Cystic echinococcosis (CE) is a zoonosis caused by metacestodes, the larval stage of Echinococcus granulosus. Although the World Health Organization (WHO) has defined CE as a neglected disease, it is the second most important foodborne parasitic disease, and it remains an important public health issue, considering its zonal endemicity and potential morbidity. The control and prevention of CE is a relevant WHO target, especially from a One Health perspective, as the disease affects not only animals and humans but also the food chain. Since not all countries have a CE surveillance strategy or reporting system and specific management guidelines, recent epidemiological data are relatively scarce, and research concerning the specific geographical distribution of the disease is ongoing. To add new information to the subject, we have analyzed and collected data from national guidelines and several medical databases. Out of the 751 research articles that were originally identified, only 52 were included in the investigation after applying specific inclusion and exclusion criteria. Notable international projects that have provided significant contributions and had a positive impact are presented. The available data were correlated with WHO recommendations on the subject, thus showcasing the measures taken and those that are still needed to properly control the disease’s spread.
Antimicrobial resistance (AMR) is a worldwide healthcare problem. Multidrug-resistant organisms (MDROs) can spread quickly owing to their resistance mechanisms. Although colonized individuals are crucial for MDRO dissemination, colonizing microbes can lead to symptomatic infections in carriers. Carbapenemase-producing Enterobacterales (CPE) are among the most important MDROs involved in colonizations and infections with severe outcomes. This review aimed to track down the first reports of CPE in Africa, describe their dissemination throughout African countries and summarize the current status of CRE and CPE data, highlighting current knowledge and limitations of reported data. Two database queries were undertaken using Medical Subject Headings (MeSH), employing relevant keywords to identify articles that had as their topics beta-lactamases, carbapenemases and carbapenem resistance pertaining to Africa or African regions and countries. The first information on CPE could be traced back to the mid-2000s, but data for many African countries were established after 2015–2018. Information is presented chronologically for each country. Although no clear conclusions could be drawn for some countries, it was observed that CPE infections and colonizations are present in most African countries and that carbapenem-resistance levels are rising. The most common CPE involved are Klebsiella pneumoniae and Escherichia coli, and the most prevalent carbapenemases are NDM-type and OXA-48-type enzymes. Prophylactic measures, such as screening, are required to combat this phenomenon.
Background: The increasing incidence of infection with Gram-negative bacilli (GNB) producing broad-spectrum β-lactamases, such as extended-spectrum β-lactamases (ESBLs), cephalosporinases (AmpCs), and carbapenemases, has become a great clinical concern. AmpCs are found in many clinically relevant Enterobacterales, where they may compromise the effectiveness of most β-lactams, including carbapenems when associated with an impaired outer membrane. Detection and distinction between these resistance mechanisms are crucial for antimicrobial therapy and for implementation of proper infection control procedures to prevent further spread. Methods: The disk diffusion antibiogram using Mueller-Hinton agar (MHA) supplemented with cloxacillin (MHC), which inhibits AmpCs, was validated to identify AmpC-producing Enterobacterales (AmpC-PE). As cloxacillin is not available in several countries, we investigated the use of oxacillin as an alternative compound to inhibit AmpCs. The ability of MHA supplemented with oxacillin (MHO) to distinguish between carbapenem-resistant Enterobacterales (CREs) due to AmpC hyperproduction and the presence of a carbapenemase has particularly been investigated. Results: MHOs containing several concentrations of oxacillin were compared to MHA and MHC containing 250 mg/L cloxacillin (MHC250). A set of well-characterized Enterobacterales with different β-lactam resistance mechanisms were evaluated. MHO containing 300 mg/L of oxacillin (MHO300) gave similar results to MHC250. Conclusions: The use of MHO300 proved to be efficient in inhibiting AmpCs, allowing differentiation between AmpC hyperproducers and carbapenemase producers. In addition, the use of MHO300 allowed detection of resistance mechanisms hidden by AmpCs, such as ESBLs.
Background: Alveolar echinococcosis (AE) is a neglected parasitic disease caused by Echinococcus multilocularis that is difficult to diagnose and treat. Methods: This systematic review has gathered articles presenting original data from the past 5 years, from January 2020 to December 2025, with epidemiological data (incidence, prevalence), treatment options, case reports, and other findings relevant to the prevention and control of this disease, representing the inclusion criteria of this study. Three medical databases were searched for the study: PubMed, Web of Science, and ScienceDirect. To improve our understanding of the available data, no spatial or temporal restrictions were imposed on the study’s duration or follow-up period. Results: A total of 248 articles are included in this review, which describe atypical sites and complications owing to Echinococcus multilocularis infection, the heterogeneity of epidemiological studies in different endemic and non-endemic regions, diagnosis techniques based on imaging, histopathology, and molecular techniques, as well as surgical and non-surgical treatment options (and lack thereof regarding the latter). Conclusions: Although advances have been made in the diagnosis, management, and treatment of AE, challenges remain, particularly with regard to misdiagnosis, delayed diagnosis, and limited antiparasitic therapy.
31 December 2021 in Romanian Archives of Microbiology and Immunology
Antibiotic resistance is a global, far-reaching phenomenon. Natural resistance to antibiotics, expressed or inducible, is common in Enterobacterales and can occur through the production of different enzymes such as penicillinases, ESBLs or cephalosporinases. In association with other resistance mechanisms, strains that lead to untreatable infections can emerge. Improper infection control measures are responsible for the selection and spread of these strains. The dissemination of acquired Extended-Spectrum Beta-Lactamases (ESBLs) across the globe is well known, a wide spectrum of enzymes being responsible for their different hydrolytic activity. Another important set of enzymes, the cephalosporinases (with the chromosomal cephalosporinase AmpC as the most important), are also concerning as their hyper-expression can alter wide spectrum beta-lactams, like carbapenems. These mechanisms can be readily observed through phenotypic tests, like antibiotic interactions on the disk diffusion antibiogram, or derepression / inhibition of enzymes using key antibiotics. Keywords: ESBL, cephalosporinase, AmpC, carbapenemase, cloxacillin, oxacillin, antibiotic resistance, antibiogram, Enterobacterales
Antimicrobial resistance (AMR) is a worldwide healthcare problem. Multidrug resistant organisms (MDRO) have the ability to spread quickly owing to their resistance mechanisms. Although colonized individuals are crucial MDRO dispensers, colonizing microbes have the potential to turn pathogenic under certain conditions, leading to symptomatic infections in carriers. Carbapenemase producing Enterobacterales (CPE) are among the most important MDRO involved in infections and colonizations, associating with multiple resistance mechanisms and virulence factors, causing infections with severe outcomes. All research papers identified in the most comprehensive online databases which contained information related to the topic of this article were analyzed, and relevant data was extracted and included. The first information on CPE could be traced back to the mid-2000s, but pertinent data for many African countries was established in the past 5-8 years. Information is presented chronologically for each country. Although no clear conclusions could be drawn for some countries, it was observed that CPE colonizations are present in most African countries and carbapenem-resistance levels are rising. The most common CPE involved are Klebsiella pneumoniae and Escherichia coli, and the most prevalent carbapenemases are NDM-type and OXA-48-type enzymes. Prophylactic measures, such as screening, are required to combat this phenomenon.