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The purpose of this paper is to assess the occurrence of the extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamase genes in 144 Escherichia coli isolates recovered from 160 vegetable salad samples.

Among the 144 E. coli isolates recovered from 160 vegetable salads, 17 (12 percent) ceftazidime-resistant isolates were screened for ESBL production with the double disk-diffusion test. The ESBL-producing isolates were characterized for antimicrobial resistance, the presence of virulence genes and plasmid-mediated quinolone resistance (PMQR) determinants. The isolates were also subjected to phylogenetic group typing. The existence of plasmid AmpC genes and mutations in the regulatory region of the chromosomal AmpC gene was assessed using polymerase chain reaction (PCR) and sequencing. All β-lactamase isolates were further characterized by pulsed-field gel electrophoresis to determine the genetic relatedness.

Overall, 17 (12 percent) of the 144 E. coli isolates studied were ceftazidime resistant. Among the 17 isolates, 13 (77 percent) were multidrug resistant and four (23.5 percent) were ESBL producers. The bla CTX-M14 was the only gene detected. Of the 12 AmpC-producing isolates, three (18 percent) harbored plasmid-encoded AmpC and sequencing analysis of the chromosomal AmpC genes revealed mutations in the promoter/attenuator region. PMQR determinants were detected in 9 (52 percent) isolates. A was the most prevalent phylogenetic group (56 percent), followed by groups B1 (31 percent), D (6 percent), and B2 (6 percent). PCR showed that six (50 percent) ESBL/AmpC-producing E. coli isolates carried one and/or two virulence genes. Pulsed-field gel electrophoresis showed no epidemiological relationship between these isolates.

This study places vegetable salads within the spectrum of ecological niches that may be vehicles for antibiotic-resistant bacteria/genes with clinical interest and these findings are worthy of attention as their spread to humans by ingestion cannot be dismissed.

Broad-spectrum cephalosporin resistance is rapidly increasing in Escherichia coli, representing a food safety problem. The purpose of this paper is to characterize eight extended-spectrum-ß-lactamase (ESBL) and acquired AmpC ß-lactamase-producing E. coli isolates and virotypes associated, obtained from chicken and pork food samples in Puebla, Mexico.

Samples (36 from chicken and 10 from pork) were cultured on Levine agar plates supplemented with cefotaxime (2 mg/L) for isolation of cefotaxime-resistant (CTXR) E. coli. CTXR-E. coli isolates were detected in 33 of 46 samples (72 percent), and one isolate/sample was characterized (28 from chicken and 5 from pork), for ESBL production, phylogenetic group, sequence typing, resistance and virulence genes by PCR and sequencing.

Results showed 16 ESBL-E. coli (35 percent) (12/16 belonging to phylogroup B1) and 8 CMY-2-E. coli (17 percent). ESBL detected were as follows (number of isolates): CTX-M-2 (8); CTX-M-1 (2); CTX-M-15 (1); SHV-2a (4) and TEM-52c (1). In total, 20 different sequence types (STs) were identified among the ESBL- or CMY-2-producing E. coli strains, which included four new ones. The CTX-M-15 β-lactamase was detected in one E. coli ST617-ST10 Cplx-B1 strain that also carried ibeA gene. One CMY-2-positive strain of lineage ST224-B2 was detected and it carried the qnrA1 gene.

In this study, a ST131-based virotyping scheme for strains from food of animal origin was established since this kind of strains constitutes an important vehicle of virulent ESBL- and CMY-2-producing E. coli isolates, which could be transmitted to humans by direct contact or through the food chain.

This study aims to investigate the influence of image and reputation of imported fresh fruits on consumer satisfaction and purchase intentions. The moderating role of familiarity with imported fruits was also assessed.

A total of 332 Taiwanese consumers who had purchased imported Korean pears participated using an online survey and were grouped based on their familiarity to Korean pears. Multi-group analysis with structural equation modeling was used to test the hypotheses.

Image and reputation of imported Korean pears were identified as predictors of the satisfaction and purchase intention. Multi-group analysis results found the moderating effect of familiarity between image and satisfaction. Images were identified as predictors of the satisfaction and purchase intention of imported Korean pears for consumers with low familiarity, whereas image did not show any influence on satisfaction for consumers with high familiarity.

This study can contribute to the limited understanding of imported fresh fruit markets and provides insights into familiarity for consuming imported fresh fruits.

The purpose of this paper is to cover some aspects about the disposal and regulatory standard around the world toward hospital effluent discharge, its managements and treatment technologies that are adopted and best suitable nowadays.

Due to large and variety of antibiotics available in the market nowadays it is difficult to control its use, thereby risking the whole ecosystem and its components. The regulation pattern is variable depending upon the various factors in different countries. The permissible limit of these emerging pollutants found in sewage as compared to in hospital effluent streams having active pharmaceutical ingredients is very narrow and is a debatable issue.

The disparity in the available legislation for hospital waste management in different countries makes it difficult to compare pro’s and con’s of methods adopted. Strict laws need to be framed for hospital wastewater management and its treatment, as it contains harmful compounds in higher concentrations resulting in development of resistant genes. The guideline applicable nowadays makes it clear that, specific management guidelines with respect to HWW, but also indicate certain characteristics that can be represented to specify their nature and indicator.

Determination of effluent characteristic for each specialized treatment need to be analyzed for meeting the framed regulatory standards. Up-gradation of existing treatment facilities, adopting new technologies and improving operation, maintained is a viable option. As there are no specific treatment schemes available hence combination and optimization of treatment methods may solve the problem to certain extent.

There is some flexibility also there so that law framework can be modified accordingly. For any health facilities direct discharges into natural water bodies it effluent need to follow national discharge standards. These are quite strict as compared to indirect standards and generally not meet by such facilities. This is quite logical because they are not being monitored or treated by municipal systems.

The law indicates that hospital needed to collect and treat effluent according to the treatment standards. But on other hand the law was made making it consideration about the HWW collection in water bodies.

The best way of management as described, is to treat HWW onsite-dividing into primary, secondary and tertiary. The document also provides details about sludge disposal, possible reuse, including the application of new and innovative treatment technologies for HWW. It also provides guidance for minimum approach for HWW management because developing countries patients do not have proper sanitation facilities.

The purpose of this paper is to explore the current state of antimicrobial stewardship implementation and development within Canada at both a federal and provincial level.

Narrative review.

There have been several prominent conferences and reports in Canada regarding the development and implementation of antimicrobial stewardship programs over the past two decades. However, despite the knowledge that there is a need for standardization of programs across Canada with accurate mechanisms and infrastructure in place for implementation and evaluation of these programs, there is still a lack of consistency across the country. In addition pharmacy information regarding inpatient and outpatient antimicrobial use is not uniformly reliable. Recently, the Public Health Agency of Canada using the Pan-Canadian Public Health Network as a vehicle organized a task group to help facilitate the working relationships among the provincial, territorial and federal governments in terms of implementing antimicrobial stewardship programs. This network has the potential to enhance and standardize programs across the country.

This paper looks at Canadian policy regarding antimicrobial stewardship at a federal as well as provincial level. Historic conferences, reports and discussions are highlighted emphasizing the progressive changes over the past two decades and highlight many of the challenges that Canada continues to face.

The purpose of this study was to comprehend the current state of green supply chain management (GSCM) and its drivers and enablers in the pharmaceutical supply chains (PSCs).

This study developed a model consisting of the factors green drivers, green enablers and green practices. For this study, data were collected from 166 supply chain heads from 124 pharmaceutical companies operating in India. The data was empirically analysed using SmartPLS3 software.

The study revealed that in Indian PSCs, public pressure, supplier pressure and competitor pressure were the major drivers for GSCM practices and coercive pressures such as pressure from government and regulatory bodies were insignificant drivers. The results indicated that the influence of green drivers and green enablers altered with supply chain flow. Green drivers indicated higher influence at the upstream of PSCs whereas the influence of green enablers was higher at the downstream of PSCs. Furthermore, the study revealed that the factor “green enablers” was a good mediator for the relationship between “green drivers” and “GSCM practices” in PSCs.

This study was an extension work with the addition of external green drivers to the self-induced organizational activities. Further investigations can be done by including the “green barriers” construct in the conceptual model.

This research connected the institutional theory with the resource-based view to understanding the role of green drivers and green enablers in greening PSC. For managers and regulators, this study provided clear insights on how to approach different supply chain drivers and enablers to maximize the impact of GSCM practices. Moreover, the findings of this study helped in incorporating knowledge about GSCM into a framework that can be used for defining strategies for setting up a sustainable PSC for pharmaceutical products leading to the development and growth of the pharmaceuticals industry.

Most of the earlier studies on GSCM were at the firm level and some studies were at the supply chain level. To further enhance the scope of GSCM theory, this study was conducted at two different levels, first at the complete supply chain level and second at three different levels: upstream, firm-level and downstream.