Antimicrobial resistance: A public health challenge

Jindal, A.K.; Pandya, Kapil; Khan, Inam Danish

doi:10.1016/j.mjafi.2014.04.011

Cited by 132 publications

(86 citation statements)

References 6 publications

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“…Similarly, other studies have reported the detection of Vibrio in discharged effluents in South Africa and have emphasized the possibility of their survival in the environment [57][58][59][60]. The lack of statistical correlation between the abundance of FIB and potentially pathogenic Vibrio species points at the feeble attempt to use indicator organisms as surrogates for pathogens in water systems [61][62][63], while more reliable pathogen detection technology such as molecular-based and next-generation sequencing techniques will give more accurate results.…”

Section: Discussionmentioning

confidence: 99%

Ecological and Public Health Implications of the Discharge of Multidrug-Resistant Bacteria and Physicochemical Contaminants from Treated Wastewater Effluents in the Eastern Cape, South Africa

Adefisoye

Okoh

2017

Water

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This study assessed the prevalence of fecal indicator bacteria (FIB) and Vibrio species, as well as the physicochemical qualities of the discharged effluents of two wastewater treatment facilities, in the Eastern Cape, South Africa over a one-year sampling period using standard methods. Bacteriological assessment revealed presumptive E. coli counts ranging from 3 to 1.2 × 10 5 CFU/100 mL, while counts of Vibrio spp. ranged from 11 to 1.4 × 10 4 CFU/100 mL. Molecular identification of the isolates by polymerase chain reactions (PCR) yielded positive reaction rates of 76.2% (381/500) and 69.8% (279/400) for E. coli and Vibrio species, respectively. The antibiotic susceptibility profiles of 205 randomly selected PCR-confirmed Vibrio isolates against 18 antibiotics revealed resistance frequencies ranging from 0.5% (imipenem) to 96.1% (penicillin G), based on recommended breakpoint concentrations. About 81% (166/205) of the Vibrio isolates exhibited multidrug resistance (resistance to three or more classes of antibiotics), while nine different antibiotic resistance genes were detected by PCR. The physicochemical qualities of the effluents also ranged as follows: pH (6.5-7.6), temperature (12-27 • C), turbidity (1.5-65.7 mg/L), total dissolved solids (95-171 mg/L), dissolved oxygen (2.1-9.8), electrical conductivity (134-267 µS/cm), free chlorine (0.08-0.72 mg/L), biochemical oxygen demand (0.12-9.81 mg/L), nitrate (1.04-21.5 mg/L), nitrite (0.11-0.76 mg/L), phosphate (1.03-18.3 mg/L) and chemical oxygen demand (27-680 mg/L). The discharged effluents fell short of the regulatory guidelines for some of the parameters assessed. We conclude that the discharged effluents are potential sources of environmental pollution and can contribute to drug resistant bacteria load in the receiving watershed, with the associated ecological and human health risks.

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Section: Discussionmentioning

confidence: 99%

Ecological and Public Health Implications of the Discharge of Multidrug-Resistant Bacteria and Physicochemical Contaminants from Treated Wastewater Effluents in the Eastern Cape, South Africa

Adefisoye

Okoh

2017

Water

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“…17 Undiagnosed and untreated active, subclinical, and latent MDRTB cases from endemic high burden world regions remain serious health hazards as tuberculosis is the leading cause of mortality from an infectious disease worldwide. 5,10,[26][27][28] Neisseria meningitidis W135 outbreaks in 2000 and 2001 during Hajj were followed by a global spread, a risk existing for all MDR bacteria. 2,3,5,13,25,29,30 Hajj is the only mass gathering that has instituted mandatory immunoprophylaxis for pilgrims, pilgrim contacts, HCPs, and the local population.…”

Section: Incident Reporting System For Indian Hajj Pilgrimsmentioning

confidence: 99%

Indian Medical Mission at Hajj-2016: Mass-Gathering Medicine Perspectives, Challenges, and Opportunities in a Mission Posture

Khan

et al. 2017

Int J Travel Med Glob Health

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IntroductionHajj is an annual mass gathering of over 3.5 million pilgrims from 200 countries who congregate in densities of 9 people/ m2 and endure strenuous rituals, compromised living standards, and a harsh desert climate in an alien ethnocultural and sociolinguist milieu for spiritual enlightenment. Mass gathering medicine at Hajj is challenged by issues of healthcare accessibility, infection control, on-site treatment, referral, evacuation, and response to disasters and public health emergencies in addition to challenges to providing support such as shelter, food and water, transportation, mass communication, interpersonal communication, sanitation, overcrowding, and human security. 1,2Hajj has historically experienced high morbidity and mortality owing to pre-existing comorbidities, outbreaks, accidents, and disasters such as such as stampedes, fires, AbstractIntroduction: Hajj is an annual mass gathering of over 3.5 million pilgrims congregating from 200 countries in the desert climate of Saudi Arabia. Mass gathering medicine at Hajj is challenged by issues of healthcare accessibility, infection control, on-site treatment, referral, evacuation, and response to disasters and public health emergencies. The Indian Medical Mission at Hajj 2016 established, operated, and coordinated a strategic network of mass gathering medical operations, the proceeds of which are discussed herein. Methods:The mission was designed to provide holistic health security through health intelligence for pre-existing chronic diseases, epidemic intelligence for endemic and exotic diseases, public-health and disaster-health preparedness, and tiered healthcare through mobile medical task forces, static clinics, tent clinics, secondary care hospitals, and evacuation capabilities. Results: Primary care, secondary care, and tertiary care treated 374 475, 930, and 523 patients, respectively. Patients exhibited limited compliance with pre-instituted treatments and precautionary protocols. Respiratory and gastrointestinal infections, cardiorespiratory, trauma, and heat illnesses were seen. Epidemic intelligence revealed an outbreak of food poisoning. Respiratory infections were reported by 90% of the healthcare personnel. Surge capacity was overwhelmed with patient throughput and ambulance transfers. Crude unadjusted mortality was 11.99/10 000. Conclusion:The Indian Medical Mission at Hajj 2016 yielded solutions to the challenges faced during the 2016 Hajj pilgrimage. The mission posture of the Indian Medical Mission in Hajj presents a modus operandi for handling crisis scenarios in mass gathering. The situational analysis of the Hajj health mission calls for dynamic interventions in preparedness, clientele, and health systems.

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“…Overwhelming fluid resuscitation and extensive procedures may lead to procedural errors, transmission of infections and antimicrobial overuse [17, [27][28][29][30]. Since the study catered to 4.5 lakh patients across a wide network of medical facilities in a setting of mass-gathering medicine, limitations exist due to variability in patients, sites and medical facilities.…”

Section: Public Health and Epidemiologymentioning

confidence: 99%

Operations Throughput as a Determinant of Golden-Hour in Mass-Gathering Medicine

Khan¹,

Asima

Khan

2017

IJMMR

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Antimicrobial resistance: A public health challenge

Cited by 132 publications

References 6 publications

Ecological and Public Health Implications of the Discharge of Multidrug-Resistant Bacteria and Physicochemical Contaminants from Treated Wastewater Effluents in the Eastern Cape, South Africa

Ecological and Public Health Implications of the Discharge of Multidrug-Resistant Bacteria and Physicochemical Contaminants from Treated Wastewater Effluents in the Eastern Cape, South Africa

Indian Medical Mission at Hajj-2016: Mass-Gathering Medicine Perspectives, Challenges, and Opportunities in a Mission Posture

Operations Throughput as a Determinant of Golden-Hour in Mass-Gathering Medicine

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