Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Antimicrobial Resistance & Infection Control
Published in: Antimicrobial Resistance & Infection Control 1/2020

Open Access 01-12-2020 | Antibiotic | Review

Genetic diversity and risk factors for the transmission of antimicrobial resistance across human, animals and environmental compartments in East Africa: a review

Authors: Bugwesa Z. Katale, Gerald Misinzo, Stephen E. Mshana, Harriet Chiyangi, Susana Campino, Taane G. Clark, Liam Good, Mark M. Rweyemamu, Mecky I. Matee

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2020

Login to get access

Abstract

Background

The emergence and spread of antimicrobial resistance (AMR) present a challenge to disease control in East Africa. Resistance to beta-lactams, which are by far the most used antibiotics worldwide and include the penicillins, cephalosporins, monobactams and carbapenems, is reducing options for effective control of both Gram-positive and Gram-negative bacteria. The World Health Organization, Food and Agricultural Organization and the World Organization for Animal Health have all advocated surveillance of AMR using an integrated One Health approach. Regional consortia also have strengthened collaboration to address the AMR problem through surveillance, training and research in a holistic and multisectoral approach. This review paper contains collective information on risk factors for transmission, clinical relevance and diversity of resistance genes relating to extended-spectrum beta-lactamase-producing (ESBL) and carbapenemase-producing Enterobacteriaceae, and Methicillin-resistant Staphylococcus aureus (MRSA) across the human, animal and environmental compartments in East Africa.

Main body

The review of the AMR literature (years 2001 to 2019) was performed using search engines such as PubMed, Scopus, Science Direct, Google and Web of Science. The search terms included ‘antimicrobial resistance and human-animal-environment’, ‘antimicrobial resistance, risk factors, genetic diversity, and human-animal-environment’ combined with respective countries of East Africa. In general, the risk factors identified were associated with the transmission of AMR. The marked genetic diversity due to multiple sequence types among drug-resistant bacteria and their replicon plasmid types sourced from the animal, human and environment were reported. The main ESBL, MRSA and carbapenem related genes/plasmids were the blaCTX-Ms (45.7%), SCCmec type III (27.3%) and IMP types (23.8%), respectively.

Conclusion

The high diversity of the AMR genes suggests there may be multiple sources of resistance bacteria, or the possible exchange of strains or a flow of genes amongst different strains due to transfer by mobile genetic elements. Therefore, there should be harmonized One Health guidelines for the use of antibiotics, as well as regulations governing their importation and sale. Moreover, the trend of ESBLs, MRSA and carbapenem resistant (CAR) carriage rates is dynamic and are on rise over time period, posing a public health concern in East Africa. Collaborative surveillance of AMR in partnership with regional and external institutions using an integrated One Health approach is required for expert knowledge and technology transfer to facilitate information sharing for informed decision-making.
Literature
1.
2.
Martínez JL, Baquero F. Emergence and spread of antibiotic resistance: setting a parameter space. Ups J Med Sci. 2014;119(2):68–77.PubMedPubMedCentral
3.
Kariuki S, Gordon MA, Feasey N, Parry CM. Antimicrobial resistance and management of invasive Salmonella disease. Vaccine. 2005;33:C21–9.
4.
Mshana SE, Kamugisha E, Mirambo M, Chakraborty T, Lyamuya EF. Prevalence of multiresistant gram-negative organisms in a tertiary hospital in Mwanza, Tanzania. BMC Res Notes. 2009;2:49.PubMedPubMedCentral
5.
6.
7.
8.
Moses A, Bwanga F, Boum Y, Bazira J. Prevalence and genotypic characterization of extended-Spectrum Beta-lactamases produced by gram negative bacilli at a tertiary Care Hospital in Rural South Western Uganda. Br Microbiol Res J. 2014;4(12):1541–50.PubMedPubMedCentral
9.
10.
Najjuka CF, Kateete DP, Kajumbula HM, Joloba ML, Essac SY. Antimicrobial susceptibility profiles of Escherichia coli and Klebsiella pneumoniae isolated from outpatients in urban and rural districts of Uganda. BMC Res Notes. 2016;9:235.PubMedPubMedCentral
11.
Moremi N, Claus H, Vogel U, Mshana SE. The role of patients and healthcare workers Staphylococcus aureus nasal colonization in occurrence of surgical site infection among patients admitted in two centers in Tanzania. Antimicrob Resist Infect Control. 2019;8:102.PubMedPubMedCentral
12.
Seni J, Falgenhauer L, Simeo N, Mirambo MM, Imirzalioglu C, Matee M, Rweyemamu M, Chakraborty T, Mshana SE. Multiple ESBL-producing Escherichia coli sequence types carrying quinolones and aminoglycoside resistance genes circulating in companion and domestic farm animals in Mwanza, Tanzania, harbor commonly occurring plasmids. Front Microbiol. 2016;7:142. https://​doi.​org/​10.​3389/​fmicb.​2016.​00142.CrossRefPubMedPubMedCentral
13.
14.
Katakweba AA, Moller KS, Muumba J, Muhairwa AP, Damborg P, Rosenkrantz JT, Minga UM, Mtambo MMA, Olsen JE. Antimicrobial resistance in faecal sampls from buffalo, wildebeest and zebra grazing together with and without cattle in Tanzania. J Appl Microbiol. 2015;118(4):966–75.PubMed
15.
Erb S, D’Mello-Guyett L, Malebo HM, Njee RM, Matwewe F, Ensink J, Hinic V, Widmer A, Frei R. High prevalence of ESBL-Producing E. coli in private and shared latrines in an informal urban settlement in Dar es Salaam, Tanzania. Antimicrob Resist Infect Control. 2018;7(1):1.
16.
Kateete DP, Bwanga F, Seni J, Mayanja R, Kigozi E, Mujuni B, Ashaba FK, Baluku H, Najjuka CF, Källander K, et al. CA-MRSA and HA-MRSA coexist in community and hospital settings in Uganda. Antimicrob Resist Infect Control. 2019;8:94.PubMedPubMedCentral
17.
Okoche D, Asiimwe BB, Katabazi FA, Kato L, Najjuka CF. Prevalence and characterization of Carbapenem-resistant Enterobacteriaceae isolated from Mulago National Referral Hospital, Uganda. PLoS One. 2015;10(8):e0135745.PubMedPubMedCentral
18.
Pop-Vicas A, Opal MS. The clinical impact of multidrug-resistance gram-negative bacilli in the management of septic shock. Virulence. 2014;5(1):206–12.PubMed
19.
Falagas ME, Karageorgopoulos DE, Leptidis J, Korbila IP. MRSA in Africa: filling the global map of antimicrobial resistance. PLoS One. 2013;8(7):e68024.PubMedPubMedCentral
20.
Stryjewski ME, Ralph Corey G. Methicillin-resistant Staphylococcus aureus: an evolving pathogen. Clin Infect Dis. 2014;58(1):S10–9.PubMed
21.
22.
23.
Blomberg B, Jureen R, Manji KP, Tamim BS, Mwakagile DSM, Urassa WK, Fataki M, Msangi V, Tellevik MG, Maselle SY, et al. High rate of fatal cases of pediatric septicemia caused by gram-negative Bacteria with extended-Spectrum Beta-lactamases in Dar Es Salaam, Tanzania. J Clin Microbiol. 2005;43(2):745–9.PubMedPubMedCentral
24.
25.
Ruppé E, Woerther P, Barbier F. Mechanisms of antimicrobial resistance in gram-negative bacilli. Ann Intensive Care. 2015;5:21.PubMedCentral
26.
Lagace-Wiens P, Nichol KA, Nicolle LE, Decorby RM, McCracken M, Alfa MJ, Mulvey MR, Zhanel GG. ESBL genotypes in fluoroquinolones-resistant and flouroquinolones-susceptible ESBL producing Escherichia coli urinary isolates in Manitoba. Can J Infect Dis Med Microbiol. 2007;2007(18):2.
27.
Henson SP, Boinett CJ, Ellington MJ, Kagia N, Mwarumba S, Nyongesa S, Mturi N, Kariuki S, Scott JAG, Thomson NR, et al. Molecular epidemiology of Klebsiella pneumoniae invasive infections over a decade at Kilifi County Hospital in Kenya. Int J Med Microbiol. 2017;307(7):422–9.PubMedPubMedCentral
28.
Revathi G, Siu LK, Po-Liang L, Huang L. First report of NDM-1 producing Acinetobacter baumannii in East Africa. Int J Infect Dis. 2013;17:1255–8.
29.
Ntirenganya C, Manzi O, Muvunyi CM, Ogbuagu O. High prevalence of antimicrobial resistance among common bacterial isolates in a tertiary healthcare Facility in Rwanda. Am J Trop Med Hyg. 2015;92(4):865–70.PubMedPubMedCentral
30.
Ampaire LM, Katawera V, Nyehangane D, Boum Y, Bazira J. Epidemiology of Carbapenem resistance among multi-drug resistant Enterobacteriaceae in Uganda. Br Microbiol Res J. 2015;8(2):418–23.PubMedPubMedCentral
31.
Kateete DP, Nakanjako R, Namugenyi J, Erume J, Joloba ML, Najjuka CF. Carbapenem resistant Pseudomonas aeruginosa and Acinetobacter baumannii at Mulago Hospital in Kampala, Uganda (2007–2009). Springerplus. 2016;5(1):1308.PubMedPubMedCentral
32.
Pitout JDD, Revathid D, Chowa BL, Kariukie S, Nordmannf P, Poirel L. Metallo-β lactamase-producing Pseudomonas aeruginosa isolated from a large tertiary Centre in Kenya. Clin Microbiol. 2008;14(8):755–9.
33.
Ssekatawa K, Byarugaba DK, Wampande E, Ejobi F. A systematic review: the current status of carbapenem resistance in East Africa. BMC Res Notes. 2018;11:629.PubMedPubMedCentral
34.
Desai K, Kazi M, Ajban K, Munshi M, Rodrigues C, Soman R, Shetty A. Clinical outcomes and safety of colistin in treatment of gram-negative infections: a prospective observational study. EJCCM. 2016;4(2):67–72.
35.
Rousham EK, Unicomb L, Islam MA. Human, animal and environmental contributors to antibiotic resistance in low-resource settings: integrating behavioural, epidemiological and One Health approaches. Proc Biol Sci. 2018;285(1876):20180332.PubMedPubMedCentral
36.
37.
38.
Caudell MA, Mair C, Subbiah M, Matthews L, Quinlan RJ, Quinlan MB, Zadoks R, Keyyu J, Call DR. Identification of risk factors associated with carriage of resistant Escherichia coli in three culturally diverse ethnic groups in Tanzania: a biological and socioeconomic analysis. Lancet Planet Health. 2018;2:e489–97.PubMedPubMedCentral
39.
Fleece M, Nshama R, Walongo T, Gratz J, Platts-Mills J, Mduma E, Houpt E. Risk Factors of Antibiotic Resistance in E. coli Isolated from the MAL-ED Birth Cohort Study in Rural Tanzania. Open Forum Infect Dis. 2018;5(1):S365–6.PubMedCentral
40.
Joachim A, Moyo SJ, Nkinda L, Majigo M, Rugarabamu S, Mkashabani EG, Mmbaga EJ, Mbembati N, Aboud S, Lyamuya EF. Nasal carriage of methicillin-resistant Staphylococcus aureus among health care workers in tertiary and regional Hospitals in Dar es Salam, Tanzania. Int J Microbiol. 2018;2018:5058390.PubMedPubMedCentral
41.
Moyo S, Haldorsen B, Aboud S, Blomberg B, Maselle SY, Sundsfjord A, Langeland N, Ørjan Samuelsen Q. Identification of VIM-2-producing Pseudomonas aeruginosa from Tanzania is associated with sequence types 244 and 640 and the location of blaVIM-2 in a TniC Integron. Antimicrob Agents Chemother. 2015;59(1):682–5.PubMed
42.
Muvunyi CM, Masaisa F, Bayingana C, Mutesa L, Musemakweri A, Muhirwa G, Claeys GW. Decreased susceptibility to commonly used antimicrobial agents in bacterial pathogens isolated from urinary tract infections in Rwanda: need for new antimicrobial guidelines. Am J Trop Med Hyg. 2011;84(6):923–8.PubMedPubMedCentral
43.
Kajeguka DC, Nambunga PP, Kabissi F, Kamugisha B, Kassam N, Nyombi B, Mataro C, Maro V, Chilongola JO. Antimicrobial resistance patterns of phenotype Extended Spectrum Beta-Lactamase producing bacterial isolates in a referral hospital in northern Tanzania. Tanzania J Health Res. 2015;17(3). https://​doi.​org/​10.​4314/​thrb.​v17i3.​2.
44.
45.
Mshana SE, Falgenhauer L, Mirambo MM, Mushi MF, Moremi N, Julius R, Seni J, Imirzalioglu C, Matee M, Chakraborty T. Predictors of blaCTX-M-15 in varieties of Escherichia coli genotypes from humans in community settings in Mwanza, Tanzania. BMC Infect Dis. 2016;16:187.PubMedPubMedCentral
46.
47.
48.
49.
50.
Marando R, Seni J, Mirambo MM, Falgenhauer L, Moremi N, Mushi MF, Kayangea NM, Manyama F, Imirzalioglu C, Chakraborty T, et al. Predictors of the extended-spectrum-beta lactamases producing Enterobacteriaceae neonatal sepsis at a tertiary hospital, Tanzania. Int J Med Microbiol. 2018;308(7):803–11.PubMedPubMedCentral
51.
Butaye P, Devriese LA, Freddy Haesebrouck F. Antimicrobial growth promoters used in animal feed: effects of less well-known antibiotics on gram-positive Bacteria. Clin Microbiol Rev. 2003;16(2):175–88.PubMedPubMedCentral
52.
Marshall BM, Levy SB. Food animals and antimicrobials: impacts on human health. Clin Microbiol Rev. 2011;24:718–33 pmid:21976606.PubMedPubMedCentral
53.
Landers TF, Cohen B, Wittum TE, Larson EL. A review of antibiotic use in food animals: perspective, policy, and potential. Public Health Rep. 2012;127:4–22 pmid:22298919.PubMedPubMedCentral
54.
55.
Sonda T, Kumburu H, van Zwetselaar M, Alifrangis M, Mmbaga BT, Lund O, Aarestrup FM, Kibiki G. Prevalence and risk factors for CTX-M gram-negative bacteria in hospitalized patients at a tertiary care hospital in Kilimanjaro, Tanzania. Eur J Clin Microbiol Infect Dis. 2018;37(5):897–906.PubMedPubMedCentral
56.
Cotton MF, Wasserman E, Smit J, Whitelaw A, Zar HJ. High incidence of antimicrobial resistant organisms including extended spectrum beta-lactamase producing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus in nasopharyngeal and blood isolates of HIV-infected children from Cape Town, South Africa. BMC Infect Dis. 2008;8:40 pmid:18380900.PubMedPubMedCentral
57.
58.
Kolár M, Urbánek K, Látal T. Antibiotic selective pressure and development of bacterial resistance. Int J Antimicrob Agents. 2001;17(5):357–63.PubMed
59.
Cantón R, Morosini M-I. Emergence and spread of antibiotic resistance following exposure to antibiotics. FEMS Microbiol Rev. 2011;35(5):977–91.PubMed
60.
61.
Isendahl J, Turlej-Rogacka A, Manjuba C, Rodrigues A, Giske CG, Nauclér P. Fecal carriage of ESBL-producing E. coli and K. pneumoniae in children in Guinea-Bissau: a hospital-based cross-sectional study. PLoS One. 2012;2012(7):e51981.
62.
Lonchel CM, Melin P, Gangoué-Piéboji J, Assoumou M-CO, Boreux R, De Mol P. Extended-spectrum β-lactamase-producing Enterobacteriaceae in Cameroonian hospitals. Eur J Clin Microbiol Infect Dis. 2013;32(1):79–87.PubMed
63.
Moremi N, Claus H, Rutta L, Frosch M, Vogel U, Mshana SE. High carriage rate of extended-spectrum beta-lactamase-producing Enterobacteriaceae among patients admitted for surgery in Tanzanian hospitals with a low rate of endogenous surgical site infections. J Hosp Infect. 2018;100(1):47–53.PubMed
64.
Seni J, Tito JN, Makoye SJ, Mbena H, Alfred HS, van der Meer F, Pitout JDD, Mshana SE, DeVinney R. Multicentre evaluation of significant bacteriuria among pregnant women in the cascade of referral healthcare system in North-Western Tanzania: bacterial pathogens, antimicrobial resistance profiles and predictors. J Glob Antimicrob Resist. 2019b;17:173–9.PubMed
65.
Seni J, Mwakyoma AA, Mashuda F, Marando R, Ahmed M, DeVinney R, Pitout JDD, Mshana SE. Deciphering risk factors for blood stream infections, bacteria species and antimicrobial resistance profiles among children under five years of age in North-Western Tanzania: a multicentre study in a cascade of referral health care system. BMC Pediatr. 2019a;19:32.PubMedPubMedCentral
66.
Moremi N, Claus H, Vogel U, Mshana SE. The role of patients and healthcare workers Staphylococcus aureus nasal colonization in occurance of surgical site infection among patients admitted in two centers in Tanzania. Antimicrob Resist Infect Control. 2019;8:102.PubMedPubMedCentral
67.
68.
Albrechtova K, Dolejska M, Cizek A. D T, Klimes J, Bebora L, Literaka I: dogs of nomadic pastoralists in northern Kenya are reservoirs of plasmid-mediated cephalosporin- and quinolone-resistant Escherichia coli, including pandemic clone B2-O25-ST131. Antimicrob Agents Chemother. 2012;56(7):4013–7.PubMedPubMedCentral
69.
Moremi N, Manda EV, Falgenhauer L, Ghosh H, Imirzalioglu C, Matee M, Chakraborty T, Mshana SE. Predominance of CTX-M-15 among ESBL producers from environment and fish gut from the shores of Lake Victoria in Mwanza, Tanzania. Front Microbiol. 2016;7:1862.PubMedPubMedCentral
70.
Mshana SE, Imirzalioglu C, Hain T, Domann E, Lyamuya EF, Chakraborty T. Multiple ST clonal complexes, with a predominance of ST131, of Escherichia coli harbouring blaCTX-M-15 in a tertiary hospital in Tanzania. Clin Microbiol Infect. 2011;17(8):1279–82.PubMed
71.
Kumburu HH, Sonda T, Leekitcharoenphon P, van Zwetselaar M, Lukjancenko O, Alifrangis M, Lund O, Mmbaga BT, Kibiki G, Aarestrup FM. Hospital Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Tertiary Care Hospital in Moshi, Tanzania, as Determined by Whole Genome Sequencing. BioMed Res Int. 2018;2018:2087693 12 pages.PubMedPubMedCentral
72.
Maina EK, Kiiyukia C, Njeri Wamae C, Waiyaki PG, Kariuki S. Characterization of methicillin-resistant Staphylococcus aureus from skin and soft tissue infections in patients in Nairobi, Kenya. Int J Infect Dis. 2013;17(2):e115–9.PubMed
73.
Kateete DP, Namazzi S, Okee M, Okeng A, Baluku H, Musisi NL, Katabazi FA, Joloba ML, Ssentongo R, Najjuka FC. High prevalence of methicillin resistant Staphylococcus aureus in the surgical units of Mulago hospital in Kampala, Uganda. BMC Res Notes. 2011;4:326.PubMedPubMedCentral
74.
Moremi N, Mshana SE, Kamugisha E, Kataraihya JB, Tappe D, Vogel U, Lyamuya EF, Claus F. Predominance of methicillin resistant Staphylococcus aureus-ST88 and new ST1797 causing wound infection and abscesses. J Infect Dev Ctries. 2012;6(8):620–5.PubMed
75.
Omuse G, Van Zyl KN, Hoek K, Abdulgader S, Kariuki S, Whitelaw A, Revathi G. Molecular characterization of Staphylococcus aureus isolates from various healthcare institutions in Nairobi, Kenya: a cross sectional study. Ann Clin Microbiol Antimicrob. 2016;15:51.PubMedPubMedCentral
76.
Seni J, Bwanga F, Najjuka CF, Makobore P, Okee M, Mshana SE, Kidenya BR, Joloba ML, Kateete DP. Molecular Characterization of Staphylococcus aureus from Patients with Surgical Si Infections at Mulago Hospital in Kampala, Uganda. PLoS One. 2013;8(6):e66153.PubMedPubMedCentral
77.
Aiken AM, Mutuku IM, Sabat AJ, Akkerboom V, Mwangi J, Scott JAG, Morpeth SC, Friedrich AW, Grundmann H. Carriage of Staphylococcus aureus in Thika level 5 hospital, Kenya: a cross-sectional study. Antimicrob Resist Infect Control. 2014;3:22.PubMedPubMedCentral
78.
Asiimwe BB, Baldan R, Trovato A, Cirillo DM. Prevalence and molecular characteristics of Staphylococcus aureus, including methicillin resistant strains, isolated from bulk can milk and raw milk products in pastoral communities of south-West Uganda. BMC Infect Dis. 2017;17:422.PubMedPubMedCentral
79.
Anjum MF, Lemma F, Cork DJ, Meunier D, Murphy N, North SE, Woodford N, Haines J, Randall LP. (Isolation and detection of extended spectrum β-lactamas ESBL)-producing Enterobacteriaceae from meat using chromogenic agars and isothermal loop-mediated amplification (LAMP) assays. J Food Sci. 2013;78:1892–8.
80.
Poirel L, Cattoir V, Nordmann P. Plasmid-mediated quinolone resistance; interactions between human, animal, and environmental ecologies. Front Microbiol. 2012;3:1–7.
81.
Moremi N, Claus H, Silago V, Kabage K, Abednego R, Matee M, Vogel U, Mshana SE. Hospital surface contamination with antimicrobial-resistant gram-negative organisms in Tanzanian regional and tertiary hospitals: the need to improve environmental cleaning. J Hosp Infect. 2019;102(1):98–100.PubMed
82.
Tekiner IH, Özpınar H. Occurrence and characteristics of extended spectrum beta-lactamases-producing Enterobacteriaceae from foods of animal origin. Braz J Microbiol. 2016;47(2):444–51.PubMedPubMedCentral
83.
Khasabuli OY, Ngugi C, Kiiru J. Carriage, antimicrobial susceptibility profiles and genetic diversity of Staphylococcus aureus and MRSA isolates recovered from students in a Kenyan university. East Afr Med J. 2017;94:7.
84.
Couce A, Rodríguez-Rojas A, Blázquez J. Determinants of genetic diversity of spontaneous drug resistance in Bacteria. Genetics. 2016;203(3):1369–80.PubMedPubMedCentral
85.
86.
Moyo SJ, Aboud S, Kasubi M, Maselle SY. Bacterial isolates and drug susceptibility patterns of urinary tract infection among pregnant women at Muhimbili National Hospital in Tanzania. Tanzania J Health Res. 2010;12(4):236–40.
87.
Wangai FK, Masika MM, Maritim MC, Seaton RA. Methicillin-resistant Staphylococcus aureus (MRSA) in East Africa: red alert or red herring? BMC Infect Dis. 2019;19:596.PubMedPubMedCentral
88.
Gitau W, Masika M, Musyoki M, Museve B, Titus Mutwiri T. Antimicrobial susceptibility pattern of Staphylococcus aureus isolates from clinical specimens at Kenyatta National Hospital. BMC Res Notes. 2018;11:226.PubMedPubMedCentral
89.
90.
Kairuki S, Keddy HK, Antonio M. Antimicrobial resistance surveillance in Africa: successes, gaps and a roadmap for the future. Afr J Lab Med. 2018;7(2):924.
91.
Guerra-Assunção JA, Crampin AC, Houben RM, Mzembe T, Mallard K, Coll F, Khan P, Banda L, Chiwaya A, Pereira RP, et al. Large-scale whole genome sequencing of M tuberculosis provides insights into transmission in a high prevalence area. Elife. 2015;3:4.
92.
Phelan JE, O’Sullivan DM, Machado D, Ramos J, Oppong YEA, Campino S, O’Grady J, McNerney R, Hibberd ML, Viveiros M, Huggett JF, Clark TG. Integrating informatics tools and portable sequencing technology for rapid detection of resistance to anti-tuberculous drugs. Genome Med. 2019;11:41.PubMedPubMedCentral
Metadata
Title
Genetic diversity and risk factors for the transmission of antimicrobial resistance across human, animals and environmental compartments in East Africa: a review
Authors
Bugwesa Z. Katale
Gerald Misinzo
Stephen E. Mshana
Harriet Chiyangi
Susana Campino
Taane G. Clark
Liam Good
Mark M. Rweyemamu
Mecky I. Matee
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Antimicrobial Resistance & Infection Control / Issue 1/2020
Electronic ISSN: 2047-2994
DOI
https://doi.org/10.1186/s13756-020-00786-7

Other articles of this Issue 1/2020

Antimicrobial Resistance & Infection Control 1/2020 Go to the issue

Research

The effect of a 5-year hand hygiene initiative based on the WHO multimodal hand hygiene improvement strategy: an interrupted time-series study

Research

The prevalence and mechanism of triclosan resistance in Escherichia coli isolated from urine samples in Wenzhou, China

Research

The epidemiology of carbapenem-non-susceptible Acinetobacter species in Europe: analysis of EARS-Net data from 2013 to 2017

Review

High rate of extended-spectrum beta-lactamase-producing gram-negative infections and associated mortality in Ethiopia: a systematic review and meta-analysis

Research

Critical Reliability Issues of Common Type Alcohol-Based Handrub Dispensers

Commentary

Use of medical face masks versus particulate respirators as a component of personal protective equipment for health care workers in the context of the COVID-19 pandemic
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits