1. Investigación

Since 2017, the SWICEU team has developed various informative actions and innovative gamification supports to educate and raise awareness about antimicrobial resistance (AMR) and the correct use of antibiotics among the general population especially among young people. This case study presents the results obtained in the last 5 years with the strategies carried out by this team, composed of students and professors of Health Sciences, Industrial Design Engineering, and Communication Sciences at CEU Cardenal Herrera University (CEU UCH) in Valencia (Spain). Over the past 5 years, playful educational supports have been developed to make the health problem of bacterial resistance and the action of antibiotics more understandable among young people. The dissemination media used, with the same objective of teaching and raising awareness about AMR in a creative and innovative way, have been selected according to the trends in digital communication and use of scientific and health content provided by the most recent studies carried out among the Spanish population. These strategies have included decalogues or “tips” with useful advice, infographics, YouTube videos, Twitter threads, online challenges on Kahoot, stories on Instagram, use of QR codes, etc. These actions have also obtained diffusion in the media and have been awarded by different national and international entities. The good results obtained in the case under study allow us to establish recommendations for the design of innovative educational gamification and dissemination supports on AMR, especially aimed at younger audiences.

Antimicrobial resistance (AMR) remains a serious global health problem. Spain is the fifth country in Europe with the highest consumption of antibiotics, due in part to ignorance of the good use of these drugs and the problem of AMR. To avoid a post-antibiotic era, adequate training on this problem is key to create social awareness. This study aimed to evaluate the impact that the SWICEU project, an academic program about antibiotic discovery, has had on the knowledge of AMR and rational use of antimicrobials in preuniversity students from seven schools in the province of Valencia during five academic years (2017–2021), as well as to evaluate the level of satisfaction of university and pre-university students who have participated in the project. For this study, a survey was carried out with multiple-choice questions with a single correct answer to evaluate the knowledge acquired by pre-university students before and after the project. A satisfaction survey was also designed with a Likert scale from the lowest to the highest level of satisfaction for the two groups of students after the project. Data on knowledge surveys indicated an increase in the mean number of correct answers after the sessions. In satisfaction surveys, we highlighted the issue that referred to the project’s recommendation. The data obtained confirm this project as a valuable activity, as it allows learning about AMR and the rational use of antibiotics in a pleasing and attractive way for young pre-university and university students.

According to the World Health Organization (WHO), antibacterial resistance is a serious problem worldwide. In Spain, knowledge about the use of antibiotics is scarce, being the third country with the highest consumption of antibiotics in the world and the first in Europe. This problem is due, partly, to the abusive use of these drugs in human medicine, livestock, and agriculture. The objective of this study was to evaluate the impact that the Tiny Earth project has had on the antibiotic knowledge in pre-university students. To do this, a survey was conducted before and after the Tiny Earth project in three different school years (2017–2020) to 322 pre-university students belonging to seven schools in the province of Valencia. The survey consisted of 12 multiple-choice questions with a single valid answer. We observed 67.6% success at the beginning and 81.2% at the end. These data indicate that they correctly answered an average of 1.64 more questions after completing the project. In view of the results, we can affirm that the Tiny Earth project has contributed to an improvement in scientific knowledge and awareness of the correct use of antibiotics and the emergence of resistances by pre-university students, which could also be transmitted to their social environment, thus improving awareness global on these issues.

Gonorrhea is a sexually transmitted disease with a high morbidity burden. Despite having guidelines for its treatment, the incidence of the disease follows an increasing trend worldwide. This is mainly due to the appearance of antibiotic-resistant strains, ine cient diagnostic methods and poor sexual education. Without an e ective vaccine available, the key priorities for the control of the disease include sexual education, contact notification, epidemiological surveillance, diagnosis and e ective antibiotic treatment. This Special Issue focuses on some of these important issues such as the molecular mechanisms of the disease, diagnostic tests and di erent treatment strategies to combat gonorrhea.

Carbapenem-resistant Enterobacteriaceae (CRE) have become a public health threat worldwide. There are three major mechanisms by which Enterobacteriaceae become resistant to carbapenems: enzyme production, e ux pumps and porin mutations. Of these, enzyme production is the main resistance mechanism. There are three main groups of enzymes responsible for most of the carbapenem resistance: KPC (Klebsiella pneumoniae carbapenemase) (Ambler class A), MBLs (Metallo-ß-Lactamases) (Ambler class B) and OXA-48-like (Ambler class D). KPC-producing Enterobacteriaceae are endemic in the United States, Colombia, Argentina, Greece and Italy. On the other hand, the MBL NDM-1 is the main carbapenemase-producing resistance in India, Pakistan and Sri Lanka, while OXA-48-like enzyme-producers are endemic in Turkey, Malta, the Middle-East and North Africa. All three groups of enzymes are plasmid-mediated, which implies an easier horizontal transfer and, thus, faster spread of carbapenem resistance worldwide. As a result, there is an urgent need to develop new therapeutic guidelines to treat CRE infections. Bearing in mind the di erent mechanisms by which Enterobacteriaceae can become resistant to carbapenems, there are di erent approaches to treat infections caused by these bacteria, which include the repurposing of already existing antibiotics, dual therapies with these antibiotics, and the development of new ß-lactamase inhibitors and antibiotics.