 Sharing of antibiotic resistance genes is an important component of bacterial life. It is also a big contributor to the spread of antibiotic resistance.
Which of the following terms describes the ability of bacteria to take up DNA directly from the extracellular environment?
a. Transformation
b. Conjugation
c. Translocation
d. Macarena
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The answer is at the bottom of this newsletter.
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MOHASC is getting ready for the Minnesota State Fair!
- Members
of the Minnesota One Health Antibiotic Stewardship Collaborative (MOHASC) will
be at the 2018 State Fair to discuss the problem of antibiotic
resistance, how antibiotic stewardship can make an impact, and what everyone can do to combat resistance.
- We encourage you to find us in the Eco Experience Building, learn more about our unique Stewardship Collaborative, and participate in our stewardship pledge!
- The Minnesota State Fair runs August 23–September 3, 2018.
New C. difficile toolkit available for nursing homes
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Minnesota Department of Health has developed a Clostridium difficile Toolkit for Long-term Care
Facilities, which focuses on
evidence-based recommendations and standards for the prevention and management
of C. difficile infections.
- Find information about preparing your facility to detect and care for residents with new C. difficile infections, implement and assess environmental cleaning, use antibiotic stewardship and other preventive measures to prevent infection, and educate staff, residents, and families.
Call
for nominations for 2018 CHAIN Award for Excellence
Advisory group opportunity for Minnesota ambulatory care professionals
- Do you work in an medical or dental ambulatory care setting? Are you interested in improving antibiotic stewardship?
- In Fall 2018, Minnesota Department of Health will gather an advisory group
to share
insights on stewardship needs in ambulatory care, identify priorities for resource and tool development, and help promote awareness of stewardship resources.
- If you are interested in joining us,
contact health.stewardship@state.mn.us.
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WHO, OIE, and FAO leaders agree to strengthen collaboration on One Health threats
- In a Memorandum of Understanding signed on May 30, World Health Organization (WHO), World Organization for Animal Health (OIE), and Food and Agriculture Organization (FAO) agreed to
strengthen a long-standing partnership and enhance focus on
tackling antimicrobial resistance.
- Read more about the agreement in the FAO news release.
Study: A warming climate may produce more
drug-resistant infections
Study links acute gastroenteritis with recent use of antibiotics
JAMA publication reports decline in U.S. pediatric antibiotic use
New publications on stewardship metrics
- In a special issue, Rhode Island Medical Journal provides several articles on antimicrobial stewardship. Two articles highlight stewardship metrics:
RIMJ: Communicating with Facility Leadership; Metrics for Successful
Antimicrobial Stewardship Programs (ASP) in Acute Care and Long-Term
Care Facilities
RIMJ: Antimicrobial Stewardship Metrics: Prospective
Audit with Intervention and Feedback
Study of small hospitals suggests need for intensive antibiotic stewardship programs to make strides
- A new publication in Clinical Infectious Diseases describes findings of a cluster-randomized study of antibiotic stewardship programs (ASP) in small hospitals.
- Only the most intensive ASP intervention was associated with reduction
in total and broad-spectrum antibiotic use when compared with baseline practices.
- The intensive (successful) intervention included stewardship education and tools, access to an infectious disease hotline, locally controlled antibiotic restrictions, antibiotic utilization data, audit and feedback on most antibiotics, and an infectious
diseases-trained clinician to approve restricted antibiotics and review
microbiology results.
- These findings are important to consider when designing ASP for small hospitals, particularly when resources and expertise are limited.
- Find the article at CID: Impact of Implementing Antibiotic Stewardship Programs in 15 Small Hospitals: A Cluster-Randomized Intervention
CDC Grand Rounds recording available now
CDC Online Antibiotic Stewardship Training
- On July 5, CDC will launch the second of a four-section web-based
training course on Antibiotic Stewardship.
- Section 2 will focus on Antibiotic Stewardship in Outpatient
Settings and Communication Practices.
- Doctors, nurse practitioners, physician assistants, certified
health education specialists, nurses, pharmacists, and public health
practitioners with a master’s degree in public health are eligible to receive
up to eight hours of free CE for the entire course.
-
Register for the CDC Training on
Antibiotic Stewardship.
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 a. Transformation
When a bacterium takes up genetic material (DNA) from its external environment, the process is called "transformation" because the bacterium undergoes a genotypic change. Once transformation occurs, the genetic material is altered by enzymes inside the cell, allowing it to be integrated into the recipient bacterium's chromosome.
In
addition to accumulation of chromosomal point mutations in response to
antibiotic exposure, antibiotic resistance traits can be acquired by transfer of
genetic material among bacteria. The processes for gene transfer include transformation, conjugation (cell-to-cell transfer of DNA), and transduction (bacteriophage-mediated transfer). This sharing of resistance determinants make resistance itself transmissible, even apart from exposure to antibiotics. The cumulative pool of genetic elements that contribute to resistance is referred to as the antibiotic resistome (1).
Because these processes can happen anywhere- inside humans and animals or in our natural and built environments- it is difficult to predict the trajectory that resistance will take. Whole genome sequencing is an important tool in understanding the emergence and spread of resistance, as it allows us high resolution to track the clonal evolution of pathogens as well as the impacts of gene sharing (2).
In spite of and because of these complexities, all sectors that use antibiotics must respond. To make an impact on the problem of antibiotic resistance, we must prioritize antibiotic stewardship, infection prevention, and antibiotic resistance tracking.
(1) Gaze et al. EID. 2013 Jul; 19(7): e120871.
(2) Baker et al. Science. 2017; 360, 733–738.
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