Electronic Theses and Dissertations

Date

2019

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Epidemiology

Committee Chair

Pratik Banerjee

Committee Member

Wilfried Karmaus

Committee Member

Pratik Banerjee

Committee Member

Wilfried Karmaus

Committee Member

Yu Jiang

Committee Member

Irshad Sulaiman

Abstract

The discovery of antibiotics was one of the greatest advancements in medicine, reducing mortality and increasing life expectancy. Unfortunately, the widespread use of antibiotics has adverse side effects that are not yet fully understood. Our purpose in this research was to explore areas lacking in data to bring new information to the forefront in terms of antibiotic use and resistance to create awareness and increase measures of control and management of antibiotic use. To do this, we first investigated the relationship between wheezing and antibiotic use during pregnancy. Then, we examine a broader issue of antibiotic resistance and its effects on bacterial virulence and prevalence in the food system.We discovered no significant association between offspring wheeze and prenatal antibiotic use in a cohort study of infants, but associations between mode of delivery and wheezing in infancy. Mode of delivery is considered as a microbiome exposure. Among the infants, we were able to distinguish subtypes of wheeze in infancy: no wheezing, infectious wheezing only, and a combination of infectious and non-infectious wheezing. In addition, while research the effects on antibiotic resistance on virulence of human pathogens, we were able to determine that conventional antibiotics, like azithromycin, tetracycline, and streptomycin, may be less effective in use against infections to highly resistant and virulent pathogens. Furthermore, we ascertained it is possible that the following virulence determinants can increase in isolates that are multi-drug resistant using, Additionally, in our point prevalence study of antibiotic resistance genes in retail foods, we established that retail foods can be considered reservoirs of antibiotic resistance genes for antibiotic classes, like beta-lactams, tetracycline, quinolones, macrolides, and phenicols.Hence, with our research we can suggest that there is a need for policy enhancement in regards to antibiotic use. Furthermore, this research is useful for risk assessment and devising strategies for management and control of infections caused by highly resistant and virulent bacteria.

Comments

Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest

Notes

embargoed

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