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Behzadi P, Baráth Z, Gajdács M. It's Not Easy Being Green: A Narrative Review on the Microbiology, Virulence and Therapeutic Prospects of Multidrug-Resistant Pseudomonas aeruginosa. Antibiotics (Basel) 2021; 10:42. [PMID: 33406652 PMCID: PMC7823828 DOI: 10.3390/antibiotics10010042] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 12/11/2022] Open
Abstract
Pseudomonas aeruginosa is the most frequent cause of infection among non-fermenting Gram-negative bacteria, predominantly affecting immunocompromised patients, but its pathogenic role should not be disregarded in immunocompetent patients. These pathogens present a concerning therapeutic challenge to clinicians, both in community and in hospital settings, due to their increasing prevalence of resistance, and this may lead to prolonged therapy, sequelae, and excess mortality in the affected patient population. The resistance mechanisms of P. aeruginosa may be classified into intrinsic and acquired resistance mechanisms. These mechanisms lead to occurrence of resistant strains against important antibiotics-relevant in the treatment of P. aeruginosa infections-such as β-lactams, quinolones, aminoglycosides, and colistin. The occurrence of a specific resistotype of P. aeruginosa, namely the emergence of carbapenem-resistant but cephalosporin-susceptible (Car-R/Ceph-S) strains, has received substantial attention from clinical microbiologists and infection control specialists; nevertheless, the available literature on this topic is still scarce. The aim of this present review paper is to provide a concise summary on the adaptability, virulence, and antibiotic resistance of P. aeruginosa to a readership of basic scientists and clinicians.
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Affiliation(s)
- Payam Behzadi
- Department of Microbiology, College of Basic Sciences, Shahr-e-Qods Branch, Islamic Azad University, Tehran 37541-374, Iran;
| | - Zoltán Baráth
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 62-64, 6720 Szeged, Hungary;
| | - Márió Gajdács
- Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Hungary
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202
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Aksomaitiene J, Novoslavskij A, Kudirkiene E, Gabinaitiene A, Malakauskas M. Whole Genome Sequence-Based Prediction of Resistance Determinants in High-Level Multidrug-Resistant Campylobacter jejuni Isolates in Lithuania. Microorganisms 2020; 9:E66. [PMID: 33383765 PMCID: PMC7823968 DOI: 10.3390/microorganisms9010066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/19/2020] [Accepted: 12/24/2020] [Indexed: 12/23/2022] Open
Abstract
Spread of antibiotic resistance via mobile genetic elements associates with transfer of genes providing resistance against multiple antibiotics. Use of various comparative genomics analysis techniques enables to find intrinsic and acquired genes associated with phenotypic antimicrobial resistance (AMR) in Campylobacter jejuni genome sequences with exceptionally high-level multidrug resistance. In this study, we used whole genome sequences of seven C. jejuni to identify isolate-specific genomic features associated with resistance and virulence determinants and their role in multidrug resistance (MDR). All isolates were phenotypically highly resistant to tetracycline, ciprofloxacin, and ceftriaxone (MIC range from 64 to ≥256 µg/mL). Besides, two C. jejuni isolates were resistant to gentamicin, and one was resistant to erythromycin. The extensive drug-resistance profiles were confirmed for the two C. jejuni isolates assigned to ST-4447 (CC179). The most occurring genetic antimicrobial-resistance determinants were tetO, beta-lactamase, and multidrug efflux pumps. In this study, mobile genetic elements (MGEs) were detected in genomic islands carrying genes that confer resistance to MDR, underline their importance for disseminating antibiotic resistance in C. jejuni. The genomic approach showed a diverse distribution of virulence markers, including both plasmids and phage sequences that serve as horizontal gene transfer tools. The study findings describe in silico prediction of AMR and virulence genetics determinants combined with phenotypic AMR detection in multidrug-resistant C. jejuni isolates from Lithuania.
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Affiliation(s)
- Jurgita Aksomaitiene
- Department of Food Safety and Quality, Faculty of Veterinary Medicine, Veterinary Academy, Lithuanian University of Health Sciences, Tilzes str. 18, LT 47181 Kaunas, Lithuania; (A.N.); (A.G.); (M.M.)
| | - Aleksandr Novoslavskij
- Department of Food Safety and Quality, Faculty of Veterinary Medicine, Veterinary Academy, Lithuanian University of Health Sciences, Tilzes str. 18, LT 47181 Kaunas, Lithuania; (A.N.); (A.G.); (M.M.)
| | - Egle Kudirkiene
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Stigbøjlen 4, 1870 Frederiksberg C, Denmark;
| | - Ausra Gabinaitiene
- Department of Food Safety and Quality, Faculty of Veterinary Medicine, Veterinary Academy, Lithuanian University of Health Sciences, Tilzes str. 18, LT 47181 Kaunas, Lithuania; (A.N.); (A.G.); (M.M.)
| | - Mindaugas Malakauskas
- Department of Food Safety and Quality, Faculty of Veterinary Medicine, Veterinary Academy, Lithuanian University of Health Sciences, Tilzes str. 18, LT 47181 Kaunas, Lithuania; (A.N.); (A.G.); (M.M.)
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203
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Xu Q, Pan F, Sun Y, Wang C, Shi Y, Zhang T, Yu F, Zhang H. Fecal Carriage and Molecular Epidemiology of Carbapenem-Resistant Enterobacteriaceae from Inpatient Children in a Pediatric Hospital of Shanghai. Infect Drug Resist 2020; 13:4405-4415. [PMID: 33328745 PMCID: PMC7735787 DOI: 10.2147/idr.s275549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/12/2020] [Indexed: 12/23/2022] Open
Abstract
Purpose To determine the epidemiology characteristics of intestinal colonization of carbapenem-resistant Enterobacteriaceae (CRE) among inpatients in a pediatric hospital in China. Methods A retrospective study was conducted from April to December 2019. Medical records were reviewed to extract the clinical information. Antimicrobial susceptibility was performed by broth microdilution method. Drug resistance determinants and plasmid types were analyzed using polymerase chain reaction (PCR) assays. Multilocus sequence typing (MLST) and Enterobacterial repetitive intergenic consensus sequences PCR (ERIC-PCR) were employed to determine the genetic relationships between strains. Results A total of 90 CRE strains were isolated, with a fecal carriage rate of 8.6% (90/1052), and mainly distributed in E. aerogenes (n=30), K. pneumoniae (n=25) and E. coli (n=23). More than 50% of CRE colonizers had a history of invasive procedures and antibiotic exposures. As high as 91.1% (82/90) of CRE isolates carried carbapenemase genes, with blaNDM-5 (n=56) being the most common, and mainly found in E. aerogenes (51.8%, 29/56) and E. coli (32.1%, 18/56) isolates, which primarily belonged to ST4 (100%, 29/29) and ST692 (55.6%, 10/18), respectively. Followed by blaKPC-2 (n=12), and all found in K. pneumoniae ST11 isolates. Other carbapenemase genes including blaNDM-1, blaIMP-4 and blaIMP-26. Meanwhile, ESBL genes (blaCTX-M, blaTEM-1 and blaSHV) and AmpC genes (blaDHA-1 and blaEBC) were also detected. All CRE isolates showed high resistance to cephalosporins and carbapenemases (97.8%-100.0%) but remained susceptible to tigecycline (98.9%). IncX3 was a major plasmid type in NDM-containing strains (91.3%), and 91.7% of KPC-2-producing K. pneumoniae harboring IncFII and IncFIB plasmids. The ERIC-PCR revealed that several strains with identical STs were genetically similar. Conclusion This study revealed a major intestinal colonization of ST4 NDM-5 E. aerogenes, ST11 KPC-2 K. pneumoniae and ST692 NDM-5 E. coli strains among inpatients in a pediatric hospital. Infection control measures should be implemented immediately to prevent the spread of these strains in clinical settings.
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Affiliation(s)
- Qi Xu
- Department of Clinical Laboratory, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Fen Pan
- Department of Clinical Laboratory, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Yan Sun
- Department of Clinical Laboratory, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Chun Wang
- Department of Clinical Laboratory, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Yingying Shi
- Department of Clinical Laboratory, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Tiandong Zhang
- Department of Clinical Laboratory, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Fangyuan Yu
- Department of Clinical Laboratory, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Hong Zhang
- Department of Clinical Laboratory, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China
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204
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Laser-Irradiated Chlorpromazine as a Potent Anti-Biofilm Agent for Coating of Biomedical Devices. COATINGS 2020. [DOI: 10.3390/coatings10121230] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nowadays, antibiotic resistance has become increasingly common, triggering a global health crisis, immediately needing alternative, including repurposed drugs with potent bactericidal effects. We demonstrated that chlorpromazine aqueous solutions exposed to laser radiation exhibited visible activity against various microorganisms. The aim of this study was to investigate the quantitative antimicrobial activity of chlorpromazine in non-irradiated and 4-h laser irradiated form. Also, we examined the effect of both solutions impregnated on a cotton patch, cannula, and urinary catheter against Gram-positive Staphylococcus aureus and Gram-negative Pseudomonas aeruginosa and Escherichia coli. In all experimental versions, the chlorpromazine antimicrobial activity was enhanced by laser exposure. Besides the experimental results, the in silico analyses using molecular docking proved that the improved antimicrobial activity of the irradiated compound was a result of the combined action of the photoproducts on the biological target (s). Our results show that laser radiation could alter the molecular structure of various drugs and their effects, proving to be a promising strategy to halt antibiotic resistance, by repurposing current medicines for new antimicrobial strategies, thereby decreasing the costs and time for the development of more efficient drugs.
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205
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Singh SR, Mao B, Evdokimov K, Tan P, Leab P, Ong R, Vonthanak S, Tam CC, Hsu LY, Turner P. Prevalence of MDR organism (MDRO) carriage in children and their household members in Siem Reap Province, Cambodia. JAC Antimicrob Resist 2020; 2:dlaa097. [PMID: 34223049 PMCID: PMC8210010 DOI: 10.1093/jacamr/dlaa097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/06/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The rising incidence of infections caused by MDR organisms (MDROs) poses a significant public health threat. However, little has been reported regarding community MDRO carriage in low- and middle-income countries. METHODS We conducted a cross-sectional study in Siem Reap, Cambodia comparing hospital-associated households, in which an index child (age: 2-14 years) had been hospitalized for at least 48 h in the preceding 2-4 weeks, with matched community households on the same street, in which no other child had a recent history of hospitalization. Participants were interviewed using a survey questionnaire and tested for carriage of MRSA, ESBL-producing Enterobacterales (ESBL-E) and carbapenemase-producing Enterobacterales (CPE) by culture followed by antibiotic susceptibility testing. We used logistic regression analysis to analyse associations between collected variables and MDRO carriage. RESULTS Forty-two pairs of households including 376 participants with 376 nasal swabs and 290 stool specimens were included in final analysis. MRSA was isolated from 26 specimens (6.9%). ESBL-producing Escherichia coli was detected in 269 specimens (92.8%) whereas ESBL-producing Klebsiella pneumoniae was isolated from 128 specimens (44.1%), of which 123 (42.4%) were co-colonized with ESBL-producing E. coli. Six (2.1%) specimens tested positive for CPE (4 E. coli and 2 K. pneumoniae). The prevalence ratios for MRSA, ESBL-producing E. coli and ESBL-producing K. pneumoniae carriage did not differ significantly in hospital-associated households and hospitalized children compared with their counterparts. CONCLUSIONS The high prevalence of ESBL-E across both household types suggests that MDRO reservoirs are common in the community. Ongoing genomic analyses will help to understand the epidemiology and course of MDRO spread.
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Affiliation(s)
- Shweta R Singh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Bunsoth Mao
- University of Health Sciences, Phnom Penh, Cambodia
| | - Konstantin Evdokimov
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Pisey Tan
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - Phana Leab
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - Rick Ong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Clarence C Tam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Paul Turner
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
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206
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Microbial Predominance and Antimicrobial Resistance in a Tertiary Hospital in Northwest China: A Six-Year Retrospective Study of Outpatients and Patients Visiting the Emergency Department. ACTA ACUST UNITED AC 2020; 2020:8838447. [PMID: 33312315 PMCID: PMC7719506 DOI: 10.1155/2020/8838447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/28/2020] [Indexed: 11/18/2022]
Abstract
Background With the wide use of antibiotics, antimicrobial resistance becomes a serious issue. Timely understanding of microbial pathogen profiles and the change of antimicrobial resistance provide an important guidance for effective and optimized use of antibiotics in local healthcare systems. The aim was to investigate the characteristics of microbial species and their antimicrobial resistances in a tertiary hospital with an Emergency Department and outpatient clinics for a period of six years. Methodology. A retrospective study was conducted using the HIS database of a tertiary hospital between 2013 and 2018. Antimicrobial susceptibility was tested by automated systems and/or the Kirby-Bauer disc diffusion method. The data were analyzed using the WHONET 5.6 software. The Cochran-Armitage test was used to study the trends over the period of research. Results In a total of 19,028 specimens submitted for microbial tests during the period from 49 units of the hospital, only the samples from the Emergency Department and Kidney Transplantation Clinic showed an annually significant increase (P < 0.001). More than 200 species with 46.4% gram-positive cocci and 45.3% gram-negative bacilli were identified in the 3,849 nonrepetitive isolates. The methicillin-resistant S. aureus and S. epidermidis rates were 25.1% and 74.6%, respectively. 60.9% E. coli and 33.5% K. pneumonia samples carried extended-spectrum-β-lactamase. All Staphylococci and Enterococci samples were not resistant to linezolid, vancomycin, and tigecycline. In addition, only 0.01% E. coli, 1.1% K. pneumonia, and 18.7% P. aeruginosa isolates showed resistance to carbapenems. Conclusions Vancomycin, linezolid and tigecycline were the most effective antibiotics for outpatients with gram-positive infection. Carbapenems were the most effective antibiotics for gram-negative infection. There was no significant annual increase of common multidrug resistances.
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207
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Albukhaty S, Al-Bayati L, Al-Karagoly H, Al-Musawi S. Preparation and characterization of titanium dioxide nanoparticles and in vitro investigation of their cytotoxicity and antibacterial activity against Staphylococcus aureus and Escherichia coli. Anim Biotechnol 2020; 33:864-870. [PMID: 33251937 DOI: 10.1080/10495398.2020.1842751] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Titanium dioxide nanoparticles (TiO2 NPs) are photo-active metallic nanoparticles becoming promising agents in modern biomedical applications. Herein, a novel process for the synthesis of TiO2 NPs with high stability was developed by a sol-gel process and to investigate their cytotoxicity and antibacterial activity. Numerous experiments have been performed to confirm the morphologies, compositions, and physicochemical properties of prepared TiO2 NPs, such as field emission scanning electron microscopy, dynamic light scattering, Zeta potential, Fourier transform infrared spectroscopy and X-ray diffraction. MTT assay was applied to assess the cytotoxicity of the prepared nanoparticles. The results indicate that the synthesized nanoparticles' diameter is about 68 nm and contains the anatase phase, in the range of 2θ from 25 to 80 °C. The hydrodynamic radius of nanoparticles is about 140.4 nm, and the zeta potential of nanoparticles is about -44.6 mV. The MTT results have not shown any toxicity; the antibacterial inhibitory effect of TiO2 NPs at 200 mg/mL concentrations exhibited superior antibacterial activity at 15.9 ± 0.1, 14.0 ± 0.1 against Staphylococcus aureus and Escherichia coli, respectively. In conclusion, colloidal solutions with high stability were successfully synthesized, contributing to decreased dimensions and increased antibacterial properties.
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Affiliation(s)
- Salim Albukhaty
- Department of Basic Sciences, University of Misan, Maysan, Iraq
| | - L Al-Bayati
- Department of Microbiology, Faculty of Medicine, University of Wassit, Wassit, Iraq
| | - H Al-Karagoly
- Department of Internal and Preventive Medicine, Veterinary Medicine College, University of Al-Qadisiyah, Diwaniyah, Iraq
| | - S Al-Musawi
- Sharafaldin Al-Musawi, Faculty of Biotechnology, Al Qasim Green University, Babylon, Iraq
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208
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Hoseini-Alfatemi SM, Fallah F, Armin S, Hafizi M, Karimi A, Kalanaky S. Evaluation of Blood and Liver Cytotoxicity and Apoptosis-necrosis Induced by Nanochelating Based Silver Nanoparticles in Mouse Model. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2020; 19:207-218. [PMID: 33224226 DOI: 10.22037/ijpr.2020.1101026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study aimed to evaluate the in-vitro and in-vivo biological activities of newly synthesized nanochelating based silver nanoparticles (AgNPs) in mouse model. Nanochelating technology was used to design and synthesize the AgNPs. The animals studies were including the lethal dose (LD50) determination by the intraperitoneal administration in mice, and determination of liver enzymes levels and hematological parameters. Flow cytometry analysis was used to quantitatively determine apoptosis and necrotic cells in-vitro. The NPs A and NPs B have LD50 = 250 mg/kg and LD50 = 350 mg/kg, respectively and classified as non-toxic. In general, minor alterations were observed in levels of liver enzymes as indicative of liver damage. For blood parameters several factors associated with significant changes in AgNPs treated animals. Regarding animals weight, combination therapy showed more effective to maintain animals weight losses after infection. Flow cytometry results showed that AgNPs induced cell apoptosis-necrosis depends on AgNP size, concentration and exposure time. Cells damage due to AgNPs (A) with lower size (20-25 nm) were relatively more than cells exposed to AgNPs (B) (30-35 nm). The findings support the potent antibacterial activities of nanochelating based AgNPs. Also, the present study showed that nanochelating based AgNPs induce a moderate level of apoptosis/necrosis in mice, and affected several clinical parameters like blood parameters, liver enzymes, and body weight with no definite signs of toxicity.
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Affiliation(s)
- Seyedeh Mahsan Hoseini-Alfatemi
- Pediatric Infections Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Fallah
- Pediatric Infections Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahnaz Armin
- Pediatric Infections Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Hafizi
- Cancer Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran.,Department of Research and Development, Sodour Ahrar Shargh Company, Tehran, Iran
| | - Abdollah Karimi
- Pediatric Infections Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Kalanaky
- Department of Research and Development, Sodour Ahrar Shargh Company, Tehran, Iran
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209
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Rossato AM, Primon-Barros M, Rocha LDL, Reiter KC, Dias CAG, d’Azevedo PA. Resistance profile to antimicrobials agents in methicillin-resistant Staphylococcus aureus isolated from hospitals in South Brazil between 2014-2019. Rev Soc Bras Med Trop 2020; 53:e20200431. [PMID: 33174961 PMCID: PMC7670760 DOI: 10.1590/0037-8682-0431-2020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 08/12/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Methicillin-resistant Staphylococcus aureus (MRSA) is a common pathogen causing healthcare-associated infections. Owing to the restricted use of beta-lactams in MRSA infections, non-beta-lactam antimicrobials are required for treatment. However, MRSA can develop resistance mechanisms to non-beta-lactam antimicrobials, which reduces viable treatment options. Here, we evaluated the antimicrobial susceptibility and resistance genes of MRSA isolated from hospitalized patients in South Brazil. METHODS The antimicrobial susceptibilities of hospital MRSA (217) isolates were determined by disk diffusion or microdilution methods. Additionally, the presence of 14 resistance genes and SCCmec typing was performed by PCR. RESULTS Among the antimicrobials tested, we observed high erythromycin (74.2%), ciprofloxacin (64.5%), and clindamycin (46.1%) resistance rates and complete susceptibility to linezolid and vancomycin. Seventeen different patterns of MRSA antimicrobial resistance were observed, of which 42.9% represented multidrug resistance. Among erythromycin-resistant MRSA, 53.4%, 45.3%, 37.9%, 13.0%, and 6.8% carried ermA, msrA, msrB, ermC, and ermB genes, respectively. Among clindamycin-resistant MRSA, 83%, 17%, 10%, 4%, and 2% carried ermA, ermC, ermB, linA, and linB genes, respectively. Among gentamicin-resistant MRSA, 96.8%, 83.9%, and 9.7% carried aac(6')/aph(2''), aph(3')-IIIa, and ant(4')-Ia genes, respectively. Among tetracycline-resistant MRSA, 6.5% and 93.5% carried tetK and tetM genes, respectively. Lastly, among trimethoprim/sulfamethoxazole-resistant MRSA, 13.3% and 100% carried dfrA and dfrG genes, respectively. The SCCmec type IV isolates were detected more frequently, whereas the SCCmec type III isolates exhibited higher multidrug resistance. CONCLUSIONS The study data provides information regarding the MRSA resistance profile in South Brazil that is associated with the clinical conditions of patients and can contribute to clinical decision-making.
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Affiliation(s)
- Adriana Medianeira Rossato
- Universidade Federal de Ciências da Saúde de Porto Alegre,
Programa de Pós-graduação em Ciências da Saúde, Porto Alegre, RS, Brasil
| | - Muriel Primon-Barros
- Universidade Federal de Ciências da Saúde de Porto Alegre,
Programa de Pós-graduação em Ciências da Saúde, Porto Alegre, RS, Brasil
| | - Lisiane da Luz Rocha
- Universidade Federal de Ciências da Saúde de Porto Alegre,
Programa de Pós-graduação em Ciências da Saúde, Porto Alegre, RS, Brasil
| | - Keli Cristine Reiter
- Universidade Federal de Ciências da Saúde de Porto Alegre,
Programa de Pós-graduação em Ciências da Saúde, Porto Alegre, RS, Brasil
| | - Cícero Armídio Gomes Dias
- Universidade Federal de Ciências da Saúde de Porto Alegre,
Programa de Pós-graduação em Ciências da Saúde, Porto Alegre, RS, Brasil
| | - Pedro Alves d’Azevedo
- Universidade Federal de Ciências da Saúde de Porto Alegre,
Programa de Pós-graduação em Ciências da Saúde, Porto Alegre, RS, Brasil
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210
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Isolation and Characterization of Multidrug-Resistant Escherichia coli and Salmonella spp. from Healthy and Diseased Turkeys. Antibiotics (Basel) 2020; 9:antibiotics9110770. [PMID: 33147736 PMCID: PMC7692380 DOI: 10.3390/antibiotics9110770] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/21/2020] [Accepted: 10/25/2020] [Indexed: 12/11/2022] Open
Abstract
Diseases caused by Escherichia coli (E. coli) and Salmonella spp. can negatively impact turkey farming. The aim of this study was to isolate and characterize multidrug-resistant (MDR) E. coli and Salmonella spp. in healthy and diseased turkeys. A total of 30 fecal samples from healthy turkeys and 25 intestinal samples from diseased turkeys that died of enteritis were collected. Bacterial isolation and identification were based on biochemical properties and polymerase chain reaction (PCR). Antibiogram profiles were determined by disk diffusion. The tetracycline-resistance gene tetA was detected by PCR. All samples were positive for E. coli. Only 11 samples (11/30; 36.67%) were positive for Salmonella spp. from healthy turkeys, whereas 16 (16/25; 64%) samples were positive for Salmonella spp. from diseased turkeys. E. coli isolated from diseased turkeys showed higher resistance to levofloxacin, gentamicin, chloramphenicol, ciprofloxacin, streptomycin, and tetracycline. Salmonella spp. isolated from healthy turkeys exhibited higher resistance to gentamicin, chloramphenicol, ciprofloxacin, streptomycin, imipenem, and meropenem. All E. coli and Salmonella spp. from both healthy and diseased turkeys were resistant to erythromycin. Salmonella spp. from both healthy and diseased turkeys were resistant to tetracycline. Multidrug resistance was observed in both E. coli and Salmonella spp. from diseased turkeys. Finally, the tetA gene was detected in 93.1% of the E. coli isolates and in 92.59% of the Salmonella spp. isolates. To the best of our knowledge, this is the first study to isolate and characterize tetA-gene-containing MDR E. coli and Salmonella spp. from healthy and diseased turkeys in Bangladesh. Both microorganisms are of zoonotic significance and represent a significant public health challenge.
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211
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Membrane-Targeting Triphenylphosphonium Functionalized Ciprofloxacin for Methicillin-Resistant Staphylococcus aureus (MRSA). Antibiotics (Basel) 2020; 9:antibiotics9110758. [PMID: 33143023 PMCID: PMC7693559 DOI: 10.3390/antibiotics9110758] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 10/21/2020] [Accepted: 10/28/2020] [Indexed: 01/08/2023] Open
Abstract
Multidrug-resistant (MDR) bacteria have become a severe problem for public health. Developing new antibiotics for MDR bacteria is difficult, from inception to the clinically approved stage. Here, we have used a new approach, modification of an antibiotic, ciprofloxacin (CFX), with triphenylphosphonium (TPP, PPh3) moiety via ester- (CFX-ester-PPh3) and amide-coupling (CFX-amide-PPh3) to target bacterial membranes. In this study, we have evaluated the antibacterial activities of CFX and its derivatives against 16 species of bacteria, including MDR bacteria, using minimum inhibitory concentration (MIC) assay, morphological monitoring, and expression of resistance-related genes. TPP-conjugated CFX, CFX-ester-PPh3, and CFX-amide-PPh3 showed significantly improved antibacterial activity against Gram-positive bacteria, Staphylococcus aureus, including MDR S. aureus (methicillin-resistant S. aureus (MRSA)) strains. The MRSA ST5 5016 strain showed high antibacterial activity, with MIC values of 11.12 µg/mL for CFX-ester-PPh3 and 2.78 µg/mL for CFX-amide-PPh3. The CFX derivatives inhibited biofilm formation in MRSA by more than 74.9% of CFX-amide-PPh3. In the sub-MIC, CFX derivatives induced significant morphological changes in MRSA, including irregular deformation and membrane disruption, accompanied by a decrease in the level of resistance-related gene expression. With these promising results, this method is very likely to combat MDR bacteria through a simple TPP moiety modification of known antibiotics, which can be readily prepared at clinical sites.
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212
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The Mobile Colistin Resistance Gene, mcr-1.1, Is Carried on IncX4 Plasmids in Multidrug Resistant E. coli Isolated from Rainbow Trout Aquaculture. Microorganisms 2020; 8:microorganisms8111636. [PMID: 33113918 PMCID: PMC7690709 DOI: 10.3390/microorganisms8111636] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/13/2020] [Accepted: 10/21/2020] [Indexed: 12/22/2022] Open
Abstract
Colistin, a last resort antibiotic, is important for controlling infections with carbapenem-resistant Enterobacteriaceae. The recent emergence of mobile-colistin-resistance (mcr) genes has threatened the effectiveness of colistin. Aquaculture is hypothesized to be a major contributor to the evolution and dissemination of mcr. However, data on mcr in aquaculture are limited. Here, the occurrence of mcr-1 was assessed in Rainbow Trout in Lebanon, a country with developing antimicrobial stewardship and an established use of colistin for medical and farming purposes. mcr-1 was detected in 5 Escherichia coli isolated from fish guts. The isolates were classified as multidrug-resistant and their colistin minimum inhibitory concentration ranged between 16 and 32 μg/mL. Whole genome sequencing analysis showed that mcr-1 was carried on transmissible IncX4 plasmids and that the isolates harbored more than 14 antibiotic resistance genes. The isolates belonged to ST48 and ST101, which have been associated with mcr and can occur in humans and fish. The mcr-1-positive E. coli persisted in 6-day biofilms, but there was a potential fitness cost. Given the status of infrastructure in Lebanon, there is a high potential for the dissemination of mcr via aquatic environments. Urgent actions are needed to control mcr and to enhance antimicrobial stewardship in Lebanon.
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213
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Garzón V, Bustos RH, G. Pinacho D. Personalized Medicine for Antibiotics: The Role of Nanobiosensors in Therapeutic Drug Monitoring. J Pers Med 2020; 10:E147. [PMID: 32993004 PMCID: PMC7712907 DOI: 10.3390/jpm10040147] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 01/01/2023] Open
Abstract
Due to the high bacterial resistance to antibiotics (AB), it has become necessary to adjust the dose aimed at personalized medicine by means of therapeutic drug monitoring (TDM). TDM is a fundamental tool for measuring the concentration of drugs that have a limited or highly toxic dose in different body fluids, such as blood, plasma, serum, and urine, among others. Using different techniques that allow for the pharmacokinetic (PK) and pharmacodynamic (PD) analysis of the drug, TDM can reduce the risks inherent in treatment. Among these techniques, nanotechnology focused on biosensors, which are relevant due to their versatility, sensitivity, specificity, and low cost. They provide results in real time, using an element for biological recognition coupled to a signal transducer. This review describes recent advances in the quantification of AB using biosensors with a focus on TDM as a fundamental aspect of personalized medicine.
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Affiliation(s)
- Vivian Garzón
- PhD Biosciences Program, Universidad de La Sabana, Chía 140013, Colombia;
| | - Rosa-Helena Bustos
- Therapeutical Evidence Group, Clinical Pharmacology, Universidad de La Sabana, Chía 140013, Colombia;
| | - Daniel G. Pinacho
- Therapeutical Evidence Group, Clinical Pharmacology, Universidad de La Sabana, Chía 140013, Colombia;
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214
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Stefanini I, Boni M, Silvaplana P, Lovera P, Pelassa S, De Renzi G, Mognetti B. Antimicrobial Resistance, an Update from the Ward: Increased Incidence of New Potential Pathogens and Site of Infection-Specific Antibacterial Resistances. Antibiotics (Basel) 2020; 9:antibiotics9090631. [PMID: 32971788 PMCID: PMC7558927 DOI: 10.3390/antibiotics9090631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/14/2020] [Accepted: 09/20/2020] [Indexed: 12/12/2022] Open
Abstract
In order to monitor the spread of antimicrobial resistance, the European Union requires hospitals to be equipped with infection control centers. With this aim, we analyzed 1583 bacterial strains isolated from samples of different origin from patients with community-onset and nosocomial infections in a public tertiary University Hospital on the outskirts of Turin, Italy. Statistical analyses of the isolates (source, type) and their antimicrobial resistance (AMR) were performed. The survey revealed infections associated with bacterial species considered as not-commensal and not-pathogenic, hence potentially emerging as new threats for human health. Conversely to the general observation of nosocomial strains being more resistant to antibiotics compared to community-acquired strains, nosocomial strains isolated in this study were more resistant only to 1/42 tested antibiotics (tetracycline). By adopting an ecological approach, we observed that blood infections are associated with the broadest range of species compared to infections affecting other areas and we obtained clear indications on the antibiotics that should be preferred in the treatment of infections at specific body sites. Future investigations carried out on a larger geographical scale will clarify whether these indications are limited to the geographical region investigated over this study, or whether the same trends are visible at national or international level.
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Affiliation(s)
- Irene Stefanini
- Department of Life Sciences and Systems Biology, University of Turin, Via Accademia Albertina 13, 10123 Turin, Italy; (I.S.); (M.B.)
| | - Martina Boni
- Department of Life Sciences and Systems Biology, University of Turin, Via Accademia Albertina 13, 10123 Turin, Italy; (I.S.); (M.B.)
| | - Paola Silvaplana
- Infectious Risk Prevention Unit, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Orbassano, 10043 Turin, Italy; (P.S.); (P.L.); (S.P.)
| | - Paola Lovera
- Infectious Risk Prevention Unit, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Orbassano, 10043 Turin, Italy; (P.S.); (P.L.); (S.P.)
| | - Stefania Pelassa
- Infectious Risk Prevention Unit, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Orbassano, 10043 Turin, Italy; (P.S.); (P.L.); (S.P.)
| | - Giuseppe De Renzi
- SCDO Laboratory of Clinical Pathology and Microbiology, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Orbassano, 10043 Turin, Italy;
| | - Barbara Mognetti
- Department of Life Sciences and Systems Biology, University of Turin, Via Accademia Albertina 13, 10123 Turin, Italy; (I.S.); (M.B.)
- Correspondence: ; Tel.: +39-0116704518
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215
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Benkő R, Gajdács M, Matuz M, Bodó G, Lázár A, Hajdú E, Papfalvi E, Hannauer P, Erdélyi P, Pető Z. Prevalence and Antibiotic Resistance of ESKAPE Pathogens Isolated in the Emergency Department of a Tertiary Care Teaching Hospital in Hungary: A 5-Year Retrospective Survey. Antibiotics (Basel) 2020; 9:antibiotics9090624. [PMID: 32961770 PMCID: PMC7560131 DOI: 10.3390/antibiotics9090624] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/13/2020] [Accepted: 09/17/2020] [Indexed: 12/20/2022] Open
Abstract
Antibiotic treatments initiated on Emergency Departments (ED) are empirical. Therefore, knowledge of local susceptibility patterns is important. Despite this, data on expected pathogens and their resistance profile are scarce from EDs internationally. The study aim was to assess the epidemiology and resistance patterns of bacterial isolates from a tertiary-care ED over 5 years, focusing on ESKAPE bacteria (including the Enterobacterales group). After removal of duplicates, n = 6887 individual bacterial isolates were recovered, out of which n = 4974 (72.22%) were ESKAPE isolates. E. coli was the most frequent isolate (2193, 44.1%), followed by the Klebsiella genus (664; 13.4%). The third most frequent isolate was S. aureus (561, 11.3%). In total, multi-drug resistance (MDR) was present in 23.8% and was most prevalent in A. baumanii (65.5%), P. mirabilis (42.7%), and K. pneumoniae (32.6%). MRSA was isolated in 19.6%, while ESBL-producing Enterobacterales in 17.7%, and these were associated with remarkably higher resistance to other antibacterials as well. Difficult-to-treat resistance (DTR) was detected in 0.5%. The frequent isolation of some ESKAPE bacteria and the detected considerable acquired resistance among ED patients raise concern. The revealed data identified problematic pathogens and will guide us to set up the optimal empiric antibiotic protocol for clinicians.
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Affiliation(s)
- Ria Benkő
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, 6725 Szeged, Hungary;
- Central Pharmacy Department, University of Szeged, Albert Szent-Györgyi Health Center, 6725 Szeged, Hungary;
- Department of Emergency Medicine, University of Szeged, Albert Szent-Györgyi Health Center, 6725 Szeged, Hungary; (P.H.); (P.E.); (Z.P.)
- Correspondence: ; Tel.: +36-62-342572
| | - Márió Gajdács
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Hungary;
| | - Mária Matuz
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, 6725 Szeged, Hungary;
- Central Pharmacy Department, University of Szeged, Albert Szent-Györgyi Health Center, 6725 Szeged, Hungary;
| | - Gabriella Bodó
- Central Pharmacy Department, University of Szeged, Albert Szent-Györgyi Health Center, 6725 Szeged, Hungary;
| | - Andrea Lázár
- Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, 6725 Szeged, Hungary;
| | - Edit Hajdú
- Infectious Disease Ward, 1st Department of Internal Medicine, University of Szeged, Albert Szent-Györgyi Medical Center, 6725 Szeged, Hungary; (E.H.); (E.P.)
| | - Erika Papfalvi
- Infectious Disease Ward, 1st Department of Internal Medicine, University of Szeged, Albert Szent-Györgyi Medical Center, 6725 Szeged, Hungary; (E.H.); (E.P.)
| | - Peter Hannauer
- Department of Emergency Medicine, University of Szeged, Albert Szent-Györgyi Health Center, 6725 Szeged, Hungary; (P.H.); (P.E.); (Z.P.)
| | - Péter Erdélyi
- Department of Emergency Medicine, University of Szeged, Albert Szent-Györgyi Health Center, 6725 Szeged, Hungary; (P.H.); (P.E.); (Z.P.)
| | - Zoltán Pető
- Department of Emergency Medicine, University of Szeged, Albert Szent-Györgyi Health Center, 6725 Szeged, Hungary; (P.H.); (P.E.); (Z.P.)
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216
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Maillard JY, Bloomfield SF, Courvalin P, Essack SY, Gandra S, Gerba CP, Rubino JR, Scott EA. Reducing antibiotic prescribing and addressing the global problem of antibiotic resistance by targeted hygiene in the home and everyday life settings: A position paper. Am J Infect Control 2020; 48:1090-1099. [PMID: 32311380 PMCID: PMC7165117 DOI: 10.1016/j.ajic.2020.04.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 12/12/2022]
Abstract
Antimicrobial resistance (AMR) continues to threaten global health. Although global and national AMR action plans are in place, infection prevention and control is primarily discussed in the context of health care facilities with home and everyday life settings barely addressed. As seen with the recent global SARS-CoV-2 pandemic, everyday hygiene measures can play an important role in containing the threat from infectious microorganisms. This position paper has been developed following a meeting of global experts in London, 2019. It presents evidence that home and community settings are important for infection transmission and also the acquisition and spread of AMR. It also demonstrates that the targeted hygiene approach offers a framework for maximizing protection against colonization and infections, thereby reducing antibiotic prescribing and minimizing selection pressure for the development of antibiotic resistance. If combined with the provision of clean water and sanitation, targeted hygiene can reduce the circulation of resistant bacteria in homes and communities, regardless of a country's Human Development Index (overall social and economic development). Achieving a reduction of AMR strains in health care settings requires a mirrored reduction in the community. The authors call upon national and international policy makers, health agencies, and health care professionals to further recognize the importance of targeted hygiene in the home and everyday life settings for preventing and controlling infection, in a unified quest to tackle AMR.
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Affiliation(s)
- Jean-Yves Maillard
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK; International Scientific Forum on Home Hygiene, Somerset, UK.
| | | | | | - Sabiha Y Essack
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Sumanth Gandra
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Charles P Gerba
- Departments of Soil, Water and Environmental Science and Environmental Health, University of Arizona, Tucson, AZ, USA
| | - Joseph R Rubino
- Research & Development, Home Hygiene, Lysol/Harpic, Reckitt Benckiser LLC., One Philips Parkway, Montvale, NJ, USA
| | - Elizabeth A Scott
- College of Natural, Behavioral and Health Sciences, Simmons University, Boston, MA, USA
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217
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Yadav S, Singh AK, Agrahari AK, Sharma K, Singh AS, Gupta MK, Tiwari VK, Prakash P. Making of water soluble curcumin to potentiate conventional antimicrobials by inducing apoptosis-like phenomena among drug-resistant bacteria. Sci Rep 2020; 10:14204. [PMID: 32848171 PMCID: PMC7450046 DOI: 10.1038/s41598-020-70921-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 08/05/2020] [Indexed: 11/09/2022] Open
Abstract
The upsurge of multidrug resistant bacterial infections with declining pipeline of newer antibiotics has made it imperative to develop newer molecules or tailor the existing molecules for more effective antimicrobial therapies. Since antiquity, the use of curcumin, in the form of Curcuma longa paste, to treat infectious lesions is unperturbed despite its grave limitations like instability and aqueous insolubility. Here, we utilized "click" chemistry to address both the issues along with improvisation of its antibacterial and antibiofilm profile. We show that soluble curcumin disrupts several bacterial cellular processes leading to the Fenton's chemistry mediated increased production of reactive oxygen species and increased membrane permeability of both Gram-positive and Gram-negative bacteria. We here report that its ability to induce oxidative stress can be harnessed to potentiate activities of ciprofloxacin, meropenem, and vancomycin. In addition, we demonstrated that the soluble curcumin reported herein even sensitizes resistant Gram-negative clinical isolates to the Gram-positive specific antibiotic vancomycin, thereby expanding the antibacterial spectrum of this drug. This work shows that the soluble curcumin can be used to enhance the action of existing antimicrobials against both Gram-positive and Gram-negative bacteria thus strengthening the antibiotic arsenal for fighting resistant bacterial infections for many years to come.
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Affiliation(s)
- Shivangi Yadav
- Bacterial Biofilm and Drug Resistance Research Laboratory, Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Ashish Kumar Singh
- Bacterial Biofilm and Drug Resistance Research Laboratory, Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Anand Kumar Agrahari
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
| | - Kavyanjali Sharma
- Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Anoop Shyam Singh
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
| | - Munesh Kumar Gupta
- Bacterial Biofilm and Drug Resistance Research Laboratory, Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Vinod Kumar Tiwari
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, 221005, India.
| | - Pradyot Prakash
- Bacterial Biofilm and Drug Resistance Research Laboratory, Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
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218
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Majumder MAA, Singh K, Hilaire MGS, Rahman S, Sa B, Haque M. Tackling Antimicrobial Resistance by promoting Antimicrobial stewardship in Medical and Allied Health Professional Curricula. Expert Rev Anti Infect Ther 2020; 18:1245-1258. [PMID: 32684048 DOI: 10.1080/14787210.2020.1796638] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Antimicrobial resistance poses a serious threat to global health with significantly higher morbidity, mortality, and economic burden. This review aims to discuss the importance of the promotion of antimicrobial stewardship in medical and allied health professional curricula and training/educating tomorrow's doctors in combatting antimicrobial resistance. A narrative literature review was conducted to retrieve relevant information related to antimicrobial resistance and stewardship and their implications on medical and allied health professional education and training from searches of computerized databases, hand searches, and authoritative texts. AREAS COVERED Antimicrobial stewardship programs improve rational antibiotic use, reduce antimicrobial resistance, decrease complications of antibiotic use, and improve patient outcomes. Though health professional students recognize the importance and impact of antibiotic prescribing knowledge, many studies have consistently demonstrated low levels of confidence and competencies amongst students, highlighting that health professional schools failed to prepare them to prescribe antibiotics accurately. EXPERT OPINION There is an urgent call for the integration of antimicrobial stewardship teaching at the undergraduate level of medical education to train future prescribers on this critical aspect of public health. Proper undergraduate education on rational antibiotics use would enable health professional graduates to enter clinical practice with adequate competencies to become rational prescribers.
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Affiliation(s)
- Md Anwarul Azim Majumder
- Director of Medical Education, Faculty of Medical Sciences, The University of the West Indies , Cave Hill Campus, Barbados
| | - Keerti Singh
- Lecturer in Anatomy, Faculty of Medical Sciences, The University of the West Indies , Cave Hill Campus, Barbados
| | - Marquita Gittens-St Hilaire
- Lecturer in Microbiology, Faculty of Medical Sciences, The University of the West Indies , Cave Hill Campus, Barbados.,Department of Microbiology, Queen Elizabeth Hospital , Bridgetown, Barbados
| | - Sayeeda Rahman
- Associate Professor of Pharmacology and Public Health, School of Medicine, American University of Integrative Sciences , Bridgetown, Barbados
| | - Bidyadhar Sa
- The University of the West Indies , St. Augustine Campus, Trinidad and Tobago
| | - Mainul Haque
- Professor of the Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia) , Kuala Lumpur, Malaysia
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219
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Otero ML, Menezes RC, Ferreira IBB, Issa FL, Agareno G, Carmo TA, Arriaga MB, Fukutani KF, Pamplona Neto L, Agareno S, Filgueiras Filho NM, Akrami KM, Andrade BB. Factors Associated with Mortality in Critically Ill Patients Diagnosed with Hospital Acquired Infections. Infect Drug Resist 2020; 13:2811-2817. [PMID: 32848430 PMCID: PMC7430765 DOI: 10.2147/idr.s264276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/05/2020] [Indexed: 11/24/2022] Open
Abstract
Objective Evaluate host and pathogen factors associated with mortality in those with hospital acquired infections (HAI) in a tertiary intensive care unit in Brazil. Methods Observational and analytical cohort single center study in a general intensive care unit (ICU) in Northeastern Brazil between January 2016 and August 2018, including those over 18 years of age admitted to the ICU found to have a HAI. Results A total of 165 patients were included, with a mean age of 72 years and male predominance (53.3%) and observed mortality of 46%. Mortality in those with HAI was significantly associated with older age, increased ICU length of stay and readmission to the ICU in univariate analysis. Multivariate analysis revealed that development of septic shock and obtundation during ICU admission was significantly associated with an increased risk of death (OR: 6.94, 95% CI 1.23–39.27, OR: 2.48, 95% CI 1.17–5.29, respectively). A trend towards mortality risk was noted in those with increased age and prior cardiovascular disease. Surprisingly, mortality risk was independent of site of infection, type of pathogen and antibiotic resistance. Furthermore, having more than one HAI over the course of the ICU admission did not impact mortality. Conclusion Risk of death in those with HAI is associated with obtundation and septic shock, in addition to vasopressor use. Host factors, rather than pathogen-specific characteristics or infecting site, impact risk of death related to HAI in the ICU.
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Affiliation(s)
- Matheus L Otero
- Curso de Medicina, Universidade Salvador (UNIFACS), Laureate Universities, Salvador, Bahia, Brazil
| | - Rodrigo C Menezes
- Curso de Medicina, União Metropolitana Para o Desenvolvimento da Educação e Cultura (UNIME), Salvador, Bahia, Brazil
| | | | - Francine L Issa
- Curso de Medicina, Universidade do Estado da Bahia, Salvador, Bahia, Brazil
| | - Gabriel Agareno
- Curso de Medicina, Universidade Salvador (UNIFACS), Laureate Universities, Salvador, Bahia, Brazil
| | - Thomas Azevedo Carmo
- Curso de Medicina, Universidade Salvador (UNIFACS), Laureate Universities, Salvador, Bahia, Brazil
| | - María B Arriaga
- Curso de Medicina, Universidade do Estado da Bahia, Salvador, Bahia, Brazil.,Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Bahia, Brazil
| | - Kiyoshi F Fukutani
- Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Bahia, Brazil
| | | | - Sydney Agareno
- Hospital Da Cidade, Intensive Care Unit, Salvador, Bahia, Brazil
| | - Nivaldo M Filgueiras Filho
- Curso de Medicina, Universidade Salvador (UNIFACS), Laureate Universities, Salvador, Bahia, Brazil.,Universidade Do Estado Da Bahia (UNEB), Salvador, Bahia, Brazil.,Hospital Da Cidade, Intensive Care Unit, Salvador, Bahia, Brazil
| | - Kevan M Akrami
- Division of Infectious Diseases and Pulmonary Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, California, USA
| | - Bruno B Andrade
- Curso de Medicina, Universidade Salvador (UNIFACS), Laureate Universities, Salvador, Bahia, Brazil.,Curso de Medicina, Universidade do Estado da Bahia, Salvador, Bahia, Brazil.,Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Bahia, Brazil.,Escola Bahiana De Medicina e Saúde Pública (EBMSP), Salvador, Bahia, Brazil
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220
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Bassetti M, Giacobbe DR. A look at the clinical, economic, and societal impact of antimicrobial resistance in 2020. Expert Opin Pharmacother 2020; 21:2067-2071. [PMID: 32749893 DOI: 10.1080/14656566.2020.1802427] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Matteo Bassetti
- Clinica Malattie Infettive, Ospedale Policlinico San Martino - IRCCS , Genoa, Italy.,Department of Health Sciences, University of Genoa , Genoa, Italy
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221
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Saki M, Seyed-Mohammadi S, Montazeri EA, Siahpoosh A, Moosavian M, Latifi SM. In vitro antibacterial properties of Cinnamomum zeylanicum essential oil against clinical extensively drug-resistant bacteria. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101146] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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222
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Country Income Is Only One of the Tiles: The Global Journey of Antimicrobial Resistance among Humans, Animals, and Environment. Antibiotics (Basel) 2020; 9:antibiotics9080473. [PMID: 32752276 PMCID: PMC7460298 DOI: 10.3390/antibiotics9080473] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 07/25/2020] [Accepted: 07/29/2020] [Indexed: 12/17/2022] Open
Abstract
Antimicrobial resistance (AMR) is one of the most complex global health challenges today: decades of overuse and misuse in human medicine, animal health, agriculture, and dispersion into the environment have produced the dire consequence of infections to become progressively untreatable. Infection control and prevention (IPC) procedures, the reduction of overuse, and the misuse of antimicrobials in human and veterinary medicine are the cornerstones required to prevent the spreading of resistant bacteria. Purified drinking water and strongly improved sanitation even in remote areas would prevent the pollution from inadequate treatment of industrial, residential, and farm waste, as all these situations are expanding the resistome in the environment. The One Health concept addresses the interconnected relationships between human, animal, and environmental health as a whole: several countries and international agencies have now included a One Health Approach within their action plans to address AMR. Improved antimicrobial usage, coupled with regulation and policy, as well as integrated surveillance, infection control and prevention, along with antimicrobial stewardship, sanitation, and animal husbandry should all be integrated parts of any new action plan targeted to tackle AMR on the Earth. Since AMR is found in bacteria from humans, animals, and in the environment, we briefly summarize herein the current concepts of One Health as a global challenge to enable the continued use of antibiotics.
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223
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Jalde SS, Choi HK. Recent advances in the development of β-lactamase inhibitors. J Microbiol 2020; 58:633-647. [PMID: 32720096 DOI: 10.1007/s12275-020-0285-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/02/2020] [Accepted: 07/02/2020] [Indexed: 02/07/2023]
Abstract
β-Lactam antibiotics are the most commonly prescribed antibiotics worldwide; however, antimicrobial resistance (AMR) is a global challenge. The β-lactam resistance in Gram-negative bacteria is due to the production of β-lactamases, including extended-spectrum β-lactamases, metallo-β-lactamases, and carbapenem-hydrolyzing class D β-lactamases. To restore the efficacy of BLAs, the most successful strategy is to use them in combination with β-lactamase inhibitors (BLI). Here we review the medically relevant β-lactamase families and penicillins, diazabicyclooctanes, boronic acids, and novel chemical scaffold-based BLIs, in particular approved and under clinical development.
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Affiliation(s)
- Shivakumar S Jalde
- Department of Medicinal Chemistry, Jungwon University, Goesan, 28420, Republic of Korea
| | - Hyun Kyung Choi
- Department of Medicinal Chemistry, Jungwon University, Goesan, 28420, Republic of Korea.
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224
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Venil CK, Dufossé L, Renuka Devi P. Bacterial Pigments: Sustainable Compounds With Market Potential for Pharma and Food Industry. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2020. [DOI: 10.3389/fsufs.2020.00100] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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225
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Dolatabadi A, Noorbazargan H, Khayam N, Moulavi P, Zamani N, Asghari Lalami Z, Ashrafi F. Ecofriendly Biomolecule-Capped Bifidobacterium bifidum-Manufactured Silver Nanoparticles and Efflux Pump Genes Expression Alteration in Klebsiella pneumoniae. Microb Drug Resist 2020; 27:247-257. [PMID: 32635796 DOI: 10.1089/mdr.2019.0366] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Klebsiella pneumoniae is currently considered as an immediate threat to human health due to its various multidrug efflux pumps. Microbially synthesized silver nanoparticles (AgNPs) are an attractive and eco-friendly approach to prevent antibiotic resistance in bacteria. In the present study, we compared the inhibitory effect of both commercial and green AgNPs by Bifidobacterium bifidum on OxqAB efflux pump genes in ciprofloxacin-resistant strains of K. pneumoniae. Materials and Methods: AgNPs were characterized by ultraviolet-visible spectrophotometer, Fourier transform infrared spectroscopy, X-ray diffraction, zeta potential, transmission electron microscopy, and scanning electron microscopy. Antibiogram was used to identify resistant isolates and the effect of the biosynthesized AgNPs against OxqAB efflux pump strains was assessed by the minimum inhibitory concentration (MIC) method. The expression levels of oxqAB genes were evaluated using real-time polymerase chain reaction (PCR) followed by exposure to subMICs of the AgNPs. Results: PCR results showed that 25 strains had OxqAB efflux pump and the MIC method indicated that AgNPs had an inhibitory effect on all resistant strains with OxqAB efflux pump. The efficacy of the synthetic nanoparticles was assessed by comparing the antiefflux pump activity with commercial AgNPs. In ciprofloxacin-resistant isolates, the oxqAB genes expression levels reduced in the subMIC of both AgNPs, whereas biosynthesized AgNPs had greater bactericidal effects compared with the commercial AgNPs. Conclusions: Efflux pumps could be an attractive target for our biosynthesized AgNPs. The oxqAB genes expression levels reduced in subMIC of both AgNPs, whereas biosynthesized AgNPs had greater bactericidal effects than the commercial AgNPs.
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Affiliation(s)
- Aghigh Dolatabadi
- Department of Biology, Tehran North Branch, Islamic Azad University, Tehran, Iran
| | - Hassan Noorbazargan
- Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazanin Khayam
- Department of Biology, Tehran North Branch, Islamic Azad University, Tehran, Iran
| | - Pooria Moulavi
- Department of Biology, Tehran North Branch, Islamic Azad University, Tehran, Iran
| | - Naghmeh Zamani
- Department of Biology, Tehran North Branch, Islamic Azad University, Tehran, Iran
| | | | - Fatemeh Ashrafi
- Department of Biology, Tehran North Branch, Islamic Azad University, Tehran, Iran
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226
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Kashef MT, Saleh NM, Assar NH, Ramadan MA. The Antimicrobial Activity of Ciprofloxacin-Loaded Niosomes against Ciprofloxacin-Resistant and Biofilm-Forming Staphylococcus aureus. Infect Drug Resist 2020; 13:1619-1629. [PMID: 32606813 PMCID: PMC7294563 DOI: 10.2147/idr.s249628] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/09/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose The threat of Staphylococcus aureus antimicrobial resistance is increasing worldwide. Niosomes are a new drug delivery system that enhances the antimicrobial potential of antibiotics. We hereby aim to evaluate the antimicrobial and antibiofilm activity of ciprofloxacin-loaded niosomes. Methods The antimicrobial susceptibility of clinical S. aureus isolates (n=59) was determined by Kirby-Bauer disk diffusion method. Their biofilm formation activity was tested by Christensen's method. Two ciprofloxacin-loaded niosomal formulations were prepared by thin-film hydration method, and their minimum inhibitory concentrations (MIC) were determined by agar dilution method, against ciprofloxacin-resistant and biofilm-forming isolates (n=24). Their ability to inhibit biofilm formation and eradicate already formed biofilms was evaluated and further confirmed by scanning electron microscope images. Non-synonymous mutations, in a quinolone resistance-determining regions of S. aureus isolates, were detected by polymerase chain reaction. Results Most of the isolates were methicillin- (47/59) and ciprofloxacin-resistant (45/59). All except two isolates were capable of biofilm production. Niosomal preparation I reduced ciprofloxacin MIC by twofold in four isolates, whereas preparation II reduced ciprofloxacin MIC of most isolates by 8- to 32-fold, with three isolates that became ciprofloxacin-susceptible. Non-synonymous mutations were detected in isolates that maintained phenotypic ciprofloxacin resistance against ciprofloxacin-loaded niosomal preparation II. Ciprofloxacin-loaded niosomes reduced the minimum biofilm inhibitory concentration and the minimum biofilm eradication concentration in 58% and 62% of the tested isolates, respectively. Conclusion Ciprofloxacin-loaded niosomes can restore ciprofloxacin activity against resistant S. aureus isolates. To our knowledge, this is the first report on the inhibition of biofilm formation and eradication of formed biofilms by ciprofloxacin-loaded niosomes.
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Affiliation(s)
- Mona T Kashef
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Nehal M Saleh
- Department of Microbiology, National Organization for Drug Control and Research, Giza, Egypt
| | - Nouran H Assar
- Department of Microbiology, National Organization for Drug Control and Research, Giza, Egypt
| | - Mohammed A Ramadan
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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227
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Simonson AW, Aronson MR, Medina SH. Supramolecular Peptide Assemblies as Antimicrobial Scaffolds. Molecules 2020; 25:E2751. [PMID: 32545885 PMCID: PMC7355828 DOI: 10.3390/molecules25122751] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 12/15/2022] Open
Abstract
Antimicrobial discovery in the age of antibiotic resistance has demanded the prioritization of non-conventional therapies that act on new targets or employ novel mechanisms. Among these, supramolecular antimicrobial peptide assemblies have emerged as attractive therapeutic platforms, operating as both the bactericidal agent and delivery vector for combinatorial antibiotics. Leveraging their programmable inter- and intra-molecular interactions, peptides can be engineered to form higher ordered monolithic or co-assembled structures, including nano-fibers, -nets, and -tubes, where their unique bifunctionalities often emerge from the supramolecular state. Further advancements have included the formation of macroscopic hydrogels that act as bioresponsive, bactericidal materials. This systematic review covers recent advances in the development of supramolecular antimicrobial peptide technologies and discusses their potential impact on future drug discovery efforts.
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Affiliation(s)
- Andrew W. Simonson
- Department of Biomedical Engineering, The Pennsylvania State University, Suite 122, CBE Building, University Park, PA 16802-4400, USA; (A.W.S.); (M.R.A.)
| | - Matthew R. Aronson
- Department of Biomedical Engineering, The Pennsylvania State University, Suite 122, CBE Building, University Park, PA 16802-4400, USA; (A.W.S.); (M.R.A.)
| | - Scott H. Medina
- Department of Biomedical Engineering, The Pennsylvania State University, Suite 122, CBE Building, University Park, PA 16802-4400, USA; (A.W.S.); (M.R.A.)
- Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802-4400, USA
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228
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Bispo PJM, Ung L, Chodosh J, Gilmore MS. Hospital-Associated Multidrug-Resistant MRSA Lineages Are Trophic to the Ocular Surface and Cause Severe Microbial Keratitis. Front Public Health 2020; 8:204. [PMID: 32582610 PMCID: PMC7283494 DOI: 10.3389/fpubh.2020.00204] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 05/05/2020] [Indexed: 12/02/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of severe and difficult to treat ocular infection. In this study, the population structure of 68 ocular MRSA isolates collected at Massachusetts Eye and Ear between January 2014 and June 2016 was assessed. By using a combination of multilocus sequence typing (MLST) analysis, SCCmec typing and detection of the panton-valentine leukocidin (PVL) gene, we found that the population structure of ocular MRSA is composed of lineages with community and hospital origins. As determined by eBURST analysis of MLST data, the ocular MRSA population consisted of 14 different sequence types (STs) that grouped within two predominant clonal complexes: CC8 (47.0%) and CC5 (41.2%). Most CC8 strains were ST8, harbored type IV SCCmec and were positive for the PVL-toxin (93.7%). The CC5 group was divided between strains carrying SCCmec type II (71.4%) and SCCmec type IV (28.6%). Remaining isolates grouped in 6 different clonal complexes with 3 isolates in CC6 and the other clonal complexes being represented by a single isolate. Interestingly, major MRSA CC5 and CC8 lineages were isolated from discrete ocular niches. Orbital and preseptal abscess/cellulitis were predominantly caused by CC8-SCCmec IV PVL-positive strains. In contrast, infections of the cornea, conjunctiva and lacrimal system were associated with the MDR CC5 lineage, particularly as causes of severe infectious keratitis. This niche specialization of MRSA is consistent with a model where CC8-SCCmec IV PVL-positive strains are better adapted to cause infections of the keratinized and soft adnexal eye tissues, whereas MDR CC5 appear to have greater ability in overcoming innate defense mechanisms of the wet epithelium of the ocular surface.
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Affiliation(s)
- Paulo J M Bispo
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States.,Infectious Disease Institute, Harvard Medical School, Boston, MA, United States
| | - Lawson Ung
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States.,Infectious Disease Institute, Harvard Medical School, Boston, MA, United States
| | - James Chodosh
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States.,Infectious Disease Institute, Harvard Medical School, Boston, MA, United States
| | - Michael S Gilmore
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States.,Infectious Disease Institute, Harvard Medical School, Boston, MA, United States.,Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA, United States
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229
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Khan F, Pham DTN, Oloketuyi SF, Kim YM. Antibiotics Application Strategies to Control Biofilm Formation in Pathogenic Bacteria. Curr Pharm Biotechnol 2020; 21:270-286. [PMID: 31721708 DOI: 10.2174/1389201020666191112155905] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/09/2019] [Accepted: 10/31/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The establishment of a biofilm by most pathogenic bacteria has been known as one of the resistance mechanisms against antibiotics. A biofilm is a structural component where the bacterial community adheres to the biotic or abiotic surfaces by the help of Extracellular Polymeric Substances (EPS) produced by bacterial cells. The biofilm matrix possesses the ability to resist several adverse environmental factors, including the effect of antibiotics. Therefore, the resistance of bacterial biofilm-forming cells could be increased up to 1000 times than the planktonic cells, hence requiring a significantly high concentration of antibiotics for treatment. METHODS Up to the present, several methodologies employing antibiotics as an anti-biofilm, antivirulence or quorum quenching agent have been developed for biofilm inhibition and eradication of a pre-formed mature biofilm. RESULTS Among the anti-biofilm strategies being tested, the sub-minimal inhibitory concentration of several antibiotics either alone or in combination has been shown to inhibit biofilm formation and down-regulate the production of virulence factors. The combinatorial strategies include (1) combination of multiple antibiotics, (2) combination of antibiotics with non-antibiotic agents and (3) loading of antibiotics onto a carrier. CONCLUSION The present review paper describes the role of several antibiotics as biofilm inhibitors and also the alternative strategies adopted for applications in eradicating and inhibiting the formation of biofilm by pathogenic bacteria.
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Affiliation(s)
- Fazlurrahman Khan
- Marine-Integrated Bionics Research Center, Pukyong National University, Busan 48513, Korea.,Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida 201306, U.P., India
| | - Dung T N Pham
- Department of Food Science and Technology, Pukyong National University, Busan 48513, Korea
| | - Sandra F Oloketuyi
- Laboratory for Environmental and Life Sciences, University of Nova Gorica 5000, Nova Gorica, Slovenia
| | - Young-Mog Kim
- Marine-Integrated Bionics Research Center, Pukyong National University, Busan 48513, Korea.,Department of Food Science and Technology, Pukyong National University, Busan 48513, Korea
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230
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Potential probiotic of Lactobacillus strains isolated from the intestinal tracts of pigs and feces of dogs with antibacterial activity against multidrug-resistant pathogenic bacteria. Arch Microbiol 2020; 202:1849-1860. [PMID: 32447432 DOI: 10.1007/s00203-020-01908-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 12/16/2022]
Abstract
The occurrence of multidrug-resistant pathogenic bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Acinetobacter baumannii (MDRAB), extended-spectrum β-lactamase (ESBL) Escherichia coli, and Pseudomonas aeruginosa, has become a serious problem in animals and public. The objective of this study was to identify and isolate lactic acid bacterial (LAB) strains from the intestinal tracts of pigs and feces of dogs and then characterize them as potential probiotics with antimicrobial activity against multidrug-resistant pathogenic bacteria. In a preliminary isolation screening, 45 of 1167 isolated LAB strains were found to have anti-S. aureus ATCC 27,735 activity. Using 16S rDNA and 16S-23S rDNA intergenic spacer region (ISR) sequences, five of these isolates were further identified as Lactobacillus animalis 30a-2, Lactobacillus reuteri 4-12E, Weissella cibaria C34, Lactococcus lactis 5-12H, and Lactococcus lactis 6-3H. Antimicrobial substance assays suggest that the L. lactis 5-12H, L. lactis 6-3H, L. animalis 30a-2, L. reuteri 4-12E, and W. cibaria C34 strains might produce bacteriocins and hydrogen peroxide (H2O2) as antimicrobial substances. The L. animalis 30a-2 and W. cibaria C34 strains were further characterized for probiotic properties and shown to have high acid and bile salt tolerance. Additionally, they have broad antimicrobial spectra, and can significantly repress the growth of all of the tested strains of MRSA isolates, some MDRAB, ESBL E. coli, and P. aeruginosa isolates, along with food-borne pathogenic bacteria such as Bacillus cereus ATCC 11778, Listeria monocytogens ATCC 19111, Salmonella spp., Shigella spp., and Yersinia enterocolitica BCRC 12986. This is the first report of H2O2-producing L. animalis 30a-2 and W. cibaria C34 isolated from the intestinal tracts of pigs and feces of dogs that have good antimicrobial activity against multidrug-resistant and food-borne pathogenic bacteria and have excellent probiotic properties.
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231
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Kilic U, Koroglu M, Olmez M, Altindis M. Investigation of the In Vitro Effectiveness of Aztreonam/Avibactam, Colistin/Apramycin, and Meropenem/Apramycin Combinations Against Carbapenemase-Producing, Extensively Drug-Resistant Klebsiella pneumoniae Strains. Microb Drug Resist 2020; 26:1291-1297. [PMID: 32401692 DOI: 10.1089/mdr.2019.0498] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
This study aimed at investigating the in vitro effectiveness of aztreonam/avibactam, colistin/avibactam, colistin/apramycin, and meropenem/apramycin combinations against carbapenemase-producing, extensively drug-resistant (XDR) Klebsiella pneumoniae strains. This study evaluated 38 carbapenem-resistant, carbapenemase-producing, and XDR K. pneumoniae strains. The checkerboard method was used to examine the efficacy of aztreonam/avibactam, and meropenem/apramycin combinations in all strains and the colistin/apramycin combination in colistin-resistant strains (n = 26). It was found that when used alone, aztreonam and avibactam had high minimum inhibitory concentration values in all strains and that all strains were resistant to aztreonam. Nevertheless, the aztreonam/avibactam combination was found to have a synergistic effect against all strains. Apramycin alone was effective against 30 K. pneumoniae strains (79%); however, 8 strains (21%) were found to be resistant. In the synergy testing of 26 colistin-resistant strains with the checkerboard method, the colistin/apramycin combination was found to have a synergistic effect against 4 strains (15.3%), an antagonistic effect against 8 strains (30.7%), and an additive effect against 14 strains (54%). By comparison, the meropenem/apramycin combination had a synergistic effect against 20 strains (52%) and an additive effect against 12 strains (31%). The aztreonam/avibactam combination showed a high in vitro synergistic effect on carbapenemase-producing and XDR K. pneumoniae strains, such as Metallo-β-lactamase, and provided good prospects for the successful treatment. The meropenem/apramycin combination was also highly synergistic. The synergistic effects were low for the colistin/apramycin combination that was tested on colistin-resistant strains. However, it is promising that apramycin has low minimal inhibitory concentration values.
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Affiliation(s)
- Umit Kilic
- Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Mehmet Koroglu
- Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Mehmet Olmez
- Faculty of Medicine, Sakarya University, Sakarya, Turkey
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232
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Abbasi E, Mondanizadeh M, van Belkum A, Ghaznavi-Rad E. Multi-Drug-Resistant Diarrheagenic Escherichia coli Pathotypes in Pediatric Patients with Gastroenteritis from Central Iran. Infect Drug Resist 2020; 13:1387-1396. [PMID: 32523359 PMCID: PMC7234969 DOI: 10.2147/idr.s247732] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/28/2020] [Indexed: 12/15/2022] Open
Abstract
Background Diarrheagenic Escherichia coli (DEC) is a significant cause of gastroenteritis and a major public health problem. This study investigates the prevalence and the antibiotic resistance patterns of DEC that were isolated from infectious diarrhea samples of pediatric patients from central Iran. Patients and Methods Pediatric diarrhea samples were collected from 230 pediatric patients visiting the hospital. E. coli pathotypes were diagnosed by using conventional culture methods and PCR. Antibiotic resistance profiles, the frequency of multi-drug resistance (MDR), and the phenotypic and genotypic characteristics of extended spectrum-β-lactamase (ESBL), AmpC and integron-associated genes were analyzed. Results Of the 230 samples of infectious diarrhea, 91 (39.5%) produced E. coli isolates. Of these, 32 cases (35.1%) were identified as DEC by culture and PCR. The frequency of the E. coli pathotypes obtained was as follows: EAEC 11/32 (34.3%), EPEC 9/32 (28.1%), ETEC 6/32 (18.7%), EIEC 3/32 (9.3%), and EHEC 3/32 (9.3%). The antibiotic resistance rates were greater for nalidixic acid (30/32; 93.7%), ampicillin (29/32; 90.6%), and tetracycline (25/32; 78.1%) than for any of the other tested antibiotics. High levels of MDR (25/32; 78.1%) and the presence of ESBL (18/32; 56.2%) and AmpC (9/32; 28.1%) were observed in the DEC isolates. The isolates showed a higher frequency of the ESBL genes [blaTEM (18/18; 100%), blaCTX-M15 (17/18; 94.4%)], and AmpC [bla CIT (4/9; 44.4%) and blaDHA (4/9; 44.4%)] than of the other ESBL and AmpC genes. Conclusion Compared to the previous study, DEC appeared to be the second-most abundant agent of diarrhea in pediatric patients after Campylobacter jejuni, with frequent MDR and ESBL presence.
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Affiliation(s)
- Elnaz Abbasi
- Department of Microbiology & Immunology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mahdieh Mondanizadeh
- Department of Biotechnology and Molecular Medicine, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Alex van Belkum
- Data Analytics Department, BioMérieux, La Balme les Grottes, France
| | - Ehsanollah Ghaznavi-Rad
- Molecular and Medicine Research Center, Faculty of Medicine Arak University of Medical Sciences, Arak, Iran.,Department of Medical Laboratory Sciences, Arak School of Paramedicine, Arak University of Medical Sciences, Arak, Iran
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233
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Nallasamy P, Ramalingam T, Nooruddin T, Shanmuganathan R, Arivalagan P, Natarajan S. Polyherbal drug loaded starch nanoparticles as promising drug delivery system: Antimicrobial, antibiofilm and neuroprotective studies. Process Biochem 2020. [DOI: 10.1016/j.procbio.2020.01.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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234
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Koguchi D, Murakami Y, Ikeda M, Dobashi M, Ishii J. Cefaclor as a first-line treatment for acute uncomplicated cystitis: a retrospective single-center study. BMC Urol 2020; 20:38. [PMID: 32252747 PMCID: PMC7137291 DOI: 10.1186/s12894-020-00605-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/25/2020] [Indexed: 11/24/2022] Open
Abstract
Background Wide-spectrum antibiotics have been favored to treat acute uncomplicated cystitis (AUC) for a long time, leading to the emergence of multi-drug resistant bacteria. We hypothesize that narrow-spectrum antibiotics might mitigate the issue and aim to investigate the clinical efficacy of cefaclor in patients with AUC. Methods We retrospectively reviewed the clinical data of female outpatients with AUC treated with cefaclor and evaluated the safety and clinical efficacy. Clinical cure was defined as the elimination of clinical symptom under 4 white blood cells (WBCs) per high power field on microscopy. Results Overall, 223 women with AUC were enrolled. Escherichia coli was the dominant pathogen (n = 160; 68.6%), followed by Klebsiella species and E. coli-extended spectrum β-lactamase (ESBL) (n = 19; 8.1% and n = 18; 7.7%). Overall success rate was 94.0% (n = 219) and susceptibility rate of cefazolin was 84.1%, which was close to that of levofloxacin (82.9%). Ampicillin showed the lowest rate of 63.7% with a significantly greater resistance rate of 35.3% among all antibiotics (P < 0.001). In the subgroup analysis, the success rate in patients with resistance to levofloxacin or cefazolin was 100% (n = 24) or 93.3% (n = 14). The rate in patients with resistance to both antibiotics was 60.0% (n = 9), and the pathogens in the other 40.0% (n = 6) of patients with treatment failure were E. coli-ESBL. Conclusion Cefaclor showed excellent efficacy in AUC patients, even in those with in vitro resistance to cefazolin or levofloxacin. Cefaclor may be considered as a first-line option in patients with AUC and a second-line option for those with levofloxacin treatment failure.
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Affiliation(s)
- Dai Koguchi
- Department of Urology, International University of Health and Welfare Atami Hospital, 13-1 Higashikaiganchou Atami, Shizuoka, 413-0012, Japan.
| | - Yasukiyo Murakami
- Department of Urology, International University of Health and Welfare Atami Hospital, 13-1 Higashikaiganchou Atami, Shizuoka, 413-0012, Japan
| | - Masaomi Ikeda
- Department of Urology, International University of Health and Welfare Atami Hospital, 13-1 Higashikaiganchou Atami, Shizuoka, 413-0012, Japan
| | - Masato Dobashi
- Department of Urology, International University of Health and Welfare Atami Hospital, 13-1 Higashikaiganchou Atami, Shizuoka, 413-0012, Japan
| | - Junichiro Ishii
- Department of Urology, International University of Health and Welfare Atami Hospital, 13-1 Higashikaiganchou Atami, Shizuoka, 413-0012, Japan
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235
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Coimbra NDR, Goes-Neto A, Azevedo V, Ouangraoua A. Reconstructing the Phylogeny of Corynebacteriales while Accounting for Horizontal Gene Transfer. Genome Biol Evol 2020; 12:381-395. [PMID: 32186700 PMCID: PMC7186787 DOI: 10.1093/gbe/evaa058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2020] [Indexed: 12/25/2022] Open
Abstract
Horizontal gene transfer is a common mechanism in Bacteria that has contributed to the genomic content of existing organisms. Traditional methods for estimating bacterial phylogeny, however, assume only vertical inheritance in the evolution of homologous genes, which may result in errors in the estimated phylogenies. We present a new method for estimating bacterial phylogeny that accounts for the presence of genes acquired by horizontal gene transfer between genomes. The method identifies and corrects putative transferred genes in gene families, before applying a gene tree-based summary method to estimate bacterial species trees. The method was applied to estimate the phylogeny of the order Corynebacteriales, which is the largest clade in the phylum Actinobacteria. We report a collection of 14 phylogenetic trees on 360 Corynebacteriales genomes. All estimated trees display each genus as a monophyletic clade. The trees also display several relationships proposed by past studies, as well as new relevant relationships between and within the main genera of Corynebacteriales: Corynebacterium, Mycobacterium, Nocardia, Rhodococcus, and Gordonia. An implementation of the method in Python is available on GitHub at https://github.com/UdeS-CoBIUS/EXECT (last accessed April 2, 2020).
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Affiliation(s)
- Nilson Da Rocha Coimbra
- Department of Computer Science, University of Sherbrooke, Quebec, Canada
- Programa Interunidades de Pós-graduação em Bioinformática, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Aristoteles Goes-Neto
- Programa Interunidades de Pós-graduação em Bioinformática, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vasco Azevedo
- Programa Interunidades de Pós-graduação em Bioinformática, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Aïda Ouangraoua
- Department of Computer Science, University of Sherbrooke, Quebec, Canada
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Rizi KS, Mosavat A, Youssefi M, Jamehdar SA, Ghazvini K, Safdari H, Amini Y, Farsiani H. High prevalence of bla CMY AmpC beta-lactamase in ESBL co-producing Escherichia coli and Klebsiella spp. clinical isolates in the northeast of Iran. J Glob Antimicrob Resist 2020; 22:477-482. [PMID: 32247080 DOI: 10.1016/j.jgar.2020.03.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/02/2020] [Accepted: 03/07/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The production of β-lactamase enzymes such as AmpC β-lactamases and extended-spectrum β-lactamases (ESBLs) is among the main mechanisms for resistance to expanded-spectrum cephalosporins. The present study was conducted to investigate the prevalence and molecular epidemiology of plasmid-mediated AmpC beta (β)-lactamase in ESBL co-producing Escherichia coli (E. coli) and Klebsiella spp. (Klebsiella pneumoniae and Klebsiella oxytoca) clinical isolates in the northeast of Iran. METHODS A total of 602 E. coli and Klebsiella spp. clinical isolates were collected from three hospitals in Mashhad (northeast of Iran). A combination disk test (CDT) was performed for the phenotypic detection of ESBLs. Screening for the detection of AmpC β-lactamases was performed by a susceptibility test to a cefoxitin disc among ESBL producing isolates. A confirmatory test for AmpC β-lactamases was performed using the Mast® D68C test. Identification of plasmid-mediated AmpC cluster genes was done by multiplex polymerase chain reaction (PCR). RESULTS Among 336 ESBL-producing strains, 230 (68.4%) isolates were resistant to cefoxitin. Results of the Mast® D68C test showed that 30% (69/230) of cefoxitin-resistant isolates simultaneously exhibited ESBL and AmpC activity and 22% (51/230) of isolates probably showed multi-drug resistant (MDR) phenotype. Results of multiplex PCR among ESBL-positive isolates showed that, 16.7% (56/336) of isolates were positive for plasmid-borneampC cluster genes, and CMY (38%) was the most frequent genotype of plasmid mediated AmpC. CONCLUSION Findings of the study revealed that an increase in the prevalence of ESBL and AmpC co-producer in E. coli and Klebsiella spp. strains may become an important public health issue. Therefore, there is a vital need for surveillance of spread of these clinical isolates.
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Affiliation(s)
- Kobra Salimiyan Rizi
- Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arman Mosavat
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research, Mashhad, Razavi Khorasan, Iran
| | - Masoud Youssefi
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeid Amel Jamehdar
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kiarash Ghazvini
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Safdari
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Yousef Amini
- Infectious Disease and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hadi Farsiani
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Mazzei R, Leonti M, Spadafora S, Patitucci A, Tagarelli G. A review of the antimicrobial potential of herbal drugs used in popular Italian medicine (1850s-1950s) to treat bacterial skin diseases. JOURNAL OF ETHNOPHARMACOLOGY 2020; 250:112443. [PMID: 31790819 DOI: 10.1016/j.jep.2019.112443] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/28/2019] [Accepted: 11/28/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Before the advent of modern antibiotics, microbial infections were treated with herbal medicine or cauterization. Literature from the latter half of the nineteenth to the early mid-twentieth century, when antibiotics became widely available, arguably holds the most progressive information about herbal remedies to treat bacterial skin diseases. The corpus of literature produced in Italy during that period is not easily accessible and mostly out of print. MATERIAL AND METHODS Plant-based remedies utilized in popular Italian medicine to treat anthrax, boils, erysipelas, impetigo, pustules, and whitlow were sourced from literature indexed in and available through the National Library Service website of the Italian Libraries Network. The remedies are assessed for their antimicrobial potential based on a detailed search of the herbal drug species in scientific databases. RESULTS A considerable part of the reviewed recipes included specific excipients (41 out of 139) and others were produced with fresh plant material (48 out of 139). Out of the 52 identified herbal drug species used in popular Italian medicine against dermatologic infections, extracts of 43 were shown to have moderate in vitro activity against Gram-positive and Gram-negative bacteria. CONCLUSION The antibacterial activity of the extracts and pure compounds as reported in the reviewed literature is mostly based on in vitro assays and generally does not encourage follow up studies. The effectiveness of the reported recipes, which include fresh plant material and excipients can only be assessed through in vivo studies. Those remedies including herbal drugs with reported antimicrobial activity might have the potential as complementary therapies. The reviewed plant based antimicrobial recipes might serve as inspirations in the search for alternative topical antibacterial strategies and the search for their synergistic and potentiating ingredients.
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Affiliation(s)
- Rosalucia Mazzei
- Institute for Agricultural and Forest Systems in the Mediterranean, National Research Council, Via Cavour 4-6, 87036, Rende, CS, Italy
| | - Marco Leonti
- Department of Biomedical Sciences, University of Cagliari, Via Ospedale 72, 09124, Cagliari, Italy
| | - Santo Spadafora
- Unità Operativa Complessa di Dermatologia -Azienda Ospedaliera di Cosenza, Italy
| | - Alessandra Patitucci
- Institute for Agricultural and Forest Systems in the Mediterranean, National Research Council, Via Cavour 4-6, 87036, Rende, CS, Italy
| | - Giuseppe Tagarelli
- Institute for Agricultural and Forest Systems in the Mediterranean, National Research Council, Via Cavour 4-6, 87036, Rende, CS, Italy.
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Multi-functionalized nanocarriers targeting bacterial reservoirs to overcome challenges of multi drug-resistance. ACTA ACUST UNITED AC 2020; 28:319-332. [PMID: 32193748 DOI: 10.1007/s40199-020-00337-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/11/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Infectious diseases associated with intracellular bacteria such as Staphylococcus aureus, Salmonella typhimurium and Mycobacterium tuberculosis are important public health concern. Emergence of multi and extensively drug-resistant bacterial strains have made it even more obstinate to offset such infections. Bacteria residing within intracellular compartments provide additional barriers to effective treatment. METHOD Information provided in this review has been collected by accessing various electronic databases including Google scholar, Web of science, Scopus, and Nature index. Search was performed using keywords nanoparticles, intracellular targeting, multidrug resistance, Staphylococcus aureus; Salmonella typhimurium; Mycobacterium tuberculosis. Information gathered was categorized into three major sections as 'Intracellular targeting of Staphylococcus aureus, Intracellular targeting of Salmonella typhimurium and Intracellular targeting of Mycobacterium tuberculosis' using variety of nanocarrier systems. RESULTS Conventional management for infectious diseases typically comprises of long-term treatment with a combination of antibiotics, which may lead to side effects and decreased patient compliance. A wide range of multi-functionalized nanocarrier systems have been studied for delivery of drugs within cellular compartments where bacteria including Staphylococcus aureus, Salmonella typhimurium and Mycobacterium tuberculosis reside. Such carrier systems along with targeted delivery have been utilized for sustained and controlled delivery of drugs. These strategies have been found useful in overcoming the drawbacks of conventional treatments including multi-drug resistance. CONCLUSION Development of multi-functional nanocargoes encapsulating antibiotics that are proficient in targeting and releasing drug into infected reservoirs seems to be a promising strategy to circumvent the challenge of multidrug resistance. Graphical abstract.
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van Duin D, Arias CA, Komarow L, Chen L, Hanson BM, Weston G, Cober E, Garner OB, Jacob JT, Satlin MJ, Fries BC, Garcia-Diaz J, Doi Y, Dhar S, Kaye KS, Earley M, Hujer AM, Hujer KM, Domitrovic TN, Shropshire WC, Dinh A, Manca C, Luterbach CL, Wang M, Paterson DL, Banerjee R, Patel R, Evans S, Hill C, Arias R, Chambers HF, Fowler VG, Kreiswirth BN, Bonomo RA. Molecular and clinical epidemiology of carbapenem-resistant Enterobacterales in the USA (CRACKLE-2): a prospective cohort study. THE LANCET. INFECTIOUS DISEASES 2020; 20:731-741. [PMID: 32151332 DOI: 10.1016/s1473-3099(19)30755-8] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 12/04/2019] [Accepted: 12/20/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Carbapenem-resistant Enterobacterales (CRE) are a global threat. We aimed to describe the clinical and molecular characteristics of Centers for Disease Control and Prevention (CDC)-defined CRE in the USA. METHODS CRACKLE-2 is a prospective, multicentre, cohort study. Patients hospitalised in 49 US hospitals, with clinical cultures positive for CDC-defined CRE between April 30, 2016, and Aug 31, 2017, were included. There was no age exclusion. The primary outcome was desirability of outcome ranking (DOOR) at 30 days after index culture. Clinical data and bacteria were collected, and whole genome sequencing was done. This trial is registered with ClinicalTrials.gov, number NCT03646227. FINDINGS 1040 patients with unique isolates were included, 449 (43%) with infection and 591 (57%) with colonisation. The CDC-defined CRE admission rate was 57 per 100 000 admissions (95% CI 45-71). Three subsets of CDC-defined CRE were identified: carbapenemase-producing Enterobacterales (618 [59%] of 1040), non-carbapenemase-producing Enterobacterales (194 [19%]), and unconfirmed CRE (228 [22%]; initially reported as CRE, but susceptible to carbapenems in two central laboratories). Klebsiella pneumoniae carbapenemase-producing clonal group 258 K pneumoniae was the most common carbapenemase-producing Enterobacterales. In 449 patients with CDC-defined CRE infections, DOOR outcomes were not significantly different in patients with carbapenemase-producing Enterobacterales, non-carbapenemase-producing Enterobacterales, and unconfirmed CRE. At 30 days 107 (24%, 95% CI 20-28) of these patients had died. INTERPRETATION Among patients with CDC-defined CRE, similar outcomes were observed among three subgroups, including the novel unconfirmed CRE group. CDC-defined CRE represent diverse bacteria, whose spread might not respond to interventions directed to carbapenemase-producing Enterobacterales. FUNDING National Institutes of Health.
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Affiliation(s)
- David van Duin
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA.
| | - Cesar A Arias
- Division of Infectious Diseases and Center for Antimicrobial Resistance and Microbial Genomics, UTHealth, Houston, TX, USA; Center for Infectious Diseases, UTHealth, Houston, TX, USA; Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia
| | - Lauren Komarow
- The Biostatistics Center, The George Washington University, Rockville, MD, USA
| | - Liang Chen
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA
| | - Blake M Hanson
- Division of Infectious Diseases and Center for Antimicrobial Resistance and Microbial Genomics, UTHealth, Houston, TX, USA; Center for Infectious Diseases, UTHealth, Houston, TX, USA
| | - Gregory Weston
- Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Eric Cober
- Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH, USA
| | - Omai B Garner
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Jesse T Jacob
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Michael J Satlin
- Division of Infectious Diseases, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA
| | - Bettina C Fries
- Department of Medicine, Division of Infectious Diseases, Stony Brook University, Stony Brook, NY, USA
| | - Julia Garcia-Diaz
- Department of Infectious Diseases, Ochsner Clinic Foundation, New Orleans, LA, USA
| | - Yohei Doi
- Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Departments of Microbiology and Infectious Diseases, Fujita Health University School of Medicine, Aichi, Japan
| | - Sorabh Dhar
- Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Keith S Kaye
- Division of Infectious Diseases, University of Michigan, Ann Arbor, MI, USA
| | - Michelle Earley
- The Biostatistics Center, The George Washington University, Rockville, MD, USA
| | - Andrea M Hujer
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, USA; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kristine M Hujer
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, USA; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - T Nicholas Domitrovic
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, USA; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - William C Shropshire
- Division of Infectious Diseases and Center for Antimicrobial Resistance and Microbial Genomics, UTHealth, Houston, TX, USA
| | - An Dinh
- Division of Infectious Diseases and Center for Antimicrobial Resistance and Microbial Genomics, UTHealth, Houston, TX, USA
| | - Claudia Manca
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA
| | - Courtney L Luterbach
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| | - Minggui Wang
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China
| | - David L Paterson
- University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital Campus, QL, Australia
| | - Ritu Banerjee
- Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Robin Patel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, and Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Scott Evans
- The Biostatistics Center, The George Washington University, Rockville, MD, USA
| | - Carol Hill
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | - Rebekka Arias
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | - Henry F Chambers
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Vance G Fowler
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA; Division of Infectious Diseases, Duke University, Durham, NC, USA
| | - Barry N Kreiswirth
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA
| | - Robert A Bonomo
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, USA; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Departments of Pharmacology, Molecular Biology and Microbiology, Biochemistry, and Proteomics and Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, OH, USA; CWRU-Cleveland VAMC Center for Antimicrobial Resistance and Epidemiology, Cleveland, OH, USA
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BAYGAR T. Characterization of silk sutures coated with propolis and biogenic silver nanoparticles (AgNPs); an eco-friendly solution with wound healing potential against surgical site infections (SSIs). Turk J Med Sci 2020; 50:258-266. [PMID: 31655520 PMCID: PMC7080367 DOI: 10.3906/sag-1906-48] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/09/2019] [Indexed: 01/09/2023] Open
Abstract
Background/aim Bacterial adherence to a suture material is one of the main causes of surgical site infections. An antibacterial suture material with enhanced wound healing function may protect the surgical site from infections. Thus, the present study aimed to investigate the synergistic effect of propolis and biogenic metallic nanoparticles when combined with silk sutures for biomedical use. Materials and methods Silver nanoparticle (AgNP) synthesis was carried out via a microbial-mediated biological route and impregnated on propolis-loaded silk sutures using an in situ process. Silk sutures fabricated with propolis and biosynthesized AgNPs (bioAgNP-propolis-coated sutures) were intensively characterized using scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), thermogravimetric analysis (TGA), and differential scanning calorimetry (DSC). The antibacterial characteristics of the bioAgNP-propolis-coated sutures were evaluated using the agar plate method. The biocompatibility of the bioAgNP-propolis- coated sutures was evaluated using 3T3 fibroblast cells, and their wound-healing potential was also investigated. Results BioAgNP-propolis-coated sutures displayed potent antibacterial activity against pathogenic gram-negative and gram-positive bacteria, Escherichia coli and Staphylococcus aureus, respectively. BioAgNP-propolis-coated silk sutures were found to be biocompatible with 3T3 fibroblast cell culture. In vitro wound healing scratch assay also demonstrated that the extract of bioAgNP-propolis-coated sutures stimulated the 3T3 fibroblasts’ cell proliferation. Conclusion Coating the silk sutures with propolis and biogenic AgNPs gave an effective antibacterial capacity to surgical sutures besides providing biocompatibility and wound healing activity.
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Affiliation(s)
- Tuba BAYGAR
- Research Laboratories Center, Muğla Sıtkı Koçman University, MuğlaTurkey
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Das N, Jena PK, Pradhan SK. Arabinosyltransferase C enzyme of Mycobacterium tuberculosis, a potential drug target: An insight from molecular docking study. Heliyon 2020; 6:e02693. [PMID: 32090179 PMCID: PMC7026281 DOI: 10.1016/j.heliyon.2019.e02693] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 08/22/2019] [Accepted: 10/16/2019] [Indexed: 11/29/2022] Open
Abstract
Multi-drug resistant in Mycobacterium tuberculosis (M.tb) is considered as major bottleneck in the treatment and cure of tuberculosis (TB). Several anti-tubercular drugs fail in its efficacy due to drug-resistant M.tb developed mechanism for resistance. So, research across globe has been carried out to develop effective anti-TB drugs to improve the treatment of these strains. Traditional drug development methods have been proved unsuccessful as it fails to develop a broad-spectrum drug due to lack of structure based approach. Several studies have been conducted in this regard and identified several drug target sites that influence drug-resistant M.tb strains. In this study, the attempt was to study the interaction between the protein Arabinosyltransferase C with the two existing drugs (Ethambutol and Isoniazid) and five modified molecules derived from Ethambutol by calculating their binding affinity and mode of binding through molecular docking study using AutoDock 4. From the comparison study of the existing drug (EMB and INH) and the five proposed modified molecules (Emb1, Emb2, Emb3, Emb4 and Emb5), it is analysed that Emb1 and Emb3 with binding affinities -5.77 kcal/mol and -5.13 kcal/mol respectively can be considered as potential inhibitors of Arabinosyltransferase C in Mycobacterium tuberculosis which is responsible for cell wall synthesis. The facts provided may be further verified experimentally for future drug discovery process to make a stand against tuberculosis and contribute an advance research for worthy antimycobacterial strategies.
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Affiliation(s)
- Nisha Das
- Department of Chemistry, College of Basic Science and Humanities, Odisha University of Agriculture and Technology, Bhubaneswar, 751003, Odisha, India
| | - Pradip Kumar Jena
- Department of Chemistry, College of Basic Science and Humanities, Odisha University of Agriculture and Technology, Bhubaneswar, 751003, Odisha, India
| | - Sukanta Kumar Pradhan
- BIF Centre, Department of Bioinformatics, Centre for Post Graduate Studies, Odisha University of Agriculture and Technology, Bhubaneswar, 751003, Odisha, India
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Lafond M, Shekhar H, Panmanee W, Collins SD, Palaniappan A, McDaniel CT, Hassett DJ, Holland CK. Bactericidal Activity of Lipid-Shelled Nitric Oxide-Loaded Microbubbles. Front Pharmacol 2020; 10:1540. [PMID: 32082143 PMCID: PMC7002315 DOI: 10.3389/fphar.2019.01540] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/27/2019] [Indexed: 12/14/2022] Open
Abstract
The global pandemic of antibiotic resistance is an ever-burgeoning public health challenge, motivating the development of adjunct bactericidal therapies. Nitric oxide (NO) is a potent bioactive gas that induces a variety of therapeutic effects, including bactericidal and biofilm dispersion properties. The short half-life, high reactivity, and rapid diffusivity of NO make therapeutic delivery challenging. The goal of this work was to characterize NO-loaded microbubbles (MB) stabilized with a lipid shell and to assess the feasibility of antibacterial therapy in vitro. MB were loaded with either NO alone (NO-MB) or with NO and octafluoropropane (NO-OFP-MB) (9:1 v/v and 1:1 v/v). The size distribution and acoustic attenuation coefficient of NO-MB and NO-OFP-MB were measured. Ultrasound-triggered release of the encapsulated gas payload was demonstrated with 3-MHz pulsed Doppler ultrasound. An amperometric microelectrode sensor was used to measure NO concentration released from the MB and compared to an NO-OFP-saturated solution. The effect of NO delivery on the viability of planktonic (free living) Staphylococcus aureus (SA) USA 300, a methicillin-resistant strain, was evaluated in a 96 well-plate format. The co-encapsulation of NO with OFP increased the total volume and attenuation coefficient of MB. The NO-OFP-MB were destroyed with a clinical ultrasound scanner with an output of 2.48 MPa peak negative pressure (in situ MI of 1.34) but maintained their echogenicity when exposed to 0.02 MPa peak negative pressure (in situ MI of 0.01. The NO dose in NO-MB and NO-OFP-MB was more than 2-fold higher than the NO-OFP-saturated solution. Delivery of NO-OFP-MB increased bactericidal efficacy compared to the NO-OFP-saturated solution or air and OFP-loaded MB. These results suggest that encapsulation of NO with OFP in lipid-shelled MB enhances payload delivery. Furthermore, these studies demonstrate the feasibility and limitations of NO-OFP-MB for antibacterial applications.
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Affiliation(s)
- Maxime Lafond
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cincinnati, OH, United States
| | - Himanshu Shekhar
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cincinnati, OH, United States
| | - Warunya Panmanee
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Sydney D. Collins
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cincinnati, OH, United States
| | - Arunkumar Palaniappan
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cincinnati, OH, United States
| | - Cameron T. McDaniel
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Daniel J. Hassett
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Christy K. Holland
- Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cincinnati, OH, United States
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, United States
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Clinical and economic burden of community-onset multidrug-resistant infections requiring hospitalization. J Infect 2020; 80:271-278. [PMID: 31917968 DOI: 10.1016/j.jinf.2019.12.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/26/2019] [Accepted: 12/31/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To analyze the clinical and economic burden of community-acquired (CA) or community-onset healthcare-associated (COHCA) multidrug-resistant (MDR) infections requiring hospitalization. METHODS Case-control study. Adults admitted with CA or COHCA MDR infections were considered cases, while those admitted in the same period with non-MDR infections were controls. The matching criteria were source of infection and/or microorganism. Primary outcome was 30-day clinical failure. Secondary outcomes were 90-day and 1-year mortality, hospitalization costs and resource consumption. RESULTS 194 patients (97 cases and 97 controls) were included. Multivariate analysis identified age (odds ratio [OR], 1.07, 95% confidence interval [CI], 1.01-1.14) and SOFA score (OR, 1.45, CI95%, 1.15-1.84) as independent predictors of 30-day clinical failure. Age (hazard ratio [HR] 1.09, 95%CI, 1.03-1.16) was the only factor associated with 90-day mortality, whereas age (HR 1.06, 95%CI, 1.03-1.09) and Charlson Index (HR 1.2, 95%CI, 1.07-1.34) were associated with 1-year mortality. MDR group showed longer hospitalization (p<0.001) and MDR hospitalization costs almost doubled those in the non-MDR group. MDR infections were associated with higher antimicrobial costs. CONCLUSIONS Worse economic outcomes were identified with community-onset MDR infections. MDR was associated with worse clinical outcomes but mainly due to higher comorbidity of patients in MDR group, rather than multidrug resistance.
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Elevated Bioactivity of Ruta graveolens against Cancer Cells and Microbes Using Seaweeds. Processes (Basel) 2020. [DOI: 10.3390/pr8010075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Human cancer and pathogenic microbes cause a significant number of deaths every year. Modulating current sources of natural products that control such diseases becomes essential. Natural algae, such as Ascophyllum nodosum and Ecklonia maxima, can modulate the metabolic processes as well the bioactivities of Ruta graveolens L. The R. graveolens plants were subjected to nine soil drenches of A. nodosum (7 mL L−1), E. maxima (7 mL L−1), or both extracts. Morphological performance, gas exchange parameters, and essential oils (EOs) composition (GC-MS) were studied and the bioactivity was assessed against several cancer cells and pathogenic bacteria or fungi. Treatment with A. nodosum + E. maxima seaweed extracts (SWE) led to the highest morphological performance and gas exchange parameters. The highest antiproliferative, apoptotic, and caspase-3/7 activities of EO were against HeLa in SWE mixture treated plants. The best EO antimicrobial activities were obtained against Staphylococcus aureus and Penicillium ochrochloron. SWE mixtures treated plants showed the best bioactivities against microbes and cancer cells. The highest abundance of 2-undecanone (62%) and 2-nonanone (18%) was found in plants treated with SWE mixtures and caused the best anticancer and antimicrobial effects. Seaweed mixtures act as natural elicitors of pharmaceutical industries and favored 2-undecanone and 2-nonanone in R. graveolens.
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Madivoli ES, Kareru PG, Gachanja AN, Mugo SM, Makhanu DS, Wanakai SI, Gavamukulya Y. Facile Synthesis of Silver Nanoparticles Using Lantana trifolia Aqueous Extracts and Their Antibacterial Activity. J Inorg Organomet Polym Mater 2020. [DOI: 10.1007/s10904-019-01432-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Febrile Neutropenia in Acute Leukemia. Epidemiology, Etiology, Pathophysiology and Treatment. Mediterr J Hematol Infect Dis 2020; 12:e2020009. [PMID: 31934319 PMCID: PMC6951355 DOI: 10.4084/mjhid.2020.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/17/2019] [Indexed: 12/11/2022] Open
Abstract
Acute leukemias are a group of aggressive malignant diseases associated with a high degree of morbidity and mortality. An important cause of both the latter is infectious complications. Patients with acute leukemia are highly susceptible to infectious diseases due to factors related to the disease itself, factors attributed to treatment, and specific individual risk factors in each patient. Patients with chemotherapy-induced neutropenia are at particularly high risk, and microbiological agents include viral, bacterial, and fungal agents. The etiology is often unknown in infectious complications, although adequate patient evaluation and sampling have diagnostic, prognostic and treatment-related consequences. Bacterial infections include a wide range of potential microbes, both Gram-negative and Gram-positive species, while fungal infections include both mold and yeast. A recurring problem is increasing resistance to antimicrobial agents, and in particular, this applies to extended-spectrum beta-lactamase resistance (ESBL), Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE) and even carbapenemase-producing Enterobacteriaceae (CPE). International guidelines for the treatment of sepsis in leukemia patients include the use of broad-spectrum Pseudomonas-acting antibiotics. However, one should implant the knowledge of local microbiological epidemiology and resistance conditions in treatment decisions. In this review, we discuss infectious diseases in acute leukemia with a major focus on febrile neutropenia and sepsis, and we problematize the diagnostic, prognostic, and therapeutic aspects of infectious complications in this patient group. Meticulously and thorough clinical and radiological examination combined with adequate microbiology samples are cornerstones of the examination. Diagnostic and prognostic evaluation includes patient review according to the multinational association for supportive care in cancer (MASCC) and sequential organ failure assessment (SOFA) scoring system. Antimicrobial treatments for important etiological agents are presented. The main challenge for reducing the spread of resistant microbes is to avoid unnecessary antibiotic treatment, but without giving to narrow treatment to the febrile neutropenic patient that reduce the prognosis.
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Frost I, Van Boeckel TP, Pires J, Craig J, Laxminarayan R. Global geographic trends in antimicrobial resistance: the role of international travel. J Travel Med 2019; 26:5496989. [PMID: 31115466 DOI: 10.1093/jtm/taz036] [Citation(s) in RCA: 147] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/03/2019] [Accepted: 05/03/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Rising antimicrobial resistance (AMR) is a threat to modern medicine, and increasing international mobility facilitates the spread of AMR. Infections with resistant organisms have higher morbidity and mortality, are costlier to treat, result in longer hospital stays and place a greater burden on health systems than infections caused by susceptible organisms. Here we review the role of travel in the international dissemination of AMR and consider actions at the levels of travelers, travel medicine practitioners and policymakers that would mitigate this threat. RESULTS Resistant pathogens do not recognize international borders; travelers to areas with high AMR prevalence are likely to be exposed to resistant bacteria and return to their home countries colonized. Medical tourists go between health facilities with drastically different rates of AMR, potentially transmitting highly resistant strains.Drug-resistant bacteria have been found in every continent; however, differences between countries in the prevalence of AMR depend on multiple factors. These include levels of antibiotic consumption (including inappropriate use), access to clean water, adequate sanitation, vaccination coverage, the availability of quality healthcare and access to high-quality medical products. CONCLUSIONS Travelers to areas with high levels of AMR should have vaccines up to date, be aware of ways of treating and preventing travelers' diarrhea (other than antibiotic use) and be informed on safe sexual practices. The healthcare systems of low- and middle-income countries require investment to reduce the transmission of resistant strains by improving access to clean water, sanitation facilities and vaccines. Efforts are needed to curb inappropriate antibiotic use worldwide. In addition, more surveillance is needed to understand the role of the movement of humans, livestock and food products in resistance transmission. The travel medicine community has a key role to play in advocating for the recognition of AMR as a priority on the international health agenda. KEY POLICY RECOMMENDATIONS AMR is a threat to modern medicine, and international travel plays a key role in the spread of highly resistant strains. It is essential that this is addressed at multiple levels. Individual travelers can reduce antibiotic consumption and the likelihood of infection. Travelers should have up-to-date vaccines and be informed on methods of preventing and treating travelers' diarrhea, other than use of antibiotics and on safe sexual practices, such as condom use. Healthcare facilities need to be aware of the travel history of patients to provide appropriate treatment to those who are at high risk of exposure and to prevent further spread. Internationally, in countries without reliable and universal access to clean water, sanitation and hygiene, investment is needed to reduce the emergence and spread of resistance and ensure the antimicrobials available are of assured quality. High-income countries must ensure their use of antimicrobials is appropriate to reduce selection for AMR. Surveillance across all countries is needed to monitor and respond to this emerging threat.
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Affiliation(s)
- Isabel Frost
- Center for Disease Dynamics, Economics & Policy, New Delhi, India.,Amity Institute of Public Health, Amity University, Noida, India
| | - Thomas P Van Boeckel
- Center for Disease Dynamics, Economics & Policy, New Delhi, India.,Swiss Federal Institute of Technology Zurich, Department of Earth Systems Science, Institute for Integrative Biology, ETH Zurich, Zurich, Switzerland
| | - João Pires
- Swiss Federal Institute of Technology Zurich, Department of Earth Systems Science, Institute for Integrative Biology, ETH Zurich, Zurich, Switzerland
| | - Jessica Craig
- Center for Disease Dynamics, Economics & Policy, New Delhi, India
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, New Delhi, India.,Princeton Environmental Institute, Princeton University, New Jersey, USA
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El-Khatib L, Al-Dalain S, Al-Matarneh R, Al-Bustanji S, Al-Dmour M, Al-Amarin Y, Gaber Y. Prevalence of Multi-drug Resistant Acinetobacter baumannii (MDRAB) in Amman Jordan During 2018. Infect Disord Drug Targets 2019; 21:105-111. [PMID: 31823709 DOI: 10.2174/1871526519666191211144344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/23/2019] [Accepted: 12/03/2019] [Indexed: 11/22/2022]
Abstract
PURPOSE Acinetobacter baumannii is an opportunistic pathogen, and is among the most problematic nosocomial infections as well as community-acquired infections. This retrospective study was conducted as an attempt to determine the prevalence of multidrug-resistant A. baumannii (MDRAB) isolates from the north and central Jordan area during 2018. METHODS Patients' records provided by an accredited central private laboratory located in Amman, were examined for A. baumannii isolates identified during this period. The isolates were identified to the species level using the API-10S system and the antimicrobial sensitivity testing was determined using the Kirby-Bauer disc diffusion method. RESULTS A total of 43 unduplicated isolates were obtained and classified according to clinical sampling source into: Group I (blood), Group II (urine) and Group III (wound, pus, sputum, bedsore and others). Total MDRAB isolates recorded were 29 (67.4 %). Resistance to imipenem was found to be 36% and 94% among groups II and III, respectively, and resistance to meropenem was 60% and 88% among the same groups, respectively. CONCLUSION Antimicrobial stewardship programs at a national scale are needed to calculate the actual proportion of MDRAB in the country and to combat its increasing emergence and decrease the magnitude of antibiotic resistance.
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Affiliation(s)
- Layla El-Khatib
- Department of Biological Sciences, School of Science, The University of Jordan, Amman, 11942, Jordan
| | - Saed Al-Dalain
- Department of Pharmacology, Faculty of Medicine, Mutah University, Al-Karak, 61710, Jordan
| | - Rama Al-Matarneh
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Mutah University, Al-Karak, 61710, Jordan
| | - Sara Al-Bustanji
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Mutah University, Al-Karak, 61710, Jordan
| | - Marwa Al-Dmour
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Mutah University, Al-Karak, 61710, Jordan
| | - Yara Al-Amarin
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Mutah University, Al-Karak, 61710, Jordan
| | - Yasser Gaber
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Mutah University, Al-Karak, 61710, Jordan
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Masri A, Anwar A, Khan NA, Siddiqui R. The Use of Nanomedicine for Targeted Therapy against Bacterial Infections. Antibiotics (Basel) 2019; 8:E260. [PMID: 31835647 PMCID: PMC6963790 DOI: 10.3390/antibiotics8040260] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/16/2019] [Accepted: 10/22/2019] [Indexed: 02/08/2023] Open
Abstract
The emergence of drug resistance combined with limited success in the discovery of newer and effective antimicrobial chemotherapeutics poses a significant challenge to human and animal health. Nanoparticles may be an approach for effective drug development and delivery against infections caused by multi-drug resistant bacteria. Here we discuss nanoparticles therapeutics and nano-drug delivery against bacterial infections. The therapeutic efficacy of numerous kinds of nanoparticles including nanoantibiotics conjugates, small molecules capped nanoparticles, polymers stabilized nanoparticles, and biomolecules functionalized nanoparticles has been discussed. Moreover, nanoparticles-based drug delivery systems against bacterial infections have been described. Furthermore, the fundamental limitation of biocompatibility and biosafety of nanoparticles is also conferred. Finally, we propose potential future strategies of nanomaterials as antibacterials.
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Affiliation(s)
- Abdulkader Masri
- Department of Biological Sciences, School of Science and Technology, Sunway University, Selangor 47500, Malaysia; (A.M.)
| | - Ayaz Anwar
- Department of Biological Sciences, School of Science and Technology, Sunway University, Selangor 47500, Malaysia; (A.M.)
| | - Naveed Ahmed Khan
- Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, University City, Sharjah 26666, UAE
| | - Ruqaiyyah Siddiqui
- Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, University City, Sharjah 26666, UAE
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Gupta M, Didwal G, Bansal S, Kaushal K, Batra N, Gautam V, Ray P. Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community. Indian J Med Res 2019; 149:276-280. [PMID: 31219094 PMCID: PMC6563735 DOI: 10.4103/ijmr.ijmr_207_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background & objectives Rampant use of β-lactam antibiotics in both community and hospitals has transformed the human healthy intestinal gut flora into a reservoir of antibiotic-resistant organisms. This study was conducted to find the faecal presence of antibiotic-resistant Enterobacteriaceae in faecal samples in the community in north India. Methods In this prospective study, 207 stool samples were collected from apparently healthy individuals residing in a semiurban community in Chandigarh, India, from August to October, 2015. Isolates belonging to family Enterobacteriaceae were identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and antibiotic susceptibility was determined using Clinical Laboratory Standard Institute disc diffusion method. Detection of extended spectrum β-lactamases (TEM, SHV, OXA-1, CTXM 1, CTXM 2, CTXM 9 and CTXM 8/25), carbapenemases (IMP, VIM and KPC) and New Delhi metallo-β-lactamase was done by multiplex PCR. Results Of the population studied, 55.5 per cent were females and 60 per cent were illiterate or had only primary education; 43.4 per cent individuals were aged <20 yr. Overall, 70.5 per cent of stool samples had antibiotic-resistant isolates. Maximum resistance was seen for cephalosporins (60.4%) followed by fluoroquinolones (41.5%). The multidrug-resistant (MDR) isolates were 2.4 per cent. The most commonly detected genes were TEM, SHV, OXA-1, CTXM-1, CTXM-2, CTXM-9 and CTXM-8/25 β-lactamases. Escherichia coli was the most common resistant isolate, and TEM was the most common gene detected. Interpretation & conclusions Overall, 70.5 per cent members of Enterobacteriaceae had antibiotic resistance in the community and 2.4 per cent were MDR. Higher resistance rates were observed for most commonly used drugs such as cephalosporins and fluoroquinolones. High rate of antibiotic-resistant Enterobacteriaceae in gut of healthy individuals points towards the need for active screening and prevention of dissemination.
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Affiliation(s)
- Madhu Gupta
- Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Gunjan Didwal
- Advanced Paediatrics Center, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Shruti Bansal
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kanica Kaushal
- Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Nitya Batra
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Vikas Gautam
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Pallab Ray
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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