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Objective. To explore the antimicrobial stewardship policy landscape in three English-speaking Caribbean countries (Barbados, Guyana, and Saint Lucia) and examine the key enablers and challenges to the design and implementation of formal antimicrobial stewardship programs. Methods. A document analysis that searched for existing policy, communications, and contributions on antimicrobial stewardship from these three countries, adapting the READ (Ready materials; Extract data; Analyze data; Distill findings) approach, a systematic procedure for health policy document review. Results. The search strategy identified 726 initial records. Of those, 15 (2%) met the inclusion criteria. The analysis included official policy documents (n = 3), scholarly works/reviews (n = 3), advocacy documents (n = 2), news articles (n = 4), and confidential reports (n = 3) from the three countries. Conclusions. Critical matters such as cross-programmatic coordination, the significance of individual action, and the need for bidirectional knowledge discourse are prominent in optimizing antimicrobial stewardship adaptation in these countries. CARICOM regional coordination has positively impacted the integration of infection prevention and control with antimicrobial stewardship across this knowledge network. [ABSTRACT FROM AUTHOR]

Objective. To map the policies related to the prevention and control of antimicrobial resistance from a human health perspective in Brazil and systematize the historical course of these policies. Method. A scoping review was performed following Joana Briggs Institute and PRISMA guidelines. A literature search was performed in December 2020 in the LILACS, PubMed and EMBASE databases. The terms "antimicrobial resistance" AND "Brazil" as well as their synonyms were used. Using the same keywords, Brazilian government websites were searched for documents published until December 2021. Studies of all designs were included, with no language or date restrictions. Clinical documents, reviews and epidemiological studies that did not focus on antimicrobial resistance management policies in Brazil were excluded. Categories based on World Health Organization documents were used for data systematization and analysis. Results. In Brazil, policies related to antimicrobial resistance such as the National Immunization Program and hospital infection control programs can be traced back to before the creation of the Unified Health System. In the late 1990s and 2000s, the first specific policies on antimicrobial resistance (surveillance networks and programs) and education strategies were established; especially noteworthy is The National Action Plan for the Prevention and Control of Antimicrobial Resistance in the Single Health Scope (PAN-BR) of 2018. Conclusions. Despite the long history of policies related to antimicrobial resistance in Brazil, gaps were identified, particularly in monitoring the use of antimicrobials and surveillance of antimicrobial resistance. The PAN-BR, the first government document prepared from a One Health perspective, represents an important milestone. [ABSTRACT FROM AUTHOR]

Objective. To determine the prevalence and antimicrobial resistance of Escherichia coli and Salmonella spp. in animal feed samples collected between 2018 and 2021 in Colombia. Methods. This was a laboratory-based cross-sectional study using routine data from the program for inspection, surveillance, and control of animal feed at the Colombian Agriculture Institute. Samples of animal feed for swine, poultry, canine, feline, leporine, piscine, and equine species were processed for detection of E. coli and Salmonella spp. using enrichment and selective culture methods. Isolates were tested for antimicrobial susceptibility using an automated microdilution method. Results. Of 1 748 animal feed samples analyzed, 83 (4.7%) were positive for E. coli and 66 (3.8%) for Salmonella spp. The presence of E. coli and Salmonella spp. was highest in feed for poultry (6.4% and 5.5%) and swine (6.1% and 4.3%). Antimicrobial resistance testing was performed in 27 (33%) E. coli isolates and 26 (39%) Salmonella isolates. Among E. coli, resistance was most frequently observed to ampicillin (44.5%) followed by cefazolin (33.3%), ciprofloxacin (29.6%), ampicillin/sulbactam (26%), and ceftriaxone (11.1%). The highest resistance levels in Salmonella spp. isolates were against cefazolin (7.7%) and piperacillin/tazobactam (7.7%). Conclusions. This is the first study from Colombia reporting on the prevalence and antimicrobial resistance of E. coli and Salmonella spp. in animal feed samples. Its results establish a baseline over a wide geographical distribution in Colombia. It highlights the need to integrate antimicrobial resistance surveillance in animal feed due to the emergence of resistant bacteria in this important stage of the supply chain. [ABSTRACT FROM AUTHOR]

Objective. To assess changes in antibiotic resistance of eight of the World Health Organization priority bug-drug combinations and consumption of six antibiotics (ceftriaxone, cefepime, piperacillin/tazobactam, meropenem, ciprofloxacin, vancomycin) before (March 2018 to July 2019) and during (March 2020 to July 2021) the COVID-19 pandemic in 31 hospitals in Valle del Cauca, Colombia. Methods. This was a before/after study using routinely collected data. For antibiotic consumption, daily defined doses (DDD) per 100 bed-days were compared. Results. There were 23 405 priority bacterial isolates with data on antibiotic resistance. The total number of isolates increased from 9 774 to 13 631 in the periods before and during the pandemic, respectively. While resistance significantly decreased for four selected bug-drug combinations (Klebsiella pneumoniae, extended spectrum beta lactamase [ESBL]-producing, 32% to 24%; K. pneumoniae, carbapenem-resistant, 4% to 2%; Pseudomonas aeruginosa, carbapenem-resistant, 12% to 8%; Acinetobacter baumannii, carbapenem-resistant, 23% to 9%), the level of resistance for Enterococcus faecium to vancomycin significantly increased (42% to 57%). There was no change in resistance for the remaining three combinations (Staphylococcus aureus, methicillin-resistant; Escherichia coli, ESBL-producing; E. coli, carbapenem-resistant). Consumption of all antibiotics increased. However, meropenem consumption decreased in intensive care unit settings (8.2 to 7.1 DDD per 100 bed-days). Conclusions. While the consumption of antibiotics increased, a decrease in antibiotic resistance of four bug-drug combinations was observed during the pandemic. This was possibly due to an increase in community-acquired infections. Increasing resistance of E. faecium to vancomycin must be monitored. The findings of this study are essential to inform stewardship programs in hospital settings of Colombia and similar contexts elsewhere. [ABSTRACT FROM AUTHOR]

Whole-genome sequencing is becoming the gold standard for pathogen characterization and offers considerable advantages for understanding the evolution and dissemination of new determinants of antimicrobial resistance. Despite the benefits of whole-genome sequencing for pathogen characterization, implementation costs and lack of expertise may limit its use by public health laboratories. This article reviews the advantages of whole-genome sequencing for pathogen characterization and the current status of the use of whole-genome sequencing for antimicrobial resistance surveillance in Ecuador. A roadmap is suggested for including whole-genome sequencing for pathogen characterization based on the needs of the health reference institutions through alliances with Ecuadorian universities. Establishing a partnership between public health institutions and academia would be valuable for clinicians, policy-makers, and epidemiologists who could then take reasonable measures in those areas and establish a basis for adapting One Health strategies to tackle antimicrobial resistance in Ecuador. [ABSTRACT FROM AUTHOR]

Golf course superintendents are often under pressure to maintain high-quality turf. Such demand entails use of inputs, which can include biostimulants that are often marketed as a way of combating plant stress and improving turf quality. However, the extent of their use by superintendents and their level of efficacy are not well understood. This survey study was designed to better describe biostimulant use by the golf industry and to gain insights on the research needs of superintendents to address them effectively. A survey instrument was developed using online software and included a total of 13 questions relating to general familiarity with biostimulants and specific familiarity with five biological products. The instrument was disseminated electronically via the online survey tool to attendees (N = 80) during the annual conference of the Georgia Golf Environmental Summit in 2022. The respondents were from 62 golf courses, geographically representing the entire state of Georgia. The response rate was 62.5%. The majority of the respondents (86%) were familiar with biostimulants. The main reason for using biostimulants was predominantly agronomic, indicating a focus on turf performance and aesthetics. Of the respondents who used biostimulants, the overwhelming majority (93%) use humic acids and plant growth hormone-containing biostimulants. Respondents also indicated that research in microbial products would be the most relevant to the industry. This may be explained by the challenges in using such products (shelf life and microbial survival in soil). In conclusion, the survey indicated that Georgia golf course superintendents have high a level of familiarity with biostimulants. The survey yielded useful results to help formulate future research objectives to better serve the Georgia golf course industry. [ABSTRACT FROM AUTHOR]

Objective. To assess antibiotic use in three hospitals in three Caribbean countries based on data from 2013 and 2018 using the World Health Organization Essential Medicines List "Access, Watch, Reserve" (AWaRe) classification. Methods. A retrospective observational study, which analyzed the World Health Organization Point Prevalence Survey data from three hospitals in three Caribbean countries, to examine proportional AWaRe group antibiotic use for the top ten inpatient indications. The Access-to-Watch ratio was calculated, and the top three antibiotics prescribed in each hospital were determined. Results. The final data set included 376 prescriptions for the top ten indications in 766 inpatients. The hospital antibiotic use point prevalence for Hospital 1 was 35.6%, Hospital 2 was 48.6%, and Hospital 3 was 47.1%. The Access-to-Watch ratio for the top ten indications was 2.45, 1.36, and 1.72 in the three hospitals. Access group prevalence was 71.0% in Hospital 1, 57.6% in Hospital 2, and 63.2% in Hospital 3. There were no Reserve antibiotics prescribed in any of the institutions. The most common indication for Watch prescription was skin and soft tissue infections in Hospital 1 and pneumonia in Hospital 2 and 3. Conclusions. This study draws urgent attention to evidence of a high proportion of Watch antibiotic prescribing and lack of Reserve group antibiotics in three Caribbean countries. This research provides data that may inform national formulary and antimicrobial stewardship policy-making across the settings analyzed and the wider region. [ABSTRACT FROM AUTHOR]

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Plasmid-mediated AmpC are enzymes belonging to the group of β-lactamases and encoded by blaAmpC genes. Of these enzymes, those known as type CMY-2 are the most frequently reported worldwide. Detection of enterobacteria that produce CMY-2-type plasmid-mediated AmpC is clinically important since the use of β-lactam antibiotics can result in treatment failure. It is also important from a public health standpoint owing to the capacity for conjugative plasmid transfer to other enterobacteria, both within the community and in nosocomial environments. Thus, bacteria of this kind are considered to have clear epidemic potential. To investigate the circulation of this resistance mechanism among Salmonella and Shigella isolates in Costa Rica, from January 2003 to May 2015 we carried out a retrospective review of the data contained in the laboratory surveillance databases of the National Reference Bacteriology Center (CNRB) of the Costa Rican Nutrition and Health Research Institute (Inciensa). Over this period, 4363 Shigella isolates and 1785 Salmonella isolates were examined. Among them, 15 Shigella sonnei isolates and nine Salmonella isolates (four from human clinical specimens and five of avian origin) displayed a phenotype suspected of carrying plasmid-mediated AmpC. Polymerase chain reaction confirmed that all these isolates belong to type CMY-2. In light of these results, we recommend that the microbiology laboratories in the national network continue to conduct surveillance and confirm any suspicious isolates using phenotypic and molecular methods. This is particularly relevant when dealing with bacterial isolates from extraintestinal infections so as to prevent treatment failure. [ABSTRACT FROM AUTHOR]

As scrutiny of formaldehyde-donor (FD) and other preservative technologies has increased in recent years, additional assurances of the relative safety and benefits of FD technologies are required. This study examines the effects of temperature and pH on free-formaldehyde levels as detected by C-13 NMR in water and personal care formulations. [ABSTRACT FROM AUTHOR]

The objective of this study was to characterize the phenotype and genotype of two isolates of rifampicin-resistant Neisseria meningitidis associated with two independent events involving transmission of severe meningococcal meningitis that occurred in September and October 2010 in Montevideo, Uruguay. The most recent 10 years of data from the national antimicrobial resistance surveillance system were reviewed to estimate the frequency of the particular meningococcal features that were characterized. Rifampicin resistance was studied using the epsilometer test. The serotype and serosubtype of the isolates were determined by ELISA, and the genotype was characterized using DNA digestion with Nhel and pulse field gel electrophoresis. The two isolates were identical: B:2a:P1.5. In the collection of 408 strains of N. meningitidis isolated in Uruguay in the past 10 years, the phenotype only appeared in two isolates, which were sensitive to rifampicin. The two isolates studied also shared a single pulse type, which was different from that of two other rifampicin-resistant isolates obtained in 2003 and 2007. Consequently, it was concluded that both cases of transmission were caused by a single rifampicin-resistant strain, which could have been an import from another country or else the result of a drift from serogroup C to B due to selective pressure exerted by vaccines administered to the population. It is essential to maintain and maximize surveillance. However, since this type of finding has been sporadic so far, unless a secondary case is identified, there is no justification for changing the antimicrobial drug currently being administered to contacts as prophylaxis. [ABSTRACT FROM AUTHOR]

Antibacterial drug resistance is a particularly significant issue in Latin America. This article explores antimicrobial resistance in three classes of clinically important bacteria: gram-positive bacteria, enterobacteria, and nonfermenting gram-negative bacilli. The gram-positive bacteria frequently responsible for infections in humans are for the most part cocci: staphylococci, streptococci (including pneumococci), and enterococci, in both community and hospital settings. This situation is no different in the Region of the Americas. Among the gram-positive bacteria, the causative agents of bacteremia are most commonly strains of coagulase-negative Staphylococcus, followed by enterococci. This report explores the resistance of these species to different antimicrobial drugs, resistance mechanisms in community and hospital strains, and new drugs for treating infections caused by these bacteria. In Latin America, antimicrobial resistance in Enterococcus strains is still a minor problem compared to the situation in the United States. The strains of the genus Streptococcus isolated from respiratory infections are still sensitive to penicillin. Furthermore, the resistance of enterobacteria is extremely important in the Region, particularly because of the broad dissemination of CTX-M extended-spectrum beta-lactamases (ESBL), some of which originated in Latin America. This article analyzes the resistance of Streptococcus pneumoniae, betahemolytic streptococci, and viridans group streptococci. Among the nonfermenting gram-negative bacilli, while Pseudomonas aeruginosa strains remain the leading cause of bacteremia, infections caused by strains of Acinetobacter spp. have proliferated extensively in some areas. With regard to antibiotics, several options are available for treating gram-positive bacterial infections. The same cannot be said for infections caused by enterobacteria and nonfermenting gram-negative bacilli, where options for the effective treatment of patients are still insufficient. [ABSTRACT FROM AUTHOR]

Objective. Compare mortality in multidrug-susceptible Acinetobacter baumannii-infected patients and multidrug-resistant A. baumannii-infected patients hospitalized in intensive care units (ICUs) in Colombia. Methods. A prospective, observational, and multicenter study. A total of 165 patients admitted to the participating ICUs from April 2006 to April 2010 were included. On day 14 and day 30 of hospitalization, mortality in multidrug-resistant patients with clinical isolates of A. baumannii was compared with that in multidrug-susceptible patients. Results. Of the 165 adult patients who had health care-associated infections (HAI) caused by A. baumannii, multidrug-susceptible bacteria were found in 62 patients and multidrug-resistant bacteria in 103. Statistically significant differences in mortality on day 14 of hospitalization in the ICU were not found. On the other hand, significant differences (P < 0.05) in mortality on day 30 of hospitalization were observed between patients with multidrug-resistant isolates and those with multidrug-susceptible isolates. This difference was maintained when the patients' risk factors were evaluated by multivariate analysis. Conclusions. The presence of multidrug resistance is the primary risk factor for mortality in patients with HAI caused by A. baumannii in Colombian ICUs. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To describe the trends in antibiotic utilization in eight Latin American countries between 1997-2007 METHODS: We analyzed retail sales data of oral and injectable antibiotics (World Health Organization (WHO) Anatomic Therapeutic Chemical (ATC) code J01) between 1997 and 2007 for Argentina, Brazil, Chile, Colombia, Mexico, Peru, Uruguay, and Venezuela. Antibiotics were aggregated and utilization was calculated for all antibiotics (J01); for macrolides, lincosamindes, and streptogramins (J01 F); and for quinolones (J01 M). The kilogram sales of each antibiotic were converted into defined daily dose per 1 000 inhabitants per day (DID) according to the WHO ATC classification system. We calculated the absolute change in DID and relative change expressed in percent of DID variation, using 1997 as a reference RESULTS: Total antibiotic utilization has increased in Peru, Venezuela, Uruguay, and Brazil, with the largest relative increases observed in Peru (5.58 DID, +70.6%) and Venezuela (4.81 DID, +43.0%). For Mexico (-2.43 DID; -15.5%) and Colombia (-4.10; -33.7%), utilization decreased. Argentina and Chile showed major reductions in antibiotic utilization during the middle of this period. In all countries, quinolone use increased, particularly sharply in Venezuela (1.86 DID, +282%). The increase in macrolide, lincosaminde, and streptogramin use was greatest in Peru (0.76 DID, +82.1%), followed by Brazil, Argentina, and Chile CONCLUSIONS: Analyzing antibiotic utilization in Latin America presents a series of challenges. Creating policy-relevant evidence based on antimicrobial consumption patterns is needed in order to foster policies aimed at improving appropriate use of antibiotics in the region. [ABSTRACT FROM AUTHOR]

Hand sanitizing is a proven public health benefit that has grown globally. While alcohol is the most tested and proven active used for hand sanitizing, other actives are employed, including quats, triclosan and natural antimicrobials. Here, the authors review the benefits and limitations of various hand sanitizer actives. [ABSTRACT FROM AUTHOR]

Objective. To determine the prevalence and characteristics of selected enteric pathogens in diarrheic children in six counties of the island of Trinidad. Methods. This cross-sectional study was conducted from April 1998 through March 2000. Fecal or rectal swab specimens from children (< 12 years) were collected and then processed, using standard methods, to detect Salmonella spp., Shigella spp., enteropathogenic Escherichia coli (SPEC), Campylobacter spp., Yersinia spp., Cryptosporidium parvum, and parasite ova. The antibiograms of the enteropathogens were determined using the disk diffusion method. Results. A total of 236 samples were processed; 86 samples originated directly from 27 heath centers in two counties (St. George East and St. George West), while 150 samples were obtained from the Trinidad Public Health Laboratory, having been submitted by private practitioners and personnel from six counties in Trinidad. Of the 236 samples, 33 (14.0%) were positive for Shigella, 4 (1.7%) for Salmonella, and 1 (0.4%) for SPEC. Two of the samples (0.8%) were positive for Campylobacter jejuni, while 1 sample (0.4%) was positive far hookworm ova. All the samples were negative for Cryptosporidium parvum and Yersinia spp. With the 86 samples collected directly from the health centers, in St. George East County the frequency of Shigella was 20.0% (12 of 60), compared with 26.9% (7 of 26) for samples from St. George West County, but the difference was not statistically significant (P > 0.05 with the chi-square test). For the 150 samples from the six counties that had been submitted directly to the Trinidad Public Health Laboratory, 14 of them. (9.3%) were positive for Shigella, a figure statistically significantly lower than that found with the samples sampled directly from the health centers (P < 0.05 with the chi-square test). Sh. sonnei was the predominant serotype detected, accounting for 28 of the 33 Shigella isolates (84.8%) recovered from the 236 samples.... [ABSTRACT FROM AUTHOR]

Special conditions suggest microbial organisms could lurk under the surface. [ABSTRACT FROM PUBLISHER]