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Krishnan L, Chakrabarty P, Govarthanan K, Rao S, Santra TS. Bioglass and nano bioglass: A next-generation biomaterial for therapeutic and regenerative medicine applications. Int J Biol Macromol 2024; 277:133073. [PMID: 38880457 DOI: 10.1016/j.ijbiomac.2024.133073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 05/20/2024] [Accepted: 06/08/2024] [Indexed: 06/18/2024]
Abstract
Biomaterials are an indispensable component in tissue engineering that primarily functions to resemble the extracellular matrix of any tissue targeted for regeneration. In the last five decades, bioglass has been extensively used in the field of therapeutic and tissue engineering. The doping of metal components into bioglass and the synthesizing of nano bioglass particles have found remarkable implications, both in vivo and in vitro. These include various medical and biological applications such as rejuvenating tissues, facilitating regeneration, and delivering biomolecules into cells and therapy, etc. Therefore, the current review discusses the various techniques used in synthesizing bioglass particles, trends of various ion-doped nano bioglass, and their applications in therapy as well as in regenerative medicine, specifically in the fields of dentistry, cardiovascular, skin, nervous, and respiratory systems. Apart from these, this review also emphasizes the bioglass combined with diverse natural polymers (like collagen, chitosan, etc.) and their applications. Furthermore, we discuss the effectiveness of bioglass properties such as antibacterial effects, biomolecular delivery systems, tissue compatibility, and regenerative material. Finally, the prospects and limitations are elaborated.
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Affiliation(s)
- Lakshmi Krishnan
- Department of Engineering Design, Indian Institute of Technology Madras, Chennai, India
| | - Pulasta Chakrabarty
- Department of Engineering Design, Indian Institute of Technology Madras, Chennai, India
| | - Kavitha Govarthanan
- Department of Engineering Design, Indian Institute of Technology Madras, Chennai, India
| | - Suresh Rao
- Department of Engineering Design, Indian Institute of Technology Madras, Chennai, India
| | - Tuhin Subhra Santra
- Department of Engineering Design, Indian Institute of Technology Madras, Chennai, India.
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2
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Elsewedy HS, Alshehri S, Alsammak NS, Abou Chahin NF, Alotaibi MS, Alshammari RA, Shehata TM, Aldhubiab B, Soliman WE. Investigating topical delivery of erythromycin laden into lipid nanocarrier for enhancing the anti-bacterial activity. Saudi Pharm J 2024; 32:102152. [PMID: 39165579 PMCID: PMC11334861 DOI: 10.1016/j.jsps.2024.102152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/26/2024] [Indexed: 08/22/2024] Open
Abstract
Skin infections considered as one of the predominant disorders that could greatly influence humans. Topical drug delivery is believed to be an effective substitute to systemically delivered medication for skin disorders management. Erythromycin has been proven to retain anti-bacterial activity. Based on that, the aim of existent study is to develop a proper nanocarrier, namely; nanoemulsion using tea tree oil including Erythromycin. Applying quality by design approach, the optimized nanoemulsion was selected based on number of independent variables namely; particle size and in vitro release study. Yet, in order to get appropriate topical application, the optimized nanoemulsion was combined with previously prepared hydrogel base to provide Erythromycin based nanoemulgel. The developed nanoemulgel was assessed for its organoleptic and physical characters to ensure its suitability for topical application. Stability study was implemented over three months after being kept in two distinct environments. Eventually, the antibacterial behavior of the preparation was investigated on MRSA to verify the expected antibacterial improvement and validate the effectiveness of the developed nanocarrier. The formulation showed consistent appearance, with pH (6.11 ± 0.19), viscosity (10400 ± 1275 cP), spreadability (54.03 ± 2.3 mm), extrudability (80.36 ± 3.15 g/cm2) and drug content (99.3 ± 0.46 %) that seemed to be satisfied for topical application. It could provide 48.1 ± 4.2 % releases over 6 h in addition to be stable at room temperature and at refrigerator. Ultimately, the formula showed a significant antibacterial activity against MRSA proving the combination and the nanocarrier effectiveness.
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Affiliation(s)
- Heba S. Elsewedy
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Dariyah, Riyadh 13713, Saudi Arabia
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Naheda S. Alsammak
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Dariyah, Riyadh 13713, Saudi Arabia
| | - Nada F. Abou Chahin
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Dariyah, Riyadh 13713, Saudi Arabia
| | - Manal S. Alotaibi
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Dariyah, Riyadh 13713, Saudi Arabia
| | - Rehab A. Alshammari
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Dariyah, Riyadh 13713, Saudi Arabia
| | - Tamer M. Shehata
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Saudi Arabia
- Department of Pharmaceutics, College of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| | - Bandar Aldhubiab
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Saudi Arabia
| | - Wafaa E. Soliman
- Department of Biomedical Sciences, College of Clinical Pharmacy, King Faisal University, Alhofuf 36362, Al-Ahsa, Saudi Arabia
- Department of Microbiology and Immunology, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa, 11152, Mansoura, Egypt
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3
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Zhang H, Wang Y, Zhang X, Xu C, Xu D, Shen H, Jin H, Yang J, Zhang X. Carbapenem-resistant Enterobacterales sepsis following endoscopic retrograde cholangiopancreatography: risk factors for 30-day all-cause mortality and the development of a nomogram based on a retrospective cohort. Antimicrob Resist Infect Control 2024; 13:84. [PMID: 39113089 PMCID: PMC11304701 DOI: 10.1186/s13756-024-01441-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 07/25/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Endoscopic retrograde cholangiopancreatography (ERCP) has become a routine endoscopic procedure that is essential for diagnosing and managing various conditions, including gallstone extraction and the treatment of bile duct and pancreatic tumors. Despite its efficacy, post-ERCP infections - particularly those caused by carbapenem-resistant Enterobacterales (CRE) - present significant risks. These risks highlight the need for accurate predictive models to enhance postprocedural care, reduce the mortality risk associated with post-ERCP CRE sepsis, and improve patient outcomes in the context of increasing antibiotic resistance. OBJECTIVE This study aimed to examine the risk factors for 30-day mortality in patients with CRE sepsis following ERCP and to develop a nomogram for accurately predicting 30-day mortality risk. METHODS Data from 195 patients who experienced post-ERCP CRE sepsis between January 2010 and December 2022 were analyzed. Variable selection was optimized via the least absolute shrinkage and selection operator (LASSO) regression model. Multivariate logistic regression analysis was then employed to develop a predictive model, which was evaluated in terms of discrimination, calibration, and clinical utility. Internal validation was achieved through bootstrapping. RESULTS The nomogram included the following predictors: age > 80 years (hazard ratio [HR] 2.61), intensive care unit (ICU) admission within 90 days prior to ERCP (HR 2.64), hypoproteinemia (HR 4.55), quick Pitt bacteremia score ≥ 2 (HR 2.61), post-ERCP pancreatitis (HR 2.52), inappropriate empirical therapy (HR 3.48), delayed definitive therapy (HR 2.64), and short treatment duration (< 10 days) (HR 5.03). The model demonstrated strong discrimination and calibration. CONCLUSIONS This study identified significant risk factors associated with 30-day mortality in patients with post-ERCP CRE sepsis and developed a nomogram to accurately predict this risk. This tool enables healthcare practitioners to provide personalized risk assessments and promptly administer appropriate therapies against CRE, thereby reducing mortality rates.
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Affiliation(s)
- Hongchen Zhang
- The Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, No. 261 HuanSha Road, Zhejiang, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People's Hospital, Hangzhou, 310003, China
- Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Zhejiang, China
- Hangzhou Institute of Digestive Disease, Zhejiang, China
| | - Yue Wang
- The Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, No. 261 HuanSha Road, Zhejiang, China
- Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Zhejiang, China
- Hangzhou Institute of Digestive Disease, Zhejiang, China
| | - Xiaochen Zhang
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People's Hospital, Hangzhou, 310003, China
- Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Zhejiang, China
- Hangzhou Institute of Digestive Disease, Zhejiang, China
| | - Chenshan Xu
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People's Hospital, Hangzhou, 310003, China
- Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Zhejiang, China
- Hangzhou Institute of Digestive Disease, Zhejiang, China
| | - Dongchao Xu
- The Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, No. 261 HuanSha Road, Zhejiang, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People's Hospital, Hangzhou, 310003, China
- Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Zhejiang, China
- Hangzhou Institute of Digestive Disease, Zhejiang, China
| | - Hongzhang Shen
- The Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, No. 261 HuanSha Road, Zhejiang, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People's Hospital, Hangzhou, 310003, China
- Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Zhejiang, China
- Hangzhou Institute of Digestive Disease, Zhejiang, China
| | - Hangbin Jin
- The Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, No. 261 HuanSha Road, Zhejiang, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People's Hospital, Hangzhou, 310003, China
- Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Zhejiang, China
- Hangzhou Institute of Digestive Disease, Zhejiang, China
| | - Jianfeng Yang
- The Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, No. 261 HuanSha Road, Zhejiang, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People's Hospital, Hangzhou, 310003, China
- Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Zhejiang, China
- Hangzhou Institute of Digestive Disease, Zhejiang, China
| | - Xiaofeng Zhang
- The Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, No. 261 HuanSha Road, Zhejiang, China.
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People's Hospital, Hangzhou, 310003, China.
- Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Zhejiang, China.
- Hangzhou Institute of Digestive Disease, Zhejiang, China.
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Bellanti F, Lo Buglio A, Ricci A, Aquilino A, Labbate A, Vendemiale G. In-hospital use of antibiotics in internal medicine: A cross-sectional study before, during and after the COVID-19 pandemic in a COVID-19-free ward. J Infect Public Health 2024; 17:102490. [PMID: 38991413 DOI: 10.1016/j.jiph.2024.102490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/24/2024] [Accepted: 06/27/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Coronavirus Disease-19 (COVID-19) pandemic impacted the use of antibiotics in hospitalized patients. However, most data on antibiotic therapy (AT) were recorded in COVID-19 settings. This study analyzed the appropriateness of AT in the real-world scenario of a COVID-19-free internal medicine ward before, during, and after the pandemic. METHODS Clinical information of hospitalized patients was collected, and data related to AT prescription were analyzed. The appropriateness of AT was independently assessed by two specialists in internal medicine and infectious disease, combining evidence-based guidelines with a validated tool. RESULTS Records of 1249 patients were analyzed: AT was prescribed in 229 (55.2 %) patients before, 134 (53.2 %) patients during, and 315 (54.1 %) patients after COVID-19 pandemic. Compared to the pre-pandemic period, there was a decrease in monotherapy with 3rd and 4th generation cephalosporins and fluoroquinolones, and an increase in β-lactams + β-lactamase inhibitors and antibiotic combinations. Furthermore, AT was longer and more expensive during the pandemic, with duration and cost remaining higher after its end. The inappropriateness of AT increased during and after COVID-19 pandemic. Compared to the pre-pandemic period, inappropriate AT was longer and more expensive than appropriate AT. The COVID-19 pandemic had a significant impact on changes related to AT type and antibiotic classes. CONCLUSIONS The COVID-19 pandemic increased the inappropriateness of AT in a COVID-19-free internal medicine ward. Most modifications persist despite the end of pandemic, potentially leading to negative effects on in-hospital antimicrobial resistance. There is an urgent need to re-establish antimicrobial stewardship policies to address the longer-term global threat of antimicrobial resistance.
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Affiliation(s)
- Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Italy.
| | - Aurelio Lo Buglio
- Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Antonio Ricci
- Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Anna Aquilino
- Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Annamaria Labbate
- Department of Medical and Surgical Sciences, University of Foggia, Italy
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Liabeuf S, Hafez G, Pešić V, Spasovski G, Bobot M, Mačiulaitis R, Bumblyte IA, Ferreira AC, Farinha A, Malyszko J, Pépin M, Massy ZA, Unwin R, Capasso G, Mani LY. Drugs with a negative impact on cognitive functions (part 3): antibacterial agents in patients with chronic kidney disease. Clin Kidney J 2024; 17:sfae174. [PMID: 39114495 PMCID: PMC11304602 DOI: 10.1093/ckj/sfae174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Indexed: 08/10/2024] Open
Abstract
The relationship between chronic kidney disease (CKD) and cognitive function has received increased attention in recent years. Antibacterial agents (ABs) represent a critical component of therapy regimens in patients with CKD due to increased susceptibility to infections. Following our reviewing work on the neurocognitive impact of long-term medications in patients with CKD, we propose to focus on AB-induced direct and indirect consequences on cognitive function. Patients with CKD are predisposed to adverse drug reactions (ADRs) due to altered drug pharmacokinetics, glomerular filtration decline, and the potential disruption of the blood-brain barrier. ABs have been identified as a major cause of ADRs in vulnerable patient populations. This review examines the direct neurotoxic effects of AB classes (e.g. beta-lactams, fluoroquinolones, aminoglycosides, and metronidazole) on the central nervous system (CNS) in patients with CKD. We will mainly focus on the acute effects on the CNS associated with AB since they are the most extensively studied effects in CKD patients. Moreover, the review describes the modulation of the gut microbiota by ABs, potentially influencing CNS symptoms. The intricate brain-gut-kidney axis emerges as a pivotal focus, revealing the interplay between microbiota alterations induced by ABs and CNS manifestations in patients with CKD. The prevalence of antibiotic-associated encephalopathy in patients with CKD undergoing intravenous AB therapy supports the use of therapeutic drug monitoring for ABs to reduce the number and seriousness of ADRs in this patient population. In conclusion, elucidating AB-induced cognitive effects in patients with CKD demands a comprehensive understanding and tailored therapeutic strategies that account for altered pharmacokinetics and the brain-gut-kidney axis.
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Affiliation(s)
- Sophie Liabeuf
- Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens University Medical Center, Amiens, France
- MP3CV Laboratory, EA7517, Jules Verne University of Picardie, Amiens, France
| | - Gaye Hafez
- Department of Pharmacology, Faculty of Pharmacy, Altinbas University, Istanbul, Turkey
| | - Vesna Pešić
- Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Goce Spasovski
- Department of Nephrology, Clinical Centre “Mother Theresa”, Saints Cyril and Methodius University, Skopje, North Macedonia
| | - Mickaël Bobot
- Aix-Marseille University, Department of Nephrology, AP-HM, La Conception Hospital, Marseille, France; C2VN Laboratory, Inserm 1263, INRAE 1260, Aix-Marseille University, Marseille, France
| | - Romaldas Mačiulaitis
- Department of Nephrology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Physiology and Pharmacology, Faculty of Medicines, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Inga Arune Bumblyte
- Department of Nephrology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ana Carina Ferreira
- Nephrology Department, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal
- Universidade Nova de Lisboa-Faculdade de Ciências Médicas-Nephology, Lisbon, Portugal
| | - Ana Farinha
- Department of Nephrology, Hospital de Vila Franca de Xira, Lisbon, Portugal
| | - Jolanta Malyszko
- Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Marion Pépin
- Department of Geriatrics, Ambroise Paré University Medical Center, APHP, Boulogne-Billancourt, France
- Paris-Saclay University, UVSQ, Inserm, Clinical Epidemiology Team, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Villejuif, France
| | - Ziad A Massy
- Paris-Saclay University, UVSQ, Inserm, Clinical Epidemiology Team, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Villejuif, France
- Department of Nephrology, Ambroise Paré University Medical Center, APHP, Paris, France
| | - Robert Unwin
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK
| | - Giovambattista Capasso
- Department of Translantional Medical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
- Biogem Research Institute, Ariano Irpino, Italy
| | - Laila-Yasmin Mani
- Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Khurana MP, Curran-Sebastian J, Bhatt S, Knight GM. Modelling the implementation of narrow versus broader spectrum antibiotics in the empiric treatment of E. coli bacteraemia. Sci Rep 2024; 14:16986. [PMID: 39043719 PMCID: PMC11266692 DOI: 10.1038/s41598-024-66193-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 06/28/2024] [Indexed: 07/25/2024] Open
Abstract
The implementation of new antimicrobial resistance stewardship programs is crucial in optimizing antibiotic use. However, prescription choices can be difficult during empiric therapy; clinicians must balance the survival benefits of broader spectrum antibiotics with associated increases in resistance. The aim of this study was to evaluate the overall feasibility of switching to narrow spectrum antibiotics during the empiric treatment of E. coli bacteraemia by quantifying changes in resistance rates, antibiotic usage, and mortality using a deterministic state-transition model. Three unique model scenarios (A, B, and C), each representing a progressively broader spectrum empiric treatment regimen, were used to compare outcomes at 5 years. We show that the empiric use of the narrowest spectrum (first-line) antibiotics can lead to reductions in resistance to second-line antibiotics and the use of third-line antibiotics, but they also lead to increases in resistance to first-line therapy and higher mortality. Crucially, we find that shortening the duration of empiric and overall treatment, as well as reducing the baseline mortality rate, are important for increasing the feasibility of switching to narrow spectrum antibiotics in the empiric treatment of E. coli bacteraemia. We provide a flexible model design to investigate optimal treatment approaches for other bacterial infections.
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Affiliation(s)
- Mark P Khurana
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1352, Copenhagen, Denmark.
| | - Jacob Curran-Sebastian
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1352, Copenhagen, Denmark
| | - Samir Bhatt
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1352, Copenhagen, Denmark
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, SW7 2AZ, UK
| | - Gwenan M Knight
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, AMR Centre, Centre for Mathematical Modeling of Infectious Diseases, London School of Hygiene and Tropical Medicine (LSHTM), London, UK
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Behairi N, Samer A, Sahraoui L, Mataam DH, Trari R, Flissi B, Belguendouz H, Amir ZC, Touil-Boukoffa C. Neuroinflammation, neurodegeneration and alteration of spatial memory in BALB/c mice through ampicillin-induced gut dysbiosis; NOS2 and NFL involvement in a microbiota-gut-brain axis model. J Neuroimmunol 2024; 392:578374. [PMID: 38797060 DOI: 10.1016/j.jneuroim.2024.578374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/05/2024] [Accepted: 05/18/2024] [Indexed: 05/29/2024]
Abstract
We aimed to investigate ampicillin (AMP) mechanisms in microbiota-gut-brain axis. We evaluated its effect on two gut and brain regions and behavioral performances. We administred AMP (1 g/l) to BALB/c mice for 21 days. Then, we analyzed body weigth change, stool consistency scoring, gut length, intestinal microbiota composition, nitric oxide synthase 2 (NOS2) expression and tissue integrity. We subsequently evaluated NOS2, GFAP, CD68 and NFL cerebral expression and spatial memory.Interestingly, our data showed gut microbiota disruption, NOS2 upregulation and tissue damage, associated to cerebral NOS2, GFAP, CD68 and NFL over-expression and behavioral alteration. Antiobiotic therapy should be prescribed with great caution.
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Affiliation(s)
- Nassima Behairi
- University of Sciences and Technology Houari Boumediene (USTHB), Faculty of Biological Sciences, Cellular and Molecular Biology Laboratory, Cytokines and NO Synthases, Immunity and Pathogeny Team, El-Alia, BP 32, 16111 Algiers, Algeria
| | - Arezki Samer
- University of Sciences and Technology Houari Boumediene (USTHB), Faculty of Biological Sciences, Cellular and Molecular Biology Laboratory, Cytokines and NO Synthases, Immunity and Pathogeny Team, El-Alia, BP 32, 16111 Algiers, Algeria
| | - Lynda Sahraoui
- Laboratory of Animal Health and Production, Higher National Veterinary School of Issad-Abbes Oued-Smar, Algiers, Algeria
| | - Djehane Houria Mataam
- University of Sciences and Technology Houari Boumediene (USTHB), Faculty of Biological Sciences, Cellular and Molecular Biology Laboratory, Cytokines and NO Synthases, Immunity and Pathogeny Team, El-Alia, BP 32, 16111 Algiers, Algeria
| | - Ryad Trari
- University of Sciences and Technology Houari Boumediene (USTHB), Faculty of Biological Sciences, Cellular and Molecular Biology Laboratory, Cytokines and NO Synthases, Immunity and Pathogeny Team, El-Alia, BP 32, 16111 Algiers, Algeria
| | - Billel Flissi
- University of Sciences and Technology Houari Boumediene (USTHB), Faculty of Biological Sciences, Cellular and Molecular Biology Laboratory, Cytokines and NO Synthases, Immunity and Pathogeny Team, El-Alia, BP 32, 16111 Algiers, Algeria
| | - Houda Belguendouz
- University of Sciences and Technology Houari Boumediene (USTHB), Faculty of Biological Sciences, Cellular and Molecular Biology Laboratory, Cytokines and NO Synthases, Immunity and Pathogeny Team, El-Alia, BP 32, 16111 Algiers, Algeria
| | - Zine-Charaf Amir
- Department of Anatomy and Pathological Cytology, University Hospital Center Mustapha Pacha, 1945 Pl. May 1st, Sidi M'Hamed, 16000 Algiers, Algeria
| | - Chafia Touil-Boukoffa
- University of Sciences and Technology Houari Boumediene (USTHB), Faculty of Biological Sciences, Cellular and Molecular Biology Laboratory, Cytokines and NO Synthases, Immunity and Pathogeny Team, El-Alia, BP 32, 16111 Algiers, Algeria.
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8
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Das B, Biswas P, Mallick AI, Gupta P. Application of Mono and Trinuclear Cyclometalated Iridium (III) Complexes in Differential Bacterial Imaging and Antimicrobial Photodynamic Therapy. Chemistry 2024; 30:e202400646. [PMID: 38652686 DOI: 10.1002/chem.202400646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/18/2024] [Accepted: 04/23/2024] [Indexed: 04/25/2024]
Abstract
The application of transition metal complexes for antimicrobial photodynamic therapy (PDT) has emerged as an attractive alternative in mitigating a broad range of bacterial pathogens, including multidrug-resistant pathogens. In view of their photostability, long excited-state lifetimes, and tunable emission properties, transition metal complexes also contribute as bioimaging agents. In the present work, we designed mono and trinuclear cyclometalated iridium (III) complexes to explore their imaging application and antibacterial potential. For this, we used Methicillin-resistant S. aureus (MRSA), the most prevalent of community-associated (CA) multidrug-resistant (MDR) bacteria (CA MDR) and Lactococcus lactis (L. lactis) as Gram-positive while Campylobacter jejuni (C. jejuni) and E. coli as Gram-negative bacteria. In addition to differential bioimaging of these bacteria, we assessed the antibacterial effects of both mono and trinuclear Ir(III) complexes under exposure to 427 nm LED light. The data presented herein strongly suggest better efficacy of trinuclear Ir(III) complex over the mononuclear complex in imparting photoinduced cell death of MRSA. Based on the safety profile of these complexes, we propose that trinuclear cyclometalated iridium(III) complex holds great promise for selective recognition and targeting MDR bacteria with minimal off-target effect.
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Affiliation(s)
- Bishnu Das
- Department of Chemical Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur, West Bengal, 741246, India
- Present address, Department of Chemistry & Biomolecular Science, Clarkson University, Potsdam, 13699, New York, US
| | - Prakash Biswas
- Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur, West Bengal, 741246, India
| | - Amirul Islam Mallick
- Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur, West Bengal, 741246, India
| | - Parna Gupta
- Department of Chemical Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur, West Bengal, 741246, India
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Hirata A, Matsumori T, Yasuda M, Nishikawa Y, Shiokawa M, Uza N, Seno H. A rare case of acute obstructive suppurative pancreatic ductitis (AOSPD) which developed pyogenic spondylitis. Clin J Gastroenterol 2024:10.1007/s12328-024-02004-y. [PMID: 38902593 DOI: 10.1007/s12328-024-02004-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 06/14/2024] [Indexed: 06/22/2024]
Abstract
Acute obstructive suppurative pancreatic ductitis (AOSPD) is an acute suppuration of the pancreatic duct. Endoscopic retrograde cholangiopancreatography (ERCP) drainage and intravenous antibiotics treatment is the mainstay of therapy. Herein we describe an extremely rare case of AOSPD leading to pyogenic spondylitis. A 61-year-old male with a past medical history of chronic pancreatitis and diabetes mellitus presented to our hospital with abdominal and dorsal pain, fever, and shock status. Laboratory data showed severe inflammation, disseminated intravascular coagulation, and normal pancreatic enzymes. Computed tomography showed dilated main pancreatic duct and surrounding pancreatic abscesses. Spinal abnormalities were not detected at this point. He was initially diagnosed as infected pancreatic pseudocyst, but did not respond well to conservative intravenous antibiotic treatment. ERCP performed one week later revealed purulent pancreatic juice and the diagnosis was changed to AOSPD. Upon ERCP, we experienced technical difficulty in passing obstructing calculi. However, successful pancreatic drainage was achieved using new dilation and penetration devices. The patient responded quickly to drainage, but later developed pyogenic spondylitis. Our case highlights the difficulty of diagnosing AOSPD, the usefulness of new devices in urgent endoscopic drainage, and underscores the possibility of progression of pyogenic spondylitis even after adequate treatment.
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Affiliation(s)
- Ayako Hirata
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Sakyo-Ku, Shogoin, Kyoto, Japan
| | - Tomoaki Matsumori
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Sakyo-Ku, Shogoin, Kyoto, Japan.
| | - Muneji Yasuda
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Sakyo-Ku, Shogoin, Kyoto, Japan
| | - Yoshihiro Nishikawa
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Sakyo-Ku, Shogoin, Kyoto, Japan
| | - Masahiro Shiokawa
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Sakyo-Ku, Shogoin, Kyoto, Japan
| | - Norimitsu Uza
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Sakyo-Ku, Shogoin, Kyoto, Japan
| | - Hiroshi Seno
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Kawahara-Cho, Sakyo-Ku, Shogoin, Kyoto, Japan
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Charest AM, Reed E, Bozorgzadeh S, Hernandez L, Getsey NV, Smith L, Galperina A, Beauregard HE, Charest HA, Mitchell M, Riley MA. Nisin Inhibition of Gram-Negative Bacteria. Microorganisms 2024; 12:1230. [PMID: 38930612 PMCID: PMC11205666 DOI: 10.3390/microorganisms12061230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/11/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
Aims: This study investigates the activity of the broad-spectrum bacteriocin nisin against a large panel of Gram-negative bacterial isolates, including relevant plant, animal, and human pathogens. The aim is to generate supportive evidence towards the use/inclusion of bacteriocin-based therapeutics and open avenues for their continued development. Methods and Results: Nisin inhibitory activity was screened against a panel of 575 strains of Gram-negative bacteria, encompassing 17 genera. Nisin inhibition was observed in 309 out of 575 strains, challenging the prevailing belief that nisin lacks effectiveness against Gram-negative bacteria. The genera Acinetobacter, Helicobacter, Erwinia, and Xanthomonas exhibited particularly high nisin sensitivity. Conclusions: The findings of this study highlight the promising potential of nisin as a therapeutic agent for several key Gram-negative plant, animal, and human pathogens. These results challenge the prevailing notion that nisin is less effective or ineffective against Gram-negative pathogens when compared to Gram-positive pathogens and support future pursuits of nisin as a complementary therapy to existing antibiotics. Significance and Impact of Study: This research supports further exploration of nisin as a promising therapeutic agent for numerous human, animal, and plant health applications, offering a complementary tool for infection control in the face of multidrug-resistant bacteria.
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Affiliation(s)
- Adam M. Charest
- Department of Biology, University of Massachusetts, Amherst, MA 01002, USA; (A.M.C.); (E.R.); (S.B.); (L.H.); (N.V.G.); (L.S.); (A.G.); (H.E.B.); (H.A.C.)
| | - Ethan Reed
- Department of Biology, University of Massachusetts, Amherst, MA 01002, USA; (A.M.C.); (E.R.); (S.B.); (L.H.); (N.V.G.); (L.S.); (A.G.); (H.E.B.); (H.A.C.)
| | - Samantha Bozorgzadeh
- Department of Biology, University of Massachusetts, Amherst, MA 01002, USA; (A.M.C.); (E.R.); (S.B.); (L.H.); (N.V.G.); (L.S.); (A.G.); (H.E.B.); (H.A.C.)
| | - Lorenzo Hernandez
- Department of Biology, University of Massachusetts, Amherst, MA 01002, USA; (A.M.C.); (E.R.); (S.B.); (L.H.); (N.V.G.); (L.S.); (A.G.); (H.E.B.); (H.A.C.)
| | - Natalie V. Getsey
- Department of Biology, University of Massachusetts, Amherst, MA 01002, USA; (A.M.C.); (E.R.); (S.B.); (L.H.); (N.V.G.); (L.S.); (A.G.); (H.E.B.); (H.A.C.)
| | - Liam Smith
- Department of Biology, University of Massachusetts, Amherst, MA 01002, USA; (A.M.C.); (E.R.); (S.B.); (L.H.); (N.V.G.); (L.S.); (A.G.); (H.E.B.); (H.A.C.)
| | - Anastasia Galperina
- Department of Biology, University of Massachusetts, Amherst, MA 01002, USA; (A.M.C.); (E.R.); (S.B.); (L.H.); (N.V.G.); (L.S.); (A.G.); (H.E.B.); (H.A.C.)
| | - Hadley E. Beauregard
- Department of Biology, University of Massachusetts, Amherst, MA 01002, USA; (A.M.C.); (E.R.); (S.B.); (L.H.); (N.V.G.); (L.S.); (A.G.); (H.E.B.); (H.A.C.)
| | - Hailey A. Charest
- Department of Biology, University of Massachusetts, Amherst, MA 01002, USA; (A.M.C.); (E.R.); (S.B.); (L.H.); (N.V.G.); (L.S.); (A.G.); (H.E.B.); (H.A.C.)
| | - Mathew Mitchell
- Organicin Scientific, 240 Thatcher Road, Amherst, MA 01003, USA;
| | - Margaret A. Riley
- Department of Biology, University of Massachusetts, Amherst, MA 01002, USA; (A.M.C.); (E.R.); (S.B.); (L.H.); (N.V.G.); (L.S.); (A.G.); (H.E.B.); (H.A.C.)
- Organicin Scientific, 240 Thatcher Road, Amherst, MA 01003, USA;
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11
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Sartelli M, Tascini C, Coccolini F, Dellai F, Ansaloni L, Antonelli M, Bartoletti M, Bassetti M, Boncagni F, Carlini M, Cattelan AM, Cavaliere A, Ceresoli M, Cipriano A, Cortegiani A, Cortese F, Cristini F, Cucinotta E, Dalfino L, De Pascale G, De Rosa FG, Falcone M, Forfori F, Fugazzola P, Gatti M, Gentile I, Ghiadoni L, Giannella M, Giarratano A, Giordano A, Girardis M, Mastroianni C, Monti G, Montori G, Palmieri M, Pani M, Paolillo C, Parini D, Parruti G, Pasero D, Pea F, Peghin M, Petrosillo N, Podda M, Rizzo C, Rossolini GM, Russo A, Scoccia L, Sganga G, Signorini L, Stefani S, Tumbarello M, Tumietto F, Valentino M, Venditti M, Viaggi B, Vivaldi F, Zaghi C, Labricciosa FM, Abu-Zidan F, Catena F, Viale P. Management of intra-abdominal infections: recommendations by the Italian council for the optimization of antimicrobial use. World J Emerg Surg 2024; 19:23. [PMID: 38851757 PMCID: PMC11162065 DOI: 10.1186/s13017-024-00551-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/01/2024] [Indexed: 06/10/2024] Open
Abstract
Intra-abdominal infections (IAIs) are common surgical emergencies and are an important cause of morbidity and mortality in hospital settings, particularly if poorly managed. The cornerstones of effective IAIs management include early diagnosis, adequate source control, appropriate antimicrobial therapy, and early physiologic stabilization using intravenous fluids and vasopressor agents in critically ill patients. Adequate empiric antimicrobial therapy in patients with IAIs is of paramount importance because inappropriate antimicrobial therapy is associated with poor outcomes. Optimizing antimicrobial prescriptions improves treatment effectiveness, increases patients' safety, and minimizes the risk of opportunistic infections (such as Clostridioides difficile) and antimicrobial resistance selection. The growing emergence of multi-drug resistant organisms has caused an impending crisis with alarming implications, especially regarding Gram-negative bacteria. The Multidisciplinary and Intersociety Italian Council for the Optimization of Antimicrobial Use promoted a consensus conference on the antimicrobial management of IAIs, including emergency medicine specialists, radiologists, surgeons, intensivists, infectious disease specialists, clinical pharmacologists, hospital pharmacists, microbiologists and public health specialists. Relevant clinical questions were constructed by the Organizational Committee in order to investigate the topic. The expert panel produced recommendation statements based on the best scientific evidence from PubMed and EMBASE Library and experts' opinions. The statements were planned and graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) hierarchy of evidence. On November 10, 2023, the experts met in Mestre (Italy) to debate the statements. After the approval of the statements, the expert panel met via email and virtual meetings to prepare and revise the definitive document. This document represents the executive summary of the consensus conference and comprises three sections. The first section focuses on the general principles of diagnosis and treatment of IAIs. The second section provides twenty-three evidence-based recommendations for the antimicrobial therapy of IAIs. The third section presents eight clinical diagnostic-therapeutic pathways for the most common IAIs. The document has been endorsed by the Italian Society of Surgery.
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Affiliation(s)
- Massimo Sartelli
- Department of Surgery, Macerata Hospital, Via Santa Lucia 2, 62100, Macerata, Italy.
| | - Carlo Tascini
- Infectious Diseases Clinic, Santa Maria Della Misericordia University Hospital of Udine, ASUFC, Udine, Italy
- Infectious Diseases Clinic, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Federico Coccolini
- Department of General, Emergency and Trauma Surgery, Azienda Ospedaliero Universitaria Pisana, University Hospital, Pisa, Italy
| | - Fabiana Dellai
- Infectious Diseases Clinic, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Luca Ansaloni
- Division of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Massimo Antonelli
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze Dell'Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Michele Bartoletti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Infectious Disease Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Matteo Bassetti
- Division of Infectious Diseases, Department of Health Sciences, University of Genova, Genoa, Italy
- Division of Infectious Diseases, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Federico Boncagni
- Anesthesiology and Intensive Care Unit, Macerata Hospital, Macerata, Italy
| | - Massimo Carlini
- Department of General Surgery, S. Eugenio Hospital, Rome, Italy
| | - Anna Maria Cattelan
- Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy
- Department of Molecular Medicine, University of Padua, Padua, Italy
| | - Arturo Cavaliere
- Unit of Hospital Pharmacy, Viterbo Local Health Authority, Viterbo, Italy
| | - Marco Ceresoli
- General and Emergency Surgery, Milano-Bicocca University, School of Medicine and Surgery, Monza, Italy
| | - Alessandro Cipriano
- Department of Emergency Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Andrea Cortegiani
- Department of Precision Medicine in Medical Surgical and Critical Care, University of Palermo, Palermo, Italy
- Department of Anesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy
| | | | - Francesco Cristini
- Infectious Diseases Unit, AUSL Romagna, Forlì and Cesena Hospitals, Forlì, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Eugenio Cucinotta
- Department of Human Pathology of the Adult and Evolutive Age "Gaetano Barresi", Section of General Surgery, University of Messina, Messina, Italy
| | - Lidia Dalfino
- Anesthesia and Intensive Care Unit, Department of Precision and Regenerative Medicine and Ionian Area, Polyclinic of Bari, University of Bari, Bari, Italy
| | - Gennaro De Pascale
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze Dell'Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Marco Falcone
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Francesco Forfori
- Anesthesia and Intensive Care, Anesthesia and Resuscitation Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Paola Fugazzola
- Division of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Milo Gatti
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Clinical Pharmacology Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Ivan Gentile
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Lorenzo Ghiadoni
- Department of Emergency Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
- Department on Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Maddalena Giannella
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Infectious Diseases Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Antonino Giarratano
- Department of Precision Medicine in Medical Surgical and Critical Care, University of Palermo, Palermo, Italy
- Department of Anesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy
| | - Alessio Giordano
- Unit of Emergency Surgery, Careggi University Hospital, Florence, Italy
| | - Massimo Girardis
- Anesthesia and Intensive Care Medicine, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, AOU Policlinico Umberto 1, Sapienza University of Rome, Rome, Italy
| | - Gianpaola Monti
- Department of Anesthesia and Intensive Care, ASST GOM Niguarda Ca' Granda, Milan, Italy
| | - Giulia Montori
- Unit of General and Emergency Surgery, Vittorio Veneto Hospital, Vittorio Veneto, Italy
| | - Miriam Palmieri
- Department of Surgery, Macerata Hospital, Via Santa Lucia 2, 62100, Macerata, Italy
| | - Marcello Pani
- Hospital Pharmacy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ciro Paolillo
- Emergency Department, University of Verona, Verona, Italy
| | - Dario Parini
- General Surgery Department, Santa Maria Della Misericordia Hospital, Rovigo, Italy
| | - Giustino Parruti
- Infectious Diseases Unit, Pescara General Hospital, Pescara, Italy
| | - Daniela Pasero
- Department of Emergency, Anaesthesia and Intensive Care Unit, ASL1 Sassari, Sassari, Italy
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Federico Pea
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Clinical Pharmacology Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Maddalena Peghin
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy
| | - Nicola Petrosillo
- Infection Prevention and Control Service, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Mauro Podda
- Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, "Renato Dulbecco" Teaching Hospital, Catanzaro, Italy
| | - Loredana Scoccia
- Hospital Pharmacy Unit, Macerata Hospital, AST Macerata, Macerata, Italy
| | - Gabriele Sganga
- Emergency and Trauma Surgery Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
- Department of Medical and Surgical Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Liana Signorini
- Unit of Infectious and Tropical Diseases, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Stefania Stefani
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, Catania, Italy
| | - Mario Tumbarello
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Infectious and Tropical Diseases Unit, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Fabio Tumietto
- UO Antimicrobial Stewardship-AUSL Bologna, Bologna, Italy
| | | | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Bruno Viaggi
- Intensive Care Department, Careggi Hospital, Florence, Italy
| | | | - Claudia Zaghi
- General, Emergency and Trauma Surgery Department, Vicenza Hospital, Vicenza, Italy
| | | | - Fikri Abu-Zidan
- Statistics and Research Methodology, The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Fausto Catena
- Emergency and General Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Pierluigi Viale
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Infectious Diseases Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Blondeau JM, Fitch SD. Comparative In Vitro Killing by Pradofloxacin in Comparison to Ceftiofur, Enrofloxacin, Florfenicol, Marbofloxacin, Tildipirosin, Tilmicosin and Tulathromycin against Bovine Respiratory Bacterial Pathogens. Microorganisms 2024; 12:996. [PMID: 38792823 PMCID: PMC11123926 DOI: 10.3390/microorganisms12050996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/03/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Pradofloxacin is the newest of the veterinary fluoroquinolones to be approved for use in animals-initially companion animals and most recently food animals. It has a broad spectrum of in vitro activity, working actively against Gram-positive/negative, atypical and some anaerobic microorganisms. It simultaneously targets DNA gyrase (topoisomerase type II) and topoisomerase type IV, suggesting a lower propensity to select for antimicrobial resistance. The purpose of this study was to determine the rate and extent of bacterial killing by pradofloxacin against bovine strains of Mannheimia haemolytica and Pasteurella multocida, in comparison with several other agents (ceftiofur, enrofloxacin, florfenicol, marbofloxacin, tildipirosin, tilmicosin and tulathromycin) using four clinically relevant drug concentrations: minimum inhibitory and mutant prevention drug concentration, maximum serum and maximum tissue drug concentrations. At the maximum serum and tissue drug concentrations, pradofloxacin killed 99.99% of M. haemolytica cells following 5 min of drug exposure (versus growth to 76% kill rate for the other agents) and 94.1-98.6% of P. multocida following 60-120 min of drug exposure (versus growth to 98.6% kill rate for the other agents). Statistically significant differences in kill rates were seen between the various drugs tested depending on drug concentration and time of sampling after drug exposure.
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Affiliation(s)
- Joseph M. Blondeau
- Department of Clinical Microbiology, Royal University Hospital and Saskatchewan Health Authority, Saskatoon, SK S7N 0W8, Canada;
- Pathology and Laboratory Medicine and Ophthalmology, Departments Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, SK S7N 0W8, Canada
| | - Shantelle D. Fitch
- Department of Clinical Microbiology, Royal University Hospital and Saskatchewan Health Authority, Saskatoon, SK S7N 0W8, Canada;
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Ilyes I, Boariu M, Rusu D, Iorio-Siciliano V, Vela O, Boia S, Radulescu V, Șurlin P, Jentsch H, Lodin A, Stratul SI. Comparative Study of Systemic vs. Local Antibiotics with Subgingival Instrumentation in Stage III-IV Periodontitis: A Retrospective Analysis. Antibiotics (Basel) 2024; 13:430. [PMID: 38786158 PMCID: PMC11117343 DOI: 10.3390/antibiotics13050430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
To improve the clinical and microbiological outcomes of non-surgical mechanical periodontal therapy, the adjunctive use of antimicrobials has been utilized in treating moderate-to-severe periodontitis. In our study, the retrospective design included previously collected health-related patient data, obtained from the printed and digital charts of patients who received systemic or local antibiotic adjuncts to SI (subgingival instrumentation). A total of 34 patients (diagnosed with generalized Stage III/IV periodontitis) met the inclusion and exclusion criteria and were evaluated. The samples were tested for the following bacterial strains: Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), Prevotella intermedia (P. intermedia), Tanererella forsythia (T. forsythia), and Treponema denticola (T. denticola). The inter-group comparisons of the bacterial species did not show statistically significant differences between groups. The present study aimed to evaluate the clinical effects after SI and the adjunctive use of systemically administered (SA) AMX (amoxicillin) + MET (metronidazole) (administered for 7 days), with locally delivered (LDD) piperacillin + tazobactam in step 2 of periodontal therapy. Results: Overall, all parameters were improved in the groups, with a significant difference in inter-group comparison regarding the full-mouth bleeding score (FMBS) (p < 0.05) in favor of the SA group, and the p-value < 0.05 was considered to be statistically significant. Statistically significant PPD (probing pocket depth) reductions and CAL (clinical attachment level) gains were observed in both groups at the 3-month follow-up. In conclusion, within the limitations, the outcomes of this study suggest that SI, with adjunctive local or systemic antibiotic therapy, provided comparable clinical improvements. Systemic AMX + MET protocols were more efficacious with regard to the reduction in FMBS. Follow-up studies with larger patient numbers are needed to further investigate this effect.
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Affiliation(s)
- Ioana Ilyes
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.I.); (D.R.); (O.V.); (S.B.); (V.R.); (S.-I.S.)
| | - Marius Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.I.); (D.R.); (O.V.); (S.B.); (V.R.); (S.-I.S.)
| | | | - Octavia Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.I.); (D.R.); (O.V.); (S.B.); (V.R.); (S.-I.S.)
| | - Simina Boia
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.I.); (D.R.); (O.V.); (S.B.); (V.R.); (S.-I.S.)
| | - Viorelia Radulescu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.I.); (D.R.); (O.V.); (S.B.); (V.R.); (S.-I.S.)
| | - Petra Șurlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania;
| | - Holger Jentsch
- Medical Faculty, University of Leipzig, 04103 Leipzig, Germany;
| | - Alexandru Lodin
- Department Basis of Electronics, Faculty of Electronics, Telecommunications and Information Technology, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania;
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.I.); (D.R.); (O.V.); (S.B.); (V.R.); (S.-I.S.)
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Elsewedy HS, Shehata TM, Genedy SM, Siddiq KM, Asiri BY, Alshammari RA, Bukhari SI, Kola-Mustapha AT, Ramadan HA, Soliman WE. Enhancing the Topical Antibacterial Activity of Fusidic Acid via Embedding into Cinnamon Oil Nano-Lipid Carrier. Gels 2024; 10:268. [PMID: 38667687 PMCID: PMC11049292 DOI: 10.3390/gels10040268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/02/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Presently, antimicrobial resistance is of great risk to remarkable improvements in health conditions and infection management. Resistance to various antibiotics has been considered a great obstacle in their usage, necessitating alternative strategies for enhancing the antibacterial effect. Combination therapy has been recognized as a considerable strategy that could improve the therapeutic influence of antibacterial agents. Therefore, the aim of this study was to combine the antibacterial action of compounds of natural origin like fusidic acid (FA) and cinnamon essential oil (CEO) for synergistic effects. A distinctive nanoemulsion (NE) was developed using cinnamon oil loaded with FA. Applying the Box-Behnken design (BBD) approach, one optimized formula was selected and integrated into a gel base to provide an FA-NE-hydrogel for optimal topical application. The FA-NE-hydrogel was examined physically, studied for in vitro release, and investigated for stability upon storage at different conditions, at room (25 °C) and refrigerator (4 °C) temperatures, for up to 3 months. Ultimately, the NE-hydrogel preparation was inspected for its antibacterial behavior using multidrug-resistant bacteria and checked by scanning electron microscopy. The FA-NE-hydrogel formulation demonstrated a pH (6.32), viscosity (12,680 cP), and spreadability (56.7 mm) that are acceptable for topical application. The in vitro release could be extended for 6 h, providing 52.0%. The formulation was stable under both test conditions for up to 3 months of storage. Finally, the FA-NE-hydrogel was found to inhibit the bacterial growth of not only Gram-positive but also Gram-negative bacteria. The inhibition was further elucidated by a scanning electron micrograph, indicating the efficiency of CEO in enhancing the antibacterial influence of FA when combined in an NE system.
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Affiliation(s)
- Heba S. Elsewedy
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Diriyah 13713, Saudi Arabia
| | - Tamer M. Shehata
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Alhofuf 36362, Saudi Arabia
- Department of Pharmaceutics, College of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| | - Shaymaa M. Genedy
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Diriyah 13713, Saudi Arabia
| | - Khuzama M. Siddiq
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Diriyah 13713, Saudi Arabia
| | - Bushra Y. Asiri
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Diriyah 13713, Saudi Arabia
| | - Rehab A. Alshammari
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Diriyah 13713, Saudi Arabia
| | - Sarah I. Bukhari
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Adeola T. Kola-Mustapha
- Department of Pharmaceutical Sciences, College of Pharmacy, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, University of Ilorin, Ilorin 240003, Nigeria
| | - Heba A. Ramadan
- Department of Microbiology and Immunology, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa, Mansoura 11152, Egypt
| | - Wafaa E. Soliman
- Department of Microbiology and Immunology, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa, Mansoura 11152, Egypt
- Department of Biomedical Sciences, College of Clinical Pharmacy, King Faisal University, Alhofuf 36362, Saudi Arabia
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15
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Nar Otgun S, Ketre Kolukirik CZ, Unal Sahin N, Kolukirik M, Girgin Ozgumus G, Turan M, Elmas M, Kilic S. Enhancing sensitivity of qPCR assays targeting Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae by using a mutant Taq DNA polymerase. J Microbiol Methods 2024; 219:106899. [PMID: 38360298 DOI: 10.1016/j.mimet.2024.106899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/19/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
AIMS Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae are important causes of bacterial meningitis. In this study, the DNA binding site of the wild type Taq DNA polymerase was modified to produce a mutant enzyme with enhanced DNA affinity and PCR performance. The engineered and the wild type enzymes were integrated into qPCR-based assays for molecular detection of S. pneumoniae, N. meningitidis, H. influenzae, and serogroups and serotypes of these three pathogens. METHODS Bio-Speedy® Bacterial DNA Isolation Kit (Bioeksen R&D Technologies, Turkiye) and 2× qPCR-Mix for hydrolysis probes (Bioeksen R&D Technologies, Turkiye) and CFX96 Instrument (Biorad Inc., USA) were used for all molecular analyses. Spiked negative clinical specimens were tested using the developed qPCR assays and the culture-based conventional methods for the analytical performance evaluation. RESULTS All qPCR assays did not produce any positive results for the samples spiked with potential cross-reacting bacteria. Limit of detection (LOD) of the assays containing the mutant enzyme was 1 genome/reaction (10 cfu/mL sample) which is at least 3 times lower than the previously reported LOD levels for DNA amplification based molecular assays. LODs for the spiked serum and cerebrospinal fluid (CSF) samples decreased 2.3-4.7 and 1.2-3.5 times respectively when the mutant enzyme was used instead of the wild type Taq DNA polymerase. CONCLUSIONS It is possible to enhance analytical sensitivity of qPCR assays targeting the bacterial agents of meningitis by using an engineered Taq DNA polymerase. These qPCR-based assays can be used for direct detection and serogrouping / serotyping of S. pneumoniae, N. meningitidis and H. influenzae at concentrations close to the lower limit of medical decision point.
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Affiliation(s)
- Selin Nar Otgun
- Public Health General Directorate, Microbiology Reference Laboratories and Biological Products Department, Ankara, Turkiye.
| | | | - Nuriye Unal Sahin
- Public Health General Directorate, Microbiology Reference Laboratories and Biological Products Department, Ankara, Turkiye
| | - Mustafa Kolukirik
- Bioeksen R&D Technologies Ltd., Istanbul Technical University Ari-3 Technopark, Istanbul, Turkiye
| | - Gozde Girgin Ozgumus
- Bioeksen R&D Technologies Ltd., Istanbul Technical University Ari-3 Technopark, Istanbul, Turkiye
| | - Meral Turan
- Public Health General Directorate, Microbiology Reference Laboratories and Biological Products Department, Ankara, Turkiye
| | - Mert Elmas
- Bioeksen R&D Technologies Ltd., Istanbul Technical University Ari-3 Technopark, Istanbul, Turkiye
| | - Selcuk Kilic
- Health Sciences University, Defence Health Sciences Institute, Ankara, Turkiye
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16
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Agyemang EA, Makanga DM, Abdallah M, Ogunnaya F, Forbes S. Idiopathic CD4 Lymphocytopenia: A Case Report and Literature Review. Cureus 2024; 16:e56968. [PMID: 38665729 PMCID: PMC11044977 DOI: 10.7759/cureus.56968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Idiopathic CD4 lymphocytopenia (ICL) is a rare condition where CD4 T cell counts are low, similar to advanced human immunodeficiency virus (HIV) infection but without acquired immunodeficiency syndrome (AIDS)-related symptoms. The cause is unknown, and theories suggest issues with T cell production, survival, migration, or immune system dysregulation. Diagnosis involves ruling out other causes of low CD4 T cells. Treatment is based on managing infections and may include immunomodulatory therapies, but evidence is limited. Clinical presentations vary widely, including infections, autoimmune disorders, and malignancies. This study explores challenges in diagnosing persistent fevers and lymphopenia, the role of medical history in treatment, HIV screening issues, UTI management in recurrent cases, and the importance of follow-up care for unresolved symptoms or abnormal lab results. This study utilized a case study approach, focusing on the detailed presentation, evaluation, and management of the patient. Data were collected from the patient's medical records, including laboratory tests. Relevant literature was reviewed to provide context and support for the discussion of diagnostic challenges and management strategies. This case highlights the importance of considering uncommon presentations of common infections in patients with complex medical histories. It underscores the need for thorough evaluation, including comprehensive medical history, diagnostic testing, and follow-up care, to ensure accurate diagnosis and appropriate management. By sharing this case, we aim to enhance the awareness and understanding of such presentations among healthcare providers, leading to improved patient care and outcomes.
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Affiliation(s)
| | - David M Makanga
- Internal Medicine, Newark Beth Israel Medical Center, Newark, USA
| | - Malaz Abdallah
- Internal Medicine, Newark Beth Israel Medical Center, Newark, USA
| | - Frances Ogunnaya
- Internal Medicine, Newark Beth Israel Medical Center, Newark, USA
| | - Shari Forbes
- Internal Medicine, Newark Beth Israel Medical Center, Newark, USA
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17
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Obe T, Kiess AS, Nannapaneni R. Antimicrobial Tolerance in Salmonella: Contributions to Survival and Persistence in Processing Environments. Animals (Basel) 2024; 14:578. [PMID: 38396546 PMCID: PMC10886206 DOI: 10.3390/ani14040578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Salmonella remains a top bacterial pathogen implicated in several food-borne outbreaks, despite the use of antimicrobials and sanitizers during production and processing. While these chemicals have been effective, Salmonella has shown the ability to survive and persist in poultry processing environments. This can be credited to its microbial ability to adapt and develop/acquire tolerance and/or resistance to different antimicrobial agents including oxidizers, acids (organic and inorganic), phenols, and surfactants. Moreover, there are several factors in processing environments that can limit the efficacy of these antimicrobials, thus allowing survival and persistence. This mini-review examines the antimicrobial activity of common disinfectants/sanitizers used in poultry processing environments and the ability of Salmonella to respond with innate or acquired tolerance and survive exposure to persists in such environments. Instead of relying on a single antimicrobial agent, the right combination of different disinfectants needs to be developed to target multiple pathways within Salmonella.
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Affiliation(s)
- Tomi Obe
- Department of Poultry Science, University of Arkansas, Fayetteville, AR 72701, USA
| | - Aaron S. Kiess
- Prestage Department of Poultry Science, College of Agriculture and Life Sciences, North Carolina State University, Raleigh, NC 27695, USA;
| | - Ramakrishna Nannapaneni
- Department of Food Science, Nutrition and Health Promotion, Mississippi State University, Mississippi, MS 39762, USA;
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18
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Bharuka V, Meshram R, Munjewar PK. Comprehensive Review of Urinary Tract Infections in Renal Transplant Recipients: Clinical Insights and Management Strategies. Cureus 2024; 16:e53882. [PMID: 38465031 PMCID: PMC10924982 DOI: 10.7759/cureus.53882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/04/2024] [Indexed: 03/12/2024] Open
Abstract
Urinary tract infections (UTIs) pose a significant challenge in the care of renal transplant recipients. This comprehensive review explores this population's multifaceted landscape of UTIs, emphasizing the importance of early diagnosis and tailored management strategies. Renal transplant recipients face an elevated risk of UTIs due to immunosuppression, altered urinary tract anatomy, and complex comorbidities. Complications of UTIs can lead to graft dysfunction and systemic illness, underscoring the need for effective management. The emergence of multidrug-resistant uropathogens adds complexity to treatment, highlighting the importance of targeted antibiotic therapy. Antibiotics are the most commonly prescribed drugs for UTIs, with nitrofurantoin, fosfomycin, amoxicillin, and amoxicillin-clavulanate potassium being some of the commonly used antibiotics. However, the emergence of multidrug-resistant uropathogens has led to the exploration of alternative treatments, such as bacteriophage therapy, as a potential alternative against multidrug-resistant uropathogenic bacteria. Analgesics such as phenazopyridine can be prescribed to relieve discomfort associated with UTIs. Estrogen therapy has also been suggested as a potential treatment option for UTIs, particularly in postmenopausal women. Trimethoprim-sulfamethoxazole or trimethoprim is recommended as first-line therapy for uncomplicated UTIs. The choice of drug and therapy for UTIs depends on the severity of the infection, the causative organism, and the presence of antibiotic resistance. Preventive measures encompass pre-transplant evaluation, perioperative strategies, post-transplant follow-up, and vaccination. A multidisciplinary approach involving transplant specialists, infectious disease experts, pharmacists, and patient engagement is vital for successful care. The future of UTI management lies in ongoing research, exploring personalized medicine, novel therapies, and innovative prevention strategies. By implementing these strategies and advancing research, healthcare providers can improve graft and patient survival, enhancing the quality of care for renal transplant recipients.
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Affiliation(s)
- Vidhi Bharuka
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Revat Meshram
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pratiksha K Munjewar
- Medical Surgical Nursing, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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19
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Alharbi NMJ, Tashkandi NF, Banjar AM, Alotaibi AY, Al-Harbi S, Alqarni AMA, Alharbi YA, Alkenani HH, Bokhari AA. Pattern of Antibiotic Use Among Children With Acute Respiratory Infections in Saudi Arabia: Clinical Assessment. Cureus 2024; 16:e54799. [PMID: 38529426 PMCID: PMC10961668 DOI: 10.7759/cureus.54799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2024] [Indexed: 03/27/2024] Open
Abstract
OBJECTIVES This study aimed to evaluate the common clinical diagnoses and treatment management of acute respiratory infections (ARIs) in children and determine when antibiotics are recommended and prescribed. METHODS A retrospective review of medical charts was carried out at King Salman Bin Abdulaziz Medical City (KSAMC) Hospital to assess pediatric patients diagnosed with ARIs aged 0-14 years, excluding those requiring antibiotics for conditions other than ARIs. Data, including demographic diagnoses and treatment management, were extracted using consecutive sampling, and statistical analyses were conducted using Jamovi software. RESULTS A total of 285 pediatric patients were included, with a median age of 3 (IQR = 1-6) years and a male predominance of 59.2%. Bronchopneumonia was the most common respiratory disease, diagnosed in 39.1% of participants. The median durations for illness and hospital admission were four and three days, respectively. Clinical evaluations showed an average respiratory rate of 28±10.5 breaths per minute and a mean oxygen saturation of 96.4±3.46% through pulse oximetry. The use of antibiotics was commonly prescribed in ARI patients only when accompanied by certain bacterial infections (46.32%). CONCLUSIONS ARIs are a common viral health issue among children, emphasizing that not all ARIs in children are caused by bacteria and that antibiotics should only be used when there is a bacterial infection present. Enhanced diagnostic precision, patient awareness, and provider education are the global community's recommendations to prevent the presence of antibiotic resistance and the irrational use of antibiotics.
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Affiliation(s)
| | - Noha Farouk Tashkandi
- Medical Research, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
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20
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Kim HK, Baek HW, Park HH, Cho YS. Reusable mechano-bactericidal surface with echinoid-shaped hierarchical micro/nano-structure. Colloids Surf B Biointerfaces 2024; 234:113729. [PMID: 38160475 DOI: 10.1016/j.colsurfb.2023.113729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/09/2023] [Accepted: 12/23/2023] [Indexed: 01/03/2024]
Abstract
Biofilms formed owing to the attachment of bacteria to surfaces have caused various problems in industries such as marine transportation/logistics and medicine. In response, many studies have been conducted on bactericidal surfaces, and nanostructured surfaces mimicking cicada and dragonfly wings are emerging as candidates for mechano-bactericidal surfaces. In specific circumstances involving mechano-bactericidal activity, certain nanostructured surfaces could exhibit their bactericidal effects by directly deforming the membranes of bacteria that adhere to these nanostructures. Additionally, in most cases, debris of bacterial cells may accumulate on these nanostructured surfaces. Such accumulation poses a significant challenge: it diminishes the mechano-bactericidal effectiveness of the surface, as it hinders the direct interaction between the nanostructures and any new bacteria that attach subsequently. In specific circumstances involving mechano-bactericidal activity, certain nanostructured surfaces could exhibit their bactericidal effects by directly deforming the membranes of bacteria that adhere to these nanostructures. Additionally, in most cases, debris of bacterial cells may accumulate on these nanostructured surfaces. Such accumulation poses a significant challenge: it diminishes the mechano-bactericidal effectiveness of the surface, as it hinders the direct interaction between the nanostructures and any new bacteria that attach subsequently.In other words, there is a need for strategies to remove the accumulated bacterial debris in order to sustain the mechano-bactericidal effect of the nanostructured surface. In this study, hierarchical micro/nano-structured surface (echinoid-shaped nanotextures were formed on Al micro-particle's surfaces) was fabricated using a simple pressure-less sintering method, and effective bactericidal efficiency was shown against E. coli (97 ± 3.81%) and S. aureus (80 ± 9.34%). In addition, thermal cleaning at 500 °C effectively eliminated accumulated dead bacterial debris while maintaining the intact Al2O3 nanostructure, resulting in significant mechano-bactericidal activity (E. coli: 89 ± 6.86%, S. aureus: 75 ± 8.31%). As a result, thermal cleaning maintains the intact nanostructure and allows the continuance of the mechano-bactericidal effect. This effect was consistently maintained even after five repetitive use (E. coli: 80 ± 16.26%, S. aureus: 76 ± 12.67%).
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Affiliation(s)
- Hee-Kyeong Kim
- Department of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea
| | - Hyeon Woo Baek
- Department of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea
| | - Hyun-Ha Park
- Department of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea; MECHABIO Group, Wonkwang University, 460 Ikandae-ro, Iksan, Jeonbuk 54538, Republic of Korea.
| | - Young-Sam Cho
- Department of Mechanical Design Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea; MECHABIO Group, Wonkwang University, 460 Ikandae-ro, Iksan, Jeonbuk 54538, Republic of Korea.
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21
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Niode NJ, Kepel BJ, Hessel SS, Kairupan TS, Tallei TE. Rhynchophorus ferrugineus larvae: A novel source for combating broad-spectrum bacterial and fungal infections. Vet World 2024; 17:156-170. [PMID: 38406375 PMCID: PMC10884581 DOI: 10.14202/vetworld.2024.156-170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/21/2023] [Indexed: 02/27/2024] Open
Abstract
Antimicrobial resistance is a growing concern due to the growth of antibiotic-resistant microorganisms, which makes it difficult to treat infection. Due to its broad-spectrum antimicrobial properties against a diverse array of bacteria, both Gram-positive and Gram-negative bacteria, and fungi, Rhynchophorus ferrugineus larval antimicrobial peptides (AMPs) have demonstrated potential as antimicrobial agents for the treatment of microbial infections and prevention of antibiotic resistance. This study emphasizes the unexplored mechanisms of action of R. ferrugineus larvae against microorganisms. Among the most widely discussed mechanisms is the effect of AMPs in larvae in response to a threat or infection. Modulation of immune-related genes in the intestine and phagocytic capacity of its hemocytes may also affect the antimicrobial activity of R. ferrugineus larvae, with an increase in phenoloxidase activity possibly correlated with microbial clearance and survival rates of larvae. The safety and toxicity of R. ferrugineus larvae extracts, as well as their long-term efficacy, are also addressed in this paper. The implications of future research are explored in this paper, and it is certain that R. ferrugineus larvae have the potential to be developed as a broad-spectrum antimicrobial agent with proper investigation.
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Affiliation(s)
- Nurdjannah Jane Niode
- Department of Dermatology and Venereology, Faculty of Medicine, Sam Ratulangi University, Prof. Dr. R. D. Kandou Hospital Manado, Manado 95115, North Sulawesi, Indonesia
| | - Billy Johnson Kepel
- Department of Chemistry, Faculty of Medicine, Sam Ratulangi University, Manado 95115, North Sulawesi, Indonesia
| | - Sofia Safitri Hessel
- Department of Biotechnology, Indonesia Biodiversity and Biogeography Research Institute (INABIG), Bandung 40132, West Java, Indonesia
| | - Tara Sefanya Kairupan
- Department of Dermatology and Venereology, Faculty of Medicine, Sam Ratulangi University, Prof. Dr. R. D. Kandou Hospital Manado, Manado 95115, North Sulawesi, Indonesia
| | - Trina Ekawati Tallei
- Department of Biology, Faculty of Mathematics and Natural Sciences, Sam Ratulangi University, Manado 95115, North Sulawesi, Indonesia
- Department of Biology, Faculty of Medicine, Sam Ratulangi University, Manado 95115, North Sulawesi, Indonesia
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22
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Chen ER, Wozniak RAF. Reimagining the Past: A Future for Antibiotic Drug Discovery in Ophthalmology. Cornea 2024; 43:1-5. [PMID: 37702607 DOI: 10.1097/ico.0000000000003391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/09/2023] [Indexed: 09/14/2023]
Abstract
ABSTRACT Antibiotic resistance has emerged as a critical threat for the treatment of bacterial ocular infections. To address the critical need for novel therapeutics, antibiotic drug repurposing holds significant promise. As such, examples of existing FDA-approved drugs currently under development for new applications, novel combinations, and improved delivery systems are discussed.
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Affiliation(s)
- Eric R Chen
- Department of Ophthalmology, Flaum Eye Institute, University of Rochester Medical Center, Rochester, NY
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23
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Niriayo YL, Ayalneh M, Demoz GT, Tesfay N, Gidey K. Antimicrobial use related problems and determinants in surgical ward of Ethiopian tertiary hospital. PLoS One 2023; 18:e0296284. [PMID: 38134131 PMCID: PMC10745209 DOI: 10.1371/journal.pone.0296284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Antibiotic use related problems lead to the emergence of resistance, failure of therapy, morbidity, mortality, and unnecessary healthcare expenditure. However, little is known about antimicrobial use related problems in our setting particularly in hospitalized surgical patients. OBJECTIVE The purpose of this study was to investigate antibiotic use related problems and their determinants among hospitalized surgical patients. METHODOLOGY A prospective observational study was conducted from December 2018 to April 2019 at the surgical ward of the Ayder comprehensive specialized hospital, located in Northern Ethiopia. We included patients admitted to the surgical ward who were on antibiotic therapy or were candidates for antibiotic therapy/prophylaxis. The patients were recruited during admission and were followed daily until discharge. Data were collected through patient interviews and expert reviews of medical and medication records. The appropriateness of antibiotic use was evaluated according to the Infectious Disease Society of America, American Society of Health System Pharmacists, and World Health Organization guidelines. Subsequently, antibiotic use related problems were identified and classified based on Cipolle's method followed by consensus review with experts. Binary logistic regression was performed to identify the determinants of antibiotic use related problems. Statistical significance was set at p <0.05. RESULTS Among 272 patients, 167(61.4%) experienced antibiotics use related problems. A total of 235 antibiotics use related problems were identified equating 0.86±0.82 problems per patient. The commonly identified antibiotic use related problems were the need for additional drug therapy (29.4%), unnecessary drug therapy (15%), and dosage too high (12.1%). Cephalosporin (47.02%) was the most commonly implicated class of antibiotics in these drug related problems, followed by penicillin (18.45%) and metronidazole (16.02%). Prolonged hospitalization (AOR: 3.57, 95% CI: 1.91-6.70), number of medications≥5 (AOR: 2.08, 95%CI: 1.10-3.94), and lower qualifications of practitioners [general practitioners (AOR: 10.27, 95%CI: 4.13-25.58) and surgical residents (AOR: 2.28, 95%CI: 1.12-4.63)] were predictors of antibiotic use related problems. CONCLUSION Antibiotic use related problems were common among the hospitalized surgical patients. Prolonged hospitalizations, number of medications, and lower qualifications of practitioners were predictors of antibiotic use related problems. Therefore, more emphasis should be given for patients with prolonged hospitalization and multiple medications. Moreover, practitioners with higher qualifications including surgical specialists need to be involved in patient evaluations.
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Affiliation(s)
- Yirga Legesse Niriayo
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Melisew Ayalneh
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Gebre Teklemariam Demoz
- Clinical Pharmacy and Pharmacy Practice Unit, Departments of Pharmacy, College of Health Sciences, Aksum University, Axum, Tigray, Ethiopia
| | - Nigusse Tesfay
- School of dental medicine, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Kidu Gidey
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
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Sánchez-Cárdenas MA, Vargas-Escobar LM, Correa-Morales JE, Michelsen-Andrade M, González-Salazar L, Muñoz-Olivar C, López Alba JA, León-Delgado MX. Effectiveness of Subcutaneous Administration of Antibiotics to Control Infections in Elder Palliative Patients: A Systematic Review. Am J Hosp Palliat Care 2023; 40:1379-1389. [PMID: 36964691 DOI: 10.1177/10499091231156866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023] Open
Abstract
Background: Infections are common in patients with advanced illnesses for whom the intravenous or oral route is not possible. The subcutaneous administration of antibiotics is a promising alternative, but there is not enough theoretical support for its use. This study aims to explore the effectiveness and safety of subcutaneous antibiotic therapy in the context of palliative care in elderly patients. Methods: A systematic review was conducted using PubMed and Embase, without time or language limits. Seven articles were selected on the effectiveness of subcutaneous antibiotic therapy in adult patients with chronic progressive diseases. The quality of the articles was assessed with the Newcastle Ottawa Scale and relevant data was extracted using a selection capture file. Results: Seven quasi-experimental studies evaluated 865 elderly patients with advanced diseases, comorbidities, and infections (ie, urinary tract, respiratory system, and bone joint) who received subcutaneous antibiotic therapy (ie, Ceftriaxone, Ertapenem, and Teicoplanin). The pooled success rate of subcutaneous antibiotics for the 7 studies was 71%, the therapy failure rate was 22%, its withdrawal mean was 8%, and the mean mortality rate was 7%. The studies were of low quality and were heterogeneous in the types of infections, types of antibiotics, time of follow-up, and outcomes assessed. Conclusions: Pilot studies have found a limited number of antibiotics that can be safely used to treat specific infections. Nevertheless, the data isn´t robust enough to recommend their use.
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25
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Khadse SN, Ugemuge S, Singh C. Impact of Antimicrobial Stewardship on Reducing Antimicrobial Resistance. Cureus 2023; 15:e49935. [PMID: 38179391 PMCID: PMC10765068 DOI: 10.7759/cureus.49935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Antimicrobial resistance has become a serious global issue, posing a significant threat to public health and healthcare professionals. Since the advent of penicillin, many antibiotics have lost their effectiveness in combating microbes simply due to inappropriate, irrational, unnecessary, and unrestricted use. The ineffectiveness of an increasing number of antibiotics necessitates the utilization of more potent antimicrobial agents for combatting uncomplicated infections. In response to the escalating prevalence of multidrug-resistant pathogens and the imperative to curtail the demand for novel antibiotics, the Antimicrobial Stewardship Program was conceived and implemented. This initiative is characterized by a lead physician, ideally possessing expertise in infectious diseases, alongside a pharmacist serving as a secondary leader and a microbiologist with defined responsibilities to achieve several objectives. These objectives include reducing indiscriminate usage of antimicrobial agents, promoting selective antimicrobial utilization based on culture results, de-escalating therapy from broad-spectrum to targeted antimicrobial agents, and transitioning from parenteral to oral administration when feasible. These objectives are pursued through a combination of pre-prescription and post-prescription strategies. While the Antimicrobial Stewardship Program is widely established in developed nations, a pressing need exists for its more comprehensive implementation in less developed regions. This review aims to examine the strategies used in antimicrobial stewardship programs to evaluate their effectiveness in preventing the development of multidrug-resistant organisms (MDROs) based on existing research studies. Under the Antimicrobial Stewardship Program, education of healthcare professionals and continuous disposal of information about antimicrobial resistance have helped to restrict the emergence of multidrug-resistant organisms.
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Affiliation(s)
- Sagar N Khadse
- Medical Education, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Sarita Ugemuge
- Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Charu Singh
- Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
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Muteeb G, Rehman MT, Shahwan M, Aatif M. Origin of Antibiotics and Antibiotic Resistance, and Their Impacts on Drug Development: A Narrative Review. Pharmaceuticals (Basel) 2023; 16:1615. [PMID: 38004480 PMCID: PMC10675245 DOI: 10.3390/ph16111615] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Antibiotics have revolutionized medicine, saving countless lives since their discovery in the early 20th century. However, the origin of antibiotics is now overshadowed by the alarming rise in antibiotic resistance. This global crisis stems from the relentless adaptability of microorganisms, driven by misuse and overuse of antibiotics. This article explores the origin of antibiotics and the subsequent emergence of antibiotic resistance. It delves into the mechanisms employed by bacteria to develop resistance, highlighting the dire consequences of drug resistance, including compromised patient care, increased mortality rates, and escalating healthcare costs. The article elucidates the latest strategies against drug-resistant microorganisms, encompassing innovative approaches such as phage therapy, CRISPR-Cas9 technology, and the exploration of natural compounds. Moreover, it examines the profound impact of antibiotic resistance on drug development, rendering the pursuit of new antibiotics economically challenging. The limitations and challenges in developing novel antibiotics are discussed, along with hurdles in the regulatory process that hinder progress in this critical field. Proposals for modifying the regulatory process to facilitate antibiotic development are presented. The withdrawal of major pharmaceutical firms from antibiotic research is examined, along with potential strategies to re-engage their interest. The article also outlines initiatives to overcome economic challenges and incentivize antibiotic development, emphasizing international collaborations and partnerships. Finally, the article sheds light on government-led initiatives against antibiotic resistance, with a specific focus on the Middle East. It discusses the proactive measures taken by governments in the region, such as Saudi Arabia and the United Arab Emirates, to combat this global threat. In the face of antibiotic resistance, a multifaceted approach is imperative. This article provides valuable insights into the complex landscape of antibiotic development, regulatory challenges, and collaborative efforts required to ensure a future where antibiotics remain effective tools in safeguarding public health.
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Affiliation(s)
- Ghazala Muteeb
- Department of Nursing, College of Applied Medical Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Md Tabish Rehman
- Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh 11437, Saudi Arabia;
- Center for Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates;
| | - Moayad Shahwan
- Center for Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates;
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman 346, United Arab Emirates
| | - Mohammad Aatif
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
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Sartelli M, Barie PS, Coccolini F, Abbas M, Abbo LM, Abdukhalilova GK, Abraham Y, Abubakar S, Abu-Zidan FM, Adebisi YA, Adamou H, Afandiyeva G, Agastra E, Alfouzan WA, Al-Hasan MN, Ali S, Ali SM, Allaw F, Allwell-Brown G, Amir A, Amponsah OKO, Al Omari A, Ansaloni L, Ansari S, Arauz AB, Augustin G, Awazi B, Azfar M, Bah MSB, Bala M, Banagala ASK, Baral S, Bassetti M, Bavestrello L, Beilman G, Bekele K, Benboubker M, Beović B, Bergamasco MD, Bertagnolio S, Biffl WL, Blot S, Boermeester MA, Bonomo RA, Brink A, Brusaferro S, Butemba J, Caínzos MA, Camacho-Ortiz A, Canton R, Cascio A, Cassini A, Cástro-Sanchez E, Catarci M, Catena R, Chamani-Tabriz L, Chandy SJ, Charani E, Cheadle WG, Chebet D, Chikowe I, Chiara F, Cheng VCC, Chioti A, Cocuz ME, Coimbra R, Cortese F, Cui Y, Czepiel J, Dasic M, de Francisco Serpa N, de Jonge SW, Delibegovic S, Dellinger EP, Demetrashvili Z, De Palma A, De Silva D, De Simone B, De Waele J, Dhingra S, Diaz JJ, Dima C, Dirani N, Dodoo CC, Dorj G, Duane TM, Eckmann C, Egyir B, Elmangory MM, Enani MA, Ergonul O, Escalera-Antezana JP, Escandon K, Ettu AWOO, Fadare JO, Fantoni M, Farahbakhsh M, Faro MP, Ferreres A, Flocco G, Foianini E, Fry DE, Garcia AF, Gerardi C, Ghannam W, Giamarellou H, Glushkova N, Gkiokas G, Goff DA, Gomi H, Gottfredsson M, Griffiths EA, Guerra Gronerth RI, Guirao X, Gupta YK, Halle-Ekane G, Hansen S, Haque M, Hardcastle TC, Hayman DTS, Hecker A, Hell M, Ho VP, Hodonou AM, Isik A, Islam S, Itani KMF, Jaidane N, Jammer I, Jenkins DR, Kamara IF, Kanj SS, Jumbam D, Keikha M, Khanna AK, Khanna S, Kapoor G, Kapoor G, Kariuki S, Khamis F, Khokha V, Kiggundu R, Kiguba R, Kim HB, Kim PK, Kirkpatrick AW, Kluger Y, Ko WC, Kok KYY, Kotecha V, Kouma I, Kovacevic B, Krasniqi J, Krutova M, Kryvoruchko I, Kullar R, Labi KA, Labricciosa FM, Lakoh S, Lakatos B, Lansang MAD, Laxminarayan R, Lee YR, Leone M, Leppaniemi A, Hara GL, Litvin A, Lohsiriwat V, Machain GM, Mahomoodally F, Maier RV, Majumder MAA, Malama S, Manasa J, Manchanda V, Manzano-Nunez R, Martínez-Martínez L, Martin-Loeches I, Marwah S, Maseda E, Mathewos M, Maves RC, McNamara D, Memish Z, Mertz D, Mishra SK, Montravers P, Moro ML, Mossialos E, Motta F, Mudenda S, Mugabi P, Mugisha MJM, Mylonakis E, Napolitano LM, Nathwani D, Nkamba L, Nsutebu EF, O’Connor DB, Ogunsola S, Jensen PØ, Ordoñez JM, Ordoñez CA, Ottolino P, Ouedraogo AS, Paiva JA, Palmieri M, Pan A, Pant N, Panyko A, Paolillo C, Patel J, Pea F, Petrone P, Petrosillo N, Pintar T, Plaudis H, Podda M, Ponce-de-Leon A, Powell SL, Puello-Guerrero A, Pulcini C, Rasa K, Regimbeau JM, Rello J, Retamozo-Palacios MR, Reynolds-Campbell G, Ribeiro J, Rickard J, Rocha-Pereira N, Rosenthal VD, Rossolini GM, Rwegerera GM, Rwigamba M, Sabbatucci M, Saladžinskas Ž, Salama RE, Sali T, Salile SS, Sall I, Kafil HS, Sakakushev BE, Sawyer RG, Scatizzi M, Seni J, Septimus EJ, Sganga G, Shabanzadeh DM, Shelat VG, Shibabaw A, Somville F, Souf S, Stefani S, Tacconelli E, Tan BK, Tattevin P, Rodriguez-Taveras C, Telles JP, Téllez-Almenares O, Tessier J, Thang NT, Timmermann C, Timsit JF, Tochie JN, Tolonen M, Trueba G, Tsioutis C, Tumietto F, Tuon FF, Ulrych J, Uranues S, van Dongen M, van Goor H, Velmahos GC, Vereczkei A, Viaggi B, Viale P, Vila J, Voss A, Vraneš J, Watkins RR, Wanjiru-Korir N, Waworuntu O, Wechsler-Fördös A, Yadgarova K, Yahaya M, Yahya AI, Xiao Y, Zakaria AD, Zakrison TL, Zamora Mesia V, Siquini W, Darzi A, Pagani L, Catena F. Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action. World J Emerg Surg 2023; 18:50. [PMID: 37845673 PMCID: PMC10580644 DOI: 10.1186/s13017-023-00518-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/23/2023] [Indexed: 10/18/2023] Open
Abstract
Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or "golden rules," for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice.
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Feng Y, Wang Z, Hao Z, Du J, Jiang H. Rising Drug Resistance Among Gram-Negative Pathogens in Bloodstream Infections: A Multicenter Study in Ulanhot, Inner Mongolia (2017-2021). Med Sci Monit 2023; 29:e940686. [PMID: 37828733 PMCID: PMC10583603 DOI: 10.12659/msm.940686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/18/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Bloodstream infections, which arise when pathogenic microorganisms infiltrate the bloodstream, present a grave health risk. Their potentially lethal nature combined with the ability to severely impair physiological functions underscore the importance of understanding and mitigating such infections. This study aimed to elucidate drug sensitivity profiles and distribution of these pathogens in hospitals in Ulanhot, Inner Mongolia. MATERIAL AND METHODS From 2017 to 2021, we gathered blood culture-positive samples from several hospitals across Ulanhot. Using combined diagnostic techniques, including the instrument method, paper diffusion, and Epsilometer test (E-test), we determined the identity of pathogens and assessed their drug sensitivity. Subsequent data processing with WHONET 5.6 software provided insights into the patterns of microbial distribution and extent of drug resistance. RESULTS Of 2498 pathogenic strains identified, 35.83% were gram-positive, 62.45% were gram-negative, and a smaller fraction of 1.72% were fungi. Escherichia coli and Klebsiella pneumoniae were the primary bacteria, contributing to 35.15% and 15.73% of infections, respectively. Alarmingly, methicillin-resistant strains exhibited pronounced resistance to drugs, notably penicillin G (resistance rates of 80.87% to 100.00%) and erythromycin (resistance rates of 91.16% to 97.28%). Acinetobacter baumannii had a particularly high resistance profile, surpassing Pseudomonas aeruginosa, which exhibited a resistance rate below 30.00%. CONCLUSIONS Ulanhot's primary bloodstream infection agents were gram-negative bacteria, specifically E. coli and K. pneumoniae. The growing drug resistance observed, particularly among strains like A. baumannii, highlights the pressing need for rigorous drug resistance surveillance and the strategic use of antibiotics, ensuring their efficacy is preserved for future medical needs.
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Affiliation(s)
- Yinxia Feng
- Department of Laboratory Medicine, Xing’an League People’s Hospital, Xing’an League, Ulanhot, Inner Mongolia, PR China
| | - Zhijun Wang
- Department of Laboratory Medicine, Xing’an League People’s Hospital, Xing’an League, Ulanhot, Inner Mongolia, PR China
| | - Zelin Hao
- Department of Laboratory Medicine, Ulanhot People’s Hospital, Xing’an League, Ulanhot, Inner Mongolia, PR China
| | - Jinlong Du
- Department of Laboratory Medicine, Keyou Qianqi People’s Hospital, Xing’an League, Tongliao, Inner Mongolia, PR China
| | - Hui Jiang
- Department of Laboratory Medicine, Xing’an League People’s Hospital, Xing’an League, Ulanhot, Inner Mongolia, PR China
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Ronghe V, Modak A, Gomase K, Mahakalkar MG. From Prevention to Management: Understanding Postoperative Infections in Gynaecology. Cureus 2023; 15:e46319. [PMID: 37916257 PMCID: PMC10617751 DOI: 10.7759/cureus.46319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/01/2023] [Indexed: 11/03/2023] Open
Abstract
This narrative review examines the multifaceted realm of postoperative infections in gynaecology, addressing their significance, types, risk factors, prevention, management, and emerging trends. Postoperative infections, encompassing surgical site infections, urinary tract infections, and pelvic inflammatory disease, pose considerable challenges in patient care, warranting comprehensive exploration. Strategies for prevention include preoperative patient assessment, antimicrobial prophylaxis, and aseptic techniques. Intraoperative measures encompass infection control and instrument sterilization, while postoperative care involves wound management and early infection detection. Diagnostic tools, including blood tests, imaging, and microbiological cultures, aid in timely identification. Management strategies encompass antibiotic therapy, surgical interventions, supportive care, and addressing complications. The review underscores the necessity of personalized approaches, multidisciplinary collaboration, and innovative technologies in future infection management. It calls for ongoing research, heightened awareness, and meticulous care to minimize the impact of postoperative infections and optimize patient outcomes.
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Affiliation(s)
- Vaishnavi Ronghe
- Obstetrics and Gynaecology, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Anushree Modak
- Obstetrics and Gynaecology, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Kavita Gomase
- Obstetrics and Gynaecology, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Manjusha G Mahakalkar
- Obstetrics and Gynaecology, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Khasawneh RA, Almomani BA, Al‐Shatnawi SF, Al-Natour L. Clinical utility of prior positive cultures to optimize empiric antibiotic therapy selection: A cross-sectional analysis. New Microbes New Infect 2023; 55:101182. [PMID: 37786609 PMCID: PMC10542003 DOI: 10.1016/j.nmni.2023.101182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/15/2023] [Accepted: 09/15/2023] [Indexed: 10/04/2023] Open
Abstract
Background Despite reduced infectious disease mortality and improved survival, infectious diseases continue to pose health threats due to their contagiousness, societal harm, and morbidity. Empiric antibiotic therapy, often prescribed without knowledge of the causative pathogen, faces challenges from rising antibiotic resistance. This study explores the potential of prior positive culture results to guide empiric antibiotic therapy. Methods Data from King Abdullah University Hospital (Jan 2014-Dec 2019) included adult patients with recurrent bacterial infections (pneumonia, sepsis, UTIs, wounds). Excluded cases included: mixed infections, transfers, <14 days or >12 months between episodes. The study compared bacterial growth and sensitivity patterns between previous and recent cultures. Results The study included 970 episodes from 650 patients, mainly UTIs (60.3%) and gram-negative bacteria (77.9%). The study found that (65.1%) of culture pairs matched. Empirical therapy was accurate in (71.8%) of cases. Further, accuracy of selected empiric antibiotic therapy was significantly predicted (p < 0.001) by: type of infection, type of antibiotics, and concordance with prior microbiologic data. Multivariate logistic analysis showed blood culture as less predictive of pending identity (OR: 0.234, P < 0.001) compared to urine culture; and prior affirmed gram negative bacterial culture was less predictive (OR: 0.606, P = 0.021) compared to gram positive bacterial culture. Conclusion This study underscores the potential of prior positive culture results in guiding empiric antibiotic therapy, enhancing accuracy and identity agreement. Future research should explore this approach in different infection contexts and across multiple centers. Reducing the indiscriminate use of broad-spectrum antibiotics is essential to combat antibiotic resistance.
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Affiliation(s)
- Rawand A. Khasawneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Basima A. Almomani
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Samah F. Al‐Shatnawi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Lara Al-Natour
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Dudhane RA, Bankar NJ, Shelke YP, Badge AK. The Rise of Non-typhoidal Salmonella Infections in India: Causes, Symptoms, and Prevention. Cureus 2023; 15:e46699. [PMID: 38021876 PMCID: PMC10630329 DOI: 10.7759/cureus.46699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
Non-typhoidal Salmonella infections (NTS) are a growing concern in India, posing a significant health risk to the population. These infections are becoming more common at worrisome rates, primarily because of inadequate surveillance. Salmonella non-typhoidal causes severe gastroenteritis and can even cause invasive infections, such as bacteremia, and focal infections, such as meningitis and septic arthritis, and is acquired through contaminated food and water sources. From moderate to severe, the symptoms might vary. Certain serovars exhibit a stronger propensity for specific syndromes, with serious infections more commonly observed in vulnerable populations. Consuming contaminated food, using inadequate sanitation procedures while handling meat from animals slaughtered, and contaminated water supplies are some of the causes of these diseases. Proper food and water treatment, better sanitary facilities, public awareness campaigns, and adherence to food safety laws are all part of prevention measures. The issue of antimicrobial resistance further emphasizes the necessity for prudent antibiotic usage. The Indian government has put in place programs including public awareness campaigns, better sanitary facilities, and stricter food safety laws. In the future, efforts should, however, concentrate on improving laws, boosting hygienic practices, and funding the development of new medicines and vaccines. These actions will lessen the burden of NTS infections in India by assisting in their prevention and management. This review aims to understand the reasons for this growing tendency, which is essential for creating efficient control and prevention strategies.
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Affiliation(s)
- Radhika A Dudhane
- Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nandkishor J Bankar
- Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Yogendra P Shelke
- Microbiology, Bhaktshreshtha Kamalakarpant Laxmanrao Walwalkar Rural Medical College, Ratnagiri, IND
| | - Ankit K Badge
- Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Picca M, Carrozzo R, Milani GP, Corsello A, Macchi M, Buzzetti R, Marchisio P, Mameli C. Leading reasons for antibiotic prescriptions in pediatric respiratory infections: influence of fever in a primary care setting. Ital J Pediatr 2023; 49:131. [PMID: 37775784 PMCID: PMC10541709 DOI: 10.1186/s13052-023-01533-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/14/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Antibiotic overuse in children is a significant public health concern, as it can lead to the emergence and spread of antibiotic-resistant bacteria. Although respiratory infections account for most antibiotic prescriptions in children, many of these infections are viral and do not require antibiotics. In this study, we aimed to investigate the use of antibiotics in children with respiratory infections in a primary care setting and to explore the possible role of fever on antibiotic prescription. METHODS We conducted a prospective observational study that evaluated preschool children aged 0-5 years who were assessed by their primary care pediatricians for respiratory infectious diseases between October 2019 and March 2021. The study involved 69 public primary care pediatricians and a total of 678 pediatric episodes for respiratory infections. RESULTS Amoxicillin/clavulanate was the most frequently prescribed drug. Bronchitis accounted for most of inappropriate antibiotic prescriptions (73%). Furthermore, the presence of fever was associated with a ~ 300% increase in the likelihood of prescribing antibiotics for respiratory infections that do not typically require antibiotics. CONCLUSION Our findings emphasize the need for adherence to international guidelines and recommendations in the primary care of children to reduce unnecessary antibiotic use and prevent the development of antibiotic resistance. This study also underscores the potential relevance of new studies to evaluate antibiotic prescription attitudes in other clinical settings and geographical areas.
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Affiliation(s)
- Marina Picca
- Italian Primary Care Paediatrics Society (SICuPP), Lombardy, Italy
| | - Romeo Carrozzo
- Italian Primary Care Paediatrics Society (SICuPP), Lombardy, Italy
| | - Gregorio Paolo Milani
- Department of Health Science and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Corsello
- Department of Health Science and Community Health, University of Milan, Milan, Italy.
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- University of Milan, Via della Commenda 9, Milan, 20122, Italy.
| | - Marina Macchi
- Department of Health Science and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan, Via della Commenda 9, Milan, 20122, Italy
| | - Chiara Mameli
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Milan, Italy
- Department of Biomedical and Clinical Science "L. Sacco", University of Milan, Milan, Italy
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Ardila CM, Zuluaga-Gómez M, Vivares-Builes AM. Applications of Lab on a Chip in Antimicrobial Susceptibility of Staphylococcus aureus: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1719. [PMID: 37893437 PMCID: PMC10608121 DOI: 10.3390/medicina59101719] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Staphylococcus aureus is a prevalent bacterium capable of inducing various infections, including skin and soft tissue infections, bloodstream infections, pneumonia, and surgical site infections. The emergence of antimicrobial resistance in S. aureus, particularly methicillin-resistant S. aureus, has raised substantial concerns within global healthcare settings. Prior to antibiotic prescription, the ideal approach is antimicrobial susceptibility testing (AST); however, this is frequently perceived as excessively complex and time-intensive. Lab-on-a-chip (LOC) technology holds promise in addressing these challenges and advancing fundamental microbiological research while also aiding in the development of therapeutic strategies. This systematic review aims to evaluate the potential utility of LOC for AST of S. aureus. Materials and Methods: This study adhered to the PRISMA guidelines. Various databases, including SCOPUS, PubMed/MEDLINE, SCIELO, and LILACS, in addition to gray literature sources, were employed in the review process. Results: Sixteen studies were included in this systematic review. All these studies detailed the effectiveness, rapidity, and predictability of LOC systems for assessing S. aureus susceptibility to various antibiotics. When comparing the LOC approach to traditional manual methods, it was evident that LOC requires a minimal quantity of reagents. Furthermore, most studies reported that the entire LOC procedure took 10 min to 7 h, with results being equally accurate as those obtained through traditional AST protocols. Conclusions: The potential application of LOC for AST of S. aureus is emphasized by its ability to provide rapid access to minimum inhibitory concentration data, which can substantially aid in selecting the most suitable antibiotics and dosages for treating challenging infections caused by this microorganism. Moreover, the rapid AST facilitated by LOC holds promise for enhancing the appropriateness and efficacy of therapy in clinical settings.
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Affiliation(s)
- Carlos M. Ardila
- Basic Studies Department, School of Dentistry, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Mateo Zuluaga-Gómez
- Emergency Department, Universidad Pontificia Bolivariana, Medellín 050010, Colombia;
- Hospital San Vicente Fundación, Rionegro 054047, Colombia
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Broermann LE, Al-Hasan MN, Withers S, Benbow KL, Ramsey T, McTavish M, Winders HR. Intravenous versus Partial Oral Antibiotic Therapy in the Treatment of Uncomplicated Bloodstream Infection Due to Streptococcus Species. Microorganisms 2023; 11:2313. [PMID: 37764157 PMCID: PMC10536542 DOI: 10.3390/microorganisms11092313] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/24/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
This retrospective cohort study examines effectiveness of partial oral antibiotic regimens in uncomplicated bloodstream infections (BSIs) due to Streptococcus species compared to standard intravenous therapy. Adult patients with uncomplicated streptococcal BSIs from April 2016 to June 2020 in seven hospitals in South Carolina, USA, were evaluated. Multivariate Cox proportional hazards regression was used to examine the time to treatment failure within 90 days of a BSI after adjustment for the propensity to receive partial oral therapy. Multivariate linear regression was used to examine the hospital length of stay (HLOS). Among the 222 patients included, 99 received standard intravenous antibiotics and 123 received partial oral therapy. Of the standard intravenous therapy group, 46/99 (46.5%) required outpatient parenteral antibiotic therapy (OPAT). There was no difference in the risk of treatment failure between partial oral and standard intravenous therapy (hazards ratio 0.53, 95% CI 0.18, 1.60; p = 0.25). Partial oral therapy was independently associated with a shorter HLOS after adjustments for the propensity to receive partial oral therapy and other potential confounders (-2.23 days, 95% CI -3.53, -0.94; p < 0.001). Transitioning patients to oral antibiotics may be a reasonable strategy in the management of uncomplicated streptococcal BSIs. Partial oral therapy does not seem to have a higher risk of treatment failure and may spare patients from prolonged hospitalizations and OPAT complications.
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Affiliation(s)
- Lynn E. Broermann
- University of South Carolina College of Pharmacy, Columbia, SC 29208, USA; (L.E.B.); (K.L.B.); (T.R.); (M.M.)
| | - Majdi N. Al-Hasan
- Department of Medicine, University of South Carolina School of Medicine, Columbia, SC 29209, USA
- Department of Internal Medicine, Division of Infectious Diseases, Prisma Health Midlands, Columbia, SC 29203, USA
| | | | - Kristina L. Benbow
- University of South Carolina College of Pharmacy, Columbia, SC 29208, USA; (L.E.B.); (K.L.B.); (T.R.); (M.M.)
| | - Taylor Ramsey
- University of South Carolina College of Pharmacy, Columbia, SC 29208, USA; (L.E.B.); (K.L.B.); (T.R.); (M.M.)
| | - Meghan McTavish
- University of South Carolina College of Pharmacy, Columbia, SC 29208, USA; (L.E.B.); (K.L.B.); (T.R.); (M.M.)
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Hayer SS, Hwang S, Clayton JB. Antibiotic-induced gut dysbiosis and cognitive, emotional, and behavioral changes in rodents: a systematic review and meta-analysis. Front Neurosci 2023; 17:1237177. [PMID: 37719161 PMCID: PMC10504664 DOI: 10.3389/fnins.2023.1237177] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/18/2023] [Indexed: 09/19/2023] Open
Abstract
There are previous epidemiological studies reporting associations between antibiotic use and psychiatric symptoms. Antibiotic-induced gut dysbiosis and alteration of microbiota-gut-brain axis communication has been proposed to play a role in this association. In this systematic review and meta-analysis, we reviewed published articles that have presented results on changes in cognition, emotion, and behavior in rodents (rats and mice) after antibiotic-induced gut dysbiosis. We searched three databases-PubMed, Web of Science, and SCOPUS to identify such articles using dedicated search strings and extracted data from 48 articles. Increase in anxiety and depression-like behavior was reported in 32.7 and 40.7 percent of the study-populations, respectively. Decrease in sociability, social novelty preference, recognition memory and spatial cognition was found in 18.1, 35.3, 26.1, and 62.5 percent of the study-populations, respectively. Only one bacterial taxon (increase in gut Proteobacteria) showed statistically significant association with behavioral changes (increase in anxiety). There were no consistent findings with statistical significance for the potential biomarkers [Brain-derived neurotrophic factor (BDNF) expression in the hippocampus, serum corticosterone and circulating IL-6 and IL-1β levels]. Results of the meta-analysis revealed a significant association between symptoms of negative valence system (including anxiety and depression) and cognitive system (decreased spatial cognition) with antibiotic intake (p < 0.05). However, between-study heterogeneity and publication bias were statistically significant (p < 0.05). Risk of bias was evaluated to be high in the majority of the studies. We identified and discussed several reasons that could contribute to the heterogeneity between the results of the studies examined. The results of the meta-analysis provide promising evidence that there is indeed an association between antibiotic-induced gut dysbiosis and psychopathologies. However, inconsistencies in the implemented methodologies make generalizing these results difficult. Gut microbiota depletion using antibiotics may be a useful strategy to evaluate if and how gut microbes influence cognition, emotion, and behavior, but the heterogeneity in methodologies used precludes any definitive interpretations for a translational impact on clinical practice.
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Affiliation(s)
- Shivdeep S. Hayer
- Department of Biology, University of Nebraska at Omaha, Omaha, NE, United States
- Callitrichid Research Center, University of Nebraska at Omaha, Omaha, NE, United States
- Nebraska Food for Health Center, University of Nebraska-Lincoln, Lincoln, NE, United States
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
| | - Soonjo Hwang
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - Jonathan B. Clayton
- Department of Biology, University of Nebraska at Omaha, Omaha, NE, United States
- Callitrichid Research Center, University of Nebraska at Omaha, Omaha, NE, United States
- Nebraska Food for Health Center, University of Nebraska-Lincoln, Lincoln, NE, United States
- Department of Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE, United States
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States
- Primate Microbiome Project, University of Nebraska-Lincoln, Lincoln, NE, United States
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Spanakis M, Alon-Ellenbogen D, Ioannou P, Spernovasilis N. Antibiotics and Lipid-Modifying Agents: Potential Drug-Drug Interactions and Their Clinical Implications. PHARMACY 2023; 11:130. [PMID: 37624085 PMCID: PMC10457919 DOI: 10.3390/pharmacy11040130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/30/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023] Open
Abstract
Evidence-based prescribing requires taking into consideration the many aspects of optimal drug administration (e.g., dosage, comorbidities, co-administered drugs, etc.). A key issue is the administration of drugs for acute disorders that may potentially interfere with previously prescribed long-term medications. Initiating an antibiotic for an acute bacterial infection constitutes a common example. Hence, appropriate knowledge and awareness of the potential DDIs of antibiotics would lead to proper adjustments, thus preventing over- or under-treatment. For example, some statins, which are the most prescribed lipid-modifying agent (LMA), can lead to clinically important drug-drug interactions (DDIs) with the concurrent administration of antibiotics, e.g., macrolides. This review discusses the clinically significant DDIs of antibiotics associated with co-administrated lipid-lowering therapy and highlights common cases where regimen modifications may or may not be necessary.
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Affiliation(s)
- Marios Spanakis
- Department Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece;
- Computational Biomedicine Laboratory, Institute of Computer Science, Foundation for Research & Technology-Hellas (FORTH), 70013 Heraklion, Greece
| | - Danny Alon-Ellenbogen
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 2417 Nicosia, Cyprus;
| | - Petros Ioannou
- Department of Internal Medicine & Infectious Diseases, University Hospital of Heraklion, 71110 Heraklion, Greece;
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Jun I, Cohen SA, Ser SE, Marini S, Lucero RJ, Bian J, Prosperi M. Optimizing Dynamic Antibiotic Treatment Strategies against Invasive Methicillin-Resistant Staphylococcus Aureus Infections using Causal Survival Forests and G-Formula on Statewide Electronic Health Record Data. PROCEEDINGS OF MACHINE LEARNING RESEARCH 2023; 218:98-115. [PMID: 37854935 PMCID: PMC10584043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Developing models for individualized, time-varying treatment optimization from observational data with large variable spaces, e.g., electronic health records (EHR), is problematic because of inherent, complex bias that can change over time. Traditional methods such as the g-formula are robust, but must identify critical subsets of variables due to combinatorial issues. Machine learning approaches such as causal survival forests have fewer constraints and can provide fine-tuned, individualized counterfactual predictions. In this study, we aimed to optimize time-varying antibiotic treatment -identifying treatment heterogeneity and conditional treatment effects- against invasive methicillin-resistant Staphylococcus Aureus (MRSA) infections, using statewide EHR data collected in Florida, USA. While many previous studies focused on measuring the effects of the first empiric treatment (i.e., usually vancomycin), our study focuses on dynamic sequential treatment changes, comparing possible vancomycin switches with other antibiotics at clinically relevant time points, e.g., after obtaining a bacterial culture and susceptibility testing. Our study population included adult individuals admitted to the hospital with invasive MRSA. We collected demographic, clinical, medication, and laboratory information from the EHR for these patients. Then, we followed three sequential antibiotic choices (i.e., their empiric treatment, subsequent directed treatment, and final sustaining treatment), evaluating 30-day mortality as the outcome. We applied both causal survival forests and g-formula using different clinical intervention policies. We found that switching from vancomycin to another antibiotic improved survival probability, yet there was a benefit from initiating vancomycin compared to not using it at any time point. These findings show consistency with the empiric choice of vancomycin before confirmation of MRSA and shed light on how to manage switches on course. In conclusion, this application of causal machine learning on EHR demonstrates utility in modeling dynamic, heterogeneous treatment effects that cannot be evaluated precisely using randomized clinical trials.
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Affiliation(s)
- Inyoung Jun
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Scott A Cohen
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Sarah E Ser
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Simone Marini
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Robert J Lucero
- School of Nursing, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Mattia Prosperi
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
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Black C, Al Mahmud H, Howle V, Wilson S, Smith AC, Wakeman CA. Development of a Polymicrobial Checkerboard Assay as a Tool for Determining Combinatorial Antibiotic Effectiveness in Polymicrobial Communities. Antibiotics (Basel) 2023; 12:1207. [PMID: 37508303 PMCID: PMC10376321 DOI: 10.3390/antibiotics12071207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
The checkerboard assay is a well-established tool used to determine the antimicrobial effects of two compounds in combination. Usually, data collected from the checkerboard assay use visible turbidity and optical density as a readout. While helpful in traditional checkerboard assays, these measurements become less useful in a polymicrobial context as they do not enable assessment of the drug effects on the individual members of the community. The methodology described herein allows for the determination of cell viability through selective and differential plating of each individual species in a community while retaining much of the high-throughput nature of a turbidity-based analysis and requiring no specialized equipment. This methodology further improves turbidity-based measurements by providing a distinction between bacteriostatic versus bactericidal concentrations of antibiotics. Herein, we use this method to demonstrate that the clinically used antibiotic combination of ceftazidime and gentamicin works synergistically against Pseudomonas aeruginosa in monoculture but antagonistically in a polymicrobial culture also containing Acinetobacter baumannii, Staphylococcus aureus, and Enterococcus faecalis, highlighting the fundamental importance of this methodology in improving clinical practices. We propose that this method could be implemented in clinical microbiology laboratories with minimal impact on the overall time for diagnosis.
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Affiliation(s)
- Caroline Black
- Department of Biological Sciences, Texas Tech University, Lubbock, TX 79409, USA; (C.B.)
| | - Hafij Al Mahmud
- Department of Biological Sciences, Texas Tech University, Lubbock, TX 79409, USA; (C.B.)
| | - Victoria Howle
- Department of Mathematics and Statistics, Texas Tech University, Lubbock, TX 79409, USA
| | - Sabrina Wilson
- Department of Honors Studies, Texas Tech University, Lubbock, TX 79409, USA
| | - Allie C. Smith
- Department of Honors Studies, Texas Tech University, Lubbock, TX 79409, USA
| | - Catherine A. Wakeman
- Department of Biological Sciences, Texas Tech University, Lubbock, TX 79409, USA; (C.B.)
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Almuhayawi MS, Gattan HS, Alruhaili MH, Alharbi MT, Nagshabandi MK, Tarabulsi MK, Almuhayawi SM, Al Jaouni SK, Selim S, Alanazi A, Alruwaili Y, Faried OA, Amin I, Elnosary ME. Molecular Profile and the Effectiveness of Antimicrobials Drugs Against Staphylococcus aureus and Pseudomonas aeruginosa in the Diagnostic Approaches of Otitis Infection. Infect Drug Resist 2023; 16:4397-4408. [PMID: 37431447 PMCID: PMC10329836 DOI: 10.2147/idr.s418685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/27/2023] [Indexed: 07/12/2023] Open
Abstract
Background Otitis externa and otitis media are two types of ear infections that affect people of all ages, although they are more common in newborns and young children. Antibiotic usage, healthcare, and advanced age all play a role in the development of this illness. Methods Fifty-eight patients with various kinds of infections of the ears were voluntary patients attending the outpatient clinics of the Prince Mutaib Bin Abdulaziz Hospital in Sakaka, Al Jouf, Saudi Arabia, examined to evaluate the role of bacteria and the likely significance of plasmids in their antibiotic resistance as ear infectious agents. Results Staphylococcus aureus and Pseudomonas aeruginosa are the most prevalent bacteria found in ear infections. The greatest number of major bacterial isolates were S. aureus (54%), followed by P. aeruginosa (13%), whereas a smaller number of isolates (3%) were from Streptococcus pyogenes, Bacillus subtilis, and Proteus vulgaris, respectively. Mixed growth was noted in 3.4% of instances. The isolation rate for Gram-positive organisms was 72%, while the rate for Gram-negative species was 28%. All the isolates had DNA greater than 14 kilobases. Hind III analysis of the plasmid DNA extracted from the resistant strains of ear infection demonstrated that antibiotic-resistance plasmids were extensively dispersed. Exotoxin A PCR amplification indicated 396 pb PCR-positive DNA for all identified samples, with the exception of three strains for which no band was observed. Patients in the epidemiological study ranged in number, but all were linked together for the purposes of the study because of their shared epidemiological characteristics. Conclusion Vancomycin, linezolid, tigecycline, rifampin, and daptomycin are all antibiotics that have been shown to be effective against S. aureus and P. aeruginosa. Microbiological pattern evaluation and antibiotic sensitivity patterns of the microorganisms providing empirical antibiotics are becoming increasingly crucial to minimize issues and the development of antibiotic-resistant strains.
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Affiliation(s)
- Mohammed S Almuhayawi
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King AbdulAziz University, Jeddah, 21589, Saudi Arabia
| | - Hattan S Gattan
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
- Special Infectious Agents Unit, King Fahad Medical Research Center, King AbdulAziz University, Jeddah, 21589, Saudi Arabia
| | - Mohammed H Alruhaili
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King AbdulAziz University, Jeddah, 21589, Saudi Arabia
- Special Infectious Agents Unit, King Fahad Medical Research Center, King AbdulAziz University, Jeddah, 21589, Saudi Arabia
| | - Mohanned Talal Alharbi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, 23218, Saudi Arabia
| | - Mohammed K Nagshabandi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, 23218, Saudi Arabia
| | - Muyassar K Tarabulsi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, 23218, Saudi Arabia
| | - Saad M Almuhayawi
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Soad K Al Jaouni
- Department of Hematology/Oncology, Yousef Abdulatif Jameel Scientific Chair of Prophetic Medicine Application, Faculty of Medicine, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Samy Selim
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, 72341, Saudi Arabia
| | - Awadh Alanazi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, 72341, Saudi Arabia
| | - Yasir Alruwaili
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, 72341, Saudi Arabia
| | - Osama Ahmed Faried
- Medical Microbiology and Immunology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, 62513, Egypt
| | - Islam Amin
- Central Laboratory, Ismailia General Hospital, Ismailia, Egypt
| | - Mohamed E Elnosary
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo, 11884, Egypt
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Zheng Y, Liu J, Tang PK, Hu H, Ung COL. A systematic review of self-medication practice during the COVID-19 pandemic: implications for pharmacy practice in supporting public health measures. Front Public Health 2023; 11:1184882. [PMID: 37397709 PMCID: PMC10310324 DOI: 10.3389/fpubh.2023.1184882] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Since the COVID-19 pandemic, self-medication had become highly popular due to the risk of virus infection and overwhelming medical resources. Pharmacists are well-positioned to provide public health education and disease prevention. This study aims to provide an overview of the research about self-medication during COVID-19 and the role of pharmacists in ensuring the drug safety related to self-medication. Methods Databases (PubMed, Google Scholar, Scopus, EBSCO host, and Web of Science) were searched for published studies on the practice of self-medication in COVID-19 pandemic without restriction in population and location. Primary search terms were "self-medication," "self-care," "self-management," "non-prescription drugs," "2019nCoV," and "COVID-19." Studies conducted during the pandemic but not exclusively for COVID-19 disease were eligible for inclusion. Results The database search yielded a total of 4,752 papers. After appropriate screening, 62 articles met the inclusion criteria. Most of the studies were cross-sectional in nature. The review highlighted a very high prevalence of self-medication during COVID-19, ranging from 7.14 to 88.3%. The purpose of self-medication was mainly to treat and prevent COVID-19; fever, body aches, cough, headache, and sore throat were the most frequently mentioned indications. Categories of drugs commonly used in self-medication included antibiotics, herbs, vitamins, and analgesics, most of which came from pharmacies. Information about self-medication usually obtained from relatives and friends, social networks and health care professionals. Common reasons for self-medication included saving money and time, prior experience and mild illness; reasons associated with COVID-19 were mainly fear of contracting the virus and poor access to doctors. Gender, age, education, marital status, and concern about COVID-19 were the most usual associated factors. The role of pharmacists in self-medication included sources of information, advice on medication use, and management of adverse reactions. Conclusion During the COVID-19 pandemic, self-medication practices were widespread and varied across countries and populations. Self-medication has emerged as an important component of health care, but also as a huge global challenge. The engagement of healthcare administrators and policy makers are essential to regulate self-medication practices. The expertise and favorable conditions of pharmacists make them positioned as key roles in public health interventions for self-medication. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=395423, identifier CRD42023395423.
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Affiliation(s)
- Yu Zheng
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
| | - Jiayu Liu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
| | - Pou Kuan Tang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
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Ekakoro JE, Guptill L, Hendrix K, Anderson M, Ruple A. Approaches Used to Construct Antibiograms for Dogs in a Veterinary Teaching Hospital in the United States. Antibiotics (Basel) 2023; 12:1034. [PMID: 37370353 DOI: 10.3390/antibiotics12061034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Non-judicious antimicrobial use (AMU) is a major driver of antimicrobial resistance (AMR). In human hospitals, cumulative antibiograms are often used by clinicians to evaluate local susceptibility rates and to select the most appropriate empiric therapy with the aim of minimizing inappropriate AMU. However, the use of cumulative antibiograms to guide empiric antimicrobial therapy in veterinary hospitals in the United States is limited, and there are no specific guidelines or standardized methods available for the construction of antibiograms in veterinary clinical settings. The objective of this methods article is to describe the approaches that were used to construct antibiograms from clinical samples collected from dogs seen at a veterinary teaching hospital. Laboratory data for 563 dogs for the period from 1 January 2015 to 31 December 2015 was utilized. We used the Clinical and Laboratory Standards Institute (CLSI) guidelines for use in the construction of the antibiograms in human healthcare settings as the basis for the veterinary antibiograms. One general antibiogram and antibiograms stratified by hospital section, the anatomic region of sample collection/by sample type, were created and the challenges encountered in preparing these antibiograms were highlighted. The approaches described could be useful in guiding veterinary antibiogram development for empiric therapy.
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Affiliation(s)
- John E Ekakoro
- Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Lynn Guptill
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Kenitra Hendrix
- Indiana Animal Disease Diagnostic Laboratory, Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Melinda Anderson
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Audrey Ruple
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA 24061, USA
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Baghdadi JD, Goodman KE, Magder LS, Heil EL, Claeys K, Bork J, Harris AD. Clinical, contextual and hospital-level factors associated with escalation and de-escalation of empiric Gram-negative antibiotics among US inpatients. JAC Antimicrob Resist 2023; 5:dlad054. [PMID: 37193004 PMCID: PMC10182731 DOI: 10.1093/jacamr/dlad054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/19/2023] [Indexed: 05/18/2023] Open
Abstract
Background Empiric Gram-negative antibiotics are frequently changed in response to new information. To inform antibiotic stewardship, we sought to identify predictors of antibiotic changes using information knowable before microbiological test results. Methods We performed a retrospective cohort study. Survival-time models were used to evaluate clinical factors associated with antibiotic escalation and de-escalation (defined as an increase or decrease, respectively, in the spectrum or number of Gram-negative antibiotics within 5 days of initiation). Spectrum was categorized as narrow, broad, extended or protected. Tjur's D statistic was used to estimate the discriminatory power of groups of variables. Results In 2019, 2 751 969 patients received empiric Gram-negative antibiotics at 920 study hospitals. Antibiotic escalation occurred in 6.5%, and 49.2% underwent de-escalation; 8.8% were changed to an equivalent regimen. Escalation was more likely when empiric antibiotics were narrow-spectrum (HR 19.0 relative to protected; 95% CI: 17.9-20.1), broad-spectrum (HR 10.3; 95% CI: 9.78-10.9) or extended-spectrum (HR 3.49; 95% CI: 3.30-3.69). Patients with sepsis present on admission (HR 1.94; 95% CI: 1.91-1.96) and urinary tract infection present on admission (HR 1.36; 95% CI: 1.35-1.38) were more likely to undergo antibiotic escalation than patients without these syndromes. De-escalation was more likely with combination therapy (HR 2.62 per additional agent; 95% CI: 2.61-2.63) or narrow-spectrum empiric antibiotics (HR 1.67 relative to protected; 95% CI: 1.65-1.69). Choice of empiric regimen accounted for 51% and 74% of the explained variation in antibiotic escalation and de-escalation, respectively. Conclusions Empiric Gram-negative antibiotics are frequently de-escalated early in hospitalization, whereas escalation is infrequent. Changes are primarily driven by choice of empiric therapy and presence of infectious syndromes.
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Affiliation(s)
- Jonathan D Baghdadi
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Katherine E Goodman
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Laurence S Magder
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Emily L Heil
- Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Kimberly Claeys
- Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Jacqueline Bork
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Anthony D Harris
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
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Naicker S, Mohanlall V, Ngubane S, Mellem J, Mchunu NP. Phenotypic Array for Identification and Screening of Antifungals against Aspergillus Isolates from Respiratory Infections in KwaZulu Natal, South Africa. J Fungi (Basel) 2023; 9:616. [PMID: 37367552 DOI: 10.3390/jof9060616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
The rapid emergence of invasive fungal infections correlates with the increasing population of immunocompromised individuals, with many cases leading to death. The progressive increase in the incidence of Aspergillus isolates is even more severe due to the clinical challenges in treating invasive infections in immunocompromised patients with respiratory conditions. Rapid detection and diagnosis are needed to reduce mortality in individuals with invasive aspergillosis-related infections and thus efficient identification impacts clinical success. The phenotypic array method was compared to conventional morphology and molecular identification on thirty-six Aspergillus species isolated from patients with respiratory infections at the Inkosi Albert Luthuli Hospital in Kwa-Zulu Natal. In addition, an antimicrobial array was also carried out to screen for possible novel antimicrobial compounds for treatment. Although traditional morphological techniques are useful, genetic identification was the most reliable, assigning 26 to Aspergillus fumigatus species, 8 Aspergillus niger, and 2 Aspergillus flavus including cryptic species of A. niger, A. tubingensis and A. welwitschiae. The phenotypic array technique was only able to identify isolates up to the genus level due to a lack of adequate reference clinical species in the database. However, this technique proved crucial in assessing a wide range of possible antimicrobial options after these isolates exhibited some resistance to azoles. Antifungal profiles of the thirty-six isolates on the routine azole voriconazole showed a resistance of 6%, with 61% having moderate susceptibility. All isolates resistant to the salvage therapy drug, posaconazole pose a serious concern. Significantly, A. niger was the only species resistant (25%) to voriconazole and has recently been reported as the species isolated from patients with COVID-19-associated pulmonary aspergillosis (CAPA). Phenotypic microarray showed that 83% of the isolates were susceptible to the 24 new compounds and novel compounds were identified for potentially effective combination treatment of fungal infections. This study also reports the first TR34/98 mutation in Aspergillus clinical isolates which is located in the cyp51A gene.
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Affiliation(s)
- Sarla Naicker
- Department of Biotechnology and Food Science, Durban University of Technology, Durban 4000, Kwa-Zulu Natal, South Africa
| | - Viresh Mohanlall
- Department of Biotechnology and Food Science, Durban University of Technology, Durban 4000, Kwa-Zulu Natal, South Africa
| | - Sandile Ngubane
- Department of Biotechnology and Food Science, Durban University of Technology, Durban 4000, Kwa-Zulu Natal, South Africa
| | - John Mellem
- Department of Biotechnology and Food Science, Durban University of Technology, Durban 4000, Kwa-Zulu Natal, South Africa
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Heithoff DM, Barnes V L, Mahan SP, Fried JC, Fitzgibbons LN, House JK, Mahan MJ. Re-evaluation of FDA-approved antibiotics with increased diagnostic accuracy for assessment of antimicrobial resistance. Cell Rep Med 2023; 4:101023. [PMID: 37116500 PMCID: PMC10213814 DOI: 10.1016/j.xcrm.2023.101023] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/16/2023] [Accepted: 04/05/2023] [Indexed: 04/30/2023]
Abstract
Accurate assessment of antibiotic susceptibility is critical for treatment of antimicrobial resistant (AMR) infections. Here, we examine whether antimicrobial susceptibility testing in media more physiologically representative of in vivo conditions improves prediction of clinical outcome relative to standard bacteriologic medium. This analysis reveals that ∼15% of minimum inhibitory concentration (MIC) values obtained in physiologic media predicted a change in susceptibility that crossed a clinical breakpoint used to categorize patient isolates as susceptible or resistant. The activities of antibiotics having discrepant results in different media were evaluated in murine sepsis models. Testing in cell culture medium improves the accuracy by which MIC assays predict in vivo efficacy. This analysis identifies several antibiotics for treatment of AMR infections that standard testing failed to identify and those that are ineffective despite indicated use by standard testing. Methods with increased diagnostic accuracy mitigate the AMR crisis via utilizing existing agents and optimizing drug discovery.
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Affiliation(s)
- Douglas M Heithoff
- Department of Molecular, Cellular, and Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA 93106, USA; Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
| | - Lucien Barnes V
- Department of Molecular, Cellular, and Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA 93106, USA; Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
| | - Scott P Mahan
- Department of Molecular, Cellular, and Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA 93106, USA; Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA 93106, USA; Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Jeffrey C Fried
- Department of Medical Education, Santa Barbara Cottage Hospital, Santa Barbara, CA 93105, USA; Department of Pulmonary and Critical Care Medicine, Santa Barbara Cottage Hospital, Santa Barbara, CA 93105, USA
| | - Lynn N Fitzgibbons
- Department of Medical Education, Santa Barbara Cottage Hospital, Santa Barbara, CA 93105, USA; Division of Infectious Diseases, Santa Barbara Cottage Hospital, Santa Barbara, CA 93105, USA
| | - John K House
- Faculty of Science, School of Veterinary Science, The University of Sydney, Camden, NSW 2570, Australia.
| | - Michael J Mahan
- Department of Molecular, Cellular, and Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA 93106, USA; Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA 93106, USA.
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Llor C, Hoyos Mallecot Y, Moragas A, Troncoso-Mariño A, Bjerrum L, Villmones HC. New paradigms on antibiotic recommendations for community-acquired infections in Spain. Aten Primaria 2023; 55:102648. [PMID: 37167756 PMCID: PMC10188543 DOI: 10.1016/j.aprim.2023.102648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 05/13/2023] Open
Abstract
Over the last years, the susceptibility activity of the most common microorganisms causing community-acquired infections has significantly changed in Spain. Based on the susceptibility rates of Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, and Klebsiella pneumoniae collected from outpatients aged 15 or older with symptoms of respiratory or urinary tract infections in several Microbiology Departments in Catalonia in 2021, penicillin V should be first choice for most respiratory tract infections, amoxicillin and clavulanate for chronic obstructive pulmonary disease exacerbations and a single dose of fosfomycin or a short-course nitrofurantoin should remain first-line treatments for uncomplicated urinary tract infections. Updated information on antimicrobial resistance for general practitioners is crucial for achieving appropriate empirical management of the most common infections by promoting more rational antibiotic use.
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Affiliation(s)
- Carl Llor
- Primary Care Research Institute Jordi Gol (IDIAPJGol), Barcelona, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Spain; Department of Public Health, General Practice, University of Southern Denmark, Odense, Denmark
| | - Yannick Hoyos Mallecot
- Department of Microbiology, Vall d'Hebron University Hospital, Catalonian Institute of Health, Barcelona, Spain
| | - Ana Moragas
- Primary Care Research Institute Jordi Gol (IDIAPJGol), Barcelona, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Spain; University Rovira i Virgili, Jaume I Health Centre, Tarragona, Spain
| | | | - Lars Bjerrum
- Research Unit for General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - Heidi C Villmones
- Department of Microbiology, Vestfold Hospital Trust, Tønsberg, Norway.
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Salau HD, Orchard A, Stacey S, Varughese S, Johnston D, Khan R. Antibiotic usage in a South African paediatric medical ward following the introduction of an antibiotic prescription chart. Pan Afr Med J 2023; 45:26. [PMID: 37521765 PMCID: PMC10386539 DOI: 10.11604/pamj.2023.45.26.36548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 03/09/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction the global rise in antibiotic resistance (ABR), coupled with a dry pipeline for the discovery of new antibiotics requires the conservation of currently available antibiotics. Antimicrobial stewardship (AMS) interventions are being implemented to optimize antibiotic use including the use of antibiotic prescription charts. This study reviewed the use of antibiotics before and after the introduction of an antibiotic prescription chart in a paediatric medical ward of an academic tertiary hospital in Johannesburg. Methods a cross-sectional retrospective review of patient records was conducted for patients admitted to a paediatric medical ward of an academic tertiary hospital over two study periods; before and after the introduction of an antibiotic prescription chart. Data were captured on a Microsoft® Excel (2010) spreadsheet and analyzed using Stata/IC 15.1 (StataCorp, USA). Results antibiotic use decreased significantly by 7.04% following the introduction of the antibiotic prescription chart (p=0.027). Fields often left unfilled on the antibiotic prescription chart include age (100%), a record of renal function (GFR/CrCl) (97.46%), time of antibiotic prescribing (83.62%) and a record of culture and sensitivity results (80.17%). Conclusion the findings of this study show an improvement in antibiotic use, the frequency of culture and sensitivity testing and documentation of relevant parameters after the introduction of the antibiotic prescription chart. The use of an antibiotic prescription chart is a practical way to achieve optimal antibiotic use and to encourage proper detailing of the clinical components necessary for antibiotic selection in a hospital setting in a developing country.
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Affiliation(s)
- Habibat Dolapo Salau
- Department of Pharmacy and Pharmacology, University of the Witwatersrand, Johannesburg, South Africa
| | - Ané Orchard
- Department of Pharmacy and Pharmacology, University of the Witwatersrand, Johannesburg, South Africa
| | - Sarah Stacey
- Department of Internal Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Sheeba Varughese
- Department of Paediatric and Child Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Deanne Johnston
- Discipline of Pharmaceutical Sciences, University of KwaZulu Natal, Johannesburg, South Africa
| | - Razeeya Khan
- Department of Pharmacy and Pharmacology, University of the Witwatersrand, Johannesburg, South Africa
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Petrovic Fabijan A, Iredell J, Danis-Wlodarczyk K, Kebriaei R, Abedon ST. Translating phage therapy into the clinic: Recent accomplishments but continuing challenges. PLoS Biol 2023; 21:e3002119. [PMID: 37220114 PMCID: PMC10204993 DOI: 10.1371/journal.pbio.3002119] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Phage therapy is a medical form of biological control of bacterial infections, one that uses naturally occurring viruses, called bacteriophages or phages, as antibacterial agents. Pioneered over 100 years ago, phage therapy nonetheless is currently experiencing a resurgence in interest, with growing numbers of clinical case studies being published. This renewed enthusiasm is due in large part to phage therapy holding promise for providing safe and effective cures for bacterial infections that traditional antibiotics acting alone have been unable to clear. This Essay introduces basic phage biology, provides an outline of the long history of phage therapy, highlights some advantages of using phages as antibacterial agents, and provides an overview of recent phage therapy clinical successes. Although phage therapy has clear clinical potential, it faces biological, regulatory, and economic challenges to its further implementation and more mainstream acceptance.
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Affiliation(s)
- Aleksandra Petrovic Fabijan
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Westmead, New South Wales, Australia
- Faculty of Health and Medicine, School of Medicine, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Jonathan Iredell
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Westmead, New South Wales, Australia
- Faculty of Health and Medicine, School of Medicine, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Westmead Hospital, Western Sydney Local Health District, Westmead, New South Wales, Australia
| | - Katarzyna Danis-Wlodarczyk
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio, United States of America
| | - Razieh Kebriaei
- P3 Research Laboratory, College of Pharmacy, The Ohio State University, Columbus, Ohio, United States of America
| | - Stephen T. Abedon
- Department of Microbiology, The Ohio State University, Mansfield, Ohio, United States of America
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Mohamed N, Ghazal A, Ahmed AAH, Zaki A. Prevalence and determinants of antimicrobial resistance of pathogens isolated from cancer patients in an intensive care unit in Alexandria, Egypt. J Egypt Public Health Assoc 2023; 98:9. [PMID: 37121933 PMCID: PMC10149423 DOI: 10.1186/s42506-023-00134-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 03/24/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Infections caused by multidrug-resistant organisms (MDROs) are a globally increasing threat among critically ill patients, especially those with underlying malignancies. We aimed to assess the prevalence and susceptibility patterns of MDROs among cancer patients in intensive care units (ICU), and their predictors. METHODS Over 4 years, we retrospectively reviewed medical records of 497 malignancy patients in the ICU of a tertiary hospital in Alexandria, Egypt. The data for various factors, such as demographic characteristics, comorbidities, causative pathogen, and antimicrobial resistance (AMR), were collected and analyzed using univariate analysis. Logistic multivariate regression analysis was used to estimate the probability of developing MDROs among this population. RESULTS A total of 748 isolates were obtained from 1249 specimens. Gram-negative bacteria detected (459) comprised 61.4% of all isolates, while only 75 (10%) were gram-positive, and 214 (28.6%) were fungal pathogens. The most frequently encountered isolate was Klebsiella pneumoniae (n = 183), of which 107 were carbapenem-resistant (CR) and 62 were extended-spectrum beta-lactamase (ESBL)-producing. This was followed by Escherichia coli (n = 136), of which 17 were CR and 100 were ESBL-producing strains, while 3 were resistant to quinolones. Acinetobacter baumannii came in third (n = 67), with 63 being CR. The overall susceptibility of gram-negative bacteria was recorded as highest to colistin (97.3%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcal species among gram-positive bacteria were 54.6% and 33.3%, respectively, with no resistance reported to vancomycin or linezolid. Among the MDRO infection predictors were neutropenia, recent antibiotics use, and receiving chemotherapy. Neutropenia had the highest odds ratio (OR: 2.3, CI: 1.28-4.09), followed by recent antibiotics use (OR: 1.8, CI: 1.22-2.59). CONCLUSION Gram-negative bacilli were the most frequently reported MDROs, with resistance to higher generation cephalosporins and even carbapenems limiting antibiotic treatment options to older class antibiotics, such as colistin, with potential side effects, including nephrotoxicity. Estimating AMR probability using the prediction model of risk factors, such as neutropenia and previous antibiotics use, may be functional in the rapid identification of higher-risk patients.
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Affiliation(s)
- Nancy Mohamed
- Department of Bioinformatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt.
| | - Abeer Ghazal
- Department of Microbiology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Asmaa Abdel Hameed Ahmed
- Department of Bioinformatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Adel Zaki
- Department of Bioinformatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
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Huang S, Eze UA. Awareness and Knowledge of Antimicrobial Resistance, Antimicrobial Stewardship and Barriers to Implementing Antimicrobial Susceptibility Testing among Medical Laboratory Scientists in Nigeria: A Cross-Sectional Study. Antibiotics (Basel) 2023; 12:antibiotics12050815. [PMID: 37237717 DOI: 10.3390/antibiotics12050815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
Background: Antimicrobial resistance (AMR) is now considered one of the greatest global health threats. This is further compounded by a lack of new antibiotics in development. Antimicrobial stewardship programmes can improve and optimize the use of antibiotics, thereby increasing the cure rates of antibiotic treatment and decreasing the problem of AMR. In addition, diagnostic and antimicrobial stewardships in the pathology laboratories are useful tools to guide clinicians on patient treatment and to stop the inappropriate use of antibiotics in empirical treatment or narrow antibiotics. Medical Laboratory Scientists are at the forefront of performing antibiotics susceptibility testing in pathology laboratories, thereby helping clinicians to select the appropriate antibiotics for patients suffering from bacterial infections. Methods: This cross-sectional study surveyed personal antimicrobial usage, the knowledge and awareness on AMR, and antimicrobial stewardship, as well as barriers to antimicrobial susceptibility testing among medical laboratory scientists in Nigeria using pre-tested and validated questionnaires administered online. The raw data were summarized and exported in Microsoft Excel and further analyzed using IBM SPSS version 26. Results: Most of the respondents were males (72%) and 25-35 years old (60%). In addition, the BMLS degree was the highest education qualification most of the respondents (70%) achieved. Of the 59.2% of the respondents involved in antibiotics susceptibility testing, the disc diffusion method was the most commonly used (67.2%), followed by PCR/Genome-based detection (5.2%). Only a small percentage of respondents used the E-test (3.4%). The high cost of testing, inadequate laboratory infrastructure, and a lack of skilled personnel are the major barriers to performing antibiotics susceptibility testing. A higher proportion of a good AMR knowledge level was observed in male respondents (75%) than females (42.9%). The knowledge level was associated with the respondent's gender (p = 0.048), while respondents with a master's degree were more likely to possess a good knowledge level of AMR (OR: 1.69; 95% CI: 0.33, 8.61). Conclusion: The findings of this study indicate that Nigerian medical laboratory scientists had moderate awareness of AMR and antibiotic stewardship. It is necessary to increase investments in laboratory infrastructure and manpower training, as well as set up an antimicrobial stewardship programme to ensure widespread antibiotics susceptibility testing in hospitals, thereby decreasing empirical treatment and the misuse of antibiotics.
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Affiliation(s)
- Sheng Huang
- School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Ukpai A Eze
- Leicester School of Allied Health Sciences, Faculty of Health and Life Sciences, De Montfort University, Leicester LE1 9BH, UK
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Chen H, Li B, Shi S, Zhou T, Wang X, Wang Z, Zhou X, Wang M, Shi W, Ren L. Au-Fe 3O 4 nanozyme coupled with CRISPR-Cas12a for sensitive and visual antibiotic resistance diagnosing. Anal Chim Acta 2023; 1251:341014. [PMID: 36925313 DOI: 10.1016/j.aca.2023.341014] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/16/2023] [Accepted: 02/24/2023] [Indexed: 02/27/2023]
Abstract
The accumulation and spread of antibiotic resistance bacteria (ARB) in the environment may accelerate the formation of superbugs and seriously threaten the health of all living beings. The timeliness and accurate diagnosing of antibiotic resistance is essential to controlling the propagation of superbugs in the environment and formulating effective public health management programs. Herein, we developed a speedy, sensitive, accurate, and user-friendly colorimetric assay for antibiotic resistance, via a synergistic combination of the peroxidase-like property of the Au-Fe3O4 nanozyme and the specific gene identification capability of the CRISPR-Cas12a. Once the CRISPR-Cas12a system recognizes a target resistance gene, it activates its trans-cleavage activity and subsequently releases the Au-Fe3O4 nanozymes, which oxidizes the 3,3,5,5-tetramethylbenzidine (TMB) with color change from transparent to blue. The diagnosing signals could be captured and analyzed by a smartphone. This method detected kanamycin-resistance genes, ampicillin-resistance genes, and chloramphenicol-resistance genes by simple operation steps with high sensitivity (<0.1 CFU μL-1) and speediness (<1 h). This approach may prove easy for the accurate and sensitive diagnosis of the ARGs or ARB in the field, thus surveilling and controlling the microbial water quality flexibly and efficiently.
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Affiliation(s)
- Haoxiang Chen
- Department of Biomaterials, The Higher Educational Key Laboratory for Biomedical Engineering of Fujian Province, Research Center of Biomedical Engineering of Xiamen, College of Materials, Xiamen University, Xiamen, 361005, PR China
| | - Bangying Li
- School of Pharmaceutical Sciences, Xiamen University, Xiamen, 361102, PR China
| | - Shangyi Shi
- State Key Laboratory of Computer Architecture, Institute of Computing Technology, Chinese Academy of Sciences, Beijing, 100190, PR China; School of Computer Science and Technology, University of Chinese Academy of Sciences, Beijing, 100049, PR China
| | - Tao Zhou
- Department of Biomaterials, The Higher Educational Key Laboratory for Biomedical Engineering of Fujian Province, Research Center of Biomedical Engineering of Xiamen, College of Materials, Xiamen University, Xiamen, 361005, PR China
| | - Xiumin Wang
- School of Pharmaceutical Sciences, Xiamen University, Xiamen, 361102, PR China
| | - Zuyong Wang
- College of Materials Science and Engineering, Hunan University, Changsha, 410072, PR China
| | - Xi Zhou
- Department of Biomaterials, The Higher Educational Key Laboratory for Biomedical Engineering of Fujian Province, Research Center of Biomedical Engineering of Xiamen, College of Materials, Xiamen University, Xiamen, 361005, PR China
| | - Miao Wang
- Department of Biomaterials, The Higher Educational Key Laboratory for Biomedical Engineering of Fujian Province, Research Center of Biomedical Engineering of Xiamen, College of Materials, Xiamen University, Xiamen, 361005, PR China
| | - Wei Shi
- Department of Biomaterials, The Higher Educational Key Laboratory for Biomedical Engineering of Fujian Province, Research Center of Biomedical Engineering of Xiamen, College of Materials, Xiamen University, Xiamen, 361005, PR China.
| | - Lei Ren
- Department of Biomaterials, The Higher Educational Key Laboratory for Biomedical Engineering of Fujian Province, Research Center of Biomedical Engineering of Xiamen, College of Materials, Xiamen University, Xiamen, 361005, PR China; State Key Lab of Physical Chemistry of Solid Surfaces, Xiamen University, Xiamen, 361005, PR China.
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