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In this study, antimicrobial resistance profiles were determined for 748 isolates of Escherichia coli from patients with acute nosocomial urinary tract infections (UTIs) at a Turkish Training Hospital. Thirteen antibiotics were included. Resistance to ampicillin alone (45.1%) and ciprofloxacin alone (20.6%) were the most commonly identified ‘single resistances’. Multiple resistance was found in 49.7% of the strains. The most common multiple antibiotic resistance profiles included ampicillin-sulbactam/amoxycilline-clavulonate (4.0%) and ampicillin-sulbactam/trimethoprim-sulfamethoxazole/amoxycilline-clavulonate (2.8%). From 2004 to 2006, ampicillin, trimethoprim-sulfamethoxazole and ciprofloxacin resistant strains increased to 76% from 57%, 53% from 43% and 55% from 41%, respectively. The percentage of extended-spectrum β-lactamase (ESBL) producing strains was 7.8% and imipenem resistance was seen in 5.2% of ESBL positive strains. We conclude that clinically important E.coli strains have now emerged with broader multidrug resistance. Periodical evaluation of laboratory results and clinical surveillance are crucially important for optimal antibiotic management of UTIs and infection control policies.
With 1.27 million deaths in 2019, antimicrobial resistance (AMR) has resulted in the deaths of more people than HIV/AIDS and malaria combined. AMR is listed among the top 10 global public health priorities by the WHO. The magnitude of the AMR burden is poorly prioritized in the public health sector, and its impact is difficult to accurately estimate due to a lack of sufficient data, especially in Africa. The misuse and overuse of antibiotics for various non-medical purposes is widely reported, especially in low-income developing countries, as one of the key contributors to AMR, yet little effort is put in place to curb the menace. Also, the clinical pipeline of new antimicrobials is scanty. This review explores the mechanism of AMR, the effects of AMR on health and the public sector with regard to morbidity, mortality, and economic losses, and the impact of COVID-19 on AMR. Recent potential therapies that are used to combat AMR, such as phage therapy, and how they could bring about development in the public health sector were discussed. Also, the impact of vaccines and preventive strategies to curb the spread of AMR in the public sector were highlighted.
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