Antibiotic Resistance Mechanisms and Strategies for Combating Resistance in Germany
DOI:
https://doi.org/10.47604/ijb.2502Keywords:
Antibiotic Resistance, Mechanisms, Strategies, CombatingAbstract
Purpose: The aim of the study was to explore antibiotic resistance mechanisms and strategies for combating resistance in Germany
Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries.
Findings: antibiotic resistance represents a complex and evolving challenge to public health in Germany. Mechanisms such as efflux pumps, mobile genetic elements, and enzymatic degradation contribute to the resilience of bacteria against antibiotics. However, strategic interventions have been identified to combat resistance effectively. Exploration of alternative therapies like bacteriophage therapy offers promising avenues for addressing antibiotic-resistant infections, especially in light of increasing resistance rates.
Unique Contribution to Theory, Practice and Policy: Evolutionary theory of antibiotic resistance & Game Theory in Antibiotic Stewardship may be used to anchor future studies on antibiotic resistance mechanisms and strategies for combating resistance in Germany. Implement antimicrobial stewardship programs across healthcare settings to optimize antibiotic use. These programs should involve prescriber education, antibiotic guidelines, and regular audits to promote appropriate prescribing practices and minimize unnecessary antibiotic exposure. Prioritize infection prevention measures, including hand hygiene, environmental cleaning, and infection control protocols, to reduce the spread of resistant pathogens within healthcare facilities and communities. Enact policies to regulate the use of antibiotics in human health, veterinary medicine, and agriculture. This includes restrictions on antibiotic use in food production, bans on over-the-counter antibiotic sales, and incentives for the development of new antibiotics.
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References
Allegranzi, B., Bagheri Nejad, S., Combescure, C., Graafmans, W., Attar, H., Donaldson, L., ... Pittet, D. (2011). Burden of Endemic Health-Care-Associated Infection in Developing Countries: Systematic Review and Meta-analysis. The Lancet, 377(9761), 228–241.
Blair, J. M., & Piddock, L. J. (2016). "How to measure export via bacterial multidrug resistance efflux pumps." mBio, 7(4), e00840-16.
CDC. (2013). Vital signs: Carbapenem-resistant Enterobacteriaceae. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6210a3.htm
CDC. (2019). Antibiotic Resistance Threats in the United States, 2019. Centers for Disease Control and Prevention. https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf
Dalal, A., Pawaskar, A., Das, M., Desai, R., Prabhudesai, P., Chhajed, P., ... Mathuria, J. P. (2016). High Prevalence of Extensively Drug-Resistant Tuberculosis among Patients with Multidrug-Resistant Tuberculosis in a Tertiary Care Hospital in Mumbai, India. PLOS ONE, 11(1), e0147575. https://doi.org/10.1371/journal.pone.0147575
Drawz, S. M., & Bonomo, R. A. (2010). "Three decades of β-lactamase inhibitors." Clinical Microbiology Reviews, 23(1), 160-201.
Golkar, Z., Bagasra, O., & Pace, D. G. (2014). Bacteriophage Therapy: A Potential Solution for the Antibiotic Resistance Crisis. Journal of Infection in Developing Countries, 8(2), 129–136.
Hughes, D., & Andersson, D. I. (2017). Environmental and Genetic Modulation of the Phenotypic Expression of Antibiotic Resistance. Frontiers in Microbiology, 8, 9. https://doi.org/10.3389/fmicb.2017.00009
Johnson, J. R., Porter, S. B., Thuras, P., Castanheira, M., & Sader, H. S. (2017). Epidemic emergence in the United States of Escherichia coli sequence type 131-H30 (ST131-H30), 2000 to 2009. Antimicrobial Agents and Chemotherapy, 61(6), e00732-17. https://doi.org/10.1128/AAC.00732-17
Jones, R. N., Guzman-Blanco, M., Gales, A. C., Gallegos, B., Castro, A. L., & Martino, M. D. V. (2015). Susceptibility Rates in Latin American Nations: Report from a Regional Resistance
Kariuki, S., Onsare, R. S., Damjanova, I., & Keddy, K. H. (2015). Challenges and Perspectives for Monitoring Antimicrobial Drug Resistance in Salmonella in Low-Resource Settings. BMC Proceedings, 9(Suppl 10), S7. https://doi.org/10.1186/1753-6561-9-S10-S7
Krumkamp, R., Sarpong, N., Schwarz, N. G., Adlkofer, J., Loag, W., Eibach, D., ... May, J. (2015). Gastrointestinal Infections and Diarrheal Disease in Ghanaian Infants and Children: An Outpatient Case-Control Study. PLOS Neglected Tropical Diseases, 9(3), e0003568. https://doi.org/10.1371/journal.pntd.0003568
Laxminarayan, R., Duse, A., Wattal, C., Zaidi, A. K. M., Wertheim, H. F. L., Sumpradit, N., ... Cars, O. (2013). Antibiotic Resistance—the Need for Global Solutions. The Lancet Infectious Diseases, 13(12), 1057–1098.
Lázár, V. (2014). "Bacterial evolution of antibiotic hypersensitivity." Molecular Systems Biology, 9(1), 700.
Martins, N., Picão, R. C., Cerqueira-Alves, M., & Gales, A. C. (2018). Acinetobacter baumannii in Brazil: emergence of highly resistant bacteria in a high-risk hospital setting. Infection Control & Hospital Epidemiology, 39(8), 988–989. https://doi.org/10.1017/ice.2018.143
McVay, C. S. (2017). "Bacteriophage therapy for bacterial infections: Not a 'last resort' treatment option." Clinical Microbiology and Infection, 23(9), 681-688.
Olesen, S. W., Barnett, M. L., MacFadden, D. R., & Lipsitch, M. (2018). Modeling the Impact of Interventions on an Epidemic of Clostridium difficile Infections in Hospitals. Clinical Infectious Diseases, 66(11), 1729–1737. https://doi.org/10.1093/cid/cix1112
Olowe, O. A., Taiwo, S. S., Onile-ere, O. A., & Ojurongbe, O. (2017). Prevalence of Extended-Spectrum β-Lactamase and Plasmid-Mediated Quinolone Resistance Genes in Escherichia coli and Klebsiella pneumoniae Isolated from Clinical Samples in Ogbomoso, Nigeria. Advances in Medicine, 2017, 1–6. https://doi.org/10.1155/2017/1046493
Olowe, O. A., Taiwo, S. S., Onile-ere, O. A., & Ojurongbe, O. (2017). Prevalence of Extended-Spectrum β-Lactamase and Plasmid-Mediated Quinolone Resistance Genes in Escherichia coli and Klebsiella pneumoniae Isolated from Clinical Samples in Ogbomoso, Nigeria. Advances in Medicine, 2017, 1–6. https://doi.org/10.1155/2017/1046493
PHE. (2019). English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report 2019 to 2020. Public Health England. https://www.gov.uk/government/publications/english-surveillance-programme-antimicrobial-utilisation-and-resistance-espaur-report
Pitout, J. D., & Nordmann, P. (2015). "Poirel Carbapenemase-Producing Enterobacteriaceae: A Review of Key Epidemiological and Resistance Trends." Microbiology Spectrum, 3(6).
Said, H. M., Kock, M. M., Ismail, N. A., Mphahlele, M., Baba, K., Omar, S. V., … Wainwright, H. (2018). Evolution of extensively drug-resistant tuberculosis over four decades: whole genome sequencing and dating analysis of Mycobacterium tuberculosis isolates from KwaZulu-Natal. PLOS ONE, 13(10), e0206657. https://doi.org/10.1371/journal.pone.0206657
San Millan, A. (2018). "Evolution of plasmid-mediated antibiotic resistance in the clinical context." Trends in Microbiology, 26(12), 978-985.
Schuts, E. C. (2016). "Current evidence on hospital antimicrobial stewardship objectives: a systematic review and meta-analysis." The Lancet Infectious Diseases, 16(7), 847-856.
Surveillance Program (2011). Diagnostic Microbiology and Infectious Disease, 83(2), 242–247. https://doi.org/10.1016/j.diagmicrobio.2015.07.012
Tadesse, M., Aragaw, D., Dimah, B., Efa, F., Abdella, K., Kebede, W., ... Gebeyehu, M. (2017). Drug resistance-conferring mutations in Mycobacterium tuberculosis from pulmonary tuberculosis patients in Southwest Ethiopia. International Journal of Mycobacteriology, 6(4), 361–366. https://doi.org/10.4103/ijmy.ijmy_127_17
Takizawa, Y., Taneike, I., Nakagawa, S., Oishi, T., Nitahara, Y., Iwakura, N., … Hiramatsu, K. (2013). A Panton-Valentine Leukocidin (PVL)-Positive Community-acquired Methicillin-resistant Staphylococcus aureus (MRSA) Strain, Another such Strain carrying a Multiple-drug Resistance Plasmid, and other more-typical PVL-negative MRSA Strains found in Japan. Journal of Infection and Chemotherapy, 19(3), 395–404. https://doi.org/10.1007/s10156-012-0505-x
Ventola, C. L. (2015). The Antibiotic Resistance Crisis: Part 1: Causes and Threats. Pharmacy and Therapeutics, 40(4), 277–283.
World Health Organization. (2019). Global Action Plan on Antimicrobial Resistance. https://www.who.int/antimicrobial-resistance/publications/global-action-plan/en/
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