{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:30:07Z","timestamp":1753893007231,"version":"3.41.2"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Antibiot."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study aims at determining the pattern of antibiotic consumption and resistance in Mauritius, a tropical island in the Indian Ocean.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>Antibiotic consumption was measured in kilograms of purchased antibiotics and also in defined daily dose (DDD) in different health institutions from 2015 to 2017. Data on antibiotic resistance was collected at the Central Health Laboratory (CHL) at Victoria Hospital and at Jeetoo Hospital Laboratory, where antibiotic sensitivity testing is done for all public health institutions. For this study, <jats:italic>Escherichia coli<\/jats:italic>, <jats:italic>Klebsiella<\/jats:italic> species, <jats:italic>Acinetobacter<\/jats:italic> species, and <jats:italic>Pseudomonas aeruginosa<\/jats:italic> isolates from blood samples of patients from 2015 to 2023 were included. The resistance rate and prevalence of multi-drug-resistant (MDR) organisms were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The amount of antibiotics (in kilograms) distributed to the human sector was between 11,000 to 13,000 kg, compared to only 700 to 1,500 kg in the animal sector. The DDD per 1,000 inhabitants per day was 20.9, 22.1, and 21.7 in 2015, 2016, and 2017, respectively, with a greater consumption of WATCH and RESERVE group antibiotics in the private sector. In public health institutions, health centers in the northern region had the highest DDD per 1,000 outpatients per day for beta-lactams penicillins and quinolones. Concerning antibiotic resistance, the proportion of MDR <jats:italic>Acinetobacter baumannii<\/jats:italic> and <jats:italic>Pseudomonas aeruginosa<\/jats:italic> has increased from 58% to 74% and from 33% to 45%, respectively, from 2015 to 2023. During the same period, the proportion of <jats:italic>E. coli and K. pneumoniae<\/jats:italic> isolates sensitive to ceftriaxone decreased from 55% to 39% and from 37% to 22%, respectively, while the proportion of <jats:italic>E. coli<\/jats:italic>, <jats:italic>Klebsiella pneumoniae<\/jats:italic>, <jats:italic>Acinetobacter baumannii<\/jats:italic>, and <jats:italic>Pseudomonas aeruginosa<\/jats:italic> isolates sensitive to meropenem decreased from 98% to 94%, 83% to 53%, 45% to 28%, and 63% to 47%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides valuable insights on antibiotic consumption and resistance in the country and emphasizes the significance of adopting a One Health approach to combat antimicrobial resistance (AMR) effectively. These findings will aid policymakers in formulating targeted strategies to address the challenge of AMR and should be integrated into the National Action Plan on AMR in Mauritius.<\/jats:p><\/jats:sec>","DOI":"10.3389\/frabi.2024.1222580","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T11:33:17Z","timestamp":1713267197000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology of antibiotic consumption and resistance in Mauritius"],"prefix":"10.3389","volume":"3","author":[{"given":"Lovena Preeyadarshini","family":"Veerapa-Mangroo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harena","family":"Rasamoelina-Andriamanivo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Iqbal","family":"Issack","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Cardinale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1186\/s12941-017-0251-8","article-title":"Intensive care antibiotic consumption and resistance patterns: a cross-correlation analysis","volume":"16","author":"Baditoiu","year":"2017","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"B2","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1186\/s12916-018-1109-4","article-title":"Resistance decay in individuals after antibiotic exposure in primary care: a systematic review and meta-analysis","volume":"16","author":"Bakhit","year":"2018","journal-title":"BMC Med."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-13","article-title":"A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance","volume":"14","author":"Bell","year":"2014","journal-title":"BMC Infect. Dis."},{"key":"B4","doi-asserted-by":"publisher","first-page":"243","DOI":"10.4103\/ijmr.IJMR_685_19","article-title":"NDM-beta-lactamase-1: Where do we stand","volume":"155","author":"Bose","year":"2022","journal-title":"Indian J. Med. Res."},{"key":"B5","unstructured":"CLSI Standards and GuidelinesBerwyn, United StatesClinical and Laboratory Standards Institute2022"},{"key":"B6","first-page":"2","article-title":"Alexander fleming\u2019s miraculous discovery of penicillin","volume":"3","author":"Derderian","year":"2007","journal-title":"Rivier Acad. J."},{"key":"B7","unstructured":"Surveillance of antimicrobial resistance in Europe 20172017"},{"article-title":"Antimicrobial consumption","volume-title":"ECDC. Annual epidemiological report for 2017","year":"2018","key":"B8"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0204805","article-title":"Community level antibiotic utilization in India and its comparison vis-\u00e0-vis European countries: Evidence from pharmaceutical sales data","volume":"13","author":"Farooqui","year":"2018","journal-title":"PloS One"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fvets.2017.00213","article-title":"Why antibiotic use data in animals needs to be collected and how this can be facilitated","volume":"4","author":"Ferreira","year":"2017","journal-title":"Front. Vet. Sci."},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-012244","article-title":"Why do general practitioners prescribe antibiotics for upper respiratory tract infections to meet patient expectations: a mixed methods study","volume":"6","author":"Fletcher-Lartey","year":"2016","journal-title":"BMJ Open"},{"key":"B12","unstructured":"La\u00a0Reunion BranchCIRAD2022"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1093\/jtm\/taz036","article-title":"Global geographic trends in antimicrobial resistance: the role of international travel","volume":"26","author":"Frost","year":"2019","journal-title":"J. Travel Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1488","DOI":"10.1186\/s12889-020-09591-8","article-title":"Reunion Island, a sentinel territory for antimicrobial-resistant bacteria surveillance in the South-Western Indian Ocean: a retrospective survey using hospitalized patient screening, 2015-2017","volume":"20","author":"Gay","year":"2020","journal-title":"BMC Public Health"},{"key":"B15","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1111\/j.1469-0691.2009.02725.x","article-title":"Antibiotic consumption and link to resistance","volume":"15","author":"Goosens","year":"2009","journal-title":"Clin. Microbiol. Infect."},{"key":"B16","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1111\/apm.12834","article-title":"The first human report of mobile colistin resistance gene, mcr-1, in Finland","volume":"126","author":"Gr\u00f6ndahl-Yli-Hannuksela","year":"2018","journal-title":"APMIS"},{"key":"B17","unstructured":"IssackM.\n            ManrajS.\n          2012"},{"key":"B18","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1179\/joc.2007.19.2.222","article-title":"Antimicrobial resistance among enterobacteriaceae causing uncomplicated urinary tract infections in Mauritius: consequences of past misuse of antibiotics","volume":"19","author":"Issack","year":"2007","journal-title":"J. chemotherapy"},{"key":"B19","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijid.2016.02.250","volume-title":"Antibiotic resistance among hospitalized patients in Mauritius in 2014","author":"Issack","year":"2016"},{"key":"B20","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/S1473-3099(20)30332-7","article-title":"Assessment of WHO antibiotic consumption and access targets in 76 countries, 2000-15: an analysis of pharmaceutical sales data","volume":"21","author":"Klein","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.lansea.2022.100025","article-title":"Consumption of systemic antibiotics in India in 2019","volume":"4","author":"Koya","year":"2022","journal-title":"Lancet regional Health Southeast Asia"},{"volume-title":"The State of the World\u2019s Antibiotics 2021, A Global Analysis of Antimicrobial Resisitance and its drivers","year":"2021","author":"Laxminarayan","key":"B22"},{"volume-title":"Pharmaceutical Industry in MAURITIUS, Report for Consultation","year":"2020","key":"B23"},{"volume-title":"Act 60\/1983, Proclamation No. 24 of 1984] w. e. f. 1st January 1985, Mauritius Ministry of Tourism of India, Government of India, India Tourism Statistics 2019","year":"1983","key":"B24"},{"key":"B25","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1016\/j.ijmm.2013.04.004","article-title":"Antibiotic consumption and resistance: Data from Europe and Germany","volume":"303","author":"Meyer","year":"2013","journal-title":"Int. J. Med. Microbiol."},{"key":"B26","unstructured":"MauritiusMinistry of Agro-Industry, Reduit, Mauritius: Ministry of Agro-Industry2022"},{"volume-title":"Health Statistics Report","year":"2016","key":"B27"},{"volume-title":"Health Statistics Report","year":"2017","key":"B28"},{"volume-title":"India Tourism Statistics 2019","year":"2019","key":"B29"},{"key":"B30","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1093\/jac\/dkn213","article-title":"A comparison of antimicrobial usage in human and veterinary medicine in France from 1999 to 2005","volume":"62","author":"Moulin","year":"2008","journal-title":"J. Antimicrobial Chemotherapy"},{"key":"B31","first-page":"39","article-title":"Study of Klebsiella pneumoniae isolates with ESBL activity, from ICU and Nurseries, on the island of Mauritius","volume":"10","author":"Mungloo-Rujubali","year":"2013","journal-title":"J. Cell Mol. Biol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1016\/S1473-3099(17)30394-8","article-title":"Trends in antimicrobial resistance in bloodstream infection isolates at a large urban hospital in Malawi (1998\u20132016): a surveillance study","volume":"17","author":"Musicha","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"B33","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/j.jgar.2020.02.030","article-title":"Prevalence of multidrug-resistant Gram-negative bacteria cases at admission in a multispeciality hospital","volume":"22","author":"Nagvekar","year":"2020","journal-title":"J. Global Antimicrobial Resistance"},{"key":"B34","doi-asserted-by":"publisher","first-page":"71","DOI":"10.9734\/ajmah\/2020\/v18i1130270","article-title":"The prevalence of multi-drug resistant organisms and their outcomes in an ICU in Mauritius: an observational study","volume":"18","author":"Nuckchady","year":"2020","journal-title":"Asian\u00a0J. Med. Health Asian J. Med. Health"},{"key":"B35","doi-asserted-by":"publisher","first-page":"2387","DOI":"10.1093\/molbev\/msu191","article-title":"Strength of selection pressure is an portant parameter contributing to the complexity of antibiotic resistance evolution","volume":"31","author":"Oz","year":"2014","journal-title":"Mol. Biol. Evol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1128\/AAC.05639-11","article-title":"NDM-1 producing klebsiella pneumonia in Mauritius","volume":"56","author":"Poirel","year":"2012","journal-title":"Antimicrobial Agents Chemotherapy"},{"year":"2022","key":"B37"},{"key":"B38","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1093\/cid\/civ333","article-title":"High rate of acquisition but short duration of carriage of multidrug-resistant enterobacteriaceae after travel to the tropics","author":"Rupp\u00e9","year":"2015","journal-title":"Clin. Infect. diseases: an Off. Publ. Infect. Dis. Soc. America"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES2014.19.14.20768","article-title":"Acquisition of carbapenemase-producing Enterobacteriaceae by healthy travellers to India, France, February 2012 to March 2013","volume":"19","author":"Rupp\u00e9","year":"2014","journal-title":"Eurosurveillance"},{"volume-title":"International Travel and Tourism\u2013Year 2019","year":"2019","key":"B40"},{"key":"B41","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1021\/es102725n","article-title":"Tetracycline resistance genes persist at aquaculture farms in the absence of selection pressure","volume":"45","author":"Tamminen","year":"2011","journal-title":"Environ. Sci. Technol."},{"key":"B42","unstructured":"Port Louis, MauritiusWorld Bank Branch of Mauritius2022"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3389\/frabi.2022.1045081","article-title":"Point prevalence study in the hospitals of Mauritius","volume":"1","author":"Veerapa-Mangroo","year":"2023","journal-title":"Front. Antibiotic."},{"volume-title":"World Health Organization Report on Surveillance of Antibiotic Consumption, 2016\u20132018 Early Implementation","year":"2019","key":"B44"},{"key":"B45","unstructured":"Geneva, SwitzerlandWorld Health OrganizationWHO releases the 2019 AWaRe Classification Antibiotics2019"},{"volume-title":"Global action plan on Antimicrobial Resistance","year":"2015","key":"B46"},{"volume-title":"WHO Integrated global surveillance on ESBL-producing E. coli using a \u201cOne Heath \u201capproach: Implementation and opportunities","year":"2021","key":"B47"},{"volume-title":"ATC\/ DDD Index","year":"2023","key":"B48"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.00491","article-title":"Antibiotic consumption trends in China: evidence from six-year surveillance sales records in shandong province","volume":"11","author":"Yan","year":"2020","journal-title":"Front. Pharmacol."}],"container-title":["Frontiers in Antibiotics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frabi.2024.1222580\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T11:33:27Z","timestamp":1713267207000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frabi.2024.1222580\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,16]]},"references-count":49,"alternative-id":["10.3389\/frabi.2024.1222580"],"URL":"https:\/\/doi.org\/10.3389\/frabi.2024.1222580","relation":{},"ISSN":["2813-2467"],"issn-type":[{"type":"electronic","value":"2813-2467"}],"subject":[],"published":{"date-parts":[[2024,4,16]]},"article-number":"1222580"}}