BackgroundAntimicrobial resistance (AMR) is a severe global public health threat demanding robust antimicrobial stewardship (AMS), where nurses play a critical execution role. This study evaluated nurses’ adherence to the Five Rights of antimicrobial administration and identified the professional and institutional determinants affecting their practice at Mbale Regional Referral Hospital (MRRH) in Eastern Uganda.MethodsA descriptive cross-sectional institutional study employing quantitative approach to data collection was conducted among 92 qualified nurses from November to December 2024. Data were collected using a validated, semi-structured paper questionnaire. Inferential data analysis was performed using STATA version 15.1, employing Pearson’s chi-square tests to determine statistically significant associations between independent factors and adherence, with significance set at p< 0.05.ResultsOut of 92 nurses, 57 (61.96%) adhered strictly to all Five Rights of antimicrobial administration. Adherence was significantly higher among nurses with 6 years of professional experience (70.83% versus 52.27%, p = 0.041) and those with positive attitudes towards patient education (83.08% versus 44.44%, p = 0.0003). Adherence was significantly compromised by institutional factors, notably heavy workloads (65.22% adherence, p = 0.012) and acute time constraints (33.33% adherence, p = 0.008).ConclusionNearly two-thirds of the qualified nurses fully adhered to the Five Rights of antimicrobial administration at MRRH. Adherence behaviors are strongly driven by clinical experience and positive educational attitudes, but heavily undermined by operational pressures like high workloads and time limitations. To close remaining compliance gaps and strengthen institutional AMS, hospital management must optimize staffing levels and integrate continuous AMS education into nursing workflows.
Antimicrobial resistance (AMR) is a global threat to humankind, affecting food safety, health, and the economy. Moreover, it is evolving rapidly, resulting from the misuse and overuse of antibiotics in healthcare and agriculture a result which has emerged as a One Health challenge. It alters food systems by creating threats to food safety, food security, and public health. Such resistant microorganisms have the ability to persist and spread in the food systems, animals, water, and the environment. Such microorganisms are further sustained by the production of biofilms. There is increased demand for safe and sustainable alternatives as a result of the limited applicability of conventional antibiotics and chemical preservatives. Plant-mediated phyto-nanoparticles (PNPs) are emerging antimicrobials. A PRISMA-compliant literature search and bibliometric analysis were used to identify leading research trends and gaps. This review evaluates their applicability in different aspects of food safety and preservation and in mitigating AMR. It includes major foodborne pathogens, resistance mechanisms, biofilm formation, and synthesis of bioactive nanoparticles using plants. The main antimicrobial mechanisms of these nanoparticles include the generation of reactive oxygen species (ROS), disruption of the cell membrane, release of metal ions, enzyme inhibition, DNA damage, and interference with quorum sensing. This review includes their applicability in active food packaging, edible coatings, food preservation, and food processing surfaces. This review expands existing research by including the results of real food matrices and storage studies. The review incorporates the emerging applications of artificial intelligence (AI) and machine learning (ML) in nanoparticles design, prediction of antimicrobial activities, and optimization of synthesis parameters, and trend identification. In general, PNPs have a lot of potential for sustainable approaches to food preservation. However, standardized methods, rigorous safety evaluation, AI/ML-assisted optimization, and real-food, in vivo, and industrial studies are needed for successful translation.
Surgical antibiotic prophylaxis across the East African Community is dominated by ceftriaxone, a WHO Access, Watch, and Reserve (AWaRe) Watch-group third-generation cephalosporin not recommended for routine prophylaxis. The practice recurs across regional point prevalence surveys, yet consumption surveillance cannot distinguish prophylactic from therapeutic use. Drawing on antimicrobial-use surveys, surgical-prophylaxis studies, resistance surveillance, and medicine-availability reports, we argue that four interacting failure modes sustain it: substitution of first-line agents, prolongation of postoperative prophylaxis, unnecessary combination, and empirical spillover from ward prescribing. Resistance among surgical-site isolates is already high enough to threaten the value of prophylaxis itself. Prophylaxis is measured for duration, documented indication, and guideline concordance, and agent choice is captured in point-prevalence surveys, but none of this reaches the national consumption totals that govern procurement, and no indicator records the supply constraint determining the agent or the resistance it selects. We propose four measures, one requiring routing rather than building and three genuinely absent, that would convert an ungoverned practice into a governable one.
BackgroundKlebsiella pneumoniae is a leading cause of hospital-associated infections and a major contributor to antimicrobial resistance (AMR) worldwide. Despite its importance and prioritisation in Zambia’s National Action Plan on AMR, genomic surveillance information in sub-Saharan Africa remains limited. This study investigated the population structure, determinants of AMR, and plasmid diversity of K. pneumoniae isolates from three tertiary hospitals in Zambia.MethodsThirty archived K. pneumoniae blood isolates collected between December 2023 and May 2025 from University Teaching Hospitals (UTH), Ndola University Teaching Hospital (NUTH), and Livingstone University Teaching Hospital (LUTH) and subjected to antimicrobial susceptibility testing (AST) and whole-genome sequencing (Illumina NextSeq 2000). Sequence types (STs), plasmid replicons, and antimicrobial resistance genes (ARGs) were identified using MLST, PlasmidFinder, and the Comprehensive Antibiotic Resistance Database, respectively.ResultsTwenty-eight isolates (93%) were multidrug-resistant, of which seven (25%) were extensively drug-resistant (XDR), exhibiting resistance across eight antibiotic classes, including carbapenems. Whole-genome sequencing identified 18 sequence types (STs), including two novel STs, and globally disseminated high-risk clones such as ST11, ST15, ST101, ST307, ST377, and ST607, which are circulating across hospitals. UTH exhibited the highest diversity of STs. The seven XDR K. pneumoniae isolates, six (85%) were from UTH, while the remaining isolate was from NUTH. Among the XDR isolates, five belonged to clinically dominant clones, comprising ST377 (two isolates) and single representatives of ST101, ST307, and ST607. The other two were ST13 and ST831, which have not been reported to have an XDR profile. All isolates carried multiple ARGs, dominated by those encoding β-lactamases (blaCTX-M-15: 93%, blaTEM: 70%), aminoglycoside-modifying enzymes (aac(6’)-Ib-cr5: 77%, aac(3)-IIe: 64%), and efflux pump genes (emrD: 100%). The carbapenemase-encoding gene, blaNDM-5, was present in 13% of the isolates.ConclusionsThis first genomic survey of K. pneumoniae in Zambia reveals extensive clonal diversity dominated by global high-risk lineages carrying plasmid-mediated ESBL and carbapenemase genes. The detection of XDR strains, particularly at UTH, underscores the urgent need to strengthen laboratory surveillance across all tertiary hospitals in Zambia and improve infection prevention programmes.
