Antibiotics and Antimicrobial Resistance in the COVID-19 Era: Perspective from Resource-Limited Settings

The dissemination of COVID-19 around the globe has been followed by an increased consumption of antibiotics. This is related to the concern for bacterial superinfection in COVID-19 patients. The identification of bacterial pathogens is challenging in low and middle income countries (LMIC), as there are no readily-available and cost-effective clinical or biological markers that can effectively discriminate between bacterial and viral infections. Fortunately, faced with the threat of COVID-19 spread, there has been a growing awareness of the importance of antimicrobial stewardship programs, as well as infection prevention and control measures that could help reduce the microbial load and hence circulation of pathogens, with a reduction in dissemination of antimicrobial resistance. These measures should be improved particularly in developing countries. Studies need to be conducted to evaluate the worldwide evolution of antimicrobial resistance during the COVID-19 pandemic, because pathogens do not respect borders. This issue takes on even greater importance in developing countries, where data on resistance patterns are scarce, conditions for infectious pathogen transmission are optimal, and treatment resources are suboptimal

Développement d'un essai PCR pour l'identification des espèces de campylobacter

Les Campylobacter spp. représentent la plus grande cause de diarrhée bactérienne à travers le monde avec un coût économique élevé. Les méthodes phénotypiques utilisées au laboratoire de microbiologie médicale sont longues, ne différencient que Campylobacter jejuni des autres Campylobacter spp. et ne distinguent pas entre elles les deux sous-espèces de Campylobacter jejuni. Le développement de tests moléculaires capables de pallier à ces déficiences est donc important dans une perspective épidémiologique. Ce travail de recherche avait pour but de développer un essai PCR multiplex tuf-napA pour l’identification de Campylobacter jejuni au niveau de ses deux sous-espèces et de Campylobacter coli. Ce multiplex a ensuite été appliqué aux isolats de Campylobacter spp. du CHUL au CHUQ pour la période d’étude de janvier 2007 à janvier 2010 afin de définir l’épidémiologie moléculaire à l’hôpital. La capacité du gène tuf à servir comme gène cible pour discriminer les Campylobacter spp. a été établie ici pour la première fois.Campylobacter spp. are the leading cause of bacterial diarrhea worldwide with a high economic cost. The phenotypic methods used in medical microbiology laboratories are time-consuming, differentiate only Campylobacter jejuni from other Campylobacter spp. and do not distinguish between the two subspecies of Campylobacter jejuni. The development of molecular tests able to overcome these deficiencies is important from an epidemiological perspective. This research concentrates on the development of a PCR assay tuf-napA multiplex for the identification of Campylobacter jejuni at the level of its two sub-species as well as Campylobacter coli. This multiplex was then applied to Campylobacter spp. isolates at the CHUL of CHUQ for the study period from January 2007 to January 2010 to define the molecular epidemiology in the hospital. The ability of tuf gene to serve as target gene for discriminating Campylobacter spp. was established here for the first time

Characteristics of symptomatic COVID-19 cases by disease severity.

Characteristics of symptomatic COVID-19 cases by disease severity.</p

Surveillance flow chart for reporting outpatient SARS-CoV-2 cases—Haiti: Data streams for the detection, investigation, and testing of persons suspected of having SARS-CoV-2 infection from March 18 to August 4, 2020.

NP: Nasopharyngeal; LNSP: National Public Health Laboratory (Laboratorie nationale de santé publique; NAAT: Nucleic acid amplification testing; DELR: Directorate of Epidemiology, Laboratories and Research (Direction d’epidemiologie, de laboratoire et de recherches).</p

Characteristics of all COVID-19 cases, by symptom status, Haiti, March to August 2020.

Characteristics of all COVID-19 cases, by symptom status, Haiti, March to August 2020.</p

Logistic regression modelling evaluating risk factors related to the severity of clinical manifestations of COVID-19 outpatients, i.e. comparing moderate-to-severe and mild case as the outcome.

Logistic regression modelling evaluating risk factors related to the severity of clinical manifestations of COVID-19 outpatients, i.e. comparing moderate-to-severe and mild case as the outcome.</p