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- Pham, Thi Anh Mai, et al.
(författare)
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Evaluation of screening algorithms to detect rectal colonization with carbapenemase-producing Enterobacterales in a resource-limited setting
- 2024
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Ingår i: JAC - Antimicrobial Resistance. - : OXFORD UNIV PRESS. - 2632-1823. ; 6:3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To improve and rationalize the detection of carbapenemase-producing Enterobacterales (CPE) in rectal swabs in a high-prevalence and resource-constrained setting, addressing surveillance challenges typically encountered in laboratories with limited resources.Methods A point prevalence survey (PPS) was conducted on 15 August 2022, in a provincial children's hospital in northern Vietnam. Rectal swab samples of all admitted children were collected and plated on a selective medium for carbapenem-resistant Enterobacterales (CRE). Species identification and antimicrobial susceptibility testing (AST) were performed by MALDI-TOF, and VITEK2 XL and interpreted according to CLSI breakpoints (2022). Carbapenemases were detected by the carbapenem inactivation method (CIM) and quantitative real-time PCR (qRT-PCR).Results Rectal swab samples were obtained from 376 patients. Of 178 isolates growing on the CRE screening agar, 140 isolates were confirmed as Enterobacterales of which 118 (84.3%) isolates were resistant to meropenem and/or ertapenem. CIM and PCR showed that 90/118 (76.3%) were carbapenemase producers. Overall, 83/367 (22.6%) were colonized by CPE. Klebsiella pneumoniae, Escherichia coli and Enterobacter cloacae complex were the most common CPE detected, with NDM as the predominant carbapenemase (78/90; 86.7%). Phenotypic resistance to meropenem was the best predictor of CPE production (sensitivity 85.6%, specificity 100%) compared with ertapenem resistance (95.6% sensitivity, 36% specificity). CIM was 100% concordant with PCR in detecting carbapenemases.Conclusions These findings underscore the effectiveness of meropenem resistance as a robust indicator of the production of carbapenemases and the reliability of the CIM method to detect such carbapenemases in resource-limited settings where the performance of molecular methods is not possible.
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| 2. |
- Room, Robin, 1939-, et al.
(författare)
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Research agendas for alcohol policymaking in the wider world
- 2022
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Ingår i: The international journal of alcohol and drug research. - : International Journal of Alcohol and Drug Research. - 1925-7066. ; 10:1, s. 34-44
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Tidskriftsartikel (refereegranskat)abstract
- From comparisons of World Health Organization statistics, it is clear that people in lower-income countries experience more harms per litre of alcohol and different types of harms compared to those from higher-income countries. Yet studies in higher-income countries dominate research on policies to prevent alcohol problems. The paper reports on results of collaborative work to map priority areas for research relevant to low- and middle-income countries. Research focus areas were identified and discussed among potential coauthors from diverse fields with relevant knowledge, with agreement reached on an initial list of seven research priority areas. Areas identified include: (1) the effects of choices (e.g., national vs. local, monopoly vs. licensing system) in organising the alcohol market; (2) involvement/separation of alcohol industry interests in decisions on public health regulation; (3) options and effectiveness of global agreements on alcohol governance; (4) choices and experience in controlling unrecorded alcohol; (5) means of decreasing harm from men’s drinking to family members; (6) strategies for reducing the effects of poverty on drinking’s role in harms; and (7) measuring and addressing key alcohol-induced low-and middle-income country (LMIC) health harms: infectious diseases, injuries, digestive diseases. Paths ahead for such research are briefly outlined.
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