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Antimicrobial Research and One Health in Africa

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Antimicrobial resistance is recognised among the world’s most challenging problems. Despite its global spread, Africa, specifically sub-Saharan Africa, is the most affected by this malaise. Poor living conditions and inadequate access to sanitation and potable water supplies are among contributing factors that have influenced a high disease burden on the continent, requiring extensive antimicrobials. Weak health systems and the absence of firm policies further aggravate the problem, as the use of antimicrobials is mostly unregulated. The increasing demand for animal protein to meet the starving populations’ demands has also influenced the use of these antimicrobials, including those banned on other continents, for food animal production. The ripple effect of indiscriminate use in humans and animals is the massive discharge of antimicrobials, their residues, antimicrobial-resistant microorganisms and their associated genes into the environment. 

This 14-chapter unique masterpiece presents the AMR problem in African, addressing the various compartments of the One Health – humans, animals, and the environment, to illustrate the need for concerted efforts in the fight against AMR, especially in Africa. Authors from the four cardinal points present diverse aspects of AMR in Africa, starting with behavioural and social drivers of AMR in Africa. Antimicrobial stewardship in an African context is also discussed. AMR in humans is presented through studies on antibiotic-resistant neonates and nontyphoidal Salmonella infections and the clinical relevance of the genetics of viral resistance. Topics on AMR in mastitis, biosecurity in animal farming and the linkage between disinfectants and AMR are discussed. The environmental dimension of AMR is discussed, notably in the aquatic environment, and its implication for aquaculture and irrigation and using nanomaterials to treat polluted waters from such environments are highlighted. Finally, Africa’s rich floral diversity is portrayed as an eco-friendly and cost-effective approach to combat AMR. Hopefully, the work presented will spur greater collaboration between scientists, environmental, animal and human health practitioners, the general population, and policymakers to assimilate and implement the One Health approach to combating AMR, rather than working in silos on their various sectors

Author(s): Akebe Luther King Abia, Sabiha Yusuf Essack
Publisher: Springer
Year: 2023

Language: English
Pages: 358
City: Cham

Foreword
Preface
Contents
Chapter 1: Why Context Matters: Understanding Social and Behavioural Aspects of Antimicrobial Use and Resistance in Africa
1.1 Introduction
1.2 Policy Context
1.3 Legal Context
1.4 Biomedicine’s Power
1.5 Self-Medication
1.6 The Limits to State Health Services
1.7 How Perceptions of Inequality and Access Influence Supply
1.8 Conclusion
References
Chapter 2: Antimicrobial Stewardship in Africa
2.1 Antimicrobial Use and Resistance in Humans
2.2 Antimicrobial Use and Resistance in Animals
2.3 AMR in the Environment
2.4 One Health Approach and AMR
2.5 Antimicrobial Stewardship in Africa
2.6 Recommendations
2.7 Conclusion
References
Chapter 3: Etiology of Early-Onset Bacterial Sepsis and Antibiotic Resistance in Neonates: A Case Study in an Algerian Neonatal Intensive Care Unit
3.1 Introduction
3.2 Methods
3.2.1 Study Period and Inclusion Criteria
3.2.2 Operational Definitions
3.2.3 Data Collection and Analysis
3.3 Results
3.3.1 Demographic and Clinical Characteristics
3.3.2 Profile of Pathogens
3.4 Antimicrobial Susceptibility
3.5 Predictors of Early-Onset Bacterial Sepsis
3.6 Discussion
References
Chapter 4: Genetics of Viral Resistance: Clinical Relevance and Role in Viral Disease Outbreak
4.1 Introduction
4.2 Origin and Mechanism of Viral Resistance
4.3 Molecular Basis of Immune Evasion by Viruses
4.4 Detection and Monitoring of Viral Resistance
4.4.1 Laboratory Investigation
4.4.2 Resistance Testing
4.5 Clinical Implications of Viral Resistance
4.6 Role of Viral Resistance in Disease Outbreak
4.7 Innovative Approaches to Prevention and Elimination of Viral Resistance
4.8 Conclusion
References
Chapter 5: Distribution and Prevalence of Antimicrobial Resistance of NTS Salmonella Isolated from Farm Animals and Animal Food Products in Africa
5.1 Background
5.2 Introduction
5.3 Salmonella Taxonomic Classification
5.4 Morphology, Bacteriological Culture, and Isolation Procedures
5.4.1 Collection, Transport, and Storage of Specimens for Salmonella Detection
5.4.2 Salmonella Culture and Isolation
5.4.3 Biochemical Identification
5.4.4 Serological Identification for Salmonella
5.4.5 Identification of Salmonella by MALDI-TOF MS
5.4.6 Antimicrobial Susceptibility Testing for Salmonella
5.5 Host Specificity and Adaptation
5.6 Sources and Modes of Salmonella Transmission as Zoonosis Pathogen
5.7 Manifestations of Salmonella Disease and Virulence Genes Involved
5.8 Antimicrobial Resistance in NTS Serotypes
5.9 Methods
5.10 Results
5.10.1 Literature Search
5.10.2 NTS per African Regions
5.10.3 Distribution of NTS by Origin and Serotypes
5.10.4 Antibiotic Resistance Pattern of NTS in Different Sources
5.10.5 Antibiotics Resistance Patterns in S. Enteritidis
5.10.6 Antibiotics Resistance Patterns in S. Typhimurium
5.10.7 Antibiotics Resistance Patterns in S. Kentucky
5.11 Discussion
5.12 Conclusion
References
Chapter 6: The Current Status of Antibiotic-Resistant Bacteria and Resistance Genes in African Aquaculture
6.1 Introduction
6.2 The Sources of ARB and ARGs in Aquaculture
6.2.1 Application of Antibiotics in Aquaculture
6.2.2 Animal Manure and Integrated Aquaculture as ARB and ARGs Sources
6.2.3 Aquatic Environment as a Source of ARB and ARGs
6.2.4 Wastewater Treatment Plants as ARB and ARGs Sources
6.2.5 Hospitals and Pharmaceutical Industries as ARB and ARGs Sources
6.2.6 Aquaculture Workers as ARB and ARGs Sources
6.3 Factors Causing ARB and ARGs in Aquaculture
6.3.1 Antibiotics Overuse and Misuse
6.3.2 Regulatory Barriers
6.3.3 Availability, Accessibility and Affordability of Antibiotics
6.3.4 Incorrect Antibiotic Prescriptions
6.3.5 Prolonged Use of the Same Antibiotics
6.4 Types of ARB and ARG in Aquaculture
6.5 The Socioeconomic Consequences of ARB and ARGs in Aquaculture
6.5.1 The Transfer of ARB and ARGs from Aquaculture to Humans
6.5.2 Human Health Risk
6.5.3 Economic Consequences
6.5.4 Increased Human Deaths
6.6 Conclusion
6.7 Recommendations
References
Chapter 7: Occurrence and Health Risks of Antibiotic Resistance in African Aquatic Systems
7.1 Introduction
7.2 Occurrence in Aquatic Systems
7.2.1 Sources and Drivers
7.2.2 Wastewater Systems
7.2.3 Surface Aquatic Systems
7.2.4 Rainwater Harvesting Systems
7.2.5 Groundwater Systems
7.3 Behavior, Dissemination, and Fate
7.3.1 Hydrologically Driven Dissemination
7.3.2 Horizontal Gene Transfer and the Role of Mobile Genetic Elements
7.3.2.1 Conjugation
7.3.2.2 Natural Transformation
7.3.2.3 Transduction
7.3.3 Fate of Antibiotic Resistance in Aquatic Systems
7.4 Human Health Risks, Mitigation, and Policy Perspectives
7.5 Removal of Antibiotic Resistance in Aquatic Systems
7.6 Future Perspectives and Research Directions
7.6.1 Knowledge Gaps
7.6.2 Challenges and Proposed Solutions
7.6.2.1 Lack of Accredited and Well-Equipped Analytical Laboratories
7.6.2.2 Lack of Research Funding
7.6.2.3 Lack of Research and Technical Expertise
7.7 Conclusions
References
Chapter 8: The Current State of Antimicrobial Use in Bovine Mastitis in Various African Countries
8.1 Introduction
8.2 Associated Causative Agents (Mastitis and Contributory Microbes)
8.3 Diagnosis and Treatment
8.4 Antimicrobial Resistance
8.5 Occurrence of Mastitis in African Regions
8.6 Antimicrobial Resistance and Mastitis in Africa
8.7 Prevention and Control
8.8 Conclusion
References
Chapter 9: Microbiological Safety and Antimicrobial Resistance in Fresh Produce Production in Africa
9.1 Introduction
9.2 Microorganisms of Public Health Significance in Fresh Produce in Africa
9.3 Antimicrobial Resistance (AMR) in Fresh Produce in Africa
9.4 Sources of Antimicrobial-Resistant Pathogen Contamination
9.4.1 On-Farm Sources of Contamination
9.4.1.1 Soil
9.4.1.2 Seeds
9.4.1.3 Organic Manure/Soil Amendment
9.4.2 Exposure to Contaminated Water
9.4.2.1 Irrigation
9.4.2.2 Sewage Sludge/Runoff Water
9.4.3 Faecal Contamination from Livestock and Wild Animals
9.4.3.1 Farm Workers
9.4.3.2 Farm Implements
9.5 Processing/Postharvest Sources of Contamination
9.5.1 Washing
9.5.2 Handling During Processing
9.5.3 Transport, Distribution, and Storage Equipment
9.5.4 Handling During Retail
9.5.5 Cross-Contamination During Food Preparation
9.6 Strategies for Controlling Antimicrobial-Resistant Pathogens in Fresh Produce
References
Chapter 10: Biosecurity and Disinfectant Resistance in a Post-antibiotic Era
10.1 Introduction
10.2 Alternatives to Antibiotics
10.2.1 Vaccines
10.2.2 Bacteriophages
10.3 Biosecurity in Animal Production
10.3.1 Bovine Mastitis
10.3.2 Poultry
10.4 Swine
10.5 Biosecurity in Human Health
10.6 Development of Disinfectant Resistance
10.7 Metabolic Changes in the Presence of Disinfectants
10.8 Methods to Discover Novel Disinfectant Resistance Mechanisms
10.9 Disinfectant Resistance Going Forward
10.10 Conclusion
References
Chapter 11: The Linkage Between Antibiotic and Disinfectant Resistance
11.1 Introduction
11.2 The Link Between Antibiotic and Disinfectant Resistance
11.3 The State of Antibiotic Resistance
11.4 Development of Antibiotic Resistance
11.5 Dissemination of Antibiotic Resistance
11.5.1 Dissemination of Antibiotic Resistance in Wild Animals
11.5.2 Dissemination of Antibiotic Resistance in Agriculture
11.5.3 Dissemination of Antibiotic Resistance in African Communities
11.6 Disinfectants as Antimicrobial Agents
11.6.1 Disinfectant Use in Africa
11.7 The Relationship Between Antibiotic and Disinfectant Susceptibility
11.7.1 Potential Co-selective Nature of Disinfectants and Antibiotics
11.7.2 Resistance Repertoires and Resistance Mechanisms
11.7.3 The Link Between Disinfectant and Antibiotic Susceptibilities
11.8 Resistance Acquisition and Transfer
11.8.1 Cross-Resistance to Antibiotics
11.8.2 Plasmid Maintenance
11.8.3 Inactivation and Degradation
11.8.4 Cell Surface Alterations and Decreased Compound Uptake
11.8.5 Efflux
11.9 Efflux Pumps as Joint Resistance Mechanisms
11.9.1 Classification of Efflux Pumps
11.9.2 Regulation of Efflux Pumps
11.9.3 Activity of Efflux Pumps
11.9.3.1 Qac Proteins Involved in Efflux
11.9.3.2 RND Efflux Systems
11.9.4 Efflux Pump Adaptations
11.9.4.1 Constitutive and Transient Expression
11.10 Concluding Remarks
References
Chapter 12: The Use of Nanomaterials for the Elimination of Antibiotic-Resistant Bacteria from Water and Wastewater: An African Overview
12.1 Introduction
12.2 Antibiotic Resistance Mechanisms in Bacteria
12.3 Antimicrobial Resistance Transmission in the Environment
12.4 Antibiotic-Resistant Bacteria (ARB) and Antibiotic Resistance Genes (ARGs) in African Water
12.4.1 Wastewater
12.4.2 River Water
12.4.3 Drinking Water
12.5 Current Treatment Technologies of Water/Wastewater
12.5.1 The Application of NPs for ARB and ARGs
12.5.2 NPs-Microbes Interactions and Antimicrobial Mechanism
12.6 Some African Studies on the Use of NPs for Water and Wastewater Treatment
12.7 Conclusion
References
Chapter 13: Biocidal Activity of Plant Extracts: The Case of Algeria
13.1 Introduction
13.2 The Biocidal Activity of Algerian Plants
13.2.1 Asteraceae
13.2.2 Anacardiaceae
13.2.3 Apiaceae
13.2.4 Chenopodiaceae
13.2.5 Fabaceae
13.2.6 Lamiaceae
13.2.7 Lauraceae
13.2.8 Myrtaceae
13.2.9 Pinaceae
13.2.10 Rutaceae
13.3 Conclusion
References
Chapter 14: The Combined Use of African Natural Products and Conventional Antimicrobials: An Alternative Tool Against Antimicrobial Resistance
14.1 Introduction
14.1.1 Natural Product Classification
14.1.2 Global Natural Product Use and Traditional Health Systems
14.1.3 Natural Product Use in the African Healthcare System
14.1.4 Natural Products with Antimicrobial Properties
14.2 Exploring the Combination of Natural Products with Conventional Antimicrobial Agents to Address Antimicrobial Resistance (AMR)
14.2.1 Interactive Antimicrobial Profiling of Combinations
14.2.1.1 Synergistic Interactions
14.2.1.2 Antagonistic Interactions
14.2.1.3 Additive and Non-interactive Interactions
14.2.2 Conventional Antimicrobials in Synergistic Combinations with Essential Oils
14.2.3 Conventional Antimicrobials in Synergistic Combinations with Plant Extracts
14.2.4 Conventional Antimicrobials in Synergistic Combinations with Culinary Herbs, Spices and Other Plant-Based Foods
14.2.5 Conventional Antimicrobials in Synergistic Combinations with Herbal Teas
14.2.6 Conventional Antimicrobials in Synergistic Combinations with Bee Products
14.3 Conventional Antimicrobials in Antagonistic Interactions with Natural Products
14.4 Discussion and Conclusion
References
Index