Antimicrobial resistance and the current refugee crisis

Maltezou, Helena C.; Theodoridou, Maria; Daikos, George L.

doi:10.1016/j.jgar.2017.03.013

Cited by 39 publications

(26 citation statements)

References 32 publications

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“…Studies of refugees arriving in high-income countries have noted a high prevalence of drug-resistant tuberculosis [8], infections with antibiotic-resistant Enterobacteriaceae [9, 10], and colonization with antibiotic-resistant bacteria [11]. Refugees seem to be particularly at risk in part due to the elevated levels of antimicrobial resistance in their countries of origin and enhanced acquisition due to failing infrastructure and insanitary conditions [12]. Although refugees appear to be a high-risk group, whether routine preemptive isolation and screening should be recommended and would be worthwhile is not as yet resolved [13].…”

Section: Bacterial Diseasesmentioning

confidence: 99%

Pulmonary Diseases in Refugees and Migrants in Europe

et al. 2018

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More than 2 million people fleeing conflict, persecution, and poverty applied for asylum between 2015 and 2016 in the European Union. Due to this, medical practitioners in recipient countries may be facing a broader spectrum of conditions and unusual presentations not previously encountered, including a wide range of infections with pulmonary involvement. Tuberculosis is known to be more common in migrants and has been covered broadly in other publications. The scope of this review was to provide an overview of exotic infections with pulmonary involvement that could be encountered in refugees and migrants and to briefly describe their epidemiology, diagnosis, and management. As refugees and migrants travel from numerous countries and continents, it is important to be aware of the various organisms that might cause disease according to the country of origin. Some of these diseases are very rare and geographically restricted to certain regions, while others have a more cosmopolitan distribution. Also, the spectrum of severity of these infections can vary from very benign to severe and even life-threatening. We will also describe infectious and noninfectious complications that can be associated with HIV infection as some migrants might originate from high HIV prevalence countries in sub-Saharan Africa. As the diagnosis and treatment of these diseases can be challenging in certain situations, patients with suspected infection might require referral to specialized centers with experience in their management. Additionally, a brief description of noncommunicable pulmonary diseases will be provided.

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Section: Bacterial Diseasesmentioning

confidence: 99%

Pulmonary Diseases in Refugees and Migrants in Europe

et al. 2018

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“…This lack obligates healthcare providers in Syria to use therapeutic guidelines of other countries, or to depend on their own experience. In addition, The war had a great impact on all healthcare aspects, including antimicrobial resistance, which represents a local, regional and global serious risk because of displacement and migration of Syrians (4) (5). This urges researchers to monitor this risk permanently.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial Resistance in Syria

Kaddour¹,

Alhamid²,

Homsi³

et al. 2019

Preprint

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Background Antimicrobial resistance is one of the important and serious public health problems worldwide. Syria has a severe lack of data regarding this problem, especially after war. We aimed from this study to provide a unique snapshot on antimicrobial resistance in Syria.Methods This is a multi-centric cross-sectional in-vitro study. The results of routine antimicrobial susceptibility tests were collected and analyzes from five major hospitals during the period from 1st March 2018 through 31th October 2018.Results Final analysis included 2861 isolates. We noticed extremely high rates of antimicrobial resistance among all the species studied. Gram negatives have high resistance rates for cephalosporins. 77% of E.coli, 73% of Klebsiella and 82% of pseudomonas are resistant for ceftriaxone. We also noticed minimal effect of macrolides on gram negatives. 25% of Salmonella typhi strains were resistant to ciprofloxacin. High resistance rates to nitrofurantoin is seen among uropathogenic bacteria. Most gram positive bacteria still have a low resistance rate to vancomycin and linezolid. 54% of staphylococcus aureus and 38% of streptococcus pyogens are resistant to amoxicillin-clavulanate. Resistance rates to Colistin are minimal. The comparison with resistance rates before war reveals the great impact of war on antimicrobial resistance problem.Conclusion Antimicrobial resistance rates in Syria are worrying. We recommend that the Syrian health authorities apply a policy to restrict the irrational use of antibiotics, and to increase awareness toward antimicrobials use.

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“…Better prevention and control plans and effective strategies against antibiotic resistance are needed [ 1 ]. The World Health Organization (WHO) categorizes emergence and spread of antimicrobial resistance as a high priority action, and aims to ensure its prevention and treatment with effective and safe medicine while developing new antibiotics or alternative medicine to antibiotics [ 2 , 3 ]. Efficient strategies to manage antimicrobial resistance require a quantitative and deeper understanding of microbial behavior.…”

Section: Introductionmentioning

confidence: 99%

On-Chip Isoniazid Exposure of Mycobacterium smegmatis Penicillin-Binding Protein (PBP) Mutant Using Time-Lapse Fluorescent Microscopy

Elitaş

2018

Micromachines

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Antibiotic resistance has been one of the biggest threats to global health. Despite the available prevention and control strategies and efforts in developing new antibiotics, the need remains for effective approaches against antibiotic resistance. Efficient strategies to cope with antimicrobial resistance require a quantitative and deeper understanding of microbial behavior, which can be obtained using different techniques to provide the missing pieces of the current antibiotic-resistance puzzle. Microfluidic-microscopy techniques are among the most promising methods that contribute modernization of traditional assays in microbiology. They provide monitoring and manipulation of cells at micro-scale volumes. Here, we combined population-level, culture-based assays with single-cell resolution, microfluidic-microscopy systems to investigate isoniazid response of Mycobacterium smegmatis penicillin-binding protein (PBP) mutant. This mutant exhibited normal growth in plain medium and sensitivity to stress responses when treated with thermal stress (45 °C), detergent stress (0.1% sodium dodecyl sulfate), acid stress (pH 4.5), and nutrient starvation (1XPBS). The impact of msm0031 transposon insertion on drug-mediated killing was determined for isoniazid (INH, 50 µg/mL), rifampicin (RIF, 200 µg/mL), ethionamide (ETH, 200 µg/mL), and ethambutol (EMB, 5 µg/mL). The PBP mutant demonstrated remarkable isoniazid-killing phenotype in batch culture. Therefore, we hypothesized that single-cell analysis will show increased lysis kinetics and fewer intact cells after drug treatment. However, the single-cell analysis data showed that upon isoniazid exposure, the percentage of the intact PBP mutant cells was 24%, while the percentage of the intact wild-type cells was 4.6%. The PBP mutant cells exhibited decreased cell-lysis profile. Therefore, the traditional culture-based assays were not sufficient to provide insights about the subpopulation of viable but non-culture cells. Consequently, we need more adequate tools to be able to comprehend and fight the antibiotic resistance of bacteria.

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Antimicrobial resistance and the current refugee crisis

Cited by 39 publications

References 32 publications

Pulmonary Diseases in Refugees and Migrants in Europe

Pulmonary Diseases in Refugees and Migrants in Europe

Antimicrobial Resistance in Syria

On-Chip Isoniazid Exposure of Mycobacterium smegmatis Penicillin-Binding Protein (PBP) Mutant Using Time-Lapse Fluorescent Microscopy

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