Search Results (793)

There is growing concern that antimicrobial use (AMU) in livestock may contribute to antimicrobial resistance (AMR) in humans and lead to the consumption of animal-derived foods contaminated with antimicrobial residues. As stakeholders in the livestock industry, farmers must participate in the joint effort to reduce AMU. This cross-sectional study, based on a survey questionnaire, was conducted to evaluate the biosafety measures implemented on small ruminant farms and to assess the knowledge, attitudes and practices (KAP) of small ruminant farmers regarding AMU, AMR and residues. The mean biosafety score obtained was 8.4 points on a 0–17 scale. Some biosafety measures appeared difficult to implement, namely vehicle disinfection, requiring visitors to change clothing and footwear at the farm entrance, cleaning and disinfecting farm facilities, using high-pressure washing equipment, and requiring employees to change clothing and footwear upon entering the farm. Although farmers self-reported moderate levels of knowledge (4.9 points on a 0–7 scale) and positive attitudes (5.8 points on a 0–7 scale), significant gaps in knowledge about antibiotics and antimicrobial stewardship persisted. Practices received lower scores (4.7 on a 0–7 scale), especially regarding medication recording, leftover antibiotic management, and waste disposal. Cluster analysis identified distinct farmer profiles with different patterns of knowledge and practices. These findings underscore the importance of considering farmer heterogeneity when designing interventions aimed at improving AMU. Full article

Background/Objectives: Reducing inappropriate use of antimicrobial agents in healthcare settings is a critical strategy to mitigate the growing threat of antimicrobial resistance. Globally, the highest consumption of antimicrobials in human healthcare originates from antibiotic prescriptions made in General Practice settings. Small group learning has long held a key role in General Practice education, characterized by active participation, common learning goals, and opportunities for reflection. This mode of delivery has been explored as a potential approach to increase appropriate antibiotic prescribing, supported by research indicating that more didactic educational interventions are unlikely to effectively improve physician prescribing behaviours. This systematic review specifically sought to synthesise the evidence on the effectiveness of small group-based, interventions in improving appropriate antibiotic prescribing behaviours in general practice. Methods: A mixed methods systematic review was employed. Studies were eligible if they reported on in-person, small group-based educational interventions to improve antibiotic prescribing among GPs. Full-text screening resulted in 19 eligible studies. Key characteristics, such as study design, intervention content, and outcomes, were extracted. Results: The 19 included studies used single and multi-modal interventions, with 68% focusing on respiratory tract infections. Common topics were patient communication (n = 11) and adherence to prescribing guidelines (n = 8). Most (n = 11) reported positive outcomes like reduced prescribing and were acceptable to GPs. Conclusions: These types of interventions can be effective in increasing the appropriate use of antibiotics in General Practice and are well received by GP participants. However, further research is required on the optimal content delivered in interventions and their associated long-term impact. Full article

Background/Objectives: Antimicrobial resistance (AMR) is a global health threat, with raw milk serving as a potential reservoir for antimicrobial resistance genes (ARGs) and mobile genetic elements (MGEs). This study characterized the resistome and mobilome of raw milk from cows (Bos taurus) and water buffalo (Bubalus bubalis) in the Brazilian Amazon, a region where unpasteurized dairy consumption is culturally ingrained. Methods: Using shotgun metagenomic sequencing, we analyzed 32 pooled milk samples from extensive and semi-intensive farms in the Manaus Metropolitan Region. Results: Sequencing yielded over 3.1 million contigs. While cow milk showed a higher prevalence of positive samples (80%), buffalo milk exhibited a significantly higher abundance and diversity of ARG-associated contigs (301 contigs vs. 85 in cows). Clinically relevant genes were identified, including AbaQ, ArnT, and KpnF, alongside complex multi-AMR cassettes co-occurring with plasmids and widespread viral sequences (dominated by Caudoviricetes). Integrons were ubiquitous in cattle and highly prevalent in buffalo samples. Conclusions: These findings indicate that raw milk in the Amazon harbors a rich reservoir of resistance determinants and MGEs, likely driven by farm-level antibiotic usage. This underscores a critical food safety risk and highlights the need for One Health-based surveillance in the region. Full article

L-theanine is a characteristic non-proteinogenic amino acid found in tea leaves and has attracted considerable attention because of its diverse physiological activity and broad application prospects. γ-glutamyl transpeptidase (GGT) can catalyze the synthesis of L-theanine from L-glutamine and ethylamine without ATP consumption, highlighting its advantages for enzymatic production. In this study, a complete process was established for L-theanine production. Through screening of single and dual promoters, the optimal expression combination, PyxiE-PspoVG, was identified. Furthermore, by integrating the dal selection marker, an antibiotic-free engineered strain was developed. After flask-level optimization, the GGT activity reached 27.32 U/mL and further increased to 127.37 U/mL in 3 L fed-batch fermentation. Using the fermentation broth as the biocatalyst, fed-batch conversion of 0.6 M L-glutamine and 2 M ethylamine yielded 0.52 M (91.44 g/L) L-theanine within 24 h. Further integration of ceramic membrane filtration, ultrafiltration, nanofiltration, electrodialysis, activated-carbon decolorization and ethanol crystallization afforded a final product purity of 95.6%. This study offers a useful reference for large-scale L-theanine production. Full article

Background and Objectives: The epidemiological characteristics of Candida species have changed worldwide, with an increasing number of reports on co-infections with non-albicans Candida species (NACs) and multidrug-resistant bacteria. A longer length of hospital stay, more severely ill patients, and empirical antimicrobial use in intensive care units (ICUs) increased the prevalence of Candida healthcare-associated infections (HAIs). If the diagnosis or treatment of invasive candidiasis is delayed, the morbidity and mortality of patients will significantly increase. Materials and Methods: We conducted a nationwide surveillance study to analyze data on HAIs in the ICUs of medical centers and regional hospitals between 2018 and 2023. We assessed the temporal trends of Candida species (including Candida albicans and NACs) across all HAIs, bloodstream infections (BSIs), and urinary tract infections (UTIs), and simultaneously assessed the corresponding trends of Enterococcus faecium (Efm). A linear trend for the proportions of microorganisms from 2018 to 2023 was noted according to the Mantel–Haenszel chi-square test. Spearman’s rank correlation coefficients were used to analyze the correlations between pathogen proportions, systemic antimicrobial agent consumption, and length of ICU stay. Results: The overall proportion of all Candida species in HAIs in the ICUs increased significantly from 15.13% to 16.74% (p < 0.001); this increase was driven mainly by NACs (increasing from 6.84% to 7.91%, p < 0.001) from 2018 to 2023. The proportion of Efm increased significantly, from 7.7% to 11.11% (p < 0.001). The proportions of all Candida species significantly increased in UTIs (from 24.63% to 28.13%, p < 0.001), especially NACs, while the proportion of Efm also increased significantly in UTIs (from 9.47% to 15.32%, p < 0.001). With respect to the UTIs, the proportion of all the Candida species, C.albicans, and NACs were positively correlated with the amount of systemic antibiotics used. A longer hospital stay was strongly correlated with all Candida HAIs and UTIs, especially NACs. Significantly ecological associations between all the Candida strains and Efm were observed for UTIs. Conclusions: This study revealed that a persistent expansion of NAC infections was associated with increased Efm infections and rising antibiotic consumption. The changes in the proportions of different Candida species in UTIs were most pronounced. These findings support an ecological model in which antibiotic stress and chronic critical illness contribute to the expansion of fungal–bacterial co-infections in the ICU setting and underscore the need for integrated antibiotic management and multi-infection surveillance. Full article

Hydroxylamine-modified transition-metal oxides (HA-TMOs) represent a promising class of catalysts for activating peroxymonosulfate (PMS) to degrade antibiotics. However, identifying energy-efficient operational conditions remains challenging. This study established a comprehensive dataset encompassing 600 experimental records from both in-house experiments and literature and systematically compared 12 machine learning algorithms for predicting the antibiotic degradation efficiency (%) in hydroxylamine-modified transition metal oxide/peroxymonosulfate (HA-TMO/PMS) systems. Among these models, CatBoost delivered the best generalization (test-set R² = 0.8110, RMSE = 8.92, MAE = 6.15) across repeated 80/20 stratified splits with 5-fold cross-validation, outperforming other ensembles as confirmed by cumulative distribution plots and error-metric analyses. Moreover, the permutation importance analysis identified PMS dosage, HA level, pH, initial pollutant concentration, and catalyst loading as the dominant drivers governing the pollutant removal performance. The partial-dependence plots, incorporating two-variable interactions, elucidated the response surfaces and enabled the discovery of operating windows that jointly maximize degradation efficiency and minimize electrical energy per order (EE/O). ML-guided optimization yielded optimal conditions, which were experimentally verified with sulfamethoxazole (SMZ). The HA-Co₃O₄/PMS system achieved the highest degradation rate constant (k = 0.11 min⁻¹) and the lowest EE/O value (6.84 kWh·m⁻³·order⁻¹), markedly improving kinetics and reducing energy consumption compared with non-optimized runs. This work establishes an interpretable ML framework that connects catalyst properties and reaction conditions to degradation kinetics and mechanisms, providing a practical strategy for the screening and scale-up of energy-efficient HA-TMOs/PMS-based advanced oxidation processes (AOPs). Full article

Background: Air pollution, antimicrobial use, and population ageing are increasingly recognised as co-occurring pressures shaping population health. This study explores their ecological association with mortality patterns in the province of Messina (Southern Italy), within a One Health-informed framework. Methods: An ecological analysis was conducted using district-by-year data (2015–2024), integrating environmental monitoring (PM₁₀, PM_2.5, NO₂, O₃), outpatient antibiotic consumption, and cause-specific mortality rates. Multivariable regression models were used to assess associations between exposures and mortality outcomes. A post-2020 indicator was included to account for COVID-19-related disruption. Results: Marked geographic variability in pollutant concentrations was observed, with higher levels in urban-industrial districts. Infectious disease mortality increased from 13.8 to 44.6 per 100,000 inhabitants between the pre-pandemic and post-pandemic periods. In Poisson regression models, particulate matter showed a small and non-significant association with respiratory mortality (RR = 1.02, 95% CI: 0.89–1.18), while antibiotic consumption was not independently associated with mortality (RR = 0.99, 95% CI: 0.94–1.05). The post-2020 period was associated with higher mortality estimates (RR = 1.15, 95% CI: 0.72–1.83), although with wide confidence intervals. Conclusions: The findings suggest the co-occurrence of environmental, demographic, and pharmaceutical pressures within the same territories, rather than demonstrating formal synergistic interaction. The observed post-pandemic increase in mortality highlights the importance of accounting for COVID-19-related disruption. These results should be interpreted as exploratory, given the ecological design and limited sample size, but support the need for integrated surveillance approaches within a One Health perspective. Full article

Lactiplantibacillus plantarum LP28 (LP28), isolated from traditional Taiwanese dried tofu, has been demonstrated to have substantial probiotic potential because it increases the production of short-chain fatty acids (SCFAs) and strengthens anti-inflammatory responses. In this study, the safety of LP28 was assessed using both in vitro and in vivo approaches, including whole-genome sequence analysis, the Ames bacterial reverse mutation assay, a chromosomal aberration test, a rodent peripheral blood micronucleus test, a 28-day subacute oral toxicity assay, and an assessment of hemolytic activity. In vitro phenotypic evaluation revealed that LP28 exhibited no hemolytic activity and was susceptible to all the tested antibiotics except kanamycin. In vivo assessments revealed no significant alterations in reticulocyte counts or micronuclei incidence in ICR mice, and SD rats exhibited no subacute toxicity at an oral LP28 dosage of 2000 mg/kg body weight/day for 28 days. Moreover, a whole-genome sequence analysis of LP28 revealed the absence of antimicrobial resistance genes, harmful virulence factors, and genes associated with biogenic amine synthesis. Additionally, the presence of genes involved in stress responses (e.g., acid, bile salt, heat, osmotic, and oxidative stresses) and adhesion-related genes was confirmed. Furthermore, LP28 contains six genes (plnA, plnE, plnF, plnJ, plnK, and plnN) that encode bacteriocin precursor peptides, suggesting the potential for enhanced probiotic effects through the production of antimicrobial plantaricins. These findings highlight the potential of LP28 as a safe and effective probiotic for human consumption. Full article

Tetracycline has been widely used as an efficient broad-spectrum antibiotic, while its long-term environmental pollution characteristics have gradually gained recognition and attention, highlighting the urgent need to identify a low-cost and effective method for removing tetracycline pollutants. This study aims to develop a one-step bamboo-based biochar preparation method based on a KCl-ZnCl₂ molten salt system; the potential application of obtained bamboo-based biochar as a tetracycline adsorbent was characterized and analyzed. Results show that the biochar prepared at 900 °C possesses abundant microporous and mesoporous structures, with abundant surface functional groups. Also, it exhibits a composite type I/IV isotherm, with a specific surface area of 1305.91 m²·g⁻¹, a total pore volume of 0.944 cm³·g⁻¹, demonstrating excellent tetracycline adsorption capacity of 298.93 mg·g⁻¹. XRD analysis confirmed that increasing the activation temperature significantly enhanced the graphitization degree of the biochar, which is a key factor influencing its tetracycline adsorption performance. Kinetic studies indicated that the adsorption kinetic process was better described by the Elovich model and Freundlich isotherm. Furthermore, cost-effectiveness analysis revealed that the cyclic preparation cost of biochar via this technique could be reduced to 18.25 USD per kilogram owing to the low consumption characteristics of the KCl-ZnCl₂ molten salt, which represents a 93.4% reduction compared with conventional preparation methods, underscoring the economic applicability of this technology in the field of tetracycline removal. The findings of this study are expected to lay a foundation for the industrial preparation of low-cost, high-performance bamboo-based biochar for tetracycline removal. Full article

Introduction: Urinary tract infections (UTIs) represent a growing health challenge, due to the rise of antimicrobial resistance (AMR) in common pathogens. Bacteria such as Escherichia coli, responsible for 80% of cases, and Pseudomonas aeruginosa, an opportunistic pathogen of concern, have developed effective virulence mechanisms. These mechanisms include the use of adhesins, such as type 1 and P fimbriae, to attach to uroepithelial cells, and the formation of biofilms, which protect bacteria from immune system and antibiotics, favoring recurrent infections. Methodology: This study is an integrative review based on articles published until 2015, identified in PubMed, Scopus, and Google Scholar using specific keywords. The inclusion criteria considered clinical relevance and the main findings. Results: In this context, cranberry (Vaccinium macrocarpon) emerges as a complementary strategy for the prevention and treatment of UTIs. The fruit is rich in bioactive compounds, particularly type A proanthocyanidins (PACs). The main action of PACs is to inhibit the adhesion of uropathogenic bacteria to the walls of the urinary tract, an effect that extends to type 1 and P fimbriae, which are resistant to other inhibitors. Additionally, studies show that PACs can interfere with quorum sensing, a cellular communication system bacteria use to coordinate biofilm formation. Conclusions: By disrupting this process, cranberries make pathogens more vulnerable to the action of the immune system and medications, possibly controlling the inflammatory response associated with the infection. Clinical evidence, although not always statistically significant, suggests a reduced risk of symptomatic UTIs with consumption of cranberry extract. Full article

Background/Objectives: In the broad and current context of antimicrobial resistance, antibiotic management and therapeutic surveillance are essential in hospitals. The present study (five-year retrospective, 2020–2024) aimed to analyze antibiotic consumption in relation to pathogens identified in a multidisciplinary hospital. Results: In terms of antibiotic consumption (overall 2020–2024), although initially Watch antibiotics were predominantly used, a decrease was observed in favor of Access class antibiotics (sharply increase from 2022 to 2023 and maximum in 2024). For Reserve antibiotics, only slight annual fluctuations were observed, but there was an important reduction in colistin consumption. The most used were cephalosporins (cefazolin, cefuroxime and ceftriaxone), carbapenems (meropenem and ertapenem), vancomycin and linezolid. Regarding pathogens, the most notable were: Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Enterococcus spp., Pseudomonas aeruginosa. Among the ESKAPE bacteria, Acinetobacter baumannii was the least frequent in our samples. ESKAPE bacteria predominantly colonized specimens from the respiratory tract, digestive tract, skin and soft tissue. Resistant strains were observed, mainly Methicillin-resistant Staphylococcus aureus (MRSA) and Extended-Spectrum Beta-Lactamase (ESBL) Klebsiella spp., but no alarming increases in number were recorded in the analyzed period. Methods: The analysis was carried out using tools recommended by the World Health Organisation (Access Watch Reserve antibiotics classification (AWaRe); Bacterial Priority Pathogen List (BBPL); Defined Daily Dose (DDD)), Average Annual Percent Change (AAPC) calculation and ESKAPE classification (bacteria group: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.). Conclusions: Relatively stable trends in bacterial isolates and resistant strains over five years (2020–2024) are consistent with effective antimicrobial stewardship practices. Full article

This study develops a visible-light-driven heterogeneous Fenton-like system for the efficient degradation and detoxification of the persistent fluoroquinolone antibiotic gatifloxacin (GAT) in water. Three Fe-based metal–organic frameworks (MIL-53(Fe), MIL-88A(Fe), and MIL-101(Fe)) were synthesized and systematically evaluated as catalysts in a visible-light/H₂O₂ process. The three MOFs were systematically characterized, and a comparative analysis was conducted to elucidate how their structural differences influence catalytic performance. Among three MOFs, MIL-88A(Fe) exhibited superior photocatalytic activity, stability, recyclability, and low energy consumption in the visible-light-driven photo-Fenton process, which was attributed to its favorable structural and photo-induced redox properties. Under the optimal conditions (pH 7.2, H₂O₂ dosage of 1.2 mL·L⁻¹, and catalyst loading of 0.1 g·L⁻¹), 95.6% of GAT was degraded within 90 min. Radical scavenging experiments demonstrated that hydroxyl radicals (•OH) dominated the oxidation process. Based on intermediate identification, plausible degradation pathways were proposed, accompanied by a pronounced reduction in the ecological risks of transformation products. Furthermore, toxicity assays revealed that both the antibacterial activity and acute toxicity of the treated solutions were significantly alleviated. Overall, the Light/MIL-88A(Fe)/H₂O₂ system offers an effective and sustainable strategy for the removal and detoxification of fluoroquinolone antibiotics from aquatic environments. Full article

Background/Objectives: Antimicrobial resistance (AMR) is a major global public health threat, particularly in hospitals. Antimicrobial Stewardship Programs (ASPs) aim to optimize prescribing, reduce unnecessary exposure to broad-spectrum agents, and mitigate resistance. This study evaluated the clinical, ecological, and economic impact of an ASP implemented in January 2021 in a high-complexity hospital in Brazil, focusing on antimicrobial consumption, temporal trends in bacterial susceptibility, and direct antimicrobial-related costs. Methods: A quasi-experimental pre–post study using an interrupted time-series design was conducted in the adult intensive care unit from January 2019 to December 2023. Antimicrobial consumption was measured as Defined Daily Doses per 1000 patient-days (DDD/1000-PD) for ceftriaxone, meropenem, piperacillin–tazobactam, vancomycin, and polymyxin B. Temporal trends were assessed using Joinpoint regression, and pre- and post-intervention periods were compared using Student’s or Mann–Whitney tests. Susceptibility data were interpreted according to BrCAST standards. Results: Significant and sustained reductions were observed for all agents except polymyxin B. Susceptibility improved or stabilized among key Gram-negative pathogens, with a significant increase in aggregated Gram-negative susceptibility after 2021, while intrinsically resistant organisms showed limited change. Annual antimicrobial costs decreased by approximately USD 174,000. Conclusions: The ASP was associated with reduced broad-spectrum antimicrobial use, favorable ecological trends, and substantial cost savings. Full article

Quinolone antibiotics (QNs) are widely used in animal production and may pose potential health risks through dietary exposure. A total of 1612 animal-derived food samples covering 10 food categories were collected in Guangzhou, China, from 2016 to 2023. Residues of six QNs were determined using ultra-performance liquid chromatography coupled with tandem mass spectrometry. Dietary exposure among different age groups was assessed using a probabilistic approach based on local food consumption data, and non-carcinogenic health risks were characterized using hazard quotient (HQ) and hazard index (HI) methods. QN residues were detected in 7.75% of samples, with an exceedance rate of 2.23%. Aquatic products, particularly fish and crustaceans, exhibited the highest detection frequencies and contributed most to overall dietary exposure. Enrofloxacin (ENR) was the most frequently detected compound, while sporadic samples showed extremely high residue concentrations (1003 unit/g in eggs). Children aged 3–6 years had the highest HI (mean is 1.94 × 10⁻²). All HQ and HI values were below 1, indicating low non-carcinogenic health risks under current exposure scenarios. Although dietary exposure to QNs among Guangzhou residents is unlikely to pose appreciable non-carcinogenic health risks, elevated exposure in children and sporadic high-residue events highlight the need for continued risk-based monitoring and targeted food safety management. Full article

Background/Objectives: Improper medication use, premature treatment discontinuation, and inadequate disposal contribute to irrational drug consumption and environmental contamination. Although pharmaceutical take-back programs have expanded globally, real-world evidence on household medication accumulation in academic and community settings remains limited. This study aimed to describe longitudinal patterns of medication collection during an eleven-year university-based take-back campaign, with detailed pharmacological characterization available for selected post-pandemic years. Methods: Real-world data were analyzed from a sustainable medication take-back campaign conducted annually at the University of Colima between 2015 and 2025. Expired or unused medications were voluntarily returned by students and community members. Total collected weight was recorded for all years, while detailed classification by dosage form, Anatomical Therapeutic Chemical (ATC) group, and Mexican regulatory fraction (Fractions II, IV, V, and VI) was performed for years with complete records (2023–2025). All materials were disposed of through an authorized hazardous-waste company in compliance with NOM-052-SEMARNAT-2005. Descriptive analyses were performed using SPSS version 29.0. Results: Approximately 3.9 tons of pharmaceutical products were collected over eleven years, reflecting persistent household accumulation of unused or expired medicines. In the years with detailed analysis, oral solid dosage forms predominated. In 2025, ATC groups M, A, and C were most frequently returned, consistent with medications used for chronic conditions. Therapeutic composition varied annually, with NSAIDs/analgesics predominating in 2023–2024 and antibiotics in 2025. Across analyzed years, 5–7% of collected items corresponded to non-medication products. Conclusions: This long-term campaign provides valuable real-world evidence on medication non-use and disposal, highlighting ongoing challenges in rational medicine use, treatment continuity, and environmentally responsible pharmaceutical waste management. Full article