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CIDRAP Stewardship/Resistance Scan - Lack of national antibiotic targets; Resistant E coli in Aussie gulls

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  • CIDRAP Stewardship/Resistance Scan - Lack of national antibiotic targets; Resistant E coli in Aussie gulls


    Stewardship / Resistance Scan for Jul 11, 2019
    Lack of national antibiotic targets; Resistant E coli in Aussie gulls[/B]
    Filed Under:
    Antimicrobial Stewardship

    Survey: Few countries have established targets for reducing antibiotic use

    A survey of antimicrobial use reduction goals for human medicine in 30 countries has found that, as of 2017, less than a third had established targets, according to an article today in Eurosurveillance.
    To review planned antimicrobial reduction goals in countries belonging to the Transatlantic Taskforce on Antimicrobial Resistance (TAFTAR), the European Centre for Disease Prevention and Control (ECDC) developed a questionnaire compromising 12 questions addressing whether countries had developed targets for reducing antimicrobial use in human medicine, the rationale for those targets, and how progress would be measured and monitored. The questionnaires were sent to all 28 European Union (EU) countries, plus Norway, Iceland, Canada, and the United States in March 2017. Thirty of 32 countries responded.
    The countries that established targets are Belgium, France, Malta, the Netherlands, Norway, Slovenia, Sweden, the United Kingdom, and the United States. The reported targets and corresponding metrics, however, varied greatly among the countries. Of the 21 countries that had not established targets, 17 indicated that work on targets was underway.
    "This review of the existing antibiotic targets in EU Member States, Norway, Iceland, Canada and the US is aimed at providing detailed information to countries willing to engage in the reduction of antibiotic use in humans," the authors of the paper write. "Monitoring of countries' progress towards existing targets, possible barriers and facilitators, as well as the assessment of these countries' need to revise their targets, should provide additional key information and may be the objective of a future survey."
    Jul 11 Eurosurveill article

    Drug-resistant, human-associated E coli clones found in Australian gulls

    A study by Australian scientists has found that seagulls carry a wide array of drug-resistant Escherichia coli clones that resemble pathogenic, drug-resistant E coli clones from humans. The findings appeared in the Journal of Antimicrobial Chemotherapy.
    In the study, scientists from Murdoch University in Western Australia collected Australian silver gull fecal samples from beaches in all Australian states to look for the presence of E coli with resistance to critically important antibiotics (CIAs). Of the 562 samples tested, 135 (23.8%) were positive for fluoroquinolone-resistant E coli, and 125 (21.7%) were positive for extended-spectrum cephalosporin-resistant E coli.
    Whole-genome sequencing of 284 of the CIA-resistant isolates revealed that they belonged predominantly to human-associated extra-intestinal pathogenic E coli clones, including ST131 (17%), ST10 (8%), and ST1193 (6%). In addition, comparative analysis found that the isolates belonging to ST131 and ST1193—which are globally disseminated, highly virulent and drug-resistant E coli strains associated with urinary tract infections in humans—overlapped extensively with human clinical isolates in Australia and overseas.
    The analysis also detected a single isolate of carbapenem-resistant and an isolate of colistin-resistant E coli carrying the MCR-1 gene—the first such isolate identified in Australian wildlife.
    The authors of the study theorize the gulls, which were from areas with dense human populations, may have acquired the bacteria from leftover human food and garbage.
    "The carriage of diverse CIA-resistant E coli clones that strongly resemble pathogenic clones from humans suggests that gulls can act as ecological sponges indiscriminately accumulating and disseminating CIA-resistant bacteria over vast distances," they write.
    Jul 9 J Antimicrob Chemother abstract