Evaluation of the Antibiotic Resistance Pattern at the Medical Services Administration Hospital in Khartoum, Sudan, 2021

The number of antibiotics available is limited and does not cover the growing antibiotic resistance challenge. Misuse and overuse of antibiotics act as factors that help in improving and increasing the problem of resistance to those currently being prescribed by doctors. The study was carried out at the Medical Services Administration Hospital (MSAH) in Khartoum, Sudan to investigate the antibiotic resistance pattern for the period between Dec. 2020 and Jan. 2022. The results showed that, in a total of different clinical samples that were collected and processed, a total number of 980 organisms were isolated. The result indicated that 345 out of the total isolates (35.20%) were Klebsiella pneumonia, 326 (33.27%) Escherichia coli, 154 (15.71%) Pseudomonas aeruginosa, 130 (13.27%) Proteus mirabilis, and 25 (2.55%) Staphylococcus aureus. The results showed that K. pneumonia was quite resistant to piperacillin, cefuroxime, and azithromycin. The amikacin, imipenem, and meropenem antibiotics showed significant activity against K. pneumonia. The isolates of E. coli showed significant resistance to azithromycin and were more sensitive to imipenem and meropenem. P. aeruginosa was resistant to penicillin, amoxicillin/clavulanic acid, and azithromycin in a big way, but it was very sensitive to cefuroxime, the drug used to treat strep throat infections. P. mirabilis was found to be resistant to nalidixic acid, nitrofurantoin, amoxicillin/clavulanic acid, and azithromycin. It showed good sensitivity to amikacin, imipenem, and meropenem. It was clear that S. aureus was resistant to cefuroxime, ceftriaxone, nitrofurantoin, and norfloxacin, while tests showed that it was sensitive to imipenem

LE RÔLE DE LA TYPICALITÉ DANS LE CHOIX DE L’HUILE D’OLIVE MAROCAINE

Cette recherche tente d’explorer le concept de la typicalité perçue du produit de terroir. L’objectif est d’identifier le contenu de la notion de typicalité lorsqu’elle est transposée dans un contexte traditionnel. Notre problématique de recherche est: "Quels sont les déterminants de la typicalité de l’huile d’olive pour le consommateur marocain ?" Pour comprendre les contours du concept de la typicalité, nous avons mobilisé l’approche catégorielle qui prend ses sources de la psychologie cognitive. La revue de littérature sur ce sujet nous a permis de dégager les déterminants de la typicalité et les liens entre ces concepts. Sur le plan empirique, nous avons lancé une étude exploratoire qualitative et ce à travers une série d’entretien semi-directif, suivie d’une analyse thématique afin d’étudier les constats des entretiens de groupes effectués. À travers cette étude, nous avons pu comprendre et cerner le concept de la typicalité de l’huile d’olive marocaine. Ainsi, nous avons pu dégager les principaux déterminants évoqués par les consommateurs marocains. Il s’agit principalement de : la ressemblance familiale, la familiarité ; la fréquence d’instanciation, la satisfaction d’un idéal catégoriel et la satisfaction des attributs valorisés

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

La confiance à l’égard de la consommation des produits de terroir labellisés

Dans le cadre du Plan Maroc vert, plus de 60 produits de terroir ont été protégés par des Signes Distinctifs d’Origine et de Qualité (SDOQ). Cette stratégie de valorisation vise à garantir leur qualité et leurs attributs. Ces signes protègent, à la fois, les produits des coopératives et leurs consommateurs.Cependant un manque d’implication des marocains envers lesdits produits a suscité notre intérêt. Pour cela, nous nous sommes basés sur la théorie du comportement planifiée d’Ajzen (1991). Afin de répondre à notre problématique de recherche : « quels sont les freins à la consommation des produits de terroir portant un SDOQ ? » Ainsi nous avons eu recours à une approche qualitative à travers des entretiens de groupes. Ce qui nous a permis de cerner plusieurs freins à la consommation des produits de terroir labellisés, principalement le manque de confiance envers ces signes. Les interviewés ont exprimé un manque de confiance envers les organismes qui octroient les SDOQ ainsi que les coopératives qui doivent respecter les cahiers de charges