000			03869nam a22002537a 4500
008			210824b |||||||| |||| 00| 0 eng d
022			_a2047-2994
100			_a Bugwesa Z. Katale _923388
222			_a Genetic diversity Risk factors Antimicrobial resistance Human-animal-environment East Africa
245			_aGenetic diversity and risk factors for the transmission of antimicrobial resistance across human, animals and environmental compartments in East Africa _b a review
260			_aMwanza, Tanzania: _b Catholic University of Health and Allied Sciences CUHAS - Bugando & _bBioMed Central _c06 August 2020
300			_a Pages 1-20
490			_vAntimicrobial Resistance & Infection Control Volume 9 Issue 1
520			_aAbstract Background: The emergence and spread of antimicrobial resistance (AMR) present a challenge to disease control in East Africa. Resistance to beta-lactams, which are by far the most used antibiotics worldwide and include the penicillins, cephalosporins, monobactams and carbapenems, is reducing options for effective control of both Gram-positive and Gram-negative bacteria. The World Health Organization, Food and Agricultural Organization and the World Organization for Animal Health have all advocated surveillance of AMR using an integrated One Health approach. Regional consortia also have strengthened collaboration to address the AMR problem through surveillance, training and research in a holistic and multisectoral approach. This review paper contains collective information on risk factors for transmission, clinical relevance and diversity of resistance genes relating to extended-spectrum beta-lactamase-producing (ESBL) and carbapenemase-producing Enterobacteriaceae, and Methicillin-resistant Staphylococcus aureus (MRSA) across the human, animal and environmental compartments in East Africa. Main body: The review of the AMR literature (years 2001 to 2019) was performed using search engines such as PubMed, Scopus, Science Direct, Google and Web of Science. The search terms included ‘antimicrobial resistance and human-animal-environment’, ‘antimicrobial resistance, risk factors, genetic diversity, and human-animal-environment’ combined with respective countries of East Africa. In general, the risk factors identified were associated with the transmission of AMR. The marked genetic diversity due to multiple sequence types among drug-resistant bacteria and their replicon plasmid types sourced from the animal, human and environment were reported. The main ESBL, MRSA and carbapenem related genes/plasmids were the blaCTX-Ms (45.7%), SCCmec type III (27.3%) and IMP types (23.8%), respectively. Conclusion: The high diversity of the AMR genes suggests there may be multiple sources of resistance bacteria, or the possible exchange of strains or a flow of genes amongst different strains due to transfer by mobile genetic elements. Therefore, there should be harmonized One Health guidelines for the use of antibiotics, as well as regulations governing their importation and sale. Moreover, the trend of ESBLs, MRSA and carbapenem resistant (CAR) carriage rates is dynamic and are on rise over time period, posing a public health concern in East Africa. Collaborative surveillance of AMR in partnership with regional and external institutions using an integrated One Health approach is required for expert knowledge and technology transfer to facilitate information sharing for informed decision-making.
700			_a Mecky I. Matee _923389
700			_aMark M. Rweyemamu _923390
700			_a Gerald Misinzo _923391
700			_a Taane G. Clark, Liam Good _923392
700			_a Stephen E. Mshana _915820
700			_aHarriet Chiyangi _923393
700			_aSusana Campino _923394
856			_uhttps://doi.org/10.1186/s13756-020-00786-7
942			_2ddc _cVM
999			_c18939 _d18939