotic use, self-medication with antibiotics and antibiotic-resistant bacteria in adult immigrants in Sweden. Methods: Aqualitative interview study of nine respondents with an inductive approach was performed. Data material was collected through semi-structured interviews and analyzed according to qualitative content analysis by Graneheim & Lundman (2003). Results: The results of the study illustrate the participants’ health knowledge regarding: general knowledge of antibiotics, self-medication with antibiotics, use of antibiotics in other countries and antibiotic resistance. Conclusion: Poor awareness of antibiotics and antibiotic resistance is a severe public health problem.

Skin related injuries are some of the most dangerous forms of wounds. In addition to treating the wound itself, health care providers must be cautious of microbial infections. In this study, we evaluate a novel all-natural antimicrobial gel compound (AMG) designed to kill planktonic bacteria, penetrate bacterial biofilms, and accelerate wound healing. In -vitro experiments demonstrate that AMG is effective in inhibiting planktonic growth and biofilm development of eight common pathogens. LIVE/DEAD staining and confocal microscopy reveal that planktonic growth and three-dimensional structure of biofilms were significantly reduced. Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) was used to investigate a small panel of genes (PrsA, Sprx) and showed potential targets for future study. A physiologically relevant wound model was created for treating S. aureus infections by using AMG alone or in combination with a common topical antibiotic, Mupirocin. AMG is a safe and effective treatment option for skin related infection.

Tuberculosis (TB) is a respiratory disease caused by Mycobacterium tuberculosis (Mtb) that kills around 1.3 million people annually. Multi-drug resistant TB (MDR-TB) strains are increasingly encountered, in part resulting from shortcomings of current TB drug regimens that last between six to nine months. Patients may stop taking the antibiotics during their allotted regimen, leading to drug resistant TB strains. Novel drug screening platforms are therefore necessary to find drugs effective against MDR-TB. In order to discover compounds that target under-exploited pathways that may be essential only in vivo, the proposed screening platform will use a novel approach to drug discovery by blocking essential protein-protein interactions (PPI). In Mtb, PPI can be monitored by mycobacterial protein fragment complementation (M-PFC). This project will re-engineer the M-PFC assay to include the red fluorescent mCherry reporter for increased efficiency and sensitivity in high-throughput screening applications. To optimize the mCherry assay, we have developed fluorescent M-PFC reporter strains to monitor distinct PPI required for Mtb virulence: homodimerization of the dormancy regulator DosR. A drug screen will then identify novel compounds that inhibit this essential PPI. The screen will involve positional-scanning combinatorial synthetic libraries, which are made up of chemical compounds with varying side chains. This work will develop novel tools for TB drug discovery that could identify new treatments for the emerging world threat of MDR-TB.

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