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De Waele JJ, Boelens J. Antimicrobial stewardship and molecular diagnostics: a symbiotic approach to combating resistance in the ED and ICU. Curr Opin Crit Care 2024; 30:231-238. [PMID: 38525881 DOI: 10.1097/mcc.0000000000001154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
PURPOSE OF REVIEW This review aims to evaluate the incorporation of rapid molecular diagnostics (RMD) in antimicrobial stewardship programs (ASPs) in the management of patients in the emergency department (ED) and intensive care unit (ICU), highlighting a shift from conventional microbiological diagnostic tests to RMD strategies to optimize antimicrobial use and improve patient outcomes. RECENT FINDINGS Recent advances in RMD have demonstrated the superior accuracy of RMD in identifying pathogens, combined with shorter turnaround times. RMD allows speeding up of antimicrobial decision making in the ED and facilitates faster escalation when empirical therapy was inappropriate, as well as more efficient de-escalation of empirical therapy later in the course of the treatment. Implementation of RMD however may be challenging. SUMMARY RMD hold great value in simplifying patient management and mitigating antimicrobial exposure, particularly in settings with high levels of antimicrobial resistance where the use of broad-spectrum antimicrobials is high. While the impact on the use of antimicrobials is significant, the impact on patient outcomes is not yet clear. Successful integration of RMD in clinical decision making in the ED and ICU requires a team approach and continued education, and its use should be adapted to the local epidemiology and infrastructure.
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Affiliation(s)
- Jan J De Waele
- Department of Critical Care Medicine, Ghent University Hospital
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University
| | - Jerina Boelens
- Department of Medical Microbiology, Ghent University Hospital
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
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2
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Shao F, Li H, Hsieh K, Zhang P, Li S, Wang TH. Automated and miniaturized screening of antibiotic combinations via robotic-printed combinatorial droplet platform. Acta Pharm Sin B 2024; 14:1801-1813. [PMID: 38572105 PMCID: PMC10985126 DOI: 10.1016/j.apsb.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 04/05/2024] Open
Abstract
Antimicrobial resistance (AMR) has become a global health crisis in need of novel solutions. To this end, antibiotic combination therapies, which combine multiple antibiotics for treatment, have attracted significant attention as a potential approach for combating AMR. To facilitate advances in antibiotic combination therapies, most notably in investigating antibiotic interactions and identifying synergistic antibiotic combinations however, there remains a need for automated high-throughput platforms that can create and examine antibiotic combinations on-demand, at scale, and with minimal reagent consumption. To address these challenges, we have developed a Robotic-Printed Combinatorial Droplet (RoboDrop) platform by integrating a programmable droplet microfluidic device that generates antibiotic combinations in nanoliter droplets in automation, a robotic arm that arranges the droplets in an array, and a camera that images the array of thousands of droplets in parallel. We further implement a resazurin-based bacterial viability assay to accelerate our antibiotic combination testing. As a demonstration, we use RoboDrop to corroborate two pairs of antibiotics with known interactions and subsequently identify a new synergistic combination of cefsulodin, penicillin, and oxacillin against a model E. coli strain. We therefore envision RoboDrop becoming a useful tool to efficiently identify new synergistic antibiotic combinations toward combating AMR.
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Affiliation(s)
- Fangchi Shao
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Hui Li
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Kuangwen Hsieh
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Pengfei Zhang
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Sixuan Li
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Tza-Huei Wang
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
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3
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Yock-Corrales A, Naranjo-Zuñiga G. Regional Perspective of Antimicrobial Stewardship Programs in Latin American Pediatric Emergency Departments. Antibiotics (Basel) 2023; 12:antibiotics12050916. [PMID: 37237820 DOI: 10.3390/antibiotics12050916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/06/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
Antibiotic stewardship (AS) programs have become a priority for health authorities to reduce the number of infections by super-resistant microorganisms. The need for these initiatives to minimize the inadequate use of antimicrobials is essential, and the election of the antibiotic in the emergency department usually impacts the choice of treatment if the patients need hospital admission, becoming an opportunity for antibiotic stewardship. In the pediatric population, broad-spectrum antibiotics are more likely to be overprescribed without any evidence-based management, and most of the publications have focused on the prescription of antibiotics in ambulatory settings. Antibiotic stewardship efforts in pediatric emergency departments in Latin American settings are limited. The lack of literature on AS programs in the pediatric emergency departments in Latin America (LA) limits the information available. The aim of this review was to give a regional perspective on how pediatric emergency departments in LA are working towards antimicrobial stewardship.
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Affiliation(s)
- Adriana Yock-Corrales
- Emergency Department, Hospital Nacional de Niños "Dr. Carlos Saenz Herrera", Caja Costarricense del Seguro Social (CCSS), San José P.O. Box 1654-1000, Costa Rica
| | - Gabriela Naranjo-Zuñiga
- Infectious Disease Department, Hospital Nacional de Niños "Dr. Carlos Saenz Herrera", Caja Costarricense del Seguro Social (CCSS), San José P.O. Box 1654-1000, Costa Rica
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4
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Comparative meta-analysis of host transcriptional response during Streptococcus pneumoniae carriage or infection. Microb Pathog 2022; 173:105816. [DOI: 10.1016/j.micpath.2022.105816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/16/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
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5
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Samtiya M, Matthews KR, Dhewa T, Puniya AK. Antimicrobial Resistance in the Food Chain: Trends, Mechanisms, Pathways, and Possible Regulation Strategies. Foods 2022; 11:foods11192966. [PMID: 36230040 PMCID: PMC9614604 DOI: 10.3390/foods11192966] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial resistance (AMR) remains of major interest for different types of food stakeholders since it can negatively impact human health on a global scale. Antimicrobial-resistant bacteria and/or antimicrobial resistance genes (transfer in pathogenic bacteria) may contaminate food at any stage, from the field to retail. Research demonstrates that antimicrobial-resistant bacterial infection(s) occur more frequently in low- and middle-income countries (LMICs) than in developed countries. Worldwide, foodborne pathogens are a primary cause of morbidity and mortality. The spread of pathogenic bacteria from food to consumers may occur by direct or indirect routes. Therefore, an array of approaches both at the national and international level to control the spread of foodborne pathogens and promote food safety and security are essential. Zoonotic microbes can spread through the environment, animals, humans, and the food chain. Antimicrobial drugs are used globally to treat infections in humans and animals and prophylactically in production agriculture. Research highlights that foods may become contaminated with AMR bacteria (AMRB) during the continuum from the farm to processing to retail to the consumer. To mitigate the risk of AMRB in humans, it is crucial to control antibiotic use throughout food production, both for animal and crop agriculture. The main inferences of this review are (1) routes by which AMRB enters the food chain during crop and animal production and other modes, (2) prevention and control steps for AMRB, and (3) impact on human health if AMR is not addressed globally. A thorough perspective is presented on the gaps in current systems for surveillance of antimicrobial use in food production and/ or AMR in the food chain.
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Affiliation(s)
- Mrinal Samtiya
- Department of Nutrition Biology, Central University of Haryana, Mahendergarh 123029, India
| | - Karl R. Matthews
- Department of Food Science, Rutgers University, New Brunswick, NJ 08901, USA
| | - Tejpal Dhewa
- Department of Nutrition Biology, Central University of Haryana, Mahendergarh 123029, India
- Correspondence:
| | - Anil Kumar Puniya
- Dairy Microbiology Division, ICAR-National Dairy Research Institute, Karnal 132001, India
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Arrazuria R, Kerscher B, Huber KE, Hoover JL, Lundberg CV, Hansen JU, Sordello S, Renard S, Aranzana-Climent V, Hughes D, Gribbon P, Friberg LE, Bekeredjian-Ding I. Expert workshop summary: Advancing toward a standardized murine model to evaluate treatments for antimicrobial resistance lung infections. Front Microbiol 2022; 13:988725. [PMID: 36160186 PMCID: PMC9493304 DOI: 10.3389/fmicb.2022.988725] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
The rise in antimicrobial resistance (AMR), and increase in treatment-refractory AMR infections, generates an urgent need to accelerate the discovery and development of novel anti-infectives. Preclinical animal models play a crucial role in assessing the efficacy of novel drugs, informing human dosing regimens and progressing drug candidates into the clinic. The Innovative Medicines Initiative-funded “Collaboration for prevention and treatment of MDR bacterial infections” (COMBINE) consortium is establishing a validated and globally harmonized preclinical model to increase reproducibility and more reliably translate results from animals to humans. Toward this goal, in April 2021, COMBINE organized the expert workshop “Advancing toward a standardized murine model to evaluate treatments for AMR lung infections”. This workshop explored the conduct and interpretation of mouse infection models, with presentations on PK/PD and efficacy studies of small molecule antibiotics, combination treatments (β-lactam/β-lactamase inhibitor), bacteriophage therapy, monoclonal antibodies and iron sequestering molecules, with a focus on the major Gram-negative AMR respiratory pathogens Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii. Here we summarize the factors of variability that we identified in murine lung infection models used for antimicrobial efficacy testing, as well as the workshop presentations, panel discussions and the survey results for the harmonization of key experimental parameters. The resulting recommendations for standard design parameters are presented in this document and will provide the basis for the development of a harmonized and bench-marked efficacy studies in preclinical murine pneumonia model.
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Affiliation(s)
- Rakel Arrazuria
- Division of Microbiology, Paul-Ehrlich-Institut, Langen, Germany
| | | | - Karen E. Huber
- Division of Microbiology, Paul-Ehrlich-Institut, Langen, Germany
| | - Jennifer L. Hoover
- Infectious Diseases Research Unit, GlaxoSmithKline Pharmaceuticals, Collegeville, PA, United States
| | | | - Jon Ulf Hansen
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | | | | | | | - Diarmaid Hughes
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Philip Gribbon
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Discovery Research ScreeningPort, Hamburg, Germany
| | | | - Isabelle Bekeredjian-Ding
- Division of Microbiology, Paul-Ehrlich-Institut, Langen, Germany
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
- *Correspondence: Isabelle Bekeredjian-Ding,
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Diagnostic Stewardship—The Impact of Rapid Diagnostic Testing for Paediatric Respiratory Presentations in the Emergency Setting: A Systematic Review. CHILDREN 2022; 9:children9081226. [PMID: 36010116 PMCID: PMC9406643 DOI: 10.3390/children9081226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/06/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022]
Abstract
Antimicrobial resistance is a growing public health crisis, propelled by inappropriate antibiotic prescription, in particular the over-prescription of antibiotics, prolonged duration of antibiotic therapy and the overuse of broad-spectrum antibiotics. The paediatric population, in particular, those presenting to emergency settings with respiratory symptoms, have been associated with a high rate of antibiotic prescription rates. Further research has now shown that many of these antibiotic prescriptions may have been avoided, with more targeted diagnostic methods to identify underlying aetiologies. The purpose of this systematic review was to assess the impact of rapid diagnostic testing, for paediatric respiratory presentations in the emergency setting, on antibiotic prescription rates. To review the relevant history, a comprehensive search of Medline, EMBASE and Cochrane Database of Systematic Reviews was performed. Eighteen studies were included in the review, and these studies assessed a variety of rapid diagnostic testing tools and outcome measures. Overall, rapid diagnostic testing was found to be an effective method of diagnostic antibiotic stewardship with great promise in improving antibiotic prescribing behaviours. Further studies are required to evaluate the use of rapid diagnostic testing with other methods of antibiotics stewardship, including clinical decisions aids and to increase the specificity of interventions following diagnosis to further reduce rates of antibiotic prescription.
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Abdelrahman Hussain M, Osman Mohamed A, Sandel Abkar A, Siddig Mohamed F, Khider Elzubair H. Knowledge, Attitude and Practice of Community Pharmacists in Relation to Dispensing Antibiotics Without Prescription in Sudan: A Cross-sectional Study. Integr Pharm Res Pract 2022; 11:107-116. [PMID: 35915837 PMCID: PMC9338346 DOI: 10.2147/iprp.s363079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/13/2022] [Indexed: 11/23/2022]
Abstract
Background Dispensing antibiotics without prescription (DAwP) is a widespread practice, especially in developing countries, contributing to antibiotic resistance. Community pharmacists play a significant role in promoting rational use of antibiotics by refraining from DAwP, and providing drug information to patients. This study aimed to evaluate community pharmacists’ knowledge, attitude and practice, and to assess the factors behind DAwP. Methods A cross-sectional study was conducted in 2020 among random sample of community pharmacists in Sudan. Online semi-structured questionnaire was used for data collection. The association between dependent and independent variables was assessed using Chi-square test; a P-value less than 0.05 was considered significant. Results Of the 1217 pharmacists who participated, the majority were female (n = 645, 53%). Most pharmacists have a B. Pharm degree (n = 1026, 84%) and less than 5 years’ experience (n = 718, 59%). Notably, the majority of community pharmacists have good knowledge (n = 735, 61.7%), which is significantly associated with years of experience (P < 0.00). More than half (n = 623, 52.2%) of the pharmacists have above average score of practice. Nearly all the pharmacists who participated have a positive attitude in relation to DAwP (n = 1204, 98.9%). More than half of the pharmacists were DAwP for tonsillitis (n = 817, 67%), wound infection (n = 766, 62.9%), and urinary tract infection (n = 664, 54%). The leading factor behind DAwP was the low socioeconomic status of the patients (n = 624, 51%). Additionally, 47% of the pharmacists (n = 572) thought that they were knowledgeable enough to DAwP. Conclusion Despite their positive attitude and average level of knowledge regarding DAwP, Sudanese community pharmacists frequently are DAwP for tonsillitis. Low patients’ socioeconomic status was the leading factor behind DAwP. Accordingly, extensive work from health authorities to improve the accessibility and affordability of the health system as well as the development of an antibiotic stewardship program are required to diminish DAwP.
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Affiliation(s)
- Mohamed Abdelrahman Hussain
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan
| | - Ahmed Osman Mohamed
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan
| | - Alsara Sandel Abkar
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan
| | - Fatima Siddig Mohamed
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan
| | - Hana Khider Elzubair
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan
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9
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Souganidis ES, Patel B, Sampayo EM. Physician-Specific Utilization of an Electronic Best Practice Alert for Pediatric Sepsis in the Emergency Department. Pediatr Emerg Care 2022; 38:e1417-e1422. [PMID: 35696307 DOI: 10.1097/pec.0000000000002778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Early recognition of sepsis remains a critical goal in the pediatric emergency department (ED). Although this has led to the development of best practice alerts (BPAs) to facilitate screening and bundled care, research on how individual physicians interact with sepsis alerts and protocols is limited. This study aims to identify common reasons for acceptance and rejection of a sepsis BPA by pediatric emergency medicine (PEM) physicians and understand how the BPA affects physician management of patients with suspected sepsis. METHODS This is a qualitative study of PEM physicians in a quaternary-care children's hospital. Data were collected through semistructured interviews and analyzed through an iterative coding process until thematic saturation was achieved. Member checking was completed to ensure trustworthiness. Thematic analysis of PEM physicians' rejection reasons in the electronic health record was used to categorize their responses and calculate each theme's frequency. RESULTS Twenty-two physicians participated in this study. Seven physicians (32%) relied solely on patient characteristics when deciding to accept the BPA, whereas the remaining physicians considered nonpatient factors specific to the ED environment, individualized practice patterns, and BPA design. Eleven principal reasons for BPA rejection were derived from 1406 electronic health record responses, with clinical appearance not consistent with shock being the most common. Physicians identified the BPA's configuration and incomplete understanding of the BPA as the biggest barriers to utilization and provided strategies to improve the BPA screening process and streamline sepsis care. Physicians emphasized the need for further BPA education for physicians and triage staff and improved transparency of the alert. CONCLUSIONS Physicians consider patient and nonpatient factors when responding to the BPA. Improved BPA functionality combined with measures to enhance screening, optimize sepsis management, and educate ED providers on the BPA may increase satisfaction with the alert and promote more effective utilization when it fires.
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Affiliation(s)
- Ellie S Souganidis
- From the Texas Children's Hospital, Baylor College of Medicine, Houston, TX
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10
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Lim DW, Htun HL, Ong LS, Guo H, Chow A. Systematic review of determinants influencing antibiotic prescribing for uncomplicated acute respiratory tract infections in adult patients at the emergency department. Infect Control Hosp Epidemiol 2022; 43:366-375. [PMID: 33118891 DOI: 10.1017/ice.2020.1245] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Overuse of antibiotics in the emergency department (ED) for uncomplicated acute respiratory tract infections (uARTIs) is a public health issue that needs to be addressed. We aimed to identify factors associated with antibiotic use for uARTIs in adults presenting at the ED. DESIGN We searched Medline, Embase, PsycINFO and the Cochrane Library for articles published from 1 January 2005 to 30 June 2017 using a predetermined search strategy. Titles and abstracts of English articles on antibiotic prescription and inappropriate antibiotic use for adult ARTI at EDs were assessed, followed by full article review, by 2 authors. SETTING Emergency departments. PARTICIPANTS Adults aged 18 years and older. RESULTS Of the 2,591 articles retrieved, 12 articles met the inclusion criteria and 11 studies were conducted in the United States. Patients with normal C-reactive protein levels and positive influenza tests were less likely to receive antibiotic treatment. Nonclinical factors associated with antibiotic use were longer waiting time and perceived patient desire for antibiotics. Patients attended by internal medicine physicians comanaged by house staff or who visited an ED which provided education to healthcare providers on antibiotics use were less likely to receive antibiotics. CONCLUSIONS English-language articles that fulfilled the selection criteria outside the United States were limited. Factors associated with antibiotics use are multifaceted. Education of healthcare providers presents an opportunity to improve antibiotic use.
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Affiliation(s)
- Dwee Wee Lim
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
| | - Htet Lin Htun
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
| | - Lay See Ong
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
| | - Huiling Guo
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
| | - Angela Chow
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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11
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Matlock A, Garcia JA, Moussavi K, Long B, Liang SYT. Advances in novel antibiotics to treat multidrug-resistant gram-negative bacterial infections. Intern Emerg Med 2021; 16:2231-2241. [PMID: 33956311 PMCID: PMC8100742 DOI: 10.1007/s11739-021-02749-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/16/2021] [Indexed: 01/01/2023]
Abstract
Antimicrobial resistance is a growing threat to public health and an increasingly common problem for acute care physicians to confront. Several novel antibiotics have been approved in the past decade to combat these infections; however, physicians may be unfamiliar with how to appropriately utilize them. The purpose of this review is to evaluate novel antibiotics active against resistant gram-negative bacteria and highlight clinical information regarding their use in the acute care setting. This review focuses on novel antibiotics useful in the treatment of infections caused by resistant gram-negative organisms that may be seen in the acute care setting. These novel antibiotics include ceftolozane/tazobactam, ceftazidime/avibactam, meropenem/vaborbactam, imipenem/cilistatin/relebactam, cefiderocol, plazomicin, eravacycline, and omadacycline. Acute care physicians should be familiar with these novel antibiotics so they can utilize them appropriately.
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Affiliation(s)
- Aaron Matlock
- Department of Emergency Medicine, Brooke Army Medical Center, 3841 Roger Brooke Dr, Fort Sam Houston, TX 78234 USA
| | - Joshua Allan Garcia
- Assistant Professor, Department of Pharmacy Practice, Marshall B. Ketchum University College of Pharmacy, Fullerton, CA USA
| | - Kayvan Moussavi
- Assistant Professor, Department of Pharmacy Practice, Marshall B. Ketchum University College of Pharmacy, Fullerton, CA USA
| | - Brit Long
- Department of Emergency Medicine, Brooke Army Medical Center, 3841 Roger Brooke Dr, Fort Sam Houston, TX 78234 USA
| | - Stephen Yuan-Tung Liang
- Department of Emergency Medicine and Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO USA
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12
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Obolski U, Kassem E, Na'amnih W, Tannous S, Kagan V, Muhsen K. Unnecessary antibiotic treatment of children hospitalised with respiratory syncytial virus (RSV) bronchiolitis: risk factors and prescription patterns. J Glob Antimicrob Resist 2021; 27:303-308. [PMID: 34718202 DOI: 10.1016/j.jgar.2021.10.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/25/2021] [Accepted: 10/01/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Respiratory syncytial virus (RSV) is a leading cause of respiratory tract infections, especially in young children. Antibiotics are often unnecessarily prescribed for the treatment of RSV. Such treatments affect antibiotic resistance in future bacterial infections of treated patients and the general population. This study aimed to understand risk factors for and patterns of unnecessary antibiotic prescription in children with RSV. METHODS In a single-centre, retrospective study in Israel, we obtained data for children aged ≤2 years (n = 1016) hospitalised for RSV bronchiolitis during 2008-2018 and ascertained not to have bacterial co-infections. Antibiotic misuse was defined as prescription of antibiotics during hospitalisation of the study population. Demographic and clinical variables were assessed as predictors of unnecessary antibiotic treatment in a multivariable logistic regression model. RESULTS The unnecessary antibiotic treatment rate of children infected with RSV and ascertained not to have a bacterial co-infection was estimated at 33.4% (95% CI 30.5-36.4%). An increased likelihood of antibiotic misuse was associated with drawing bacterial cultures and with variables indicative of a severe patient status such as lower oxygen saturation, higher body temperature, tachypnoea and prior recent emergency room visit. Older age and female sex were also associated with an increased likelihood of unnecessary antibiotic treatment. CONCLUSIONS Unnecessary antibiotic treatment in RSV patients was very common and may be largely attributed to physicians' perception of patients' severity. Improving prescription guidelines, implementing antibiotic stewardship programmes and utilising decision support systems may help achieve a better balance between prescribing and withholding antibiotic treatment.
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Affiliation(s)
- Uri Obolski
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Porter School of Environmental and Earth Sciences, Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - Eias Kassem
- Department of Pediatrics, Hillel Yaffe Medical Center, Hadera, Israel
| | - Wasef Na'amnih
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shebly Tannous
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Viktoria Kagan
- Department of Pediatrics, Hillel Yaffe Medical Center, Hadera, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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SİG AK, KULA ATİK T, ÇETİN DURAN A. Antibiotic resistance of Enterococcus species: 3-year data. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.949498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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14
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Kim H, Lee DG. Contribution of SOS genes to H 2O 2-induced apoptosis-like death in Escherichia coli. Curr Genet 2021; 67:969-980. [PMID: 34435216 DOI: 10.1007/s00294-021-01204-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 01/07/2023]
Abstract
Hydrogen peroxide (H2O2) is a debriding agent that damages the microbial structure and function by generating various reactive oxygen species (ROS). H2O2-produced hydroxyl radical (OH∙) also exerts oxidative stress on microorganisms. The spread of antibiotic-resistance in bacteria is a serious issue worldwide, and greater efforts are needed to identify and characterize novel antibacterial mechanisms to develop new treatment strategies. Therefore, this study aimed to clarify the relationship between H2O2 and Escherichia coli and to elucidate a novel antibacterial mechanism(s) of H2O2. Following H2O2 exposure, increased levels of 8-hydroxydeoxyguanosine and malondialdehyde indicated that H2O2 accelerates oxidation of bacterial DNA and lipids in E. coli. As oxidative damage worsened, the SOS response was triggered. Cell division arrest and resulting filamentous cells were identified in cells, indicating that LexA was involved in DNA replication. It was also verified that RecA, a representative SOS gene, helps self-cleavage of LexA and acts as a bacterial caspase-like protein. Our findings also showed that dinF is essential to preserve E. coli from H2O2-induced ROS, and furthermore, demonstrated that H2O2-induced SOS response and SOS genes participate differently in guarding E. coli from oxidative stress. As an extreme SOS response is considered apoptosis-like death (ALD) in bacteria, additional experiments were performed to examine the characteristics of ALD. DNA fragmentation and membrane depolarization appeared in H2O2-treated cells, suggesting that H2O2 causes ALD in E. coli. In conclusion, our investigations revealed that ALD is a novel antibacterial mode of action(s) of H2O2 with important contributions from SOS genes.
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Affiliation(s)
- Heesu Kim
- School of Life Sciences, BK21 FOUR KNU Creative BioResearch Group, Kyungpook National University, Daegu, 41566, Korea
| | - Dong Gun Lee
- School of Life Sciences, BK21 FOUR KNU Creative BioResearch Group, Kyungpook National University, Daegu, 41566, Korea.
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Pinto L, Torres C, Gil C, Santos HM, Capelo JL, Borges V, Gomes JP, Silva C, Vieira L, Poeta P, Igrejas G. Multiomics Substrates of Resistance to Emerging Pathogens? Transcriptome and Proteome Profile of a Vancomycin-Resistant Enterococcus faecalis Clinical Strain. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2020; 24:81-95. [PMID: 32073998 DOI: 10.1089/omi.2019.0164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Antibiotic resistance and hospital acquired infections are on the rise worldwide. Vancomycin-resistant enterococci have been reported in clinical settings in recent decades. In this multiomics study, we provide comprehensive proteomic and transcriptomic analyses of a vancomycin-resistant Enterococcus faecalis clinical isolate from a patient with a urinary tract infection. The previous genotypic profile of the strain C2620 indicated the presence of antibiotic resistance genes characteristic of the vanB cluster. To further investigate the transcriptome of this pathogenic strain, we used whole genome sequencing and RNA-sequencing to detect and quantify the genes expressed. In parallel, we used two-dimensional gel electrophoresis followed by MALDI-TOF/MS (Matrix-assisted laser desorption/ionization-Time-of-flight/Mass spectrometry) to identify the proteins in the proteome. We studied the membrane and cytoplasm subproteomes separately. From a total of 207 analysis spots, we identified 118 proteins. The protein list was compared to the results obtained from the full transcriptome assay. Several genes and proteins related to stress and cellular response were identified, as well as some linked to antibiotic and drug responses, which is consistent with the known state of multiresistance. Even though the correlation between transcriptome and proteome data is not yet fully understood, the use of multiomics approaches has proven to be increasingly relevant to achieve deeper insights into the survival ability of pathogenic bacteria found in health care facilities.
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Affiliation(s)
- Luís Pinto
- Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Veterinary Science Department, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Carmen Torres
- Área de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain
| | - Concha Gil
- Departamento de Microbiologia II, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
| | - Hugo M Santos
- LAQV-REQUIMTE, Faculty of Science and Technology, Nova University of Lisbon, Lisbon, Portugal
| | - José Luís Capelo
- LAQV-REQUIMTE, Faculty of Science and Technology, Nova University of Lisbon, Lisbon, Portugal
| | - Vítor Borges
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health, Lisbon, Portugal
| | - João Paulo Gomes
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health, Lisbon, Portugal
| | - Catarina Silva
- Innovation and Technology Unit, Department of Human Genetics, National Institute of Health, Lisbon, Portugal
| | - Luís Vieira
- Innovation and Technology Unit, Department of Human Genetics, National Institute of Health, Lisbon, Portugal
| | - Patrícia Poeta
- Veterinary Science Department, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,LAQV-REQUIMTE, Faculty of Science and Technology, Nova University of Lisbon, Lisbon, Portugal
| | - Gilberto Igrejas
- Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,LAQV-REQUIMTE, Faculty of Science and Technology, Nova University of Lisbon, Lisbon, Portugal
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16
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Xue B, Huang J, Zhang H, Li B, Xu M, Zhang Y, Xie M, Li X. Micronized curcumin fabricated by supercritical CO2 to improve antibacterial activity against Pseudomonas aeruginosa. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2020; 48:1135-1143. [PMID: 32896157 DOI: 10.1080/21691401.2020.1815755] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Baiji Xue
- The Second Affiliated Hospital of Guangzhou Medical University; Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital; Department of Biomedical Engineering, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, PR China
- School of Basic Medical Sciences, Baicheng Medical College, Baicheng, PR China
| | - Jinxiang Huang
- The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital; State Key Laboratory of Respiratory Disease, Sino-French Hoffmann Institute, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, PR China
| | - Haoxiang Zhang
- The Second Affiliated Hospital of Guangzhou Medical University; Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital; Department of Biomedical Engineering, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, PR China
| | - Bingliang Li
- Nan Shan School, Guangzhou Medical University, Guangzhou, PR China
| | - Man Xu
- The Second Affiliated Hospital of Guangzhou Medical University; Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital; Department of Biomedical Engineering, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, PR China
| | - Yuelan Zhang
- The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital; State Key Laboratory of Respiratory Disease, Sino-French Hoffmann Institute, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, PR China
| | - Maobin Xie
- The Second Affiliated Hospital of Guangzhou Medical University; Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital; Department of Biomedical Engineering, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, PR China
| | - Xuefeng Li
- The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital; State Key Laboratory of Respiratory Disease, Sino-French Hoffmann Institute, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, PR China
- Shenzhen Luohu People’s Hospital, The Third Affiliated Hospital of Shenzhen University, Shenzhen, PR China
- Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, PR China
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17
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Long B, April MD, Koyfman A. Dog Bites are an Indication for Routine Antibiotic Therapy. Ann Emerg Med 2020; 76:85-86. [PMID: 32591126 DOI: 10.1016/j.annemergmed.2020.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Indexed: 10/24/2022]
Affiliation(s)
- Brit Long
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, TX
| | - Michael D April
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, TX
| | - Alex Koyfman
- The University of Texas Southwestern Medical Center, Department of Emergency Medicine, Dallas, TX
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18
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Garber B, Glauser J. Recent Developments in Infectious Disease Chemotherapy: Review for Emergency Department Practitioners 2020. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2020; 8:116-121. [PMID: 32837804 PMCID: PMC7296288 DOI: 10.1007/s40138-020-00218-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Purpose of Review We discuss and review new antimicrobials for treatment of bacterial, viral, fungal, and parasitic infections with indications, contraindications, and side effects for each. We will also review new information and indications on older agents that are relevant to clinical practice. Many of them may be unfamiliar to Emergency Physicians given their newness and at times hospital restrictions on their use. We also review some new promising agents that are not yet in the clinical pipeline. Recent Findings As new antibiotics become available for clinicians to use, new information becomes available with respect to the drugs' indications, efficacy, pathogen resistance, drug-drug interactions, and side effects. Summary This article provides Emergency Department clinicians with a useful summary with new information on antibiotic use and recent research into agents which may become available.
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Affiliation(s)
- Boris Garber
- MetroHealth Medical Center, Case Western Reserve School of Medicine, Cleveland, OH USA
| | - Jonathan Glauser
- MetroHealth Medical Center, Case Western Reserve School of Medicine, Cleveland, OH USA
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19
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Qian Y, Allegretta G, Janardhanan J, Peng Z, Mahasenan KV, Lastochkin E, Gozun MMN, Tejera S, Schroeder VA, Wolter WR, Feltzer R, Mobashery S, Chang M. Exploration of the Structural Space in 4(3 H)-Quinazolinone Antibacterials. J Med Chem 2020; 63:5287-5296. [PMID: 32343145 DOI: 10.1021/acs.jmedchem.0c00153] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We report herein the syntheses of 79 derivatives of the 4(3H)-quinazolinones and their structure-activity relationship (SAR) against methicillin-resistant Staphylococcus aureus (MRSA). Twenty one analogs were further evaluated in in vitro assays. Subsequent investigation of the pharmacokinetic properties singled out compound 73 ((E)-3-(5-carboxy-2-fluorophenyl)-2-(4-cyanostyryl)quinazolin-4(3H)-one) for further study. The compound synergized with piperacillin-tazobactam (TZP) both in vitro and in vivo in a clinically relevant mouse model of MRSA infection. The TZP combination lacks activity against MRSA, yet it synergized with compound 73 to kill MRSA in a bactericidal manner. The synergy is rationalized by the ability of the quinazolinones to bind to the allosteric site of penicillin-binding protein (PBP)2a, resulting in opening of the active site, whereby the β-lactam antibiotic now is enabled to bind to the active site in its mechanism of action. The combination effectively treats MRSA infection, for which many antibiotics (including TZP) have faced clinical obsolescence.
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Affiliation(s)
- Yuanyuan Qian
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556, United States
| | - Giuseppe Allegretta
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556, United States
| | - Jeshina Janardhanan
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556, United States
| | - Zhihong Peng
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556, United States
| | - Kiran V Mahasenan
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556, United States
| | - Elena Lastochkin
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556, United States
| | - Melissa Malia N Gozun
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556, United States
| | - Sara Tejera
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556, United States
| | - Valerie A Schroeder
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556, United States
| | - William R Wolter
- Freimann Life Sciences Center, University of Notre Dame, Notre Dame, Indiana 46556, United States
| | - Rhona Feltzer
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556, United States
| | - Shahriar Mobashery
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556, United States
| | - Mayland Chang
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556, United States
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20
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Conway J, Friedman B. Adjuvant Antibiotic Therapy After Incision and Drainage of Cutaneous Abscesses. Acad Emerg Med 2020; 27:427-428. [PMID: 31749255 DOI: 10.1111/acem.13892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 11/18/2019] [Accepted: 11/19/2019] [Indexed: 12/13/2022]
Affiliation(s)
- John Conway
- Department of Emergency Medicine Albert Einstein College of Medicine Bronx NY
| | - Benjamin Friedman
- Department of Emergency Medicine Albert Einstein College of Medicine Bronx NY
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21
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Rodriguez L, Fišera R, Gaálová B, Koči K, Bujdáková H, Mečiarová M, Górová R, Jurdáková H, Šebesta R. Synthesis of Chiral 3,4-Disubstituted Pyrrolidines with Antibacterial Properties. European J Org Chem 2020. [DOI: 10.1002/ejoc.202000235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
| | - Roman Fišera
- SYNKOLA Ltd.; Ilkovičova 6 84215 Bratislava Slovakia
| | - Barbora Gaálová
- Comenius University in Bratislava; 84215 Bratislava Slovakia
| | - Kamila Koči
- Comenius University in Bratislava; 84215 Bratislava Slovakia
| | | | - Mária Mečiarová
- Department of Organic Chemistry; Faculty of Natural Sciences; Comenius University in Bratislava; Mlynská dolina, Ilkovičova 6 84215 Bratislava Slovakia
| | - Renáta Górová
- Institute of Chemistry; Faculty of Natural Sciences; Comenius University in Bratislava; 84215 Bratislava Slovakia
| | - Helena Jurdáková
- Institute of Chemistry; Faculty of Natural Sciences; Comenius University in Bratislava; 84215 Bratislava Slovakia
| | - Radovan Šebesta
- Department of Organic Chemistry; Faculty of Natural Sciences; Comenius University in Bratislava; Mlynská dolina, Ilkovičova 6 84215 Bratislava Slovakia
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22
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Zhang X, Han D, Pei P, Hao J, Lu Y, Wan P, Peng X, Lv W, Xiong W, Zeng Z. In vitro Antibacterial Activity of Isopropoxy Benzene Guanidine Against Multidrug-Resistant Enterococci. Infect Drug Resist 2019; 12:3943-3953. [PMID: 31920348 PMCID: PMC6934121 DOI: 10.2147/idr.s234509] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 11/22/2019] [Indexed: 12/23/2022] Open
Abstract
Background Bacterial infections cause a serious public health crisis due to the emergence of resistance towards multiple conventional antibacterial drugs. In particular, multidrug-resistant (MDR) Enterococcus faecium which belongs to "ESKAPE" organisms is causing significant problems worldwide. Hence, there is an urgent need to find alternative therapies. Recently, substituted benzene guanidine compounds have been used as lead structures to discover new promising drugs in both synthetic and medicinal chemistry. Purpose Here we investigated the antimicrobial activity of a new substituted benzene guanidine analog, isopropoxy benzene guanidine, against Enterococci. Material and methods The isopropoxy benzene guanidine was synthesized by Guangzhou Insighter Biotechnology Co., Ltd and tested on both reference bacterial strain and 32 clinical MDR Enterococci strains. The in vitro antibacterial activity was evaluated by microdilution method and kill kinetic assays. The potential antibacterial mechanism was measured by fluorescence spectrometry using fluorescent membrane potential probe 3, 3-diethyloxacarbocyanine iodide (DiOC2 (3)). Results Isopropoxy benzene guanidine exhibited potent bactericidal activity against both reference strain and MDR Enterococci isolates. The minimum inhibitory concentration (MIC) range for isopropoxy benzene guanidine was 1-4 μg/mL. Minimum bactericidal concentration (MBC) was about 2-8-fold of its MIC values. Time-kill studies showed that isopropoxy benzene guanidine provided superior bactericidal effect against reference and MDR strains within 12 hrs at 2×MIC. Furthermore, isopropoxy benzene guanidine could cause a large reduction in the magnitude of the generated membrane potential compared to that of the untreated cells. Conclusion The present study highlights the potent bactericidal activity of isopropoxy benzene guanidine on Enterococci by disrupting the cell membrane potential. These findings demonstrate that isopropoxy benzene guanidine may be a good chemical lead for further medicinal chemistry and pharmaceutical development and could be used as a therapeutic agent for infectious diseases caused by MDR Enterococci.
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Affiliation(s)
- Xiufeng Zhang
- National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou 510642, People's Republic of China.,Guangdong Provincial Key Laboratory of Veterinary Drugs Development and Safety Evaluation, South China Agricultural University, Guangzhou 510642, People's Republic of China.,National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou 510642, People's Republic of China
| | - Dongdong Han
- National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou 510642, People's Republic of China.,Guangdong Provincial Key Laboratory of Veterinary Drugs Development and Safety Evaluation, South China Agricultural University, Guangzhou 510642, People's Republic of China.,National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou 510642, People's Republic of China
| | - Pengfei Pei
- National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou 510642, People's Republic of China.,Guangdong Provincial Key Laboratory of Veterinary Drugs Development and Safety Evaluation, South China Agricultural University, Guangzhou 510642, People's Republic of China.,National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou 510642, People's Republic of China
| | - Jie Hao
- National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou 510642, People's Republic of China.,Guangdong Provincial Key Laboratory of Veterinary Drugs Development and Safety Evaluation, South China Agricultural University, Guangzhou 510642, People's Republic of China.,National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou 510642, People's Republic of China
| | - Yixing Lu
- National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou 510642, People's Republic of China.,Guangdong Provincial Key Laboratory of Veterinary Drugs Development and Safety Evaluation, South China Agricultural University, Guangzhou 510642, People's Republic of China.,National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou 510642, People's Republic of China
| | - Peng Wan
- National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou 510642, People's Republic of China.,Guangdong Provincial Key Laboratory of Veterinary Drugs Development and Safety Evaluation, South China Agricultural University, Guangzhou 510642, People's Republic of China.,National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou 510642, People's Republic of China
| | - Xianfeng Peng
- Guangzhou Insighter Biotechnology Co., Ltd, Guangzhou 510642, People's Republic of China
| | - Weibiao Lv
- Department of Clinical Laboratory, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan 528000, People's Republic of China
| | - Wenguang Xiong
- National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou 510642, People's Republic of China.,Guangdong Provincial Key Laboratory of Veterinary Drugs Development and Safety Evaluation, South China Agricultural University, Guangzhou 510642, People's Republic of China.,National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou 510642, People's Republic of China
| | - Zhenling Zeng
- National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou 510642, People's Republic of China.,Guangdong Provincial Key Laboratory of Veterinary Drugs Development and Safety Evaluation, South China Agricultural University, Guangzhou 510642, People's Republic of China.,National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou 510642, People's Republic of China
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23
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Zakaa El-Din M, Samy F, Mohamed A, Hamdy F, Yasser S, Ehab M. Egyptian community pharmacists' attitudes and practices towards antibiotic dispensing and antibiotic resistance; a cross-sectional survey in Greater Cairo. Curr Med Res Opin 2019; 35:939-946. [PMID: 30388895 DOI: 10.1080/03007995.2018.1544119] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Antibiotic resistance is an increasing worldwide crisis. In Egypt, it is prohibited by law to dispense antibiotics with no prescription; however, there are no active and enforced governmental policies and laws to regulate such a process. This has led to increased antibiotic dispensing and consumption. AIMS To assess some basic knowledge and attitudes towards antibiotic resistance and the practice of antibiotic dispensing among Egyptian community pharmacists in Greater Cairo. METHODOLOGY An observational cross-sectional self-administrated survey targeting licensed community pharmacists in Greater Cairo, Egypt. The survey was validated by both face and content validation. RESULTS Exactly 531 pharmacists were invited to join the survey, and only 461 pharmacists agreed to participate. Approximately half of the participants (51.2%) were considered to have good basic knowledge regarding antibiotic use and antibiotic resistance. The majority (74%) of the respondents strongly agreed that antibiotics are over-prescribed in Egypt, and almost all of them (90%) were hoping the Ministry of Health could publish guidelines for antibiotic dispensing in Egypt. Male pharmacists were more likely to engage and communicate with either patient or prescriber during the antibiotic dispensing process compared to females. CONCLUSION The Egyptian Ministry of Health should regulate and monitor the process of dispensing antibiotics without a prescription with law enforcements. Moreover, community pharmacists should have more awareness on the consequences of the problem of antibiotic dispensing without a prescription, regardless of the business profit behind it.
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Affiliation(s)
| | | | | | | | | | - Moataz Ehab
- b Department of Pharmacy Practice, Faculty of Pharmacy , Helwan University , Cairo , Egypt
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24
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Fernandez J, Acosta G, Pulido D, Malý M, Copa-Patiño JL, Soliveri J, Royo M, Gómez R, Albericio F, Ortega P, de la Mata FJ. Carbosilane Dendron-Peptide Nanoconjugates as Antimicrobial Agents. Mol Pharm 2019; 16:2661-2674. [PMID: 31009225 DOI: 10.1021/acs.molpharmaceut.9b00222] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Over the last decades, multidrug-resistant bacteria have emerged and spread, increasing the number of bacteria, against which commonly used antibiotics are no longer effective. It has become a serious public health problem whose solution requires medical research in order to explore novel effective antimicrobial molecules. On the one hand, antimicrobial peptides (AMPs) are regarded as good alternatives because of their generally broad-spectrum activities, but sometimes they can be easily degraded by the organism or be toxic to animal cells. On the other hand, cationic carbosilane dendrons, whose focal point can be functionalized in many different ways, have also shown good antimicrobial activity. In this work, we synthetized first- and second-generation cationic carbosilane dendrons with a maleimide molecule on their focal point, enabling their functionalization with three different AMPs. After different microbiology studies, we found an additive effect between first-generation dendron and AMP3 whose study reveals three interesting effects: (i) bacteria aggregation due to AMP3, which could facilitate bacteria detection or even contribute to antibacterial activity by preventing host cell attack, (ii) bacteria disaggregation capability of second-generation cationic dendrons, and (iii) a higher AMP3 aggregation ability when dendrons were added previously to peptide treatment. These compounds and their different effects observed over bacteria constitute an interesting system for further mechanism studies.
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Affiliation(s)
- Jael Fernandez
- Instituto de Investigación Química "Andrés M. del Río" (IQAR) , UAH , 28801 Alcalá de Henares , Spain.,Networking Research Center on Bioengineering , Biomaterials and Nanomedicine (CIBER-BBN) , 28029 Madrid , Spain.,Instituto Ramón y Cajal de Investigación Sanitaria, IRYCIS , 28034 Madrid , Spain
| | - Gerardo Acosta
- Networking Research Center on Bioengineering , Biomaterials and Nanomedicine (CIBER-BBN) , 28029 Madrid , Spain.,Deparment of Organic and Inorganic Chemistry , University of Barcelona , 08028 Barcelona , Spain.,Institute for Advanced Chemistry of Catalonia-CSIC , 08034 Barcelona , Spain
| | - Daniel Pulido
- Networking Research Center on Bioengineering , Biomaterials and Nanomedicine (CIBER-BBN) , 28029 Madrid , Spain.,Institute for Advanced Chemistry of Catalonia-CSIC , 08034 Barcelona , Spain
| | - Marek Malý
- Faculty of Science , J. E. Purkinje University , České mládeže 8 , 400 96 Ústí nad Labem , Czech Republic
| | | | | | - Miriam Royo
- Networking Research Center on Bioengineering , Biomaterials and Nanomedicine (CIBER-BBN) , 28029 Madrid , Spain.,Institute for Advanced Chemistry of Catalonia-CSIC , 08034 Barcelona , Spain
| | - Rafael Gómez
- Instituto de Investigación Química "Andrés M. del Río" (IQAR) , UAH , 28801 Alcalá de Henares , Spain.,Networking Research Center on Bioengineering , Biomaterials and Nanomedicine (CIBER-BBN) , 28029 Madrid , Spain.,Instituto Ramón y Cajal de Investigación Sanitaria, IRYCIS , 28034 Madrid , Spain
| | - Fernando Albericio
- Networking Research Center on Bioengineering , Biomaterials and Nanomedicine (CIBER-BBN) , 28029 Madrid , Spain.,Deparment of Organic and Inorganic Chemistry , University of Barcelona , 08028 Barcelona , Spain.,Institute for Advanced Chemistry of Catalonia-CSIC , 08034 Barcelona , Spain.,School of Chemistry and Physics , University of KwaZulu-Natal , 4001 Durban , South Africa
| | - Paula Ortega
- Instituto de Investigación Química "Andrés M. del Río" (IQAR) , UAH , 28801 Alcalá de Henares , Spain.,Networking Research Center on Bioengineering , Biomaterials and Nanomedicine (CIBER-BBN) , 28029 Madrid , Spain.,Instituto Ramón y Cajal de Investigación Sanitaria, IRYCIS , 28034 Madrid , Spain
| | - F Javier de la Mata
- Instituto de Investigación Química "Andrés M. del Río" (IQAR) , UAH , 28801 Alcalá de Henares , Spain.,Networking Research Center on Bioengineering , Biomaterials and Nanomedicine (CIBER-BBN) , 28029 Madrid , Spain.,Instituto Ramón y Cajal de Investigación Sanitaria, IRYCIS , 28034 Madrid , Spain
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25
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Zelelie TZ, Gebreyes DS, Tilahun AT, Craddock HA, Gishen NZ. Enteropathogens in Under-Five Children with Diarrhea in Health Facilities of Debre Berhan Town, North Shoa, Ethiopia. Ethiop J Health Sci 2019; 29:203-214. [PMID: 31011268 PMCID: PMC6460452 DOI: 10.4314/ejhs.v29i2.7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Diarrheal disease is a major cause of mortality and morbidity for under-five children in Ethiopia. The purpose of this study was to investigate the behavioral and socioeconomic risk factors, etiology, and drug susceptibility of bacteria isolated from under-five children with acute diarrhea who were treated at Debre Berhan Referral Hospital or Health Center in Ethiopia. Methods A health facility based cross-sectional study design was used to investigate enteropathogens from 163 under-five children with acute diarrhea. After obtaining written consent from parents or guardians, data were collected using a standardized questionnaire. Freshly passed stool samples were collected for microbiological tests for bacteria and parasites. The chi-square test was used for assessing the relationships of variables. Results Enteropathogens were detected among 55.8% (91/163) participants. There was a 46%(75/163) bacterial culture positivity rate and a 9.8%(16/163) prevalence of parasites. The isolated enteropathogens were Escherchia coli, Klebsiella specie, Proteus species, Salmonella species, Shigella species, Enterobacter species, Giardia lamblia, Enteameba histolytica, Ascaris lumbricoides, Trichuris trichiura and Hymnoleps nana. Level of antimicrobial resistance of bacterial isolates ranged from 0 to 87.2%. Poor hand washing and poor cleaning of feeding utensils showed significant association with the presence of enteropathogens. Conclusion Bacterial enteropathogens with drug resistance were observed in this study. Continuous health education and promotion about diarrheal disease for mothers/caretakers and regular surveillance of entropathogenes are recommended to reduce under-five mortality.
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Affiliation(s)
- Tizazu Zenebe Zelelie
- Department of Medicine, Medical Microbiology Unit, Debre Berhan University, Ethiopia
| | | | | | | | - Nigus Zegeye Gishen
- Department of Medicine, Medical Microbiology Unit, Debre Berhan University, Ethiopia
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Latendorf T, Gerstel U, Wu Z, Bartels J, Becker A, Tholey A, Schröder JM. Cationic Intrinsically Disordered Antimicrobial Peptides (CIDAMPs) Represent a New Paradigm of Innate Defense with a Potential for Novel Anti-Infectives. Sci Rep 2019; 9:3331. [PMID: 30833614 PMCID: PMC6399351 DOI: 10.1038/s41598-019-39219-w] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 12/19/2018] [Indexed: 12/22/2022] Open
Abstract
In the search for potential mechanisms underlying the remarkable resistance of healthy skin against infection by soil bacteria like Pseudomonas (P.) aeruginosa we identified fragments of the intrinsically disordered protein hornerin as potent microbicidal agents in the stratum corneum. We found that, independent of the amino acid (AA)-sequence, any tested linear cationic peptide containing a high percentage of disorder-promoting AA and a low percentage of order-promoting AA is a potent microbicidal antimicrobial. We further show that the antimicrobial activity of these cationic intrinsically disordered antimicrobial peptides (CIDAMPs) depends on the peptide chain length, its net charge, lipidation and environmental conditions. The ubiquitous presence of latent CIDAMP sources in nature suggests a common and yet overlooked adapted innate disinfection system of body surfaces. The simple structure and virtually any imaginable sequence or composition of disorder-promoting AA allow the generation of a plethora of CIDAMPs. These are potential novel microbicidal anti-infectives for various bacterial pathogens, including P. aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA) and fungal pathogens like Candida albicans and Cryptococcus neoformans.
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Affiliation(s)
- Ties Latendorf
- Department of Dermatology, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ulrich Gerstel
- Department of Dermatology, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Zhihong Wu
- Department of Dermatology, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
- Institute of Biochemistry and Cell Biology, Zhejiang University of Science and Technology, 310023, Hangzhou, China
| | - Joachim Bartels
- Department of Dermatology, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Alexander Becker
- Institute for Experimental Medicine-AG Systematic Proteomics & Bioanalytics, Kiel University (CAU), Kiel, Germany
| | - Andreas Tholey
- Institute for Experimental Medicine-AG Systematic Proteomics & Bioanalytics, Kiel University (CAU), Kiel, Germany
| | - Jens-Michael Schröder
- Department of Dermatology, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
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Cationic biaryl 1,2,3-triazolyl peptidomimetic amphiphiles: synthesis, antibacterial evaluation and preliminary mechanism of action studies. Eur J Med Chem 2019; 168:386-404. [PMID: 30831407 DOI: 10.1016/j.ejmech.2019.02.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/18/2019] [Accepted: 02/04/2019] [Indexed: 11/20/2022]
Abstract
Synthetic small molecular antimicrobial peptidomimetics represent a promising new class of potential antibiotics due to their membrane-disrupting ability and their decreased propensity for bacterial resistance. A library of 43 mono- and di-cationic biaryl 1,2,3-triazolyl peptidomimetics was designed and synthesized based upon previously established lead biarylpeptidomimetics and a known pharmacophore. A reliable, facile and modular synthetic pathway allowed for the efficient synthesis of multiple unique scaffolds which were subjected to divergent derivatization to furnish the amphiphilic compounds. In vitro testing revealed enhanced antibacterial efficacy against a range of pathogenic bacteria, including bacterial isolates with methicillin, vancomycin, daptomycin, or multi-drug resistance. Preliminary time-kill kinetics and membrane-disruption assays revealed a likely membrane-active mechanism for the tested peptidomimetics. An optimal balance between hydrophobicity and cationic charge was found to be essential for reduced cytotoxicity/haemolysis (i.e. membrane selectivity) and enhanced Gram-negative activity. The cationic biaryl amphiphile 81 was identified as a potent, broad-spectrum peptidomimetic with activity against Gram-positive (methicillin-resistant Staphylococcus aureus - MIC = 2 μg/mL) and Gram-negative (Escherichia coli - MIC = 4 μg/mL) pathogenic bacteria.
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Langata LM, Maingi JM, Musonye HA, Kiiru J, Nyamache AK. Antimicrobial resistance genes in Salmonella and Escherichia coli isolates from chicken droppings in Nairobi, Kenya. BMC Res Notes 2019; 12:22. [PMID: 30642404 PMCID: PMC6332563 DOI: 10.1186/s13104-019-4068-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/09/2019] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Increase in antimicrobial resistance is a threat to health sector globally. Surveillance on the spread and emergence of antimicrobial resistance is therefore invertible. This study investigated prevalence of Salmonella and Escherichia coli, molecularly characterized their antimicrobial resistance patterns and spread among resistant isolates from chicken droppings. RESULTS A total of 150 chicken households were selected randomly within Nairobi and fresh chicken droppings collected. Salmonella and Escherichia coli were isolated and antimicrobial susceptibility test carried out. Beta-lactamase genes and class 1 integrons were determined among amoxicillin resistant isolates. Isolates carrying TEM gene were further subjected to (GTG)5 PCR genotyping. Of the analysed samples, 57% and 12% contained Escherichia coli and Salmonella respectively. Most of the isolates were susceptible to the tested antibiotics with exemption of 53% of the isolates that were resistant to amoxicillin. The isolates were detected with TEM (46%), CTX-M (18%) resistance genes and class 1 integrons (25%). The study reveals presence of beta-lactamase genes and class 1 integrons across Salmonella and Escherichia coli isolates from droppings of reared chicken. Therefore, the wide distribution of chicken and their fecal waste is likely to increase development of antibiotic resistance.
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Affiliation(s)
- Lydia Mali Langata
- Department of Microbiology, Kenyatta University, P.O Box 43844, Nairobi, 00100, Kenya.
| | - John M Maingi
- Department of Microbiology, Kenyatta University, P.O Box 43844, Nairobi, 00100, Kenya
| | - Harry Asena Musonye
- Department of Microbiology, Kenyatta University, P.O Box 43844, Nairobi, 00100, Kenya
| | - John Kiiru
- Centre of Microbiology Research, Kenya Medical Research Institute, P.O Box 54840, Nairobi, 00200, Kenya
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Sroka Z, Zgórka G, Żbikowska B, Sowa A, Franiczek R, Wychowaniec K, Krzyżanowska B. High Antimicrobial Efficacy, Antioxidant Activity, and a Novel Approach to Phytochemical Analysis of Bioactive Polyphenols in Extracts from Leaves of Pyrus communis and Pyrus pyrifolia Collected During One Vegetative Season. Microb Drug Resist 2018; 25:582-593. [PMID: 30547716 DOI: 10.1089/mdr.2018.0149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Dried leaf samples of Pyrus communis L. var. 'Conference' and Pyrus pyrifolia Burm. f. (Nakai) var. 'Shinseiki' were subjected to the successful extraction procedures using various solvents, followed by filtering and/or drying liquid plant preparations under reduced pressure. As a result of this, for each Pyrus leaf sample examined, four dried residues were obtained, including methanolic (EA), ethyl acetate (EC), water (EB), and the residue obtained from aqueous solution (ED). Antiradical activity of these preparations was measured using the ABTS+• assay, and antimicrobial activity was examined using various strains of bacteria and yeasts. The highest antiradical activity was observed for EC from leaves of P. communis var. 'Conference' collected in May, but the highest average antibacterial activity was noted for EC residues from P. pyrifolia var. 'Shinseiki' collected in May. Antibacterial activity positively correlated with concentration of hydroquinone in extracts. No antifungal activity was observed for any extract. In addition, qualitative and quantitative analyses of active polyphenolic components in extracts from Pyrus were performed. Hydroquinone and hydroxycinnamic acid derivatives were analyzed using a new optimized method comprising reversed-phase high-performance liquid chromatography (RP-LC) coupled with simultaneous photodiode-array and fluorescence detection.
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Affiliation(s)
- Zbigniew Sroka
- 1 Department of Pharmacognosy, Faculty of Pharmacy, Wrocław Medical University, Wrocław, Poland
| | - Grażyna Zgórka
- 2 Chair and Department of Pharmacognosy with Medicinal Plant Unit, Faculty of Pharmacy with Medical Analytics Division, Medical University of Lublin, Lublin, Poland
| | - Beata Żbikowska
- 1 Department of Pharmacognosy, Faculty of Pharmacy, Wrocław Medical University, Wrocław, Poland
| | - Alina Sowa
- 1 Department of Pharmacognosy, Faculty of Pharmacy, Wrocław Medical University, Wrocław, Poland
| | - Roman Franiczek
- 3 Department of Microbiology, Faculty of Medicine, Wrocław Medical University, Wrocław, Poland
| | - Karolina Wychowaniec
- 1 Department of Pharmacognosy, Faculty of Pharmacy, Wrocław Medical University, Wrocław, Poland
| | - Barbara Krzyżanowska
- 3 Department of Microbiology, Faculty of Medicine, Wrocław Medical University, Wrocław, Poland
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Fernández M, Corral-Lugo A, Krell T. The plant compound rosmarinic acid induces a broad quorum sensing response in Pseudomonas aeruginosa PAO1. Environ Microbiol 2018; 20:4230-4244. [PMID: 30051572 DOI: 10.1111/1462-2920.14301] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/28/2018] [Indexed: 02/05/2023]
Abstract
The interference of plant compounds with bacterial quorum sensing (QS) is a major mechanism through which plants and bacteria communicate. However, little is known about the modes of action and effects on signal integrity during this type of communication. We have recently shown that the plant compound rosmarinic acid (RA) specifically binds to the Pseudomonas aeruginosa RhlR QS receptor. To determine the effect of RA on expression patterns, we carried out global RNA-seq analysis. The results show that RA induces the expression of 128 genes, amongst which many virulence factor genes. RA triggers a broad QS response because 88% of the induced genes are known to be controlled by QS, and because RA stimulated genes were found to be involved in all four QS signalling systems within P. aeruginosa. This finding was confirmed through the analysis of transcriptional fusions transferred to wt and a rhlI/lasI double mutant. RA did not induce gene expression in the rhlI/lasI/rhlR triple mutant indicating that the effects observed are due to the RA-RhlR interaction. Furthermore, RA induced seven sRNAs that were all encoded in regions close to QS and/or RA induced genes. This work significantly enhances our understanding of plant bacteria interaction.
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Affiliation(s)
- Matilde Fernández
- Department of Environmental Protection, Estación Experimental del Zaidín, Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - Andrés Corral-Lugo
- Department of Environmental Protection, Estación Experimental del Zaidín, Consejo Superior de Investigaciones Científicas, Granada, Spain
- Institut de Biologie Intégrative de la Cellule (I2BC), CNRS, Gif-Sur-Yvette, France
| | - Tino Krell
- Department of Environmental Protection, Estación Experimental del Zaidín, Consejo Superior de Investigaciones Científicas, Granada, Spain
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31
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Gottlieb M, DeMott JM, Hallock M, Peksa GD. Systemic Antibiotics for the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysis. Ann Emerg Med 2018. [PMID: 29530658 DOI: 10.1016/j.annemergmed.2018.02.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE The addition of antibiotics to standard incision and drainage is controversial, with earlier studies demonstrating no significant benefit. However, 2 large, multicenter trials have recently been published that have challenged the previous literature. The goal of this review was to determine whether systemic antibiotics for abscesses after incision and drainage improve cure rates. METHODS PubMed, the Cumulative Index of Nursing and Allied Health Literature, Scopus, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and bibliographies of selected articles were assessed for all randomized controlled trials comparing adjuvant antibiotics with placebo in the treatment of drained abscesses, with an outcome of treatment failure assessed within 21 days. Data were dual extracted into a predefined worksheet and quality analysis was performed with the Cochrane Risk of Bias tool. RESULTS Four studies (n=2,406 participants) were identified. There were 89 treatment failures (7.7%) in the antibiotic group and 150 (16.1%) in the placebo group. The calculated risk difference was 7.4% (95% confidence interval [CI] 2.8% to 12.1%), with an odds ratio for clinical cure of 2.32 (95% CI 1.75 to 3.08) in favor of the antibiotic group. There was also a decreased incidence of new lesions in the antibiotic group (risk difference -10.0%, 95% CI -12.8% to -7.2%; odds ratio 0.32, 95% CI 0.23 to 0.44), with a minimally increased risk of minor adverse events (risk difference 4.4%, 95% CI 1.0% to 7.8%; odds ratio 1.29, 95% CI 1.06 to 1.58). CONCLUSION The use of systemic antibiotics for skin and soft tissue abscesses after incision and drainage resulted in an increased rate of clinical cure. Providers should consider the use of antibiotics while balancing the risk of adverse events.
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Affiliation(s)
- Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL.
| | - Joshua M DeMott
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL
| | - Marilyn Hallock
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL
| | - Gary D Peksa
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL
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