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Background and Aim:Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most recognized “superbugs” and a common cause of community-associated and nosocomial infections; furthermore, when chicken meat is considered a good growth medium for S. aureus to make a plausible vehicle to propagate MRSA, then this study was conducted to evaluate the efficiency of ozonated water (0.5 ppm) in the elimination or reduction of MRSA contaminating fresh and frozen chicken meat sold in local markets in the Wasit Province.Materials and Methods:A total of 72 samples of fresh and frozen chicken meat were randomly collected from dissimilar native markets: Fresh chicken meat (n=32) and frozen chicken meat (n=40). Isolation and identification of MRSA isolates were conducted using standard bacteriological, biochemical, RapID™ Staph Plus System (Remel, R8311009), and latex agglutination tests such as Dry SPOT Staphytect Plus (Oxoid, DR0100M) and PBP2’ Test Kit (Oxoid, DR0900A). The generation of ozone (O3) was carried out using O3 generator (A2Z/AQUA-6, USA), and its concentration (ppm) in water was determined using CHE-Mets®-Kit, USA.Results:A total of 39 (54.2%) of 72 fresh and frozen chicken meat were positive for S. aureus; of those 39 positive samples, 13 (33.3%) were identified as MRSA. The antibiotic sensitivity test results revealed that all MRSA isolates had multiple resistance to at least four antimicrobial agents for which these isolates had 12 antibiotic resistance patterns. Results of O3 treatment in MRSA isolate contaminating 13 of both fresh and frozen chicken meat samples showed that, after treatment with ozonated water (0.5 ppm/4°C), the overall negative samples were 23.1% and 69.2% for 30 and 45 min, respectively. The decrease in the percentage of positive samples was very significant from a public health perspective. Furthermore, the antimicrobial efficacy of ozonated water (0.5 ppm) on the reduction of the MRSA count (log10 colony-forming units [CFU]/ml) was assessed in four positive samples of fresh and frozen chicken meat, and the results revealed that, after treatments, the overall reduction was 2-4 log10 (CFU/ml) after 45 min. This reduction is highly significant from a public health perspective.Conclusion:From the data obtained from this study, it can be concluded that fresh and frozen chicken meat sold in the different markets of Wasit Province was highly contaminated by S. aureus during the study period with a total prevalence of 54.2%; among those, 33.3% were recognized as MRSA. Under the conditions described in the present study, O3 at the concentration of 0.5 ppm is highly effective in reducing the number of MRSA-positive samples and the number decreased with increased exposure time to ozonated water at the same concentration. These findings indicated that O3 treatment might constitute the basis for an alternative method to reduce meat contamination with foodborne pathogens such as MRSA.

Irrational and inappropriate prescribing of antibiotics is a major problem that can lead to the development of antimicrobial resistance (AMR). In Zambia, there is insufficient information on the prescribing patterns of antibiotics according to the World Health Organization (WHO) AWaRe classification. Therefore, this study assessed the prescribing patterns of antibiotics using the AWaRe classification during the COVID-19 pandemic at the University Teaching Hospital in Lusaka, Zambia. A cross-sectional study was conducted using 384 patient medical files at the University Teaching Hospital in Lusaka, Zambia, from August 2022 to September 2022. All antibiotics were classified according to the WHO “AWaRe” tool and assessed for appropriateness using the 2020 Zambian Standard Treatment Guidelines. Of the 384 patient medical files reviewed, antibiotics were prescribed 443 times. The most prescribed antibiotics were ceftriaxone (26.6%), metronidazole (22.6%), amoxicillin (10.4%), amoxicillin/clavulanic acid (5.6%), and azithromycin (5%). The prescribing of 42.1% of “Watch” group antibiotics was greater than the recommended threshold by the WHO. Most antibiotics were prescribed for respiratory infections (26.3%) and gastrointestinal tract infections (16.4%). The most prescribed antibiotic was ceftriaxone, a Watch antibiotic. This is a worrisome observation and calls for strengthened antimicrobial stewardship and implementation of the AWaRe framework in prescribing antibiotics.

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Antimicrobial resistance (AMR) is one of the greatest public health challenges of our time, primarily due to inappropriate antimicrobial use. Addressing this threat is a public health priority that requires a collaborative global approach in all areas. The rational use of antimicrobials is the main strategy for the prevention of antimicrobial resistance, which can be achieved by changing the behavior and knowledge of the prescribers. So, for the success of any problem management program, the most important prerequisite is community participation. Therefore, this study aimed to assess the knowledge and attitude of the samples of community members, pharmacists and health professionals in the city of Al-Suwaria, in the province of Wasit, in the Middle East of Iraq, with respect to antimicrobial resistance, which helps to rationalize the use of antimicrobials. In this survey, a cross-sectional study of 102 random contributing samples was performed. From January to March 2020. Knowledge and attitudes were assessed using a typical self-administered questionnaire. Descriptive analyzes were used to express the results. A total of 102 participants answered the questionnaire. Overall, collaborators have established good knowledge and positive attitudes toward antimicrobial resistance based on 13 knowledge questions and nine attitude statements. Gaps were identified in the knowledge of the possibility of addressing resistance through the discovery of a new drug (21.6%), the possibility of using antibiotics as an effective drug against viral diseases (36.3%) and the possibility of accelerate the treatment of diseases with antibiotics (38.2%). The majority of respondents (72.5%) agreed that antibiotic resistance induces serious global problems that affect public health. Furthermore, the majority of those interviewed (69.6%) believe that this phenomenon affects our health and that of our families. Similarly, (13.7%) of the participants totally agreed, while (65.7%) agreed that pharmacists played an important role in the appearance of this problem, and (37, 3%) of the participants fully agreed, while (58.8%) agreed that it is necessary to follow the recommendations and guidelines for life-saving antibiotics in the hospital. In contrast, 27.5% of the participants expressed a weak attitude towards the possibility of fighting antimicrobial resistance in their region through infection control practices by health professionals. Contributors in this study had good knowledge and positive attitudes toward antimicrobial resistance. Although the data is indicative of gaps in the knowledge of residents of the city of Al-Suwaria/Wasit province.