Is There an Improvement of Antibiotic Use in China？ Evidence from the Usage Analysis of Combination Antibiotic Therapy for Type Ⅰ Incisions in 244 Hospitals

The improvement of antibiotic rational use in China was studied by usage analysis of combination antibiotic therapy for type Ⅰ incisions in 244 hospitals. Five kinds of hospitals, including general hospital, maternity hospital, children＇s hospital, stomatological hospital and cancer hospital, from 30 provinces were surveyed. A systematic random sampling strategy was employed to select outpatient prescriptions and inpatient cases in 2011 and 2012. A total of 29 280 outpatient prescriptions and 73 200 inpatient cases from 244 hospitals in each year were analyzed. Data were collected with regards to the implementation of the national antibiotic stewardship program（NASP）, the overall usage and the prophylactic use of antibiotic for type Ⅰ incisions. Univariate analysis was used for microbiological diagnosis rate before antimicrobial therapy, prophylactic use of antibiotics for typeⅠincision operation, and so on. For multivariate analysis, the use of antibiotics was dichotomized according to the guidelines, and entered as binary values into logistic regression analysis. The results were compared with the corresponding criteria given by the guidelines of this campaign. The antibiotic stewardship in China was effective in that more than 80% of each kind of hospitals achieved the criteria of recommended antibiotics varieties. Hospital type appeared to be a factor statistically associated with stewardship outcome. The prophylactic use of antibiotics on type Ⅰ incision operations decreased by 16.22%（P〈0.05）. The usage of combination antibiotic therapy for type Ⅰ incisions was also decreased. Region and bed size were the main determinants on surgical prophylaxis for type Ⅰ incision. This national analysis of hospitals on antibiotic use and stewardship allows relevant comparisons for bench marking. More efforts addressing the root cause of antibiotics abuse would continue to improve the rational use of antibiotics in China.

Antimicrobial usage and resistance in beef production

Antimicrobials are critical to contemporary high-intensity beef production. Many different antimicrobials are approved for beef cattle, and are used judiciously for animal welfare, and controversially, to promote growth and feed efficiency. Antimicrobial administration provides a powerful selective pressure that acts on the microbial community, selecting for resistance gene determinants and antimicrobial-resistant bacteria resident in the bovine flora. The bovine microbiota includes many harmless bacteria, but also opportunistic pathogens that may acquire and propagate resistance genes within the microbial community via horizontal gene transfer. Antimicrobial-resistant bovine pathogens can also complicate the prevention and treatment of infectious diseases in beef feedlots,threatening the efficiency of the beef production system. Likewise, the transmission of antimicrobial resistance genes to bovine-associated human pathogens is a potential public health concern. This review outlines current antimicrobial use practices pertaining to beef production, and explores the frequency of antimicrobial resistance in major bovine pathogens. The effect of antimicrobials on the composition of the bovine microbiota is examined, as are the effects on the beef production resistome. Antimicrobial resistance is further explored within the context of the wider beef production continuum, with emphasis on antimicrobial resistance genes in the food chain, and risk to the human population.

Is Nationwide Special Campaign on Antibiotic Stewardship Program Effective on Ameliorating Irrational Antibiotic Use in China? Study on the Antibiotic Use of Specialized Hospitals in China in 2011–2012

Summary： With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly overprescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program （ASP） at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children＇s, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses （DDDs） per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient eases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days （P〈0.001）. The percentage of antibiotic use in outpatient prescriptions （range： 24.12%-18.71%, P=0.109） and inpatient cases （64.85%-60.10%, P=-0.006） also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.

Diagnosis and Treatment of Rex Rabbit Infectious Coryza and Isolation of the Pathogen

Rex rabbit Bordetella bronchiseptica was isolated from a large rabbit field in Shandong Province. And which could be diagnosed to be Rex rabbit infectious coryza combining with the incidence,clinical symptoms,pathological changes and laboratory examination. Kanamycin soluble powder was used to treat the disease according to the antibiotics usage and course,and the treatment was proved to be effective.

Antibiotic usage in surgical sperm retrievals among IVF centers

Surgical sperm retrieval(SSR)is currently one of the most common procedures in in vitro fertilization(IVF).However,a gap between the guidelines and routine clinical practice regarding antibiotic use in sSR,which might lead to antibiotic resistance,is a challenging problem worldwide.A cross-sectional survey was conducted from May 1,2021,to July 15,2021,to investigate antibiotic usage by medical professionals when performing SSR in IVF centers in Vietnam.The confidential questionnaire comprised 12 items,including characteristics of the study population,awareness of antimicrobial resistance,attitude toward prescribing antibiotics,and current practice of prescribing antibiotics when performing SSR.Surveys were completed by 30 of 45 registered IVF centers(66.7%).Among 67 physicians working at those centers,the age and work-experience years(mean±standard deviation[s.d.])were 38.6±6.6 years and 11.2±7.0 years,respectively.Over 60%of them held a degree in Obstetrics and Gynecology,and over four-fifths were men.Most respondents"often/very often/always"raised awareness of antimicrobial resistance to their patients(83.3%),but only half of them"often/occasionally"prescribed antibiotics to patients with SSR in cases where the prescription would be optional.About one-tenth of respondents followed the recommendation from the American Urological Association using"prophylaxis only"for SSR patients.For more invasive SSR,physicians tended to prescribe more complicated and sometimes inappropriate regimens.In conclusion,antibiotic usage in SSR was not always appropriate among IVF centers.Further studies may define specific recommendations for regimens,intervention strategies,and programs to promote appropriate antibiotic use for SSR patients among IVF specialists.