Antibiotics are indispensable to maintaining human health, however, their overuse has resulted in resistant organisms which present a significantly higher burden to the low to middle income countries, due to the high ...Antibiotics are indispensable to maintaining human health, however, their overuse has resulted in resistant organisms which present a significantly higher burden to the low to middle income countries, due to the high incidence of communicable diseases. Insufficient antimicrobial-related training for physicians during their undergraduate education could have a negative impact on their prescribing. This study assessed the knowledge, attitudes and practices of antibiotic use and antimicrobial resistance among medical students in a private university in Dominica, a resource-limited country, in order to facilitate more effective education of these future prescribers. A cross-sectional study was undertaken with the medical students from February 2021 to April 2021 using a 36-item questionnaire. Data analysis was achieved using descriptive statistics. A total of 85 students participated in the study, majority (70%) were female, African, aged 23.8 ± 4.6 years and single. Between 64 and 99% of the respondents reported no risk factors for communicable diseases and demonstrated a low to moderate (10% - 40%) negative response to knowledge-related questions. The majority (70%) of the respondents who had used antibiotics in the past 12 months reported efficacy and limited side-effects, but confirmed lack of knowledge about the classes of antibiotics prescribed to them. Almost half of the medical students (48%) reported having abused antibiotics, while about a third (35%) of the respondents reported sharing antibiotics with friends or loved ones in the past. There was no significant association between age, gender, and the medical students’ knowledge of antibiotic resistance (p > 0.05). However, they reported that they would like more education on antimicrobial use and resistance. The medical students in this study showed knowledge of antimicrobial resistance, but lacked comprehension of components of antimicrobial stewardship, including prevention of inappropriate use and classes of antibiotics. Therefore, steps need to be taken to prepare medical students for antimicrobial resistance and stewardship initiatives effectively.展开更多
Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen causing infections resulting in severe morbidity and mortality worldwide. To date, the true nature and extent of MRSA infections in the Caribbean ...Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen causing infections resulting in severe morbidity and mortality worldwide. To date, the true nature and extent of MRSA infections in the Caribbean are not well understood. This is a review of the limited studies in the Caribbean describing the prevalence, epidemiology, and molecular characteristics of MRSA in hospitalized and non-hospitalized patients. Relevant articles were searched and extracted from PubMed and Mendeley and a narrative review of the findings was constructed. An aggregate of 24 articles, from 1999 to 2020, was found from 10 of 27 countries. Majority of the studies were from Trinidad and Tobago (29%) and Jamaica (21%) while 50% were from Barbados, Dominican Republic, Martinique, Haiti, Cuba, St. Kits & Nevis, Guadeloupe, and Guyana. Approximately 75% of investigations were conducted on hospitalized patients versus 20% on outpatients. The data revealed geographical differences in the prevalence of MRSA within the Caribbean;20% - 100% of Staphylococcus aureus clinical isolates from hospitalized patients and outpatients were resistant to methicillin, macrolides, and fluoroquinolones, but susceptible to several non-beta lactam antibiotics, due to the widespread occurrence of CA-MRSA clone ST8 SCCmec IV, PVL positive. There was moderate prevalence of ST72 SCCmec V (14% - 25%) in both hospital and community settings in a few of the countries while ST30 SCCmec IV, PVL positive, was moderately prevalent (27%) only in Dominican Republic. Also, there was moderate prevalence of HA-MRSA ST5 SCCmec II (18%) in community settings in the Dominican Republic and Martinique, but high prevalence of HA-MRSA ST239 SCCmec III (60%) in hospitalized patients in Cuba and Trinidad & Tobago. The epidemiologic profile of MRSA in both hospital and community settings is changing in the Caribbean. Epidemiological studies on outpatient settings and the implementation of stringent hospital infection control measures are needed in the region.展开更多
文摘Antibiotics are indispensable to maintaining human health, however, their overuse has resulted in resistant organisms which present a significantly higher burden to the low to middle income countries, due to the high incidence of communicable diseases. Insufficient antimicrobial-related training for physicians during their undergraduate education could have a negative impact on their prescribing. This study assessed the knowledge, attitudes and practices of antibiotic use and antimicrobial resistance among medical students in a private university in Dominica, a resource-limited country, in order to facilitate more effective education of these future prescribers. A cross-sectional study was undertaken with the medical students from February 2021 to April 2021 using a 36-item questionnaire. Data analysis was achieved using descriptive statistics. A total of 85 students participated in the study, majority (70%) were female, African, aged 23.8 ± 4.6 years and single. Between 64 and 99% of the respondents reported no risk factors for communicable diseases and demonstrated a low to moderate (10% - 40%) negative response to knowledge-related questions. The majority (70%) of the respondents who had used antibiotics in the past 12 months reported efficacy and limited side-effects, but confirmed lack of knowledge about the classes of antibiotics prescribed to them. Almost half of the medical students (48%) reported having abused antibiotics, while about a third (35%) of the respondents reported sharing antibiotics with friends or loved ones in the past. There was no significant association between age, gender, and the medical students’ knowledge of antibiotic resistance (p > 0.05). However, they reported that they would like more education on antimicrobial use and resistance. The medical students in this study showed knowledge of antimicrobial resistance, but lacked comprehension of components of antimicrobial stewardship, including prevention of inappropriate use and classes of antibiotics. Therefore, steps need to be taken to prepare medical students for antimicrobial resistance and stewardship initiatives effectively.
文摘Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen causing infections resulting in severe morbidity and mortality worldwide. To date, the true nature and extent of MRSA infections in the Caribbean are not well understood. This is a review of the limited studies in the Caribbean describing the prevalence, epidemiology, and molecular characteristics of MRSA in hospitalized and non-hospitalized patients. Relevant articles were searched and extracted from PubMed and Mendeley and a narrative review of the findings was constructed. An aggregate of 24 articles, from 1999 to 2020, was found from 10 of 27 countries. Majority of the studies were from Trinidad and Tobago (29%) and Jamaica (21%) while 50% were from Barbados, Dominican Republic, Martinique, Haiti, Cuba, St. Kits & Nevis, Guadeloupe, and Guyana. Approximately 75% of investigations were conducted on hospitalized patients versus 20% on outpatients. The data revealed geographical differences in the prevalence of MRSA within the Caribbean;20% - 100% of Staphylococcus aureus clinical isolates from hospitalized patients and outpatients were resistant to methicillin, macrolides, and fluoroquinolones, but susceptible to several non-beta lactam antibiotics, due to the widespread occurrence of CA-MRSA clone ST8 SCCmec IV, PVL positive. There was moderate prevalence of ST72 SCCmec V (14% - 25%) in both hospital and community settings in a few of the countries while ST30 SCCmec IV, PVL positive, was moderately prevalent (27%) only in Dominican Republic. Also, there was moderate prevalence of HA-MRSA ST5 SCCmec II (18%) in community settings in the Dominican Republic and Martinique, but high prevalence of HA-MRSA ST239 SCCmec III (60%) in hospitalized patients in Cuba and Trinidad & Tobago. The epidemiologic profile of MRSA in both hospital and community settings is changing in the Caribbean. Epidemiological studies on outpatient settings and the implementation of stringent hospital infection control measures are needed in the region.
