Decadal Analysis of ESBL-Escherichia coli Antibiotic Resistance Patterns in Urine Samples from Nepal: A Systematic Review and Meta-Analysis.

BACKGROUND: This systematic review aimed to determine the antimicrobial resistance pattern of the extended-spectrum ß-lactamases producing Escherichia coli (ESBL-EC) in urine samples in Nepal. METHODS: Systematic literature review was conducted to locate all articles reporting ESBL-EC in urine samples published between January 2012 to December 2022. The Egger's weighted regression analysis was done to assess the publication bias. A random-effects model was used to calculate the pooled prevalence and corresponding 95% confidence interval due to significant between-study heterogeneity. The strength of correlation between multidrug resistance and ESBL production in E.coli strains was determined using Pearson's correlation coefficient. The data were analyzed using R-language 4.2.2. software. RESULTS: The combined prevalence of E.coli in urine samples was found to be 14 % (95% CI, 11-18), while the overall pooled prevalence of ESBL E.coli and MDR E.coli were 30% (95% CI, 20-42) and 70% (95% CI, 38-90) respectively. A strong positive correlation of 0.99 (95% CI, 0.89-1.0) was found between ESBL production and MDR among E.coli isolates. Imipenem was the drug of choice against ESBL-E.coli in urine specimens. CONCLUSIONS: Our analyses showed the overall ESBL-EC and MDR-EC burden in Nepal is considerably high. Likewise, the study also infers an increasing trend of antibiotic resistance pattern of ESBL-EC in urine samples.

Lesions of lateral habenula attenuate win-stay but not lose-shift responses in a competitive choice task.

Multiple neural systems contribute to choice adaptation following reinforcement. Recent evidence suggests that the lateral habenula (LHb) plays a key role in such adaptations, particularly when reinforcements are worse than expected. Here, we investigated the effects of bilateral LHb lesions on responding in a binary choice task with no discriminatory cues. LHb lesions in rats decreased win-stay responses but surprisingly left lose-shift responses intact. This same dissociated effect was also observed after systemic administration of d-amphetamine in a separate cohort of animals. These results suggest that at least some behavioural responses triggered by reward omission do not depend on an intact LHb.

Lesions of ventrolateral striatum eliminate lose-shift but not win-stay behaviour in rats.

Animals tend to repeat actions that are associated with reward delivery, whereas they tend to shift responses to alternate choices following reward omission. These so-called win-stay and lose-shift responses are employed by a wide range of animals in a variety of decision-making scenarios, and depend on dissociated regions of the striatum. Specifically, lose-shift responding is impaired by extensive excitotoxic lesions of the lateral striatum. Here we used focal lesions to assess whether dorsal and ventral regions of the lateral striatum contribute differently to this effect. We found that damage to ventrolateral striatum reduced lose-shift responding without impairing win-stay, motoric, or motivational aspects of behaviour in the task, whereas lesions confined to the dorsolateral striatum significantly impaired the ability of rats to complete trials of the task. Moreover, lesions to the dorsomedial striatum had no effect on either lose-shift or win-stay responding. Together, these data suggest a novel role of the ventral portion of the lateral striatum in driving lose-shift decisions.

Feeder Approach between Trials Is Increased by Uncertainty and Affects Subsequent Choices.

Animals quickly learn to approach sources of food. Here, we report on a form of approach in which rats made volitional orofacial contact with inactive feeders between trials of a self-paced operant task. This extraneous feeder sampling (EFS) was never reinforced and therefore imposed an opportunity and effort cost. EFS decreased during initial training but persisted thereafter. The relative rate of EFS to operant responding increased with novel changes to the operant chamber, reward devaluation by prefeeding, or lesions to the dorsolateral striatum. We speculate that this may function to increase exploration when the task is uncertain (early in learning or introduction of novel apparatus components), when the opportunity cost is low, or when the learned sensorimotor solution is compromised. Moreover, EFS strongly affected subsequent choices by triggering a lose-shift response away from the sampled feeder, even though it occurred outside of the trial context. This indicates that at least some behaviors occurring between trials impact future behaviors and should be considered in decision-making studies.

The Memory Trace Supporting Lose-Shift Responding Decays Rapidly after Reward Omission and Is Distinct from Other Learning Mechanisms in Rats.

The propensity of animals to shift choices immediately after unexpectedly poor reinforcement outcomes is a pervasive strategy across species and tasks. We report here that the memory supporting such lose-shift responding in rats rapidly decays during the intertrial interval and persists throughout training and testing on a binary choice task, despite being a suboptimal strategy. Lose-shift responding is not positively correlated with the prevalence and temporal dependence of win-stay responding, and it is inconsistent with predictions of reinforcement learning on the task. These data provide further evidence that win-stay and lose-shift are mediated by dissociated neural mechanisms and indicate that lose-shift responding presents a potential confound for the study of choice in the many operant choice tasks with short intertrial intervals. We propose that this immediate lose-shift responding is an intrinsic feature of the brain's choice mechanisms that is engaged as a choice reflex and works in parallel with reinforcement learning and other control mechanisms to guide action selection.

Recent memory for socially transmitted food preferences in rats does not depend on the hippocampus.

The standard model of systems consolidation holds that the hippocampus (HPC) is involved only in the initial storage and retrieval of a memory. With time hippocampal-neocortical interactions slowly strengthen the neocortical memory, ultimately enabling retrieval of the memory without the HPC. Key support for this idea comes from experiments measuring memory recall in the socially-transmitted food preference (STFP) task in rats. HPC damage within a day or two of STFP learning can abolish recall, but similar damage five or more days after learning has no effect. We hypothesize that disruption of cellular consolidation outside the HPC could contribute to the amnesia with recent memories, perhaps playing a more important role than the loss of HPC. This view predicts that intraHPC infusion of Tetrodotoxin (TTX), which can block conduction of action potentials from the lesion sites, will block the retrograde amnesia in the STFP task. Here we confirm the previously reported retrograde amnesia with neurotoxic HPC damage within the first day after learning, but show that co-administration of TTX with the neurotoxin blocks the retrograde amnesia despite very extensive HPC damage. These results indicate that HPC damage disrupts cellular consolidation of the recent memory elsewhere; STFP memory may not ever depend on the HPC.