Background: Carbapenem-resistant Enterobacteriaceae (CRE) prevalence has shown increasing prevelance in Saudi Arabia, which poses a significant health concern. The antimicrobial stewardship program (ASP) plays an important role in reducing resistance by ensuring appropriate use of antibiotics.

Method: This is a retrospective data collection study performed over 3 years from 2020 to 2022, at a tertiary hospital which included adult patients who were hospitalized in the ICU and received Meropenem. The primary objective was to evaluate the appropriateness of meropenem prescription in the ICU pre-ASP and post-ASP implementation. The secondary objectives were assessing the reason for inappropriateness and the implemented action in response to inappropriate meropenem prescription.

Result: In total, 113 patients were included. The pre-ASP group included 34 patients; 41 patients were in the first year post-ASP intervention and 38 patients were in the second year post-ASP implementation. There was a significant increase in the number of patients who received appropriate prescriptions in the post-ASP intervention group 2021 and 2022 compared to pre-ASP implementation (26.8%, 53.7% vs 23.5%, p-value 0.002). The most observed reason for inappropriateness in the post-ASP group compared to the pre-ASP group varied (84.8% vs 76.9%, p value 0.53). Discontinuation of treatment in the post-ASP group was higher compared to the pre-ASP group (60% vs. 30.8%, p-value 0.036) meropenem use.

Conclusion: Approximately more than 70% of meropenem prescriptions were inappropriate, and the implementation of ASP shows a significant impact in promoting appropriate meropenem prescription patterns and shorter treatment durations in the ICU.

Introduction: Antimicrobial resistance (AMR) is among the top three health threats worldwide. It requires an effective response by implementing proper antimicrobial stewardship (AMS) measures. In Hungary, AMR is also a considerable problem, with overuse and misuse of antimicrobials. Despite still being one of the highest in Europe, Hungarian veterinary antibiotic consumption has significantly improved over the past decade. In contrast, however, the quantity of antibiotics used in human health care is relatively low, measured as DDD per 1000 inhabitants per day, but utilization and resistance patterns show worsening tendencies. In this study, we wanted to explore the quality of the current Hungarian AMS systems in human and animal health care and the barriers and facilitators of their operations.

Methods: We conducted a qualitative study using in-depth interviews with twelve Hungarian stakeholders representing the human, animal, and environmental sectors at ministerial, regulatory authority, and hospital/university levels. Semi-structured interviews were transcribed and analyzed using NVivo 15.

Results and discussion: Key informants revealed that the Hungarian veterinary antibiotic policy is greatly driven by the legal obligations of the EU Common Agricultural Policy, with its strong financial protection system focusing on food-producing animals. All sectorial interviewees emphasized that their national veterinary heath sector is aware of the problem of AMR and actively take all measures to achieve their goals. The identified facilitators were good intrasectorial communication and cooperation, ambitious leadership, efficient law-making, high-level education of vets, and the existence of antibiotic reduction strategies. In human health care, almost only pull-back factors were reported by the participants about the weak sectorial antibiotic policy, such as institutional (no dedicated leadership at any levels, no institutional framework, and lack of proper data collection and monitoring), juridical (no implemented national action plan, no legal background,and lack of funding), and personal factors (clinicians’ resistance to change and the general population’s low health literacy).

Introduction: Perspectives and competencies developed during undergraduate health education critically influence antimicrobial resistance (AMR)-associated attitudes and future clinical decision-making in healthcare staff, particularly with regard to fostering patient safety and rational antimicrobial utilization. The aim of our study was to assess nursing and allied health science students’ knowledge, attitudes, and practices related to AMR.

Methods: A quantitative, single-centre cross-sectional study was performed with purposive sampling between 01/09/2021 and 20/09/2025. Data collection was carried out using an 83-item, self-administered online questionnaire consisting of the following domains: i) socio-demographic characteristics, ii) AMR-related knowledge, iii) attitudes towards AMR, iv) recognition of AMR-related terms, and v) practices related to antimicrobial consumption. Statistical analyses (descriptive statistics, Welch’s t-tests, binary logistic regression, and a 95% confidence interval [95%CI]) were performed using IBM SPSS 28.0. The study followed the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines.

Results: Among participants (N=312), 85.6% and 46.2% identified their formal health science training and the Internet as their main sources of AMR-related information, respectively. Participants enrolled in study programmes (e.g., nursing, dental hygiene) with stronger clinical and pharmacological components were more likely to possess adequate knowledge (OR=2.36; 95%CI: 1.49–3.71; p<0.001), hold positive attitudes (OR=2.19; 95%CI: 1.38–3.46; p<0.001), and recognize more AMR-related concepts (OR=2.95; 95%CI: 1.49–5.83; p=0.002). Overall, 51.3% demonstrated adequate knowledge, 59.3% had appropriate attitudes, while 15.4% correctly recognized a sufficient number of AMR-related concepts. In the past 12 months, 24.4% had used antibiotics (sources: medical prescription: 81.4%; leftover antibiotics: 6.7%; antibiotics from friends or family members: 7.4%), most commonly taking them to treat a throat ache (34.3%), fever (22.1%), or cough (18.9%).

Conclusions: Strengthening knowledge and attitudes toward AMR during undergraduate training is key to fostering evidence-based clinical decision-making in future practice. Continuous evaluation and enhancement of AMR-specific curricula should be considered ascore components of comprehensive AMR mitigation strategies.

Denture-associated biofilms remain a significant cause of oral infections such as denture stomatitis. This study evaluated the antibiofilm efficacy of a newly developed silver-based antimicrobial denture material fabricated via stereolithography and compared its performance with that of three-dimensional printed (3DP) methacrylate dentures without an antimicrobial additive (Control). Rectangular test specimens (7.5 cm × 2.5 cm) were printed using stereolithography. The experimental denture material incorporated sodium silver zirconia hydrogen phosphate (SSZHP) as an antimicrobial additive (GL3D), while the control group comprised non-antimicrobial dentures. Both materials were tested in a mouth-simulated drip-flow biofilm reactor inoculated with pooled human saliva and enriched with clinically relevant oral microorganisms, including Candida albicans, Staphylococcus aureus, Streptococcus spp., methicillin-resistant S. aureus (MRSA), and vancomycin-resistant enterococci (VRE). The biofilm's growth and testing were carried out in accordance with a modified version of ASTM E2647-24 protocol. Microbial attachment was quantified on agar media by colony-forming unit (CFU) enumeration. Biofilm architectures were analyzed by confocal laser scanning microscopy (CLSM). Two-way ANOVA was performed using Minitab 2. The log CFU counts in GL3D were consistently lower than those in control (p < 0.05) across all microbial groups tested. CLSM analysis showed a 75.37% decrease in biofilm volume, a 49.02% reduction in mean biovolume, a 93.78% decrease in biomass, a 79.03% drop in substratum coverage, and a 92.37% decline in average thickness compared to controls. The incorporation of SSZHP into a 3D-printed denture material markedly reduced microbial viability and disrupted biofilm formation and structure. These findings demonstrate the potential of silver-based 3D-printed denture materials to improve oral health by minimizing biofilm-associated infections and enhancing the hygiene and longevity of prosthetic devices.

Urban wastewater treatment plants (WWTPs) are increasingly recognized as critical control points in the environmental dissemination of antibiotics and antibiotic resistance genes (ARGs), playing a central role within the One Health framework. If insufficient removal of antibiotics or ARGs occurs during wastewater treatment, it may facilitate the spread of antimicrobial resistance (AMR), underscoring the need to assess treatment performance.

This study investigated the occurrence, concentration, and removal of selected ARGs and antibiotics in two urban WWTPs in southeastern Spain. The plants differed in their treatment schemes, with one conducting conventional secondary treatment and the other incorporating tertiary treatment; both included lagooning systems as additional stages. A total of nine ARGs associated with resistance to clinically relevant antibiotics were analysed, intI1, sul1, mcr-1, blaKPC-3, blaTEM, blaCTX-M, blaCTX-M-32, blaOXA-48, and blaOXA-58, together with the bacterial marker gene 16S rRNA. ARG concentrations were quantified by quantitative polymerase chain reaction (qPCR) and expressed as log₁₀ absolute gene copies. In parallel, selected antibiotics were quantified using high-performance liquid chromatography.

The results showed substantial reduction of both antibiotics and most ARGs in the final effluents, indicating that the applied treatment configurations, including lagooning, effectively reduce the environmental load of AMR. This reduction is particularly relevant from a One Health perspective, as it limits the dissemination of resistant bacteria and determinants from urban wastewater into receiving aquatic environments and water reuse systems. However, certain genes of high clinical and epidemiological relevance, such as intI1, mcr-1, and blaOXA-48, showed limited removal or, in some cases, higher concentrations in effluents than in influents. Correlation analyses revealed relationships between antibiotic concentrations and ARG abundances, providing insight into interactions driving resistance dissemination. This behaviour may reflect complex microbial and physicochemical processes during treatment and highlights the need to better understand ARG dynamics, reinforcing the role of WWTPs as key monitoring interfaces.