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Shafiq M, Guo X, Wang M, Bilal H, Xin L, Yuan Y, Yao F, Sheikh TMM, Khan MN, Jiao X. Integrative metagenomic dissection of last-resort antibiotic resistance genes and mobile genetic elements in hospital wastewaters. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 949:174930. [PMID: 39067608 DOI: 10.1016/j.scitotenv.2024.174930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 07/02/2024] [Accepted: 07/19/2024] [Indexed: 07/30/2024]
Abstract
Hospital wastewater is a critical source of antimicrobial resistance (AMR), which facilitates the proliferation and spread of clinically significant antimicrobial resistance genes (ARGs) and pathogenic bacteria. This study utilized metagenomic approaches, including advanced binning techniques, such as MetaBAT2, MaxBin2, and CONCOCT, which offer significant improvements in accuracy and completeness over traditional binning methods. These methods were used to comprehensively assess the dynamics and composition of resistomes and mobilomes in untreated wastewater samples taken from two general hospitals and one cancer hospital. This study revealed a diverse bacterial landscape, largely consisting of Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria, with notable variations in microbial composition among hospitals. Analysis of the top 15 genera showed unique microbial pattern distribution in each hospital: Aeromonas was predominant in 1stHWTS (49.39 %), Acidovorax in the CAHWTS at 16.85 %, and Escherichia and Bacteroides in the 2ndHWTS at 11.44 % and 11.33 %, respectively. A total of 114 pathogenic bacteria were identified, with drug-resistant Aeromonas caviae and Escherichia coli being the most prevalent. The study identified 34 types and 1660 subtypes of ARGs, including important last-resort antibiotic resistance genes (LARGs), such as blaNDM, mcr, and tet(X). Using metagenomic binning, this study uncovered distinct patterns of host-resistance associations, particularly with Proteobacteria and Firmicutes. Network analysis highlighted the complex interactions among ARGs, mobile genetic elements (MGEs), and bacterial species, all contributing to the dissemination of AMR. These findings emphasize the intricate nature of AMR in hospital wastewater and the influence of hospital-specific factors on microbial resistance patterns. This study provides support for implementing integrated management strategies, including robust surveillance, advanced wastewater treatment, and strict antibiotic stewardship, to control the dissemination of AMR. Understanding the interplay among bacterial communities, ARGs, and MGEs is important for developing effective public health measures against AMR.
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Affiliation(s)
- Muhammad Shafiq
- Research Institute of Clinical Pharmacy, Department of Pharmacology, Shantou University Medical College, Shantou 515041, China; Department of Cell Biology and Genetics, Shantou University Medical College, Shantou 515041, China
| | - Xiaoling Guo
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou 515041, China
| | - Meimei Wang
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou 515041, China
| | - Hazrat Bilal
- Jiangxi Key Laboratory of Oncology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Cancer Institute, Nanchang, Jiangxi 330029, PR China
| | - Li Xin
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou 515041, China
| | - Yumeng Yuan
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou 515041, China
| | - Fen Yao
- Research Institute of Clinical Pharmacy, Department of Pharmacology, Shantou University Medical College, Shantou 515041, China
| | | | - Muhammad Nadeem Khan
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou 515041, China
| | - Xiaoyang Jiao
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou 515041, China.
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Orosz L, Burián K. The "COVID effect" in culture-based clinical microbiology: Changes induced by COVID-19 pandemic in a Hungarian tertiary care center. J Infect Public Health 2024; 17:102453. [PMID: 38820897 DOI: 10.1016/j.jiph.2024.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 05/03/2024] [Accepted: 05/14/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND The presence of bacterial and fungal coinfections plays an important role in the mortality of patients with coronavirus 2019 (COVID-19). We compared data from the 3 years before and 3 years after the COVID-19 pandemic outbreak to evaluate its effect on the traits of bacterial and fungal diseases. METHODS We retrospectively collected and analyzed data on positive respiratory tract samples (n = 13,133 samples from 7717 patients) and blood cultures (n = 23,652 from 9653 patients) between 2017 and 2022 from the Clinical Center of the University of Szeged, Hungary. We also evaluated antimicrobial susceptibility test results derived from 169,020 respiratory samples and 549,729 blood cultures to gain insight into changes in antimicrobial resistance. RESULTS The most common respiratory pathogen in the pre-COVID era was Pseudomonas aeruginosa, whereas Candida albicans was the most frequent during the pandemic. The number of respiratory isolates of Acinetobacter baumannii was also markedly increased. In blood cultures, Staphylococcus epidermidis, Escherichia coli, and S. aureus were dominant during the study period, and A. baumannii was widespread in blood cultures during the pandemic years. Resistance to ofloxacin, penicillin, piperacillin-tazobactam, ceftazidime, cefepime, imipenem, ceftolozane-tazobactam, and itraconazole increased significantly in the COVID era. CONCLUSIONS During the COVID-19 pandemic, there were changes in the prevalence of respiratory and blood culture pathogens at the Clinical Center of the University of Szeged. C. albicans became the predominant respiratory pathogen, and the number of A. baumannii isolates increased dramatically. Additionally, antimicrobial resistance notably increased during this period.
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Affiliation(s)
- László Orosz
- Department of Medical Microbiology, University of Szeged, H-6725 Szeged Semmelweis str. 6/b., Hungary.
| | - Katalin Burián
- Department of Medical Microbiology, University of Szeged, H-6725 Szeged Semmelweis str. 6/b., Hungary
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Zafer MM, Bassiouny DM, Ghosh S, Bornman C, Hussein AFA. Antimicrobial resistance patterns among critical priority pathogens in an intensive care unit at a tertiary hospital in Egypt: a descriptive analysis comparing pre- and COVID-19 eras. J Med Microbiol 2024; 73. [PMID: 38916589 DOI: 10.1099/jmm.0.001838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024] Open
Abstract
Background. The intensified global challenge of antimicrobial resistance, set against the backdrop of the COVID-19 pandemic, is a cause for major concern. Within healthcare settings, intensive care units are recognized as focal points for Gram-negative infections. The study pursued to assess the prevalence and antimicrobial resistance patterns of critical priority pathogens (Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacteriaceae, comprising Klebsiella pneumoniae and Escherichia coli) during both pre- and COVID-19 periods.Gap Statement. The decision to explore this topic stemmed from the urgent need to understand how the exceptional healthcare crisis of COVID-19 affected AMR patterns.Methods. This was an observational retrospective analysis of 1056 clinical specimens obtained from 950 patients who were admitted to the Medical Intensive Care Unit at Kasr Al-Aini Hospital, Cairo University, Egypt.Results. In the period before COVID-19, 342 pathogenic isolates (135 K. pneumoniae, 83 P. aeruginosa, 76 A. baumannii and 48 E. coli) were obtained from samples collected from 450 patients. Conversely, during the COVID-19 period, 714 isolates (237 K. pneumoniae, 205 A. baumannii, 199 P. aeruginosa and 73 E. coli) were collected from the same number of patients. In the course of the pandemic, there is a slight increase in A. baumannii and P. aeruginosa infections, whereas E. coli and K. pneumoniae exhibit a distinct trend with a noticeable reduction in infection rates during COVID-19. During the COVID-19 period, a noticeable rise in resistance rates was observed for all antibiotics utilized. The results from Fisher's exact test indicated a substantial increase in resistance towards certain antibiotics. Specifically, a significant rise in resistance was observed for E. coli to ciprofloxacin (P = 0.00), gentamicin and P. aeruginosa (P = 0.02), levofloxacin and A. baumannii (P = 0.01), piperacillin-tazobactam and A. baumannii (P = 0.04), and piperacillin-tazobactam and P. aeruginosa (P = 0.01).Conclusion. Our results display how the pandemic impacted bacterial infections and antibiotic resistance, indicating a general increase in resistance rates. These findings are crucial for guiding healthcare practices, emphasizing the need for continued surveillance and potentially checking antibiotic usage schemes.
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Affiliation(s)
- Mai M Zafer
- Department of Microbiology and Immunology, Faculty of Pharmacy, Ahram Canadian University, Cairo, Egypt
| | - Dina M Bassiouny
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Soumya Ghosh
- Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman
| | - Charné Bornman
- Department of Engineering Sciences, Faculty of Natural and Agricultural Sciences, University of the Free State, Bloemfontein, South Africa
- Division of Human Genetics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
- Interdisciplinary Centre for Digital Futures, University of the Free State, Bloemfontein, South Africa
| | - Amira F A Hussein
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
- Faculty of Applied Health Science, Galala University, Cairo, Egypt
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Lee YL, Liu CE, Tang HJ, Huang YT, Chen YS, Hsueh PR. Epidemiology and antimicrobial susceptibility profiles of Enterobacterales causing bloodstream infections before and during COVID-19 pandemic: Results of the Study for Monitoring Antimicrobial Resistance Trends (SMART) in Taiwan, 2018-2021. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2024:S1684-1182(24)00072-0. [PMID: 38632023 DOI: 10.1016/j.jmii.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 03/01/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has contributed to the spread of antimicrobial resistance, including carbapenem-resistant Enterobacterales. METHODS This study utilized data from the Study for Monitoring Antimicrobial Resistance Trends (SMART) surveillance program in Taiwan. Enterobacterales from patients with bloodstream infections (BSIs) were collected and subjected to antimicrobial susceptibility testing and β-lactamase gene detection using a multiplex PCR assay. Statistical analysis was conducted to compare susceptibility rates and resistance genes between time periods before (2018-2019) and during the COVID-19 pandemic (2020-2021). RESULTS A total of 1231 Enterobacterales isolates were collected, predominantly Escherichia coli (55.6%) and Klebsiella pneumoniae (29.2%). The proportion of nosocomial BSIs increased during the COVID-19 pandemic (55.5% vs. 61.7%, p < 0.05). Overall, susceptibility rates for most antimicrobial agents decreased, with Enterobacterales from nosocomial BSIs showing significantly lower susceptibility rates than those from community-acquired BSIs. Among 123 Enterobacterales isolates that underwent molecular resistance mechanism detection, ESBL, AmpC β-lactamase, and carbapenemase genes were detected in 43.1%, 48.8% and 16.3% of the tested isolates, respectively. The prevalence of carbapenemase genes among carbapenem-resistant Enterobacterales increased during the pandemic, although the difference was not statistically significant. Two novel β-lactamase inhibitor combinations, imipenem-relebactam and meropenem-vaborbactam, preserved good efficacy against Enterobacterales. However, imipenem-relebactam showed lower in vitro activity against imipenem-non-susceptible Enterobacterales than that of meropenem-vaborbactam. CONCLUSIONS The COVID-19 pandemic appears to be associated with a general decrease in antimicrobial susceptibility rates among Enterobacterales causing BSIs in Taiwan. Continuous surveillance is crucial to monitor antimicrobial resistance during the pandemic and in the future.
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Affiliation(s)
- Yu-Lin Lee
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Ph.D Program in Medical Biotechnology, National Chung-Hsing University, Taichung, Taiwan
| | - Chun-Eng Liu
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Hung-Jen Tang
- Department of Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Yu-Tsung Huang
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yao-Shen Chen
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Ph.D Program for Ageing, School of Medicine, China Medical University, Taichung, Taiwan; Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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Sili U, Tekin A, Bilgin H, Khan SA, Domecq JP, Vadgaonkar G, Segu SS, Rijhwani P, Raju U, Surapaneni KM, Zabolotskikh I, Gomaa D, Goodspeed VM, Ay P. Early empiric antibiotic use in COVID-19 patients: results from the international VIRUS registry. Int J Infect Dis 2024; 140:39-48. [PMID: 38128643 PMCID: PMC10939992 DOI: 10.1016/j.ijid.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES COVID-19 escalated inappropriate antibiotic use. We determined the distribution of pathogens causing community-acquired co-infections, the rate, and factors associated with early empiric antibiotic (EEAB) treatment among hospitalized COVID-19 patients. METHODS The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) COVID-19 Registry including 68,428 patients from 28 countries enrolled between January 2020 and October 2021 were screened. After exclusions, 7830 patients were included in the analysis. Azithromycin and/or other antibiotic treatment given within the first 3 days of hospitalization was investigated. Univariate and multivariate analyses were performed to determine factors associated with EEAB use. RESULTS The majority (6214, 79.4%) of patients received EEAB, with azithromycin combination being the most frequent (3146, 40.2%). As the pandemic advanced, the proportion of patients receiving EEAB regressed from 84.4% (786/931) in January-March 2020 to 65.2% (30/46) in April-June 2021 (P < 0.001). Beta-lactams, especially ceftriaxone was the most commonly used antibiotic. Staphylococcus aureus was the most commonly isolated pathogen. Multivariate analysis showed geographical location and pandemic timeline as the strongest independent predictors of EEAB use. CONCLUSIONS EEAB administration decreased as pandemic advanced, which may be the result of intensified antimicrobial stewardship efforts. Our study provides worldwide goals for antimicrobial stewardship programs in the post-COVID-19 era.
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Affiliation(s)
- Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Türkiye.
| | - Aysun Tekin
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Huseyin Bilgin
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Türkiye
| | - Syed Anjum Khan
- Division of Critical Care Medicine, Mayo Clinic Health System, Mankato, Minnesota, United States
| | - Juan Pablo Domecq
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | | | - Smitha S Segu
- Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Puneet Rijhwani
- Department of Medicine, Mahatma Gandhi University of Medical Sciences & Technology, Jaipur, Rajasthan, India
| | | | - Krishna Mohan Surapaneni
- Departments of Biochemistry, Molecular Virology, Research and Clinical Skills & Simulation, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu, India
| | - Igor Zabolotskikh
- Department of Anesthesiology, Intensive Care Medicine and Transfusiology, Kuban State Medical University with affiliation Territorial Hospital #2, Krasnodar, Russia
| | - Dina Gomaa
- Department of Surgery Division of Trauma and Critical Care- Trauma Research University of Cincinnati, Cincinnati, Ohio, United States
| | - Valerie M Goodspeed
- Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
| | - Pinar Ay
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Türkiye
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Abdel-Halim MS, El-Ganiny AM, Mansour B, Yahya G, Latif HKAE, Askoura M. Phenotypic, molecular, and in silico characterization of coumarin as carbapenemase inhibitor to fight carbapenem-resistant Klebsiella pneumoniae. BMC Microbiol 2024; 24:67. [PMID: 38413891 PMCID: PMC10898048 DOI: 10.1186/s12866-024-03214-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Carbapenems represent the first line treatment of serious infections caused by drug-resistant Klebsiella pneumoniae. Carbapenem-resistant K. pneumoniae (CRKP) is one of the urgent threats to human health worldwide. The current study aims to evaluate the carbapenemase inhibitory potential of coumarin and to test its ability to restore meropenem activity against CRKP. Disk diffusion method was used to test the antimicrobial susceptibility of K. pneumoniae clinical isolates to various antibiotics. Carbapenemase genes (NDM-1, VIM-2, and OXA-9) were detected using PCR. The effect of sub-MIC of coumarin on CRKP isolates was performed using combined disk assay, enzyme inhibition assay, and checkerboard assay. In addition, qRT-PCR was used to estimate the coumarin effect on expression of carbapenemase genes. Molecular docking was used to confirm the interaction between coumarin and binding sites within three carbapenemases. RESULTS K. pneumoniae clinical isolates were found to be multi-drug resistant and showed high resistance to meropenem. All bacterial isolates harbor at least one carbapenemase-encoding gene. Coumarin significantly inhibited carbapenemases in the crude periplasmic extract of CRKP. The checkerboard assay indicated that coumarin-meropenem combination was synergistic exhibiting a fractional inhibitory concentration index ≤ 0.5. In addition, qRT-PCR results revealed that coumarin significantly decreased carbapenemase-genes expression. Molecular docking revealed that the binding energies of coumarin to NDM1, VIM-2, OXA-48 and OXA-9 showed a free binding energy of -7.8757, -7.1532, -6.2064 and - 7.4331 Kcal/mol, respectively. CONCLUSION Coumarin rendered CRKP sensitive to meropenem as evidenced by its inhibitory action on hydrolytic activity and expression of carbapenemases. The current findings suggest that coumarin could be a possible solution to overcome carbapenems resistance in CRKP.
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Affiliation(s)
- Mahmoud Saad Abdel-Halim
- Microbiology and Immunology Department, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt.
| | - Amira M El-Ganiny
- Microbiology and Immunology Department, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Basem Mansour
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa, 11152, Egypt
| | - Galal Yahya
- Microbiology and Immunology Department, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Hemat K Abd El Latif
- Microbiology and Immunology Department, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Momen Askoura
- Microbiology and Immunology Department, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
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Alkafaas SS, Abdallah AM, Hassan MH, Hussien AM, Elkafas SS, Loutfy SA, Mikhail A, Murad OG, Elsalahaty MI, Hessien M, Elshazli RM, Alsaeed FA, Ahmed AE, Kamal HK, Hafez W, El-Saadony MT, El-Tarabily KA, Ghosh S. Molecular docking as a tool for the discovery of novel insight about the role of acid sphingomyelinase inhibitors in SARS- CoV-2 infectivity. BMC Public Health 2024; 24:395. [PMID: 38321448 PMCID: PMC10848368 DOI: 10.1186/s12889-024-17747-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/11/2024] [Indexed: 02/08/2024] Open
Abstract
Recently, COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants, caused > 6 million deaths. Symptoms included respiratory strain and complications, leading to severe pneumonia. SARS-CoV-2 attaches to the ACE-2 receptor of the host cell membrane to enter. Targeting the SARS-CoV-2 entry may effectively inhibit infection. Acid sphingomyelinase (ASMase) is a lysosomal protein that catalyzes the conversion of sphingolipid (sphingomyelin) to ceramide. Ceramide molecules aggregate/assemble on the plasma membrane to form "platforms" that facilitate the viral intake into the cell. Impairing the ASMase activity will eventually disrupt viral entry into the cell. In this review, we identified the metabolism of sphingolipids, sphingolipids' role in cell signal transduction cascades, and viral infection mechanisms. Also, we outlined ASMase structure and underlying mechanisms inhibiting viral entry 40 with the aid of inhibitors of acid sphingomyelinase (FIASMAs). In silico molecular docking analyses of FIASMAs with inhibitors revealed that dilazep (S = - 12.58 kcal/mol), emetine (S = - 11.65 kcal/mol), pimozide (S = - 11.29 kcal/mol), carvedilol (S = - 11.28 kcal/mol), mebeverine (S = - 11.14 kcal/mol), cepharanthine (S = - 11.06 kcal/mol), hydroxyzin (S = - 10.96 kcal/mol), astemizole (S = - 10.81 kcal/mol), sertindole (S = - 10.55 kcal/mol), and bepridil (S = - 10.47 kcal/mol) have higher inhibition activity than the candidate drug amiodarone (S = - 10.43 kcal/mol), making them better options for inhibition.
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Affiliation(s)
- Samar Sami Alkafaas
- Molecular Cell Biology Unit, Division of Biochemistry, Department of Chemistry, Faculty of Science, Tanta University, Tanta, 31527, Egypt.
| | - Abanoub Mosaad Abdallah
- Narcotic Research Department, National Center for Social and Criminological Research (NCSCR), Giza, 11561, Egypt
| | - Mai H Hassan
- Molecular Cell Biology Unit, Division of Biochemistry, Department of Chemistry, Faculty of Science, Tanta University, Tanta, 31527, Egypt
| | - Aya Misbah Hussien
- Biotechnology department at Institute of Graduate Studies and Research, Alexandria University, Alexandria, Egypt
| | - Sara Samy Elkafas
- Production Engineering and Mechanical Design Department, Faculty of Engineering, Menofia University, Menofia, Egypt
- Faculty of Control System and Robotics, ITMO University, Saint-Petersburg, 197101, Russia
| | - Samah A Loutfy
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
- Nanotechnology Research Center, British University, Cairo, Egypt
| | - Abanoub Mikhail
- Department of Physics, Faculty of Science, Minia University, Minia, Egypt
- Faculty of Physics, ITMO University, Saint Petersburg, Russia
| | - Omnia G Murad
- Division of Biochemistry, Department of Chemistry, Faculty of Science, Tanta University, Tanta, 31527, Egypt
| | - Mohamed I Elsalahaty
- Division of Biochemistry, Department of Chemistry, Faculty of Science, Tanta University, Tanta, 31527, Egypt
| | - Mohamed Hessien
- Molecular Cell Biology Unit, Division of Biochemistry, Department of Chemistry, Faculty of Science, Tanta University, Tanta, 31527, Egypt
| | - Rami M Elshazli
- Biochemistry and Molecular Genetics Unit, Department of Basic Sciences, Faculty of Physical Therapy, Horus University - Egypt, New Damietta, 34517, Egypt
| | - Fatimah A Alsaeed
- Department of Biology, College of Science, King Khalid University, Muhayl, Saudi Arabia
| | - Ahmed Ezzat Ahmed
- Biology Department, College of Science, King Khalid University, Abha, 61413, Saudi Arabia
| | - Hani K Kamal
- Anatomy and Histology, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Wael Hafez
- NMC Royal Hospital, 16Th Street, 35233, Khalifa City, Abu Dhabi, United Arab Emirates
- Medical Research Division, Department of Internal Medicine, The National Research Centre, 12622, 33 El Buhouth St, Ad Doqi, Dokki, Cairo Governorate, Egypt
| | - Mohamed T El-Saadony
- Department of Agricultural Microbiology, Faculty of Agriculture, Zagazig University, Zagazig, 44511, Egypt
| | - Khaled A El-Tarabily
- Department of Biology, College of Science, United Arab Emirates University, Al-Ain, 15551, United Arab Emirates
| | - Soumya Ghosh
- Department of Genetics, Faculty of Natural and Agricultural Sciences, University of the Free State, Bloemfontein, 9301, South Africa
- Natural & Medical Science Research Center, University of Nizwa, Nizwa, Oman
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Ventura F, Greub G, Liles WC, Jacob ST. Proposed Framework for Conducting Clinically Relevant Translational Biomarker Research for the Diagnosis, Prognosis and Management of Sepsis. Diagnostics (Basel) 2024; 14:300. [PMID: 38337815 PMCID: PMC10855655 DOI: 10.3390/diagnostics14030300] [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: 12/20/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
Although the diagnosis of sepsis requires the identification of the three components of infection, a systemic inflammation response, and organ dysfunction, there is currently no consensus on gold-standard criteria. There are however suggested tools and tests, which have been proposed in international guidelines, including those produced by the Surviving Sepsis Campaign. Biomarkers play an important role in these tools and tests, and numerous heterogeneous studies have been performed to evaluate their respective clinical utility. Our review of the current practice shows that no biomarkers of infection, systemic inflammation response, organ dysfunction and sepsis are currently specifically recommended, which is probably due to the lack of standardization of studies. We therefore propose to define a framework for conducting clinically relevant translational biomarker research and seek to establish ideal criteria that can be applied to an infection, systemic inflammation response, organ dysfunction and sepsis biomarkers, which can enable early screening of sepsis, diagnosis of sepsis at the time of clinical suspicion and monitoring of sepsis treatment efficacy.
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Affiliation(s)
- François Ventura
- Division of Anesthesiology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva, Switzerland
- Intensive Care Unit, Hirslanden Clinique des Grangettes, Chemin des Grangettes 7, CH-1224 Chêne-Bougeries, Switzerland
| | - Gilbert Greub
- Medical Microbiology, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland;
- Institute of Microbiology, University of Lausanne, Rue du Bugnon 48, CH-1005 Lausanne, Switzerland
| | - W. Conrad Liles
- Sepsis Center of Research Excellence, University of Washington, Seattle, WA 98195-6420, USA;
- Departments of Medicine, University of Washington, Seattle, WA 98195-6420, USA
| | - Shevin T. Jacob
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK;
- Walimu, Kampala P.O. Box 9924, Uganda
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Ugolini V, Lai FY. Novel, alternative analytical methodology for determination of antimicrobial chemicals in aquatic environments and public use assessment: Extraction sorbent, microbiological sensitivity, stability, and applicability. Anal Chim Acta 2024; 1286:342029. [PMID: 38049233 DOI: 10.1016/j.aca.2023.342029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Assessing antimicrobial chemicals from wastewater source to recipient water systems is crucial in planning effective, policy-related interventions for antimicrobial resistance (AMR) risk mitigation. However, the capability of related analytical methods for AMR assessment has not been explored previously. There is also a lack of knowledge on the effectiveness of alternative extraction sorbents with ion-exchange functions, and little information on chemical stability from sampling to analysis as well as preservative options. Hence, our study aims to address the clear need for advanced, broad-range and microbiologically-sensitive methodologies, paired with thorough stability assessments. RESULTS Oasis® WCX ion-exchange was for the first time employed in solid-phase extraction (SPE) for antibacterials, antifungals, antivirals and human metabolites in various water matrices. Analysis was performed using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) on a biphenyl analytical column. The optimized and validated method provided satisfactory accuracy, precision, and recovery for 53 compounds via LC-MS/MS direct injection and for up to 35 compounds via SPE-LC-MS/MS. Method quantification limits (MQLs) were determined in groundwater (0.33-54 ng L-1), surface water (0.53-75 ng L-1), effluent wastewater (2.5-470 ng L-1), and influent wastewater (11-650 ng L-1). As a novel approach, MQLs were compared with minimum inhibitory concentrations, to confirm our method's microbiological sensitivity for studying AMR. Stability assessment revealed that most compounds remained stable in standard solution at -80 °C for six months, in various waters at -20 °C for eight weeks, and during 24-h sampling at 4 °C. Sodium azide was a better preservative than sodium metabisulfite. SIGNIFICANCE Our study is an added value to the analytical methodology for water measurements of antimicrobial chemicals, in which it provides a novel, alternative method that is robust and overall more sensitive than others using generic Oasis® HLB sorbents and C18 analytical columns in SPE-LC-MS/MS. Also, the comprehensive data on antimicrobial stability helps reduce methodological uncertainty for future studies. Our method shows sufficient microbiologically-sensitivity and thus is suitable for future (inter)national regulatory water monitoring of AMR.
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Affiliation(s)
- Valentina Ugolini
- Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences (SLU), Uppsala, SE-75007, Sweden.
| | - Foon Yin Lai
- Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences (SLU), Uppsala, SE-75007, Sweden.
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10
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Feijoo-Coronel ML, Mendes B, Ramírez D, Peña-Varas C, de los Monteros-Silva NQE, Proaño-Bolaños C, de Oliveira LC, Lívio DF, da Silva JA, da Silva JMSF, Pereira MGAG, Rodrigues MQRB, Teixeira MM, Granjeiro PA, Patel K, Vaiyapuri S, Almeida JR. Antibacterial and Antiviral Properties of Chenopodin-Derived Synthetic Peptides. Antibiotics (Basel) 2024; 13:78. [PMID: 38247637 PMCID: PMC10812719 DOI: 10.3390/antibiotics13010078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Antimicrobial peptides have been developed based on plant-derived molecular scaffolds for the treatment of infectious diseases. Chenopodin is an abundant seed storage protein in quinoa, an Andean plant with high nutritional and therapeutic properties. Here, we used computer- and physicochemical-based strategies and designed four peptides derived from the primary structure of Chenopodin. Two peptides reproduce natural fragments of 14 amino acids from Chenopodin, named Chen1 and Chen2, and two engineered peptides of the same length were designed based on the Chen1 sequence. The two amino acids of Chen1 containing amide side chains were replaced by arginine (ChenR) or tryptophan (ChenW) to generate engineered cationic and hydrophobic peptides. The evaluation of these 14-mer peptides on Staphylococcus aureus and Escherichia coli showed that Chen1 does not have antibacterial activity up to 512 µM against these strains, while other peptides exhibited antibacterial effects at lower concentrations. The chemical substitutions of glutamine and asparagine by amino acids with cationic or aromatic side chains significantly favoured their antibacterial effects. These peptides did not show significant hemolytic activity. The fluorescence microscopy analysis highlighted the membranolytic nature of Chenopodin-derived peptides. Using molecular dynamic simulations, we found that a pore is formed when multiple peptides are assembled in the membrane. Whereas, some of them form secondary structures when interacting with the membrane, allowing water translocations during the simulations. Finally, Chen2 and ChenR significantly reduced SARS-CoV-2 infection. These findings demonstrate that Chenopodin is a highly useful template for the design, engineering, and manufacturing of non-toxic, antibacterial, and antiviral peptides.
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Affiliation(s)
- Marcia L. Feijoo-Coronel
- Biomolecules Discovery Group, Universidad Regional Amazónica Ikiam, Km 7 Via Muyuna, Tena 150101, Ecuador
| | - Bruno Mendes
- Biomolecules Discovery Group, Universidad Regional Amazónica Ikiam, Km 7 Via Muyuna, Tena 150101, Ecuador
| | - David Ramírez
- Departamento de Farmacología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción 4030000, Chile
| | - Carlos Peña-Varas
- Departamento de Farmacología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción 4030000, Chile
| | | | - Carolina Proaño-Bolaños
- Biomolecules Discovery Group, Universidad Regional Amazónica Ikiam, Km 7 Via Muyuna, Tena 150101, Ecuador
| | - Leonardo Camilo de Oliveira
- Centro de Pesquisa e Desenvolvimento de Fármacos, Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Diego Fernandes Lívio
- Campus Centro Oeste, Federal University of São João Del-Rei, Rua Sebastião Gonçalves Filho, n 400, Chanadour, Divinópolis 35501-296, Brazil
| | - José Antônio da Silva
- Campus Centro Oeste, Federal University of São João Del-Rei, Rua Sebastião Gonçalves Filho, n 400, Chanadour, Divinópolis 35501-296, Brazil
| | - José Maurício S. F. da Silva
- Departamento de Bioquímica, Centro de Ciências Biomédicas, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Sala E209, Alfenas 37130-001, Brazil
| | - Marília Gabriella A. G. Pereira
- Departamento de Bioquímica, Centro de Ciências Biomédicas, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Sala E209, Alfenas 37130-001, Brazil
| | - Marina Q. R. B. Rodrigues
- Departamento de Bioquímica, Centro de Ciências Biomédicas, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Sala E209, Alfenas 37130-001, Brazil
- Departamento de Engenharia de Biossistemas, Campus Dom Bosco, Federal University of São João Del-Rei, Praça Dom Helvécio, 74, Fábricas, São João del-Rei 36301-160, Brazil
| | - Mauro M. Teixeira
- Centro de Pesquisa e Desenvolvimento de Fármacos, Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Paulo Afonso Granjeiro
- Campus Centro Oeste, Federal University of São João Del-Rei, Rua Sebastião Gonçalves Filho, n 400, Chanadour, Divinópolis 35501-296, Brazil
| | - Ketan Patel
- School of Biological Sciences, University of Reading, Reading RG6 6UB, UK
| | | | - José R. Almeida
- Biomolecules Discovery Group, Universidad Regional Amazónica Ikiam, Km 7 Via Muyuna, Tena 150101, Ecuador
- School of Pharmacy, University of Reading, Reading RG6 6UB, UK
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11
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Thomsen J, Abdulrazzaq NM, AlRand H. Epidemiology and antimicrobial resistance trends of Acinetobacter species in the United Arab Emirates: a retrospective analysis of 12 years of national AMR surveillance data. Front Public Health 2024; 11:1245131. [PMID: 38239785 PMCID: PMC10794577 DOI: 10.3389/fpubh.2023.1245131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/22/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Acinetobacter spp., in particular A. baumannii, are opportunistic pathogens linked to nosocomial pneumonia (particularly ventilator-associated pneumonia), central-line catheter-associated blood stream infections, meningitis, urinary tract infections, surgical-site infections, and other types of wound infections. A. baumannii is able to acquire or upregulate various resistance determinants, making it frequently multidrug-resistant, and contributing to increased mortality and morbidity. Data on the epidemiology, levels, and trends of antimicrobial resistance of Acinetobacter spp. in clinical settings is scarce in the Gulf Cooperation Council (GCC) and Middle East and North Africa (MENA) regions. Methods A retrospective 12-year analysis of 17,564 non-duplicate diagnostic Acinetobacter spp. isolates from the United Arab Emirates (UAE) was conducted. Data was generated at 317 surveillance sites by routine patient care during 2010-2021, collected by trained personnel and reported by participating surveillance sites to the UAE National AMR Surveillance program. Data analysis was conducted with WHONET. Results Species belonging to the A. calcoaceticus-baumannii complex were mostly reported (86.7%). They were most commonly isolated from urine (32.9%), sputum (29.0%), and soft tissue (25.1%). Resistance trends to antibiotics from different classes during the surveillance period showed a decreasing trend. Specifically, there was a significant decrease in resistance to imipenem, meropenem, and amikacin. Resistance was lowest among Acinetobacter species to both colistin and tigecycline. The percentages of multidrug-resistant (MDR) and possibly extensively drug-resistant (XDR) isolates was reduced by almost half between the beginning of the study in 2010 and its culmination in 2021. Carbapenem-resistant Acinetobacter spp. (CRAB) was associated with a higher mortality (RR: 5.7), a higher admission to ICU (RR 3.3), and an increased length of stay (LOS; 13 excess inpatient days per CRAB case), as compared to Carbapenem-susceptible Acinetobacter spp. Conclusion Carbapenem-resistant Acinetobacter spp. are associated with poorer clinical outcomes, and higher associated costs, as compared to carbapenem-susceptible Acinetobacter spp. A decreasing trend of MDR Acinetobacter spp., as well as resistance to all antibiotic classes under surveillance was observed during 2010 to 2021. Further studies are needed to explore the reasons and underlying factors leading to this remarkable decrease of resistance over time.
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Affiliation(s)
- Jens Thomsen
- Abu Dhabi Public Health Center, Abu Dhabi, United Arab Emirates
- Department of Pathology and Infectious Diseases, Khalifa University, Abu Dhabi, United Arab Emirates
| | | | - Hussain AlRand
- Public Health Sector, Ministry of Health and Prevention, Dubai, United Arab Emirates
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12
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Cai L, Chen H, Wei Y, Guo X, Zheng H, Jiang X, Zhang Y, Yu G, Dai M, Ye J, Zhou H, Xu D, Huang F, Fan Z, Xu N, Shi P, Xuan L, Feng R, Liu X, Sun J, Liu Q, Wei X. Changing epidemiology, microbiology and mortality of bloodstream infections in patients with haematological malignancies before and during SARS-CoV-2 pandemic: a retrospective cohort study. BMJ Open 2023; 13:e078510. [PMID: 38159939 PMCID: PMC10759088 DOI: 10.1136/bmjopen-2023-078510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE This study was to explore the changes in bacterial bloodstream infection (BSI) in patients with haematological malignancies (HMs) before and during SARS-CoV-2 pandemic. DESIGN Retrospective cohort study between 2018 and 2021. SETTING The largest haematological centre in southern China. RESULTS A total of 599 episodes of BSI occurring in 22 717 inpatients from January 2018 to December 2021 were analysed. The frequencies of the total, Gram-negative and Gram-positive BSI before and during the pandemic were 2.90% versus 2.35% (p=0.011), 2.49% versus 1.77% (p<0.001) and 0.27% versus 0.44% (p=0.027), respectively. The main isolates from Gram-negative or Gram-positive BSI and susceptibility profiles also changed. The 30-day mortality caused by BSI was lower during the pandemic (21.1% vs 14.3%, p=0.043). Multivariate analysis revealed that disease status, pulmonary infection and shock were independent predictors of 30-day mortality. CONCLUSION Our data showed that the incidence of total and Gram-negative organisms BSI decreased, but Gram-positive BSI incidence increased in patients with HMs during the pandemic along with the changes of main isolates and susceptibility profiles. Although the 30-day mortality due to BSI was lower during the pandemic, the new infection prevention strategy should be considered for any future pandemics.
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Affiliation(s)
- Linjing Cai
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Huan Chen
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Yongqiang Wei
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Xutao Guo
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Haiqing Zheng
- Nosocomial Infection Management, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xuejie Jiang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Yu Zhang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Guopan Yu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Min Dai
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Jieyu Ye
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Hongsheng Zhou
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Dan Xu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Fen Huang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Zhiping Fan
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Na Xu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Pengcheng Shi
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Li Xuan
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Ru Feng
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Xiaoli Liu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Jing Sun
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Qifa Liu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
| | - Xiaolei Wei
- Department of Hematology, Nanfang Hospital, Southern Medical University, Clinical Medical Research Center of Hematological Diseases of Guangdong Province, Guangzhou, China
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Mehrizi R, Golestani A, Malekpour MR, Karami H, Nasehi MM, Effatpanah M, Ranjbaran H, Shahali Z, Sari AA, Daroudi R. Drug prescription patterns and their association with mortality and hospitalization duration in COVID-19 patients: insights from big data. Front Public Health 2023; 11:1280434. [PMID: 38164450 PMCID: PMC10758044 DOI: 10.3389/fpubh.2023.1280434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Background Different medication prescription patterns have been associated with varying course of disease and outcomes in COVID-19. Health claims data is a rich source of information on disease treatment and outcomes. We aimed to investigate drug prescription patterns and their association with mortality and hospitalization via insurance data for a relatively long period of the pandemic in Iran. Methods We retrieved hospitalized patients' data from Iran Health Insurance Organization (IHIO) spanning 26 months (2020-2022) nationwide. Included were patients with ICD-10 codes U07.1/U07.2 for confirmed/suspected COVID-19. A case was defined as a single hospitalization event for an individual patient. Multiple hospitalizations of a patient within a 30-day interval were aggregated into a single case, while hospitalizations with intervals exceeding 30 days were treated as independent cases. The Anatomical Therapeutic Chemical (ATC) was used for medications classification. The two main study outcomes were general and intensive care unit (ICU) hospitalization periods and mortality. Besides, various demographic and clinical associate factors were analyzed to derive the associations with medication prescription patterns and study outcomes using accelerated failure time (AFT) and logistic regression models. Results During the 26 months of the study period, 1,113,678 admissions with COVID-19 diagnosis at hospitals working in company with IHIO were recorded. 917,198 cases were detected from the database, among which 51.91% were females and 48.09% were males. Among the main groups of medications, antithrombotics (55.84% [95% CI: 55.74-55.94]), corticosteroids (54.14% [54.04-54.24]), and antibiotics (42.22% [42.12-42.32]) were the top used medications among cases with COVID-19. Investigation of the duration of hospitalization based on main medication groups showed antithrombotics (adjusted median ratio = 0.94 [0.94-0.95]) were significantly associated with shorter periods of overall hospitalization. Also, antithrombotics (adjusted odds ratio = 0.74 [95%CI, 0.73-0.76]), corticosteroids (0.97 [0.95-0.99]), antivirals (0.82 [0.80-0.83]), and ACE inhibitor/ARB (0.79 [0.77-0.80]) were significantly associated with lower mortality. Conclusion Over 2 years of investigation, antithrombotics, corticosteroids, and antibiotics were the top medications for hospitalized patients with COVID-19. Trends in medication prescription varied based on various factors across the country. Medication prescriptions could potentially significantly impact the trends of mortality and hospitalization during epidemics, thereby affecting both health and economic burdens.
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Affiliation(s)
- Reza Mehrizi
- National Center for Health Insurance Research, Tehran, Iran
| | - Ali Golestani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Karami
- National Center for Health Insurance Research, Tehran, Iran
| | - Mohammad Mahdi Nasehi
- National Center for Health Insurance Research, Tehran, Iran
- Pediatric Neurology Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Effatpanah
- National Center for Health Insurance Research, Tehran, Iran
- School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ranjbaran
- National Center for Health Insurance Research, Tehran, Iran
- Immunogenetics Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Shahali
- National Center for Health Insurance Research, Tehran, Iran
| | - Ali Akbari Sari
- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Rajabali Daroudi
- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Thomsen J, Abdulrazzaq NM, Menezes GA, Ayoub Moubareck C, Everett DB, Senok A. Methicillin resistant Staphylococcus aureus in the United Arab Emirates: a 12-year retrospective analysis of evolving trends. Front Public Health 2023; 11:1244351. [PMID: 38145065 PMCID: PMC10748512 DOI: 10.3389/fpubh.2023.1244351] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/09/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Methicillin resistant Staphylococcus aureus (MRSA) is a major contributor to the global burden of antimicrobial resistance (AMR). As MRSA continues to evolve, the need for continued surveillance to evaluate trends remains crucial. This study was carried out to assess MRSA trends in the United Arab Emirates (UAE) based on analysis of data from the national AMR surveillance program. Methods We carried out a 12-year (2010-2021) retrospective analysis of MRSA demographic and microbiological data collected as part of the UAE national AMR surveillance program. Participating centers from across the country routinely submit AMR surveillance data collected by trained personnel to the National AMR Surveillance Committee, where data is analyzed using a unified WHONET platform. Data on non-duplicate isolates associated with clinical infections were obtained and included in the analysis. Results A total of 29,414 non-duplicate MRSA isolates associated with clinical infections were reported between 2010 and 2021 (2010: n = 259; 2021: n = 4,996). MRSA represented 26.4% of all S. aureus (n = 111,623) isolates identified during the study period. In 2010, among the S. aureus isolates with reported oxacillin testing, 21.9% (n/N = 259/1,181) were identified as MRSA and this showed an increase to 33.5% (n/N = 4,996/14,925) in 2021. Although there was variation in the distribution of MRSA across the seven emirates of the country, most had an upward trend. Patient demographics reflected a male preponderance, with most being adults and from the outpatient setting. Isolates were mostly from skin and soft tissue infection specimens (72.5%; n/N = 21,335/29,414). Among the inpatients (N = 8,282), a total of 3,313 MRSA isolates were from specimens obtained ≤ 48 h after admission indicative of community acquired infection. Increasing resistance trends were observed for most antibiotics including ciprofloxacin, levofloxacin, moxifloxacin, erythromycin, gentamicin, trimethoprim-sulfamethoxazole, and quinupristin/dalfopristin. Low levels of resistance (0.0-0.8%) were sustained for linezolid except for 2015, 2016, and 2017 with 2.5, 2.6, and 2.9%, respectively. No confirmed vancomycin resistance was reported. Conclusion The increasing trend of MRSA isolates associated with clinical infections in the hospital and community settings is a concern. Continued monitoring including incorporation of genomic surveillance and infection control measures are recommended to stem the dissemination.
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Affiliation(s)
- Jens Thomsen
- Department of Environmental and Occupational Health and Safety, Abu Dhabi Public Health Center, Abu Dhabi, United Arab Emirates
- Department of Pathology and Infectious Diseases, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Najiba M. Abdulrazzaq
- Al Kuwait Hospital Dubai, Emirates Health Establishment, Dubai, United Arab Emirates
- Public Health Sector, Ministry of Health and Prevention, Dubai, United Arab Emirates
| | | | - Godfred Antony Menezes
- Department of Medical Microbiology and Immunology, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | | | - Dean B. Everett
- Department of Pathology and Infectious Diseases, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Biotechnology Center, Khalifa University, Abu Dhabi, United Arab Emirates
- Infection Research Unit, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- School of Dentistry, Cardiff University, Cardiff, United Kingdom
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15
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Belamarić G, Bukumirić Z, Vuković M, Spaho RS, Marković M, Marković G, Vuković D. Knowledge, attitudes, and practices regarding antibiotic use among the population of the Republic of Serbia - A cross-sectional study. J Infect Public Health 2023; 16 Suppl 1:111-118. [PMID: 37953110 DOI: 10.1016/j.jiph.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/03/2023] [Accepted: 11/03/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Antimicrobial resistance presents one of the most significant threats to public health. This study aimed to examine antibiotic usage within the general population in the Republic of Serbia and their knowledge, attitudes, and behavior concerning this topic. METHODS We conducted an online cross-sectional study over two weeks in December 2022, on a sample of 1014 respondents, representative of the Republic of Serbia's population. Predictors of the Antibiotic Knowledge Score (composed of four questions) were analyzed by multivariate ordinal logistic regression. RESULTS In 2022, 76.8% of the participants from the Serbian population had taken antibiotics, mostly upon a medical prescription, with the most common reasons being upper respiratory tract infections. Only 31.3% of all respondents received any kind of advice about the rational use of antibiotics and half of them changed their opinions on using antibiotics after receiving this information. The average Antibiotic Knowledge Score was 2.6 out of 4, with 32.5% of respondents answering all knowledge questions correctly. The multivariate ordinal logistic regression analysis showed that female gender, higher education level, and the willingness to change opinions regarding the usage of antibiotics after receiving information about the rational use of antibiotics from any available source were significant predictors of better knowledge about antibiotics use. Respondents who were open to changing their opinion after receiving information about the rational use of antibiotics had 28% higher odds of higher antibiotic knowledge scores. CONCLUSION This is the first population-level study on public knowledge, attitudes, and practices about antibiotic use in Serbia and therefore the baseline for future research and measuring the impact of potential interventions. Our findings underline the importance of taking into account specific population characteristics, knowledge levels, and attitudes when designing educational and intervention strategies for antibiotic use. Policymakers can leverage these findings to target specific groups and enhance the population's knowledge and practices regarding rational antibiotic usage.
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Affiliation(s)
| | - Zoran Bukumirić
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Serbia
| | | | | | | | | | - Dejana Vuković
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Serbia
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TAMBURRO MANUELA, SALZO ANGELO, SAMMARCO MICHELALUCIA, RIPABELLI GIANCARLO. Healthcare infections and antimicrobial consumption in pre-COVID-19 era: a point prevalence survey in three hospitals in a region of Central Italy. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2023; 64:E463-E470. [PMID: 38379748 PMCID: PMC10876034 DOI: 10.15167/2421-4248/jpmh2023.64.4.2962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 12/19/2023] [Indexed: 02/22/2024]
Abstract
Introduction Healthcare-associated infections (HAIs) are a major global public health concern, increasing the transmission of drug-resistant infections. This point prevalence survey investigated HAIs occurrence and antimicrobial consumption (AMC) in pre-COVID-19 era in the public hospitals of a region of Central Italy. Methods Data were collected using the protocol standardised by the European Centre for Disease Prevention and Control. Results Three-hundred and sixty-four patients were included (59.3% male) in the study. Overall, HAIs prevalence was 6.6% (95%CI 4.4-9.5), ranging from 5.2% to 7.1% within the surveyed hospitals, with at least one infection in 24 patients (ten each in medical and surgical specialties wards, and four in intensive care). Risk factors for HAIs were advanced age, having undergone surgery and wearing invasive devices. At time of the survey, 44.7% (95%CI 39.7-49.9) of patients was under treatment with at least one antibiotic, and AMC varied between 43% and 48% within hospitals. In all hospitals, a prevalence higher than 10% was found for the prescription reasons other than prophylaxis or therapy. Conclusions The results revealed a HAIs prevalence lower than that estimated compared to the most recent national data, in contrast to higher antimicrobial usage. These findings highlight the need to reinforce hygiene practices and develop bundles for HAIs, as a broad implementation of infection prevention and control practices extensively applied to both hub and spoke hospitals could significantly reduce their occurrence, as well as to implement antimicrobial stewardship for prescriptive appropriateness.
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Affiliation(s)
- MANUELA TAMBURRO
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy
| | - ANGELO SALZO
- Department of Prevention, Molise Regional Health Authority, Campobasso, Italy
| | - MICHELA LUCIA SAMMARCO
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy
| | - GIANCARLO RIPABELLI
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy
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Ang L, Hernández-Rodríguez E, Cyriaque V, Yin X. COVID-19's environmental impacts: Challenges and implications for the future. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 899:165581. [PMID: 37482347 DOI: 10.1016/j.scitotenv.2023.165581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/14/2023] [Accepted: 07/15/2023] [Indexed: 07/25/2023]
Abstract
Strict measures have curbed the spread of COVID-19, but waste generation and movement limitations have had an unintended impact on the environment over the past 3 years (2020-2022). Many studies have summarized the observed and potential environmental impacts associated with COVID-19, however, only a few have quantified and compared the effects of these unintended environmental impacts; moreover, whether COVID-19 policy stringency had the same effects on the main environmental topic (i.e., CO2 emissions) across the 3 years remains unclear. To answer these questions, we conducted a systematic review of the recent literature and analyzed the main findings. We found that the positive environmental effects of COVID-19 have received more attention than the negative ones (50.6 % versus 35.7 %), especially in emissions reduction (34 % of total literature). Medical waste (14.5 %) received the highest attention among the negative impacts. Although global emission reduction, especially in terms of CO2, has received significant attention, the positive impacts were temporary and only detected in 2020. Strict COVID-19 policies had a more profound and significant effect on CO2 emissions in the aviation sector than in the power and industry sectors. For example, compared with 2019, international aviation related CO2 emissions dropped by 59 %, 49 %, and 25 % in 2020, 2021, and 2022, respectively, while industry related ones dropped by only 3.16 % in 2020. According to our developed evaluation matrix, medical wastes and their associated effects, including the persistent pollution caused by antibiotic resistance genes, heavy metals and microplastics, are the main challenges post the pandemic, especially in China and India, which may counteract the temporary environmental benefits of COVID-19. Overall, the presented results demonstrate methods to quantify the environmental effects of COVID-19 and provide directions for policymakers to develop measures to address the associated environmental issues in the post-COVID-19 world.
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Affiliation(s)
- Leeping Ang
- Department of Systematics, Biodiversity and Evolution of Plants, Albrecht-von-Haller Institute of Plant Sciences, University of Goettingen, Untere Karspuele 2, 37073 Goettingen, Germany
| | - Enrique Hernández-Rodríguez
- Institut de Recherche sur les Forets, Université du Quebec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | - Valentine Cyriaque
- Eau Terre Environnement, Institut national de la recherche scientifique, 490 rue de la couronne, Québec, Québec G1K 9A9, Canada
| | - Xiangbo Yin
- Eau Terre Environnement, Institut national de la recherche scientifique, 490 rue de la couronne, Québec, Québec G1K 9A9, Canada.
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Brătfelan DO, Tabaran A, Colobatiu L, Mihaiu R, Mihaiu M. Prevalence and Antimicrobial Resistance of Escherichia coli Isolates from Chicken Meat in Romania. Animals (Basel) 2023; 13:3488. [PMID: 38003106 PMCID: PMC10668644 DOI: 10.3390/ani13223488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/02/2023] [Accepted: 11/11/2023] [Indexed: 11/26/2023] Open
Abstract
The current study was conducted in order to analyze the prevalence of Escherichia coli (E. coli) in samples of chicken meat (100 chicken meat samples), as well as to evaluate the antimicrobial susceptibility of these isolates. A total of 30 samples were positive for E. coli among the collected chicken samples. Most isolates proved to be highly resistant to tetracycline (80%), ampicillin (80%), sulfamethoxazole (73.33%), chloramphenicol (70%) and nalidixic acid (60%). Strong resistance to ciprofloxacin (56.66%), trimethoprim (50%), cefotaxime (46.66%), ceftazidime (43.33%) and gentamicin (40%) was also observed. Notably, one E. coli strain also proved to be resistant to colistin. The antimicrobial resistance determinants detected among the E. coli isolates recovered in our study were consistent with their resistance phenotypes. Most of the isolates harbored the tetA (53.33%), tetB (46.66%), blaTEM (36.66%) and sul1 (26.66%) genes, but also aadA1 (23.33%), blaCTX (16.66%), blaOXA (16.66%), qnrA (16.66%) and aac (10%). In conclusion, to the best of our knowledge, this is among the first studies analyzing the prevalence and antimicrobial resistance of E. coli strains isolated from chicken meat in Romania and probably the first study reporting colistin resistance in E. coli isolates recovered from food sources in our country.
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Affiliation(s)
- Dariana Olivia Brătfelan
- Department of Animal Breeding and Food Safety, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Manastur Street No. 3/5, 400372 Cluj-Napoca, Romania; (D.O.B.); (A.T.); (M.M.)
| | - Alexandra Tabaran
- Department of Animal Breeding and Food Safety, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Manastur Street No. 3/5, 400372 Cluj-Napoca, Romania; (D.O.B.); (A.T.); (M.M.)
| | - Liora Colobatiu
- Department of Medical Devices, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, Victor Babes Street No. 8, 400012 Cluj-Napoca, Romania
| | - Romolica Mihaiu
- Department of Management, Faculty of Economic Sciences and Business Administration, Babes Bolyai University, Mihail Kogalniceanu Street No.1, 400084 Cluj-Napoca, Romania;
| | - Marian Mihaiu
- Department of Animal Breeding and Food Safety, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Manastur Street No. 3/5, 400372 Cluj-Napoca, Romania; (D.O.B.); (A.T.); (M.M.)
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Zarfel G, Schmidt J, Luxner J, Grisold AJ. No Changes in the Occurrence of Methicillin-Resistant Staphylococcus aureus (MRSA) in South-East Austria during the COVID-19 Pandemic. Pathogens 2023; 12:1308. [PMID: 38003773 PMCID: PMC10675619 DOI: 10.3390/pathogens12111308] [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: 08/31/2023] [Revised: 10/21/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a universal threat. Once being well established in the healthcare setting, MRSA has undergone various epidemiological changes. This includes the emergence of more aggressive community-acquired MRSA (CA-MRSA) and the occurrence of MRSA which have their origin in animal breeding, called livestock-associated MRSA (LA-MRSA). Emergence of new clones as well as changes in the occurrence of some clonal lineages also describes the fluctuating dynamic within the MRSA family. There is paucity of data describing the possible impact of the COVID-19 pandemic on the MRSA dynamics. The aim of the study was the analysis of MRSA isolates in a three-year time period, including the pre-COVID-19 years 2018 and 2019 and the first year of the pandemic 2020. The analysis includes prevalence determination, antibiotic susceptibility testing, spa typing, and detection of genes encoding the PVL toxin. The MRSA rate remained constant throughout the study period. In terms of a dynamic within the MRSA family, only a few significant changes could be observed, but all except one occurred before the start of the COVID-19 pandemic. In summary, there was no significant impact of the COVID-19 pandemic on MRSA in Austria.
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Affiliation(s)
- Gernot Zarfel
- Diagnostic and Research Center for Molecular BioMedicine, Medical University of Graz, 8010 Graz, Austria; (G.Z.); (J.S.); (J.L.)
| | - Julia Schmidt
- Diagnostic and Research Center for Molecular BioMedicine, Medical University of Graz, 8010 Graz, Austria; (G.Z.); (J.S.); (J.L.)
- Biomedical Science, University of Applied Sciences, 8020 Graz, Austria
| | - Josefa Luxner
- Diagnostic and Research Center for Molecular BioMedicine, Medical University of Graz, 8010 Graz, Austria; (G.Z.); (J.S.); (J.L.)
| | - Andrea J. Grisold
- Diagnostic and Research Center for Molecular BioMedicine, Medical University of Graz, 8010 Graz, Austria; (G.Z.); (J.S.); (J.L.)
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Ciapponi A, Bardach A, Sandoval MM, Palermo MC, Navarro E, Espinal C, Quirós R. Systematic Review and Meta-analysis of Deaths Attributable to Antimicrobial Resistance, Latin America. Emerg Infect Dis 2023; 29:2335-2344. [PMID: 37877573 PMCID: PMC10617342 DOI: 10.3201/eid2911.230753] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Antimicrobial resistance is a pressing global health concern, leading to 4.95 million deaths in 2019. We conducted a systematic review and meta-analysis to assess the lethality attributed to infections caused by multidrug-resistant organisms (MDROs) in Latin America and the Caribbean. A comprehensive search of major databases retrieved relevant studies from 2000-2022. We included 54 observational studies, primarily from Brazil, Argentina, and Colombia. The most commonly studied organism was methicillin-resistant Staphylococcus aureus. The overall unadjusted case fatality rate related to MDROs was 45.0%; higher adjusted lethality was observed in persons infected with MDROs than in those infected with other pathogens (adjusted odds ratio 1.93, 95% CI 1.58-2.37). A higher lethality rate was seen in patients who did not receive appropriate empirical treatment (odds ratio 2.27, 95% CI 1.44-3.56). These findings underscore the increased lethality associated with antimicrobial resistance in Latin America and the Caribbean.
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21
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Calovi M, Coroneo V, Rossi S. Antibacterial efficiency over time and barrier properties of wood coatings with colloidal silver. Appl Microbiol Biotechnol 2023; 107:5975-5986. [PMID: 37552252 PMCID: PMC10484803 DOI: 10.1007/s00253-023-12710-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 08/09/2023]
Abstract
This work aims to represent a standard application for understanding the extent of the antibacterial efficacy of coatings with different amounts of colloidal silver on wooden surfaces over time. The key variable that was intended to be evaluated in this study was the "time efficiency," with concerns about the possible efficacy in the durability of the surfaces. By highlighting the "expiry date" of the agents, as in the case with other products, the study aimed to confirm the validity of the simulation tests conducted in the laboratory with degradation tests. Furthermore, the role of the silver amount on the barrier performance of the coatings was assessed by liquid resistance, water uptake, and perspiration tests, evaluating the aesthetic durability of the coatings by means of colorimetric analyses. Ultimately, this work demonstrates that these coatings may represent alternatives in terms of prolonged antimicrobial activity when compared with the biocide agents currently in use, capable to offer good resistance to detergent solutions and to water. Nevertheless, due to silver's susceptibility to extended exposure to acidic solutions, the findings of the research discourage the utilization of colloidal silver in wood paints intended for use in public settings. KEY POINTS: • Colloidal silver does not alter the deposition process and does not introduce defects in the wood paint. • Coatings containing silver show high antimicrobial activity over time, against both E.coli and S.aureus. • The silver-based filler resists contact with detergents and aqueous solutions but suffers oxidation processes in acidic environments.
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Affiliation(s)
- Massimo Calovi
- Department of Industrial Engineering, University of Trento, Via Sommarive 9, 38123, Trento, Italy.
| | - Valentina Coroneo
- Department of Medical Sciences and Public Health, University of Cagliari, S.P.8 Monserrato, 09042, Cagliari, Italy
| | - Stefano Rossi
- Department of Industrial Engineering, University of Trento, Via Sommarive 9, 38123, Trento, Italy
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22
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Shah S, Das R, Chavan B, Bajpai U, Hanif S, Ahmed S. Beyond antibiotics: phage-encoded lysins against Gram-negative pathogens. Front Microbiol 2023; 14:1170418. [PMID: 37789862 PMCID: PMC10542408 DOI: 10.3389/fmicb.2023.1170418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/25/2023] [Indexed: 10/05/2023] Open
Abstract
Antibiotics remain the frontline agents for treating deadly bacterial pathogens. However, the indiscriminate use of these valuable agents has led to an alarming rise in AMR. The antibiotic pipeline is insufficient to tackle the AMR threat, especially with respect to the WHO critical category of priority Gram-negative pathogens, which have become a serious problem as nosocomial and community infections and pose a threat globally. The AMR pandemic requires solutions that provide novel antibacterial agents that are not only effective but against which bacteria are less likely to gain resistance. In this regard, natural or engineered phage-encoded lysins (enzybiotics) armed with numerous features represent an attractive alternative to the currently available antibiotics. Several lysins have exhibited promising efficacy and safety against Gram-positive pathogens, with some in late stages of clinical development and some commercially available. However, in the case of Gram-negative bacteria, the outer membrane acts as a formidable barrier; hence, lysins are often used in combination with OMPs or engineered to overcome the outer membrane barrier. In this review, we have briefly explained AMR and the initiatives taken by different organizations globally to tackle the AMR threat at different levels. We bring forth the promising potential and challenges of lysins, focusing on the WHO critical category of priority Gram-negative bacteria and lysins under investigation for these pathogens, along with the challenges associated with developing them as therapeutics within the existing regulatory framework.
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Affiliation(s)
- Sanket Shah
- Techinvention Lifecare Private Limited, Mumbai, India
| | - Ritam Das
- Techinvention Lifecare Private Limited, Mumbai, India
| | - Bhakti Chavan
- Techinvention Lifecare Private Limited, Mumbai, India
| | - Urmi Bajpai
- Department of Biomedical Science, Acharya Narendra Dev College, University of Delhi, New Delhi, India
| | - Sarmad Hanif
- Techinvention Lifecare Private Limited, Mumbai, India
| | - Syed Ahmed
- Techinvention Lifecare Private Limited, Mumbai, India
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23
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Fait ME, Grillo PD, Garrote GL, Prieto ED, Vázquez RF, Saparrat MCN, Morcelle SR. Biocidal and antibiofilm activities of arginine-based surfactants against Candida isolates. Amino Acids 2023; 55:1083-1102. [PMID: 37382761 DOI: 10.1007/s00726-023-03296-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/19/2023] [Indexed: 06/30/2023]
Abstract
Amino-acid-based surfactants are a group of compounds that resemble natural amphiphiles and thus are expected to have a low impact on the environment, owing to either the mode of surfactant production or its means of disposal. Within this context, arginine-based tensioactives have gained particular interest, since their cationic nature-in combination with their amphiphilic character-enables them to act as broad-spectrum biocides. This capability is based mainly on their interactive affinity for the microbial envelope that alters the latter's structure and ultimately its function. In the work reported here, we investigated the efficiency of Nα-benzoyl arginine decyl- and dodecylamide against Candida spp. to further our understanding of the antifungal mechanism involved. For the assays, both a Candida albicans and a Candida tropicalis clinical isolates along with a C. albicans-collection strain were used as references. As expected, both arginine-based compounds proved to be effective against the strains tested through inhibiting both the planktonic and the sessile growth. Furthermore, atomic force microscopy techniques and lipid monolayer experiments enabled us to gain insight into the effect of the surfactant on the cellular envelope. The results demonstrated that all the yeasts treated exhibited changes in their exomorphologic structure, with respect to alterations in both roughness and stiffness, relative to the nontreated ones. This finding-in addition to the amphiphiles' proven ability to insert themselves within this model fungal membrane-could explain the changes in the yeast-membrane permeability that could be linked to viability loss and mixed-vesicle release.
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Affiliation(s)
- M Elisa Fait
- Centro de Investigación de Proteínas Vegetales (CIProVe-UNLP-Centro Asociado CICPBA), Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Centro Asociado CICPBA, Universidad Nacional de La Plata (UNLP), La Plata, Argentina.
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
| | - Patricia D Grillo
- Centro de Investigación de Proteínas Vegetales (CIProVe-UNLP-Centro Asociado CICPBA), Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Centro Asociado CICPBA, Universidad Nacional de La Plata (UNLP), La Plata, Argentina
- Agencia Nacional de Promoción Científica y Tecnológica (ANPCyT), Buenos Aires, Argentina
| | - Graciela L Garrote
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Centro de Investigación y Desarrollo en Criotecnología de Alimentos (CIDCA, CONICET-UNLP-CICPBA), La Plata, Argentina
| | - Eduardo D Prieto
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), CONICET, UNLP, CCT-La Plata, La Plata, Argentina
- Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
- Instituto Ciencias de la Salud, Universidad Nacional Arturo Jauretche, Buenos Aires, Argentina
| | - Romina F Vázquez
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Investigaciones Bioquímicas de La Plata (INIBIOLP), CCT-La Plata, CONICET, UNLP, La Plata, Argentina
| | - Mario C N Saparrat
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Fisiología Vegetal (INFIVE-CONICET-UNLP) and Cátedra de Microbiología Agrícola, Facultad de Ciencias Agrarias y Forestales, UNLP, La Plata, Argentina
| | - Susana R Morcelle
- Centro de Investigación de Proteínas Vegetales (CIProVe-UNLP-Centro Asociado CICPBA), Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Centro Asociado CICPBA, Universidad Nacional de La Plata (UNLP), La Plata, Argentina.
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
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Alkafaas SS, Abdallah AM, Hussien AM, Bedair H, Abdo M, Ghosh S, Elkafas SS, Apollon W, Saki M, Loutfy SA, Onyeaka H, Hessien M. A study on the effect of natural products against the transmission of B.1.1.529 Omicron. Virol J 2023; 20:191. [PMID: 37626376 PMCID: PMC10464336 DOI: 10.1186/s12985-023-02160-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The recent outbreak of the Coronavirus pandemic resulted in a successful vaccination program launched by the World Health Organization. However, a large population is still unvaccinated, leading to the emergence of mutated strains like alpha, beta, delta, and B.1.1.529 (Omicron). Recent reports from the World Health Organization raised concerns about the Omicron variant, which emerged in South Africa during a surge in COVID-19 cases in November 2021. Vaccines are not proven completely effective or safe against Omicron, leading to clinical trials for combating infection by the mutated virus. The absence of suitable pharmaceuticals has led scientists and clinicians to search for alternative and supplementary therapies, including dietary patterns, to reduce the effect of mutated strains. MAIN BODY This review analyzed Coronavirus aetiology, epidemiology, and natural products for combating Omicron. Although the literature search did not include keywords related to in silico or computational research, in silico investigations were emphasized in this study. Molecular docking was implemented to compare the interaction between natural products and Chloroquine with the ACE2 receptor protein amino acid residues of Omicron. The global Omicron infection proceeding SARS-CoV-2 vaccination was also elucidated. The docking results suggest that DGCG may bind to the ACE2 receptor three times more effectively than standard chloroquine. CONCLUSION The emergence of the Omicron variant has highlighted the need for alternative therapies to reduce the impact of mutated strains. The current review suggests that natural products such as DGCG may be effective in binding to the ACE2 receptor and combating the Omicron variant, however, further research is required to validate the results of this study and explore the potential of natural products to mitigate COVID-19.
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Affiliation(s)
- Samar Sami Alkafaas
- Molecular Cell Biology Unit, Division of Biochemistry, Department of Chemistry, Faculty of Science, Tanta University, Tanta, 31527, Egypt.
| | - Abanoub Mosaad Abdallah
- Narcotic Research Department, National Center for Social and Criminological Research (NCSCR), Giza, 11561, Egypt
| | - Aya Misbah Hussien
- Biotechnology Department at Institute of Graduate Studies and Research, Alexandria University, Alexandria, Egypt
| | - Heba Bedair
- Botany Department, Faculty of Science, Tanta University, Tanta, Egypt
| | - Mahmoud Abdo
- Division of Biochemistry, Department of Chemistry, Faculty of Science, Tanta University, Tanta, 31527, Egypt
| | - Soumya Ghosh
- Department of Genetics, Faculty of Natural and Agricultural Sciences, University of the Free State, Bloemfontein, 9301, South Africa.
| | - Sara Samy Elkafas
- Production Engineering and Mechanical Design Department, Faculty of Engineering, Menofia University, Menofia, Egypt
| | - Wilgince Apollon
- Department of Agricultural and Food Engineering, Faculty of Agronomy, Universidad Autónoma de Nuevo León, Francisco Villa S/N, Ex-Hacienda El Canadá, 66050, General Escobedo, Nuevo León, Mexico
| | - Morteza Saki
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Samah A Loutfy
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
- Nanotechnology Research Center, British University, Cairo, Egypt
| | - Helen Onyeaka
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Mohamed Hessien
- Molecular Cell Biology Unit, Division of Biochemistry, Department of Chemistry, Faculty of Science, Tanta University, Tanta, 31527, Egypt
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Millán-Pacheco C, Rios-Soto L, Corral-Rodríguez N, Sierra-Campos E, Valdez-Solana M, Téllez-Valencia A, Avitia-Domínguez C. Discovery of Potential Noncovalent Inhibitors of Dehydroquinate Dehydratase from Methicillin-Resistant Staphylococcus aureus through Computational-Driven Drug Design. Pharmaceuticals (Basel) 2023; 16:1148. [PMID: 37631063 PMCID: PMC10458038 DOI: 10.3390/ph16081148] [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: 06/30/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Bacteria resistance to antibiotics is a concerning global health problem; in this context, methicillin-resistant Staphylococcus aureus (MRSA) is considered as a high priority by the World Health Organization. Furthermore, patients with a positive result for COVID-19 received early antibiotic treatment, a fact that potentially encourages the increase in antibiotic resistance. Therefore, there is an urgency to develop new drugs with molecular mechanisms different from those of the actual treatments. In this context, enzymes from the shikimate pathway, a route absent in humans, such as dehydroquinate dehydratase (DHQD), are considered good targets. In this work, a computer-aided drug design strategy, which involved exhaustive virtual screening and molecular dynamics simulations with MM-PBSA analysis, as well as an in silico ADMETox characterization, was performed to find potential noncovalent inhibitors of DHQD from MRSA (SaDHQD). After filtering the 997 million compounds from the ZINC database, 6700 compounds were submitted to an exhaustive virtual screening protocol. From these data, four molecules were selected and characterized (ZINC000005753647 (1), ZINC000001720488 (2), ZINC000082049768 (3), and ZINC000644149506 (4)). The results indicate that the four potential inhibitors interacted with residues important for substrate binding and catalysis, with an estimated binding free energy like that of the enzyme's substrate. Their ADMETox-predicted properties suggest that all of them support the structural characteristics to be considered good candidates. Therefore, the four compounds reported here are excellent option to be considered for future in vitro studies to design new SaDHQD noncovalent inhibitors and contribute to the search for new drugs against MRSA.
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Affiliation(s)
- César Millán-Pacheco
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Cuernavaca, Morelos 62209, Mexico;
| | - Lluvia Rios-Soto
- Facultad de Medicina y Nutrición, Universidad Juárez del Estado de Durango, Av. Universidad y Fanny Anitua S/N, Durango 34000, Mexico; (L.R.-S.); (N.C.-R.)
| | - Noé Corral-Rodríguez
- Facultad de Medicina y Nutrición, Universidad Juárez del Estado de Durango, Av. Universidad y Fanny Anitua S/N, Durango 34000, Mexico; (L.R.-S.); (N.C.-R.)
| | - Erick Sierra-Campos
- Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango Campus Gómez Palacio, Avenida Artículo 123 S/N, Fracc. Filadelfia, Gómez Palacio 35010, Mexico; (E.S.-C.); (M.V.-S.)
| | - Mónica Valdez-Solana
- Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango Campus Gómez Palacio, Avenida Artículo 123 S/N, Fracc. Filadelfia, Gómez Palacio 35010, Mexico; (E.S.-C.); (M.V.-S.)
| | - Alfredo Téllez-Valencia
- Facultad de Medicina y Nutrición, Universidad Juárez del Estado de Durango, Av. Universidad y Fanny Anitua S/N, Durango 34000, Mexico; (L.R.-S.); (N.C.-R.)
| | - Claudia Avitia-Domínguez
- Facultad de Medicina y Nutrición, Universidad Juárez del Estado de Durango, Av. Universidad y Fanny Anitua S/N, Durango 34000, Mexico; (L.R.-S.); (N.C.-R.)
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Hosseini M, Ahmed Hamad M, Mohseni G, Salamy S, Dehghan Tarzjani S, Taati Moghadam M. Prediction of tsunami of resistance to some antibiotics is not far-fetched which used during COVID-19 pandemic. J Clin Lab Anal 2023; 37:e24959. [PMID: 37650531 PMCID: PMC10561589 DOI: 10.1002/jcla.24959] [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: 01/17/2023] [Revised: 07/19/2023] [Accepted: 08/06/2023] [Indexed: 09/01/2023] Open
Abstract
One of the most tragic events in recent history was the COVID-19 outbreak, which has caused thousands of deaths. A variety of drugs were prescribed to improve the condition of patients, including antiparasitic, antiviral, antibiotics, and anti-inflammatory medicines. It must be understood, however, that COVID-19 is like a tip of an iceberg on the ocean, and the consequences of overuse of antibiotics are like the body of a mountain under water whose greatness has not yet been determined for humanity, and additional study is needed to understand them. History of the war between microbes and antimicrobial agents has shown that microbes are intelligent organisms that win over antimicrobial agents over time through many acquired or inherent mechanisms. The key terms containing "COVID-19," "Severe acute respiratory syndrome coronavirus-2," "SARS-CoV2," "Antibiotic Resistance," "Coronavirus," "Pandemic," "Antibiotics," and "Antimicrobial Resistance" were used for searching in PubMed, Scopus, and Google Scholar databases. The COVID-19 pandemic has resulted in an increased prescription of antibiotics. Infections caused by secondary or co-bacterial infections or beneficial bacteria in the body can be increased as a result of this amount of antibiotic prescription and exposure to antibiotics. Antibiotic resistance will likely pose a major problem in the future, especially for last resort antibiotics. In order to address the antibiotic resistance crisis, it is imperative that researchers, farmers, veterinarians, physicians, public and policymakers, pharmacists, other health and environmental professionals, and others collaborate during and beyond this pandemic.
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Affiliation(s)
- Mandana Hosseini
- Department of Microbiology, Tehran North Branch, Islamic Azad University, Tehran, Iran
| | - Mohammed Ahmed Hamad
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Golazin Mohseni
- Department of Microbiology, Tonekabon Branch, Azad University, Tonekabon, Iran
| | - Shakiba Salamy
- Department of Microbiology, Faculty of Pharmacy, Islamic Azad University, Tehran, Iran
| | - Shabnam Dehghan Tarzjani
- Department of Cellular and Molecular Biology, Tehran Center Branch, Islamic Azad University, Tehran, Iran
| | - Majid Taati Moghadam
- Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Sumardi U, Valentino B, Prasetya D, Debora J, Sugianli AK. The Diagnostic Value of Kinetics of NLR to Identify Secondary Pulmonary Bacterial Infection Among COVID-19 Patients at Single Tertiary Hospital in Indonesia. Int J Gen Med 2023; 16:3281-3289. [PMID: 37546238 PMCID: PMC10404039 DOI: 10.2147/ijgm.s417569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023] Open
Abstract
Purpose Coronavirus disease 2019 (COVID-19) is a new respiratory tract infection caused by severe acute respiratory syndrome coronavirus-2. The presence of secondary pulmonary bacterial infection (SPBI) made COVID-19 difficult to treat. Neutrophil-lymphocyte count ratio (NLR) is a systemic inflammatory marker used in the diagnosis and prognosis of viral or bacterial infection. At the first 3-5 days after hyperinflammation, it occurs in relation to clinical outcome. Therefore, this study aimed to evaluate the diagnostic value of NLR based on leukocyte kinetics upon admission and after 72 hours among COVID-19 patients with or without SPBI. Patients and Methods This retrospective cross-sectional study analyzed medical records data of admitted patients with COVID-19 according to the International Classification of Disease 10th Revision (ICD-10) between January and December 2021. The list of patients was extracted and followed by a hand search to identify the inclusion or exclusion criteria and stratified into proven and non-proven SPBI based on clinical data. The study distinguished between SPBI by means of a cut-off value (COV) on the first (D1) and third day (D3), assessed using receiver operating characteristics (ROC), as well as determined the magnitude of sensitivity, specificity, and prevalence ratio. Results A screening process was conducted on 2902 COVID-19 patients, of which 236 were included, accounting for 8.1%. Among these patients, 87 (36.9%) were found to have proven SPBI. A considerable difference in NLR value between proven and non-proven SPBI was observed on both D1 (11.1 vs 4.2) and D3 (15.3 vs 5.2), with optimal COV of NLR on D1, D3 was found to be 5.29, 9.47, respectively (p < 0.001). Conclusion NLR on the D1 and D3 distinguished the occurrence of SPBI among COVID-19 patients. The application of NLR assisted in the early determination of bacterial infection and helped in controlling the empirical use of antibiotics.
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Affiliation(s)
- Uun Sumardi
- Department of Internal Medicine, Hasan Sadikin General Hospital, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
| | - Bima Valentino
- Department of Internal Medicine, Hasan Sadikin General Hospital, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
| | - Dimmy Prasetya
- Department of Internal Medicine, Hasan Sadikin General Hospital, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
| | - Josephine Debora
- Department of Internal Medicine, Hasan Sadikin General Hospital, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
| | - Adhi Kristianto Sugianli
- Department of Clinical Pathology, Hasan Sadikin General Hospital, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
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Kiffer CRV, Rezende TFT, Costa-Nobre DT, Marinonio ASS, Shiguenaga LH, Kulek DNO, Arend LNVS, Santos ICDO, Sued-Karam BR, Rocha-de-Souza CM, Kraft L, Abreu A, Peral RTDS, Carvalho-Assef APD, Pillonetto M. A 7-Year Brazilian National Perspective on Plasmid-Mediated Carbapenem Resistance in Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii Complex and the Impact of the Coronavirus Disease 2019 Pandemic on Their Occurrence. Clin Infect Dis 2023; 77:S29-S37. [PMID: 37406041 DOI: 10.1093/cid/ciad260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Carbapenemase production is a global public health threat. Antimicrobial resistance (AMR) data analysis is critical to public health policy. Here we analyzed carbapenemase detection trends using the AMR Brazilian Surveillance Network. METHODS Carbapenemase detection data from Brazilian hospitals included in the public laboratory information system dataset were evaluated. The detection rate (DR) was defined as carbapenemase detected by gene tested per isolate per year. The temporal trends were estimated using the Prais-Winsten regression model. The impact of COVID-19 on carbapenemase genes in Brazil was determined for the period 2015-2022. Detection pre- (October 2017 to March 2020) and post-pandemic onset (April 2020 to September 2022) was compared using the χ2 test. Analyses were performed with Stata 17.0 (StataCorp, College Station, TX). RESULTS 83 282 blaKPC and 86 038 blaNDM were tested for all microorganisms. Enterobacterales DR for blaKPC and blaNDM was 68.6% (41 301/60 205) and 14.4% (8377/58 172), respectively. P. aeruginosa DR for blaNDM was 2.5% (313/12 528). An annual percent increase for blaNDM of 41.1% was observed, and a decrease for blaKPC of -4.0% in Enterobacterales, and an annual increase for blaNDM of 71.6% and for blaKPC of 22.2% in P. aeruginosa. From 2020 to 2022, overall increases of 65.2% for Enterobacterales, 77.7% for ABC, and 61.3% for P. aeruginosa were observed in the total isolates. CONCLUSIONS This study shows the strengths of the AMR Brazilian Surveillance Network with robust data related to carbapenemases in Brazil and the impact of COVID-19 with a change in carbapenemase profiles with blaNDM rising over the years.
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Affiliation(s)
- Carlos R V Kiffer
- Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo-UNIFESP, São Paulo, Brazil
- Infectious Diseases Discipline, Laboratório Especial de Microbiologia Clínica-LEMC/ALERTA, EPM, UNIFESP, São Paulo, Brazil
| | - Thais F T Rezende
- Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo-UNIFESP, São Paulo, Brazil
- Infectious Diseases Discipline, Laboratório Especial de Microbiologia Clínica-LEMC/ALERTA, EPM, UNIFESP, São Paulo, Brazil
| | | | | | | | - Debora Nicole Oliveira Kulek
- Laboratorio Central do Paraná - LACENPR, Secretaria de Estado da Saúde, Curitiba, Parana, Brazil
- Escola de Medicina e Ciencias da Vida - EMCV, Pontifícia Universidade Católica do Paraná-PUCPR, Curitiba, Parana, Brazil
| | - Lavinia Nery Villa Stangler Arend
- Laboratorio Central do Paraná - LACENPR, Secretaria de Estado da Saúde, Curitiba, Parana, Brazil
- Escola de Medicina e Ciencias da Vida - EMCV, Pontifícia Universidade Católica do Paraná-PUCPR, Curitiba, Parana, Brazil
| | - Ivson Cassiano de Oliveira Santos
- Instituto Oswaldo Cruz (IOC)-Fundação Instituto Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- Laboratório de Pesquisa em Infecção Hospitalar-LAPIH, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Bruna Ribeiro Sued-Karam
- Instituto Oswaldo Cruz (IOC)-Fundação Instituto Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- Laboratório de Pesquisa em Infecção Hospitalar-LAPIH, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Claudio Marcos Rocha-de-Souza
- Instituto Oswaldo Cruz (IOC)-Fundação Instituto Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- Laboratório de Pesquisa em Infecção Hospitalar-LAPIH, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Leticia Kraft
- Coordenação Geral de Laboratórios de Saúde Publica, Departamento de Articulação Estratégica de Vigilância em Saúde e Ambiente, Secretaria de Vigilância em Saúde e Ambiente, Ministério da Saúde, Brasilia, Distrito Federal, Brazil
| | - Andre Abreu
- Núcleo de Epidemiologia e Vigilância em Saúde, Instituto Oswaldo Cruz-FIOCRUZ, Brasilia, Distrito Federal, Brazil
| | - Renata Tigulini de Souza Peral
- Coordenação Geral de Laboratórios de Saúde Publica, Departamento de Articulação Estratégica de Vigilância em Saúde e Ambiente, Secretaria de Vigilância em Saúde e Ambiente, Ministério da Saúde, Brasilia, Distrito Federal, Brazil
| | - Ana Paula D'Alincourt Carvalho-Assef
- Instituto Oswaldo Cruz (IOC)-Fundação Instituto Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- Laboratório de Pesquisa em Infecção Hospitalar-LAPIH, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marcelo Pillonetto
- Laboratorio Central do Paraná - LACENPR, Secretaria de Estado da Saúde, Curitiba, Parana, Brazil
- Escola de Medicina e Ciencias da Vida - EMCV, Pontifícia Universidade Católica do Paraná-PUCPR, Curitiba, Parana, Brazil
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Frolov NA, Seferyan MA, Valeev AB, Saverina EA, Detusheva EV, Vereshchagin AN. The Antimicrobial and Antibiofilm Potential of New Water-Soluble Tris-Quaternary Ammonium Compounds. Int J Mol Sci 2023; 24:10512. [PMID: 37445691 DOI: 10.3390/ijms241310512] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/10/2023] [Accepted: 06/14/2023] [Indexed: 07/15/2023] Open
Abstract
The invention and innovation of highly effective antimicrobials are always crucial tasks for medical and organic chemistry, especially at the current time, when there is a serious threat of shortages of effective antimicrobials following the pandemic. In the study presented in this article, we established a new approach to synthesizing three novel series of bioactive water-soluble tris-quaternary ammonium compounds using an optimized one-pot method, and we assessed their antimicrobial and antibiofilm potential. Five pathogenic microorganisms of the ESKAPE group, including highly resistant clinical isolates, were used as the test samples. Moreover, we highlighted the dependence of antibacterial activity from the hydrophilic-hydrophobic balance of the QACs and noted the significant performance of the desired products on biofilms with MBEC as low as 16 mg/L against bacteria and 8 mg/L against fungi. Particularly notable was the high activity against Pseudomonas aeruginosa and Acinetobacter baumannii, which are among the most resilient bacteria known. The presented work will provide useful insights for future research on the topic.
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Affiliation(s)
- Nikita A Frolov
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, 119991 Moscow, Russia
| | - Mary A Seferyan
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, 119991 Moscow, Russia
| | - Anvar B Valeev
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, 119991 Moscow, Russia
- Higher Chemical College of the Russian Academy of Sciences, D. Mendeleev University of Chemical Technology of Russia, Miusskaya Square 9, 125047 Moscow, Russia
| | - Evgeniya A Saverina
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, 119991 Moscow, Russia
- Laboratory of Biologically Active Compounds and Biocomposites, Tula State University, Lenin Prospect. 92, 300012 Tula, Russia
| | - Elena V Detusheva
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, 119991 Moscow, Russia
- State Research Center for Applied Microbiology and Biotechnology, 142279 Obolensk, Russia
| | - Anatoly N Vereshchagin
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, 119991 Moscow, Russia
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30
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Macyszyn J, Burmistrz M, Mieczkowski A, Wojciechowska M, Trylska J. Conjugates of Aminoglycosides with Stapled Peptides as a Way to Target Antibiotic-Resistant Bacteria. ACS OMEGA 2023; 8:19047-19056. [PMID: 37273645 PMCID: PMC10233823 DOI: 10.1021/acsomega.3c02071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023]
Abstract
The misuse and overuse of antibiotics led to the development of bacterial resistance to existing aminoglycoside (AMG) antibiotics and limited their use. Consequently, there is a growing need to develop effective antimicrobials against multidrug-resistant bacteria. To target resistant strains, we propose to combine 2-deoxystreptamine AMGs, neomycin (NEO) and amikacin (AMK), with a membrane-active antimicrobial peptide anoplin and its hydrocarbon stapled derivative. The AMG-peptide hybrids were conjugated using the click chemistry reaction in solution to obtain a non-cleavable triazole linker and by disulfide bridge formation on the resin to obtain a linker cleavable in the bacterial cytoplasm. Homo-dimers connected via disulfide bridges between the N-terminus thiol analogues of anoplin and hydrocarbon stapled anoplin were also synthesized. These hybrid compounds show a notable increase in antibacterial and bactericidal activity, as compared to the unconjugated ones or their combinations, against Gram-positive and Gram-negative bacteria, especially for the strains resistant to AMK or NEO. The conjugates and disulfide peptide dimers exhibit low hemolytic activity on sheep red blood erythrocytes.
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Affiliation(s)
- Julia Macyszyn
- Centre
of New Technologies, University of Warsaw, Banacha 2c, 02-097 Warsaw, Poland
| | - Michał Burmistrz
- Centre
of New Technologies, University of Warsaw, Banacha 2c, 02-097 Warsaw, Poland
| | - Adam Mieczkowski
- Institute
of Biochemistry and Biophysics, Polish Academy of Sciences, Pawinskiego 5a, 02-106 Warsaw, Poland
| | - Monika Wojciechowska
- Centre
of New Technologies, University of Warsaw, Banacha 2c, 02-097 Warsaw, Poland
| | - Joanna Trylska
- Centre
of New Technologies, University of Warsaw, Banacha 2c, 02-097 Warsaw, Poland
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31
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Sério J, Marques AP, Huertas R, Crespo JG, Pereira VJ. Occurrence and Treatment of Antibiotic-Resistant Bacteria Present in Surface Water. MEMBRANES 2023; 13:425. [PMID: 37103852 PMCID: PMC10141635 DOI: 10.3390/membranes13040425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
According to the World Health Organization, antibiotic resistance is one of the main threats to global health. The excessive use of several antibiotics has led to the widespread distribution of antibiotic-resistant bacteria and antibiotic resistance genes in various environment matrices, including surface water. In this study, total coliforms, Escherichia coli and enterococci, as well as total coliforms and Escherichia coli resistant to ciprofloxacin, levofloxacin, ampicillin, streptomycin, and imipenem, were monitored in several surface water sampling events. A hybrid reactor was used to test the efficiency of membrane filtration, direct photolysis (using UV-C light emitting diodes that emit light at 265 nm and UV-C low pressure mercury lamps that emit light at 254 nm), and the combination of both processes to ensure the retention and inactivation of total coliforms and Escherichia coli as well as antibiotic-resistant bacteria (total coliforms and Escherichia coli) present in river water at occurrence levels. The membranes used (unmodified silicon carbide membranes and the same membrane modified with a photocatalytic layer) effectively retained the target bacteria. Direct photolysis using low-pressure mercury lamps and light-emitting diode panels (emitting at 265 nm) achieved extremely high levels of inactivation of the target bacteria. The combined treatment (unmodified and modified photocatalytic surfaces in combination with UV-C and UV-A light sources) successfully retained the bacteria and treated the feed after 1 h of treatment. The hybrid treatment proposed is a promising approach to use as point-of-use treatment by isolated populations or when conventional systems and electricity fail due to natural disasters or war. Furthermore, the effective treatment obtained when the combined system was used with UV-A light sources indicates that the process may be a promising approach to guarantee water disinfection using natural sunlight.
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Affiliation(s)
- João Sério
- iBET—Instituto de Biologia Experimental e Tecnológica, Apartado 12, 2780-901 Oeiras, Portugal
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Av. da República, 2780-157 Oeiras, Portugal
| | - Ana Paula Marques
- iBET—Instituto de Biologia Experimental e Tecnológica, Apartado 12, 2780-901 Oeiras, Portugal
| | - Rosa Huertas
- iBET—Instituto de Biologia Experimental e Tecnológica, Apartado 12, 2780-901 Oeiras, Portugal
- LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal
| | - João Goulão Crespo
- LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal
| | - Vanessa Jorge Pereira
- iBET—Instituto de Biologia Experimental e Tecnológica, Apartado 12, 2780-901 Oeiras, Portugal
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Av. da República, 2780-157 Oeiras, Portugal
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Shapovalova K, Zatonsky G, Grammatikova N, Osterman I, Razumova E, Shchekotikhin A, Tevyashova A. Synthesis of 6″-Modified Kanamycin A Derivatives and Evaluation of Their Antibacterial Properties. Pharmaceutics 2023; 15:pharmaceutics15041177. [PMID: 37111662 PMCID: PMC10141514 DOI: 10.3390/pharmaceutics15041177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
Aminoglycosides are one of the first classes of antibiotics to have been used clinically, and they are still being used today. They have a broad spectrum of antimicrobial activity, making them effective against many different types of bacteria. Despite their long history of use, aminoglycosides are still considered promising scaffolds for the development of new antibacterial agents, particularly as bacteria continue to develop resistances to existing antibiotics. We have synthesized a series of 6″-deoxykanamycin A analogues with additional protonatable groups (amino-, guanidino or pyridinium) and tested their biological activities. For the first time we have demonstrated the ability of the tetra-N-protected-6″-O-(2,4,6-triisopropylbenzenesulfonyl)kanamycin A to interact with a weak nucleophile, pyridine, resulting in the formation of the corresponding pyridinium derivative. Introducing small diamino-substituents at the 6″-position of kanamycin A did not significantly alter the antibacterial activity of the parent antibiotic, but further modification by acylation resulted in a complete loss of the antibacterial activity. However, introducing a guanidine residue led to a compound with improved activity against S. aureus. Moreover, most of the obtained 6″-modified kanamycin A derivatives were less influenced by the resistant mechanism associated with mutations of the elongation factor G than the parent kanamycin A. This suggests that modifying the 6″-position of kanamycin A with protonatable groups is a promising direction for the further development of new antibacterial agents with reduced resistances.
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Affiliation(s)
- Kseniya Shapovalova
- Gause Institute of New Antibiotics, 11 B. Pirogovskaya, 119021 Moscow, Russia
| | - Georgy Zatonsky
- Gause Institute of New Antibiotics, 11 B. Pirogovskaya, 119021 Moscow, Russia
| | | | - Ilya Osterman
- Center of Life Sciences, Skolkovo Institute of Science and Technology, Bolshoy Boulevard 30, bld. 1, 121205 Moscow, Russia
- Center for Translational Medicine, Sirius University of Science and Technology, Olympic Avenue 1, 354340 Sochi, Russia
| | - Elizaveta Razumova
- Department of Chemistry, Lomonosov Moscow State University, Leninskie Gory 1, 119991 Moscow, Russia
| | | | - Anna Tevyashova
- Gause Institute of New Antibiotics, 11 B. Pirogovskaya, 119021 Moscow, Russia
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Mustafa ZUI, Khan AH, Harun SN, Salman M, Godman B. Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications. Antibiotics (Basel) 2023; 12:646. [PMID: 37107008 PMCID: PMC10135218 DOI: 10.3390/antibiotics12040646] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
There are concerns with excessive antibiotic prescribing among patients admitted to hospital with COVID-19, increasing antimicrobial resistance (AMR). Most studies have been conducted in adults with limited data on neonates and children, including in Pakistan. A retrospective study was conducted among four referral/tertiary care hospitals, including the clinical manifestations, laboratory findings, the prevalence of bacterial co-infections or secondary bacterial infections and antibiotics prescribed among neonates and children hospitalized due to COVID-19. Among 1237 neonates and children, 511 were admitted to the COVID-19 wards and 433 were finally included in the study. The majority of admitted children were COVID-19-positive (85.9%) with severe COVID-19 (38.2%), and 37.4% were admitted to the ICU. The prevalence of bacterial co-infections or secondary bacterial infections was 3.7%; however, 85.5% were prescribed antibiotics during their hospital stay (average 1.70 ± 0.98 antibiotics per patient). Further, 54.3% were prescribed two antibiotics via the parenteral route (75.5%) for ≤5 days (57.5), with most being 'Watch' antibiotics (80.4%). Increased antibiotic prescribing was reported among patients requiring mechanical ventilation and high WBCs, CRP, D-dimer and ferritin levels (p < 0.001). Increased COVID-19 severity, length of stay and hospital setting were significantly associated with antibiotic prescribing (p < 0.001). Excessive antibiotic prescribing among hospitalized neonates and children, despite very low bacterial co-infections or secondary bacterial infections, requires urgent attention to reduce AMR.
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Affiliation(s)
- Zia UI Mustafa
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
- Department of Pharmacy Services, District Headquarter (DHQ) Hospital, Pakpattan 57400, Pakistan
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
| | - Sabariah Noor Harun
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow G4 0RE, UK
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
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34
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Sokolović D, Drakul D, Vujić‐Aleksić V, Joksimović B, Marić S, Nežić L. Antibiotic consumption and antimicrobial resistance in the SARS-CoV-2 pandemic: A single-center experience. Front Pharmacol 2023; 14:1067973. [PMID: 37007038 PMCID: PMC10050571 DOI: 10.3389/fphar.2023.1067973] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
Introduction: Antimicrobial resistance and the rapid spread of multiresistant bacteria represent one of the main public health problem in limited resources countries. This issue is significantly worsening since the COVID-19 pandemic due to the unreasonably increased antibiotics prescription to patients with confirmed SARS-CoV-2 infection. The aim of this study was to examine whether COVID-19 pandemic (2020, 2021) was associated with increased antibiotic consumption in inpatient and outpatient settings in the middle size urban region (Republic of Srpska/Bosnia and Herzegovina) in comparison to period before the pandemic (2019). Additionally, we aimed to determine antimicrobial resistance and the presence of multiresistant bacteria in the regional hospital (“Saint Apostol Luka” Hospital Doboj) in 2021.Methodology: The consumption of antibiotics in inpatient was calculated as Defined Daily Dose per one hundred of patient-days. The consumption of antibiotics in outpatient was calculated as Defined Daily Dose per thousand inhabitants per day. Resistance of bacteria to antibiotics is expressed as a rates and density for each observed antibiotic. The rate of resistance was calculated as a percentage in relation to the total number of isolates of individual bacteria. The density of resistance of isolated bacteria against a specific antibiotic was expressed as the number of resistant pathogens/1000 patient days.Results: Antibiotic consumption in hospital setting registered during 2019, 2020 and 2021 was as follows: carbapenems (meropenem: 0.28; 1.91; 2.33 DDD/100 patient-days, respectively), glycopeptides (vancomycin: 0.14; 1.09, 1.54 DDD/100 patient-days, respectively), cephalosporins (ceftriaxone: 6.69; 14.7; 14.0 DDD/100 patient-days, respectively) and polymyxins (colistin: 0.04; 0.25; 0.35 DDD/100 bed-days, respectively). Consumption of azithromycin increased drastically in 2020, and dropped significantly in 2021 (0.48; 5.61; 0.93 DDD/100 patient-days). In outpatient setting, an increase in the consumption of oral forms of azithromycin, levofloxacin and cefixime, as well as parenteral forms of amoxicillin-clavulanic acid, ciprofloxacin and ceftriaxone, was recorded. In 2021, antimicrobial resistance to reserve antibiotics in hospital setting was as follows: Acinetobacter baumanii to meropenem 66.0%, Klebsiella spp to cefotaxime 67.14%, Pseudomonas to meropenem 25.7%.Conclusion: Recent COVID-19 pandemic was associated with increased antibiotic consumption in inpatient and outpatient settings, with characteristic change of pattern of azithromycin consumption. Also, high levels of antimicrobial resistance to reserve antibiotics were registered in hospital setting with low prevalence of identified pathogen-directed antimicrobial prescription. Strategies toward combat antimicrobial resistance in the Doboj region are urgently needed.
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Affiliation(s)
- Dragana Sokolović
- Department of Pharmacology, Faculty of Medicine Foča, University of East Sarajevo, Foča, Bosnia and Herzegovina
- Centre for Biomedical Research, Faculty of Medicine Foča, University of East Sarajevo, Foča, Bosnia and Herzegovina
- *Correspondence: Dragana Sokolović,
| | - Dragana Drakul
- Department of Pharmacology, Faculty of Medicine Foča, University of East Sarajevo, Foča, Bosnia and Herzegovina
- Centre for Biomedical Research, Faculty of Medicine Foča, University of East Sarajevo, Foča, Bosnia and Herzegovina
| | - Vesna Vujić‐Aleksić
- The Republic of Srpska Agency for Certification, Accreditation and Quality Improvement in Health Care, Banja Luka, Bosnia and Herzegovina
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Bojan Joksimović
- Department of preclinical subjects (Pathophisiology), Faculty of Medicine Foča, University of East Sarajevo, Foča, Bosnia and Herzegovina
| | - Siniša Marić
- Department of Surgery, Hospital “Saint Apostol Luka”, Doboj, Bosnia and Herzegovina
| | - Lana Nežić
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
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Bongiovanni M, Barda B. Pseudomonas aeruginosa Bloodstream Infections in SARS-CoV-2 Infected Patients: A Systematic Review. J Clin Med 2023; 12:jcm12062252. [PMID: 36983256 PMCID: PMC10056033 DOI: 10.3390/jcm12062252] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/07/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Bacterial co-infections increase the severity of respiratory viral infections and are frequent causes of mortality in COVID-19 infected subjects. During the COVID-19 period, especially at the beginning of the pandemic, an inappropriate use of broad-spectrum antibiotic treatments has been frequently described, mainly due to prolonged hospitalization, especially in intensive care unit departments, and the use of immune-suppressive treatments as steroids. This misuse has finally led to the occurrence of infections by multi-drug resistant (MDR) bacteria in hospitalized COVID-19 patients. Although different reports assessed the prevalence of Gram-negative infections in COVID-19 infected patients, scarce data are currently available on bloodstream infections caused by Pseudomonas aeruginosa in hospitalized COVID-19 patients. The aim of our systematic review is to describe data on this specific population and to discuss the possible implications that these co-infections could have in the management of COVID-19 pandemics in the future. We systematically analysed the current literature to find all the relevant articles that describe the occurrence of P. aeruginosa bloodstream infections in COVID-19 patients. We found 40 papers that described in detail P. aeruginosa HAIs-BSI in COVID-19 patients, including 756,067 patients overall. The occurrence of severe infections due to MDR bacteria had a significant impact in the management of hospitalized patients with COVID-19 infections, leading to a prolonged time of hospitalization and to a consequent increase in mortality. In the near future, the increased burden of MDR bacteria due to the COVID-19 pandemic might partially be reduced by maintaining the preventive measures of infection control implemented during the acute phase of the COVID-19 pandemic. Finally, we discuss how the COVID-19 pandemic changed the role of antimicrobial stewardship in healthcare settings, according to the isolation of MDR bacteria and how to restore on a large scale the optimization of antibiotic strategies in COVID-19 patients.
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Impact of COVID-19 pandemic on multidrug resistant gram positive and gram negative pathogens: A systematic review. J Infect Public Health 2023; 16:320-331. [PMID: 36657243 PMCID: PMC9804969 DOI: 10.1016/j.jiph.2022.12.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND There is paucity of data describing the impact of COVID-19 pandemic on antimicrobial resistance. This review evaluated the changes in the rate of multidrug resistant gram negative and gram positive bacteria during the COVID-19 pandemic. METHODS A search was conducted in PubMed, Science Direct, and Google Scholar databases to identify eligible studies. Studies that reported the impact of COVID-19 pandemic on carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Enterobacteriaceae (CRE), extended-spectrum beta-lactamase inhibitor (ESBL)-producing Enterobacteriaceae, vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Pseudomonas aeruginosa (CPE) were selected. Studies published in English language from the start of COVID-19 pandemic to July 2022 were considered for inclusion. RESULTS Thirty eligible studies were selected and most of them were from Italy (n = 8), Turkey (n = 3) and Brazil (n = 3). The results indicated changes in the rate of multidrug resistant bacteria, and the changes varied between the studies. Most studies (54.5%) reported increase in MRSA infection/colonization during the pandemic, and the increase ranged from 4.6 to 170.6%. Five studies (55.6%) reported a 6.8-65.1% increase in VRE infection/colonization during the pandemic. A 2.4-58.2% decrease in ESBL E. coli and a 1.8-13.3% reduction in ESBL Klebsiella pneumoniae was observed during the pandemic. For CRAB, most studies (58.3%) reported 1.5-621.6% increase in infection/colonization during the pandemic. Overall, studies showed increase in the rate of CRE infection/colonization during the pandemic. There was a reduction in carbapenem-resistant E. coli during COVID-19 pandemic, and an increase in carbapenem-resistant K. pneumoniae. Most studies (55.6%) showed 10.4 - 40.9% reduction in the rate of CRPA infection during the pandemic. CONCLUSION There is an increase in the rate of multidrug resistant gram positive and gram negative bacteria during the COVID-19 pandemic. However, the rate of ESBL-producing Enterobacteriaceae and CRPA has decrease during the pandemic. Both infection prevention and control strategies and antimicrobial stewardship should be strengthen to address the increasing rate of multidrug resistant gram positive and gram negative bacteria.
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Ferrara F, Zovi A, Nava E, Trama U, Vitiello A. SARS-CoV-2 caused a surge in antibiotic consumption causing a silent pandemic inside the pandemic. A retrospective analysis of Italian data in the first half of 2022. ANNALES PHARMACEUTIQUES FRANÇAISES 2023:S0003-4509(23)00022-6. [PMID: 36858285 PMCID: PMC9970653 DOI: 10.1016/j.pharma.2023.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND The phenomenon of antibiotic resistance shows no sign of stopping, despite global policies to combat it that have been in place for several years. The risk of forms of pathogenic microorganisms that are increasingly resistant to common antibiotics has led health authorities around the world to pay greater attention to the phenomenon. The worrying situation, has led to further recommendations from the World Health Organization (WHO) and national recommendations in Italy through the new National Plan against Antibiotic Resistance 2022-2025 (PNCAR 2022-2025). AIM This manuscript aims to raise the awareness of all health professionals to follow what is suggested by regulatory agencies and scientific societies. METHOD We conducted a retrospective study of antibiotic pharmacoutilization in Italy, in the Campania region at the Azienda Sanitaria Locale (ASL) Napoli 3 Sud, on consumption in the first half of 2022 in a population of more than 1 million people. RESULT The results indicate that consumption, based on defined daily doses (DDDs), is above the national average. Probably the COVID-19 pandemic has influenced this growth in prescriptions. CONCLUSIONS Our study suggests an informed and appropriate use of antibiotics, so as to embark on a virtuous path in the fight against antibiotic resistance.
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Affiliation(s)
- F Ferrara
- Pharmaceutical Department, Asl Napoli 3 Sud, Dell'amicizia street 22, 80035 Nola, Naples, Italy.
| | - A Zovi
- School of Pharmacy, University of Camerino, Via Sant'Agostino 1, 62032 Camerino, Italy.
| | - E Nava
- Pharmaceutical Coordination Area, Asl Napoli 3 Sud, Dell'amicizia street 22, 80035 Nola, Naples, Italy.
| | - U Trama
- General Direction for Health Protection and Coordination of the Campania Regional Health System, Naples, Italy.
| | - A Vitiello
- Pharmaceutical Department, USL Umbria 1, Via Guerriero Guerra, 21, 06127 Perugia, Italy.
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Sun Y, Chen X, Shi S, Tian T, Liu Z, Luo E, Lin Y. Tetrahedral Framework Nucleic Acids: A Novel Strategy for Antibiotic Treating Drug-Resistant Infections. Biomacromolecules 2023; 24:1052-1060. [PMID: 36723425 PMCID: PMC10069167 DOI: 10.1021/acs.biomac.2c01525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Antibiotic multiresistance (AMR) has emerged as a major threat to human health as millions of people die from AMR-related problems every year. As has been witnessed during the global COVID-19 pandemic, the significantly increased demand for antibiotics has aggravated the issue of AMR. Therefore, there is an urgent need to find ways to alleviate it. Tetrahedral framework nucleic acids (tFNAs) are novel nanomaterials that are often used as drug delivery platforms because of their structural diversity. This study formed a tFNAs-antibiotic compound (TAC) which has a strong growth inhibitory effect on Escherichia coli and methicillin-resistant Staphylococcus aureus (MRSA) in vitro owing to the increased absorption of antibiotics by bacteria and improved drug movement across cell membranes. We established a mouse model of systemic peritonitis and local wound infections. The TAC exhibited good biosafety and improved the survival rate of severely infected mice, promoting the healing of local infections. In addition to the better transport of antibiotics to the target, the TAC may also enhance immunity by regulating the differentiation of M1 and M2 macrophages, providing a new option for the treatment of infections.
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Affiliation(s)
- Yue Sun
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xingyu Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Sirong Shi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Taoran Tian
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Zhiqiang Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - En Luo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yunfeng Lin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.,Sichuan Provincial Engineering Research Center of Oral Biomaterials, Chengdu, Sichuan 610041, China
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Colonization and Healthcare-Associated Infection of Carbapenem-Resistant Enterobacteriaceae, Data from Polish Hospital with High Incidence of Carbapenem-Resistant Enterobacteriaceae, Does Active Target Screening Matter? Microorganisms 2023; 11:microorganisms11020437. [PMID: 36838402 PMCID: PMC9965052 DOI: 10.3390/microorganisms11020437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
The objective of the study was to analyse the incidence of carbapenem-resistant Enterobacteriaceae (CRE) at a provincial hospital from 2019-2021. Multiplex PCR was used to detect the presence of carbapenemase genes. There were 399 cases of CRE detected in total in the analysed period, including 104 healthcare-associated infections. Out of the isolated CRE, 97.7% were Klebsiella pneumoniae with OXA-48 or KPC genes. Overall, among the identified CRE genes, the most frequently present genes were the ones mediating oxacillinase OXA-48 (71%) and KPC (26%), and significantly less often New Delhi NDM metallo-β-lactamase (2.5%). Moreover, two isolates produced two carbapenemases, i.e., OXA-48 and KPC. The conducted research demonstrates that there is a constant need for continuous monitoring of the occurrence of CRE strains and the hospital antibiotic policy, as well as the implementation of procedures to prevent CRE transmission by medical personnel and hospital support staff.
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Ordine JVW, de Souza GM, Tamasco G, Virgilio S, Fernandes AFT, Silva-Rocha R, Guazzaroni ME. Metagenomic Insights for Antimicrobial Resistance Surveillance in Soils with Different Land Uses in Brazil. Antibiotics (Basel) 2023; 12:antibiotics12020334. [PMID: 36830245 PMCID: PMC9952835 DOI: 10.3390/antibiotics12020334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 02/09/2023] Open
Abstract
Land-use conversion changes soil properties and their microbial communities, which, combined with the overuse of antibiotics in human and animal health, promotes the expansion of the soil resistome. In this context, we aimed to profile the resistome and the microbiota of soils under different land practices. We collected eight soil samples from different locations in the countryside of São Paulo (Brazil), assessed the community profiles based on 16S rRNA sequencing, and analyzed the soil metagenomes based on shotgun sequencing. We found differences in the communities' structures and their dynamics that were correlated with land practices, such as the dominance of Staphylococcus and Bacillus genera in agriculture fields. Additionally, we surveyed the abundance and diversity of antibiotic resistance genes (ARGs) and virulence factors (VFs) across studied soils, observing a higher presence and homogeneity of the vanRO gene in livestock soils. Moreover, three β-lactamases were identified in orchard and urban square soils. Together, our findings reinforce the importance and urgency of AMR surveillance in the environment, especially in soils undergoing deep land-use transformations, providing an initial exploration under the One Health approach of environmental levels of resistance and profiling soil communities.
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Affiliation(s)
- João Vitor Wagner Ordine
- Department of Biology, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-900, SP, Brazil
| | - Gabrielle Messias de Souza
- Department of Biology, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-900, SP, Brazil
| | - Gustavo Tamasco
- ByMyCell Inova Simples. Avenue Dra. Nadir Águiar, 1805-Supera Parque, Ribeirão Preto 14056-680, SP, Brazil
| | - Stela Virgilio
- ByMyCell Inova Simples. Avenue Dra. Nadir Águiar, 1805-Supera Parque, Ribeirão Preto 14056-680, SP, Brazil
| | - Ana Flávia Tonelli Fernandes
- Department of Biology, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-900, SP, Brazil
| | - Rafael Silva-Rocha
- ByMyCell Inova Simples. Avenue Dra. Nadir Águiar, 1805-Supera Parque, Ribeirão Preto 14056-680, SP, Brazil
| | - María-Eugenia Guazzaroni
- Department of Biology, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-900, SP, Brazil
- Correspondence: ; Tel.: +55-(16)-33153680
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The Clash of the Titans: COVID-19, Carbapenem-Resistant Enterobacterales, and First mcr-1-Mediated Colistin Resistance in Humans in Romania. Antibiotics (Basel) 2023; 12:antibiotics12020324. [PMID: 36830235 PMCID: PMC9952164 DOI: 10.3390/antibiotics12020324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/22/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
(1) Background: Antibiotic resistance and coronavirus disease-19 (COVID-19) represent a dual challenge in daily clinical practice, inducing a high burden on public health systems. Hence, we aimed to dynamically evaluate the impact of COVID-19 on patients with carbapenem-resistant Enterobacterales (CRE) urinary tract infections (UTIs), as well as the antibiotic resistance trends after the onset of the pandemic. (2) Methods: We conducted a prospective study including patients with CRE UTIs who were enrolled both pre- and during the pandemic from 2019 to 2022. We further performed a standardized and comparative clinical, paraclinical, and microbiological assessment between patients with and without COVID-19. (3) Results: A total of 87 patients with CRE UTIs were included in this study (46 pre-pandemic and 41 during the pandemic, of which 21 had associated Severe Acute Respiratory Syndrome Coronavirus-2 infection). Klebsiella pneumoniae was the main etiological agent of the UTIs, with the majority of strains (82.7%) being carbapenemase producers (mainly OXA-48 producers), while five of the 34 colistin-resistant isolates were harboring the mobile colistin resistance-1 (mcr-1) gene. COVID-19 patients presented a significantly worse outcome with higher rates of intensive care unit (ICU) admissions (66.7% for COVID patients vs. 18.2% for non-COVID patients, p < 0.001), while the fatality rates were also considerably higher among patients with concomitant viral infection (33.3% vs. 12.1%, p < 0.001). Besides COVID-19, additional risk factors associated with increased mortality were urinary catheterization, sepsis with K. pneumoniae, impaired liver and kidney function, and an inappropriate initial empiric antibiotic therapy. (4) Conclusions: COVID-19 showed a pronounced negative impact on patients with CRE UTIs, with significantly longer hospitalizations and higher ICU admissions and mortality rates.
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Assessing the Clinical Characteristics and Management of COVID-19 among Pediatric Patients in Ghana: Findings and Implications. Antibiotics (Basel) 2023; 12:antibiotics12020283. [PMID: 36830194 PMCID: PMC9952352 DOI: 10.3390/antibiotics12020283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
There is an increasing focus across countries on researching the management of children admitted to hospital with COVID-19. This stems from an increasing prevalence due to new variants, combined with concerns with the overuse of antimicrobials driving up resistance rates. Standard treatment guidelines (STGs) have been produced in Ghana to improve their care. Consequently, there is a need to document the clinical characteristics of children diagnosed and admitted with COVID-19 to our hospital in Ghana, factors influencing compliance to the STG and treatment outcomes. In all, 201 patients were surveyed between March 2020 and December 2021, with males accounting for 51.7% of surveyed children. Those aged between 6 and 10 years were the largest group (44.8%). Nasal congestion and fever were some of the commonest presenting complaints, while pneumonia was the commonest (80.6%) COVID-19 complication. In all, 80.0% of all admissions were discharged with no untreated complications, with a 10.9% mortality rate. A combination of azithromycin and hydroxychloroquine (41.29%) was the most prescribed antimicrobial regimen. Compliance to the STG was variable (68.2% compliance). Increased compliance was associated with a sore throat as a presenting symptom. Mortality increased following transfer to the ICU. However, current recommendations to prescribe antimicrobials without demonstrable bacterial or fungal infections needs changing to reduce future resistance. These are areas to address in the future.
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Rippon MG, Rogers AA, Ousey K. Polyhexamethylene biguanide and its antimicrobial role in wound healing: a narrative review. J Wound Care 2023; 32:5-20. [PMID: 36630111 DOI: 10.12968/jowc.2023.32.1.5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
A wound offers an ideal environment for the growth and proliferation of a variety of microorganisms which, in some cases, may lead to localised or even systemic infections that can be catastrophic for the patient; the development of biofilms exacerbates these infections. Over the past few decades, there has been a progressive development of antimicrobial resistance (AMR) in microorganisms across the board in healthcare sectors. Such resistant microorganisms have arisen primarily due to the misuse and overuse of antimicrobial treatments, and the subsequent ability of microorganisms to rapidly change and mutate as a defence mechanism against treatment (e.g., antibiotics). These resistant microorganisms are now at such a level that they are of grave concern to the World Health Organization (WHO), and are one of the leading causes of illness and mortality in the 21st century. Treatment of such infections becomes imperative but presents a significant challenge for the clinician in that treatment must be effective but not add to the development of new microbes with AMR. The strategy of antimicrobial stewardship (AMS) has stemmed from the need to counteract these resistant microorganisms and requires that current antimicrobial treatments be used wisely to prevent amplification of AMR. It also requires new, improved or alternative methods of treatment that will not worsen the situation. Thus, any antimicrobial treatment should be effective while not causing further development of resistance. Some antiseptics fall into this category and, in particular, polyhexamethylene hydrochloride biguanide (PHMB) has certain characteristics that make it an ideal solution to this problem of AMR, specifically within wound care applications. PHMB is a broad-spectrum antimicrobial that kills bacteria, fungi, parasites and certain viruses with a high therapeutic index, and is widely used in clinics, homes and industry. It has been used for many years and has not been shown to cause development of resistance; it is safe (non-cytotoxic), not causing damage to newly growing wound tissue. Importantly there is substantial evidence for its effective use in wound care applications, providing a sound basis for evidence-based practice. This review presents the evidence for the use of PHMB treatments in wound care and its alignment with AMS for the prevention and treatment of wound infection.
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Affiliation(s)
- Mark G Rippon
- Huddersfield University, Huddersfield, UK.,Dane River Consultancy Ltd, Cheshire, UK
| | | | - Karen Ousey
- University of Huddersfield Department of Nursing and Midwifery, Huddersfield, UK.,School of Nursing, Faculty of Health at the Queensland University of Technology, Australia.,RCSI, Dublin, Eire
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Zaki SS, Sawaf GE, Ahmed AA, Baess AI, Beshey BN, ELSheredy A. Pattern of antibiotic use and bacterial co-infection in hospitalized Covid-19 patients. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2023; 17:20. [PMCID: PMC10063936 DOI: 10.1186/s43168-023-00195-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Background There is evidence that bacterial co-infection in respiratory viruses leads to morbidity and mortality. Patients with decreased immunity are prone to bacterial co-infection. A lack of judicious use of antibiotics leads to the spread of multi-drug resistant bacteria (MDR) that have a long-term negative impact. In this study, we attempted to observe the pattern of antibacterial use and its impact on secondary bacterial infection.
Methods An observational study was conducted at Alexandria Main University Hospital (AMUH) (Alexandria University) from June 2021- February 2022. Study participants were admitted to the Intensive Care Unit (ICU) with confirmed Covid-19 (by Polymerase Chain Reaction (PCR) and Computed tomography (CT) scan). The following data was collected (Demographic, clinical, and laboratory data).In this study, the Pattern of antibiotic use as well as the occurrence of secondary bacterial infections were reported.
Results Among 121 patients included in the present study, all received antibiotics empirically. Upon admission (19.8%) showed urinary tract infection, (11.5%) had bloodstream infection, and (57.7%) had respiratory tract infection. After 10 days secondary bacterial infection occurred in 38 patients (61.2%) with (24.1%) Urinary tract infection (UTI), (12.9%) Bloodstream infection (BSI), and (72.2%) respiratory tract infection. The respiratory sample size was (45) patients due to Infection Control (IC) restrictions on the aerosol-producing procedure.
Conclusion Upon admission, all patients received broad-spectrum antibiotics while the incidence of bacterial co-infection was low.
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Affiliation(s)
- Salma Said Zaki
- grid.7155.60000 0001 2260 6941Microbiology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Gamal El Sawaf
- grid.7155.60000 0001 2260 6941Microbiology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Asmaa AbelHameed Ahmed
- grid.7155.60000 0001 2260 6941Biomedical Informatics and Medical Statistics Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Ayman Ibrahim Baess
- grid.7155.60000 0001 2260 6941Chest Diseases Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Bassem Nashaat Beshey
- Critical Care Medicine Department, Alexandria Faculty of Medicine, Alexandria, Egypt
| | - Amel ELSheredy
- grid.7155.60000 0001 2260 6941Microbiology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
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Bauer B. Traditional approach in prevention and treatment of COVID-19 in Republic of North Macedonia. MAKEDONSKO FARMACEVTSKI BILTEN 2022. [DOI: 10.33320/maced.pharm.bull.2022.68.04.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Biljana Bauer
- Faculty of Pharmacy, University of Ss Cyril and Methodius, Mother Theresa 47, 1000 Skopje, Republic of North Macedonia
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Saleem Z, Godman B, Cook A, Khan MA, Campbell SM, Seaton RA, Siachalinga L, Haseeb A, Amir A, Kurdi A, Mwita JC, Sefah IA, Opanga SA, Fadare JO, Ogunleye OO, Meyer JC, Massele A, Kibuule D, Kalungia AC, Shahwan M, Nabayiga H, Pichierri G, Moore CE. Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future. Antibiotics (Basel) 2022; 11:1824. [PMID: 36551481 PMCID: PMC9774141 DOI: 10.3390/antibiotics11121824] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
There are serious concerns with rising antimicrobial resistance (AMR) across countries increasing morbidity, mortality and costs. These concerns have resulted in a plethora of initiatives globally and nationally including national action plans (NAPs) to reduce AMR. Africa is no exception, especially with the highest rates of AMR globally. Key activities in NAPs include gaining a greater understanding of current antimicrobial utilization patterns through point prevalence surveys (PPS) and subsequently instigating antimicrobial stewardship programs (ASPs). Consequently, there is a need to comprehensively document current utilization patterns among hospitals across Africa coupled with ASP studies. In total, 33 PPS studies ranging from single up to 18 hospitals were documented from a narrative review with typically over 50% of in-patients prescribed antimicrobials, up to 97.6% in Nigeria. The penicillins, ceftriaxone and metronidazole, were the most prescribed antibiotics. Appreciable extended prescribing of antibiotics up to 6 days or more post-operatively was seen across Africa to prevent surgical site infections. At least 19 ASPs have been instigated across Africa in recent years to improve future prescribing utilizing a range of prescribing indicators. The various findings resulted in a range of suggested activities that key stakeholders, including governments and healthcare professionals, should undertake in the short, medium and long term to improve future antimicrobial prescribing and reduce AMR across Africa.
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Affiliation(s)
- Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
| | - Aislinn Cook
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX1 2JD, UK
| | | | - Stephen M. Campbell
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
- Centre for Epidemiology and Public Health, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Ronald Andrew Seaton
- Queen Elizabeth University Hospital, Govan Road, Glasgow G51 4TF, UK
- Scottish Antimicrobial Prescribing Group, Healthcare Improvement Scotland, Delta House, 50 West Nile Street, Glasgow G1 2NP, UK
| | - Linda Siachalinga
- College of Pharmacy, Yeungnam University, Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea
| | - Abdul Haseeb
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Afreenish Amir
- Department of Microbiology, Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi 46000, Pakistan
| | - Amanj Kurdi
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
- Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil 44001, Iraq
- Center of Research and Strategic Studies, Lebanese French University, Erbil 44001, Iraq
| | - Julius C. Mwita
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Private Bag 0713 UB, Gaborone 00704, Botswana
| | - Israel Abebrese Sefah
- Pharmacy Practice Department, School of Pharmacy, University of Health and Allied Sciences, Volta Region, Hohoe PMB 31, Ghana
| | - Sylvia A. Opanga
- Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi P.O. Box 19676-00202, Kenya
| | - Joseph O. Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ado Ekiti 362103, Nigeria
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti 360211, Nigeria
| | - Olayinka O. Ogunleye
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Ikeja, Lagos 100271, Nigeria
- Department of Medicine, Lagos State University Teaching Hospital, Ikeja 100271, Nigeria
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
| | - Amos Massele
- Department of Clinical Pharmacology and Therapeutics, Hurbert Kairuki Memorial University, 70 Chwaku Road Mikocheni, Dar Es Salaam P.O. Box 65300, Tanzania
| | - Dan Kibuule
- Department of Pharmacology & Therapeutics, Busitema University, Mbale P.O. Box 236, Uganda
| | - Aubrey C. Kalungia
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia
| | - Moyad Shahwan
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman 346, United Arab Emirates
| | - Hellen Nabayiga
- Management Science Department, Strathclyde Business School, University of Strathclyde, 199 Cathedral Street, Glasgow G4 0QU, UK
| | - Giuseppe Pichierri
- Microbiology Department, Torbay and South Devon Foundation Trust, Lowes Bridge Torbay Hospital, Torquay TQ2 7AA, UK
| | - Catrin E. Moore
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK
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Antibiotics Usage and Resistance among Patients with Severe Acute Respiratory Syndrome Coronavirus 2 in the Intensive Care Unit in Makkah, Saudi Arabia. Vaccines (Basel) 2022; 10:vaccines10122148. [PMID: 36560558 PMCID: PMC9784728 DOI: 10.3390/vaccines10122148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Antibiotic resistance is a global health and development threat, especially during the Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) pandemic. Therefore, the current study was conducted to describe antibiotic usage and resistance among patients with COVID-19 in the intensive care unit (ICU) in Makkah, Saudi Arabia. In this cross-sectional study, only patients with positive COVID-19 status (42 patients) admitted to the ICU at the King Faisal Hospital were selected using a census sampling method. The susceptibility test of bacteria was carried out according to the standard protocol. The identified strains were tested in-vitro against several antibiotics drugs. Statistical analysis was performed using SPSS version 24. A total of 42 patients were included, with a mean age of 59.35 ± 18 years. Of them, 38.1% were males, and 61.9% were females. 35.7% have blood group O +. For age and blood groups, statistically significant associations were found between males and females, with p-values = 0.037 and 0.031, respectively. A large percentage (42.7%) of the obtained samples contained Klebsiella Pneumoniae; all bacteria were multidrug-resistance bacteria. Furthermore, 76.2% of bacteria were resistant to Ampicillin, 66.7% were resistant to Ciprofloxacin, 64.3% were resistant to Levofloxacin, 57.1% were resistant to Imipenem, and 57.1% were resistant to Moxifloxacin. On the contrary, among the 40 examined antibiotics, the effective antibiotics were Daptomycin, Linezolid, Mupirocin, Synercid, Teicoplanin, Vancomycin, and Nitrofurantoin. Our study demonstrates that antibiotic resistance is highly prevalent among ICU patients with COVID-19 at the King Faisal Hospital. Additionally, all bacteria were multidrug-resistance bacteria. Therefore, this high prevalence should be seriously discussed and urgently considered.
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Prijić A, Gazibara T, Prijić S, Mandić-Rajčević S, Maksimović N. Factors Associated with the Antibiotic Treatment of Children Hospitalized for COVID-19 during the Lockdown in Serbia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15590. [PMID: 36497665 PMCID: PMC9737727 DOI: 10.3390/ijerph192315590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
Unselective use of antibiotics to treat children with COVID-19 is one of the major issues during the pandemic in Serbia. Thus far, there has been no evidence about the predictors of multiple antibiotic use in the treatment of children with COVID-19. The purpose of this study was to assess the prevalence of antibiotic use, as well as to examine demographic and clinical factors associated with a greater number of antibiotics and with a longer antibiotic treatment administered to hospitalized children with COVID-19 during the lockdown in Serbia. This study included all children who were hospitalized from 6 March to 31 May 2020 at the only pediatric COVID-19 hospital, and who were confirmed to have SARS-CoV-2 infection. Demographic, clinical, and laboratory data were collected from medical records. The antibiotic treatment included the use of azithromycin, cephalosporin (ceftriaxone), ampicillin-amikacin, and hydroxychloroquine. The overall prevalence of antibiotics use in children hospitalized with COVID-19 regardless of age was 47.2% (43.3% in children aged 1-5 years and 44.4% in those aged 5-17 years). In children aged 1-5 years, not having a family member affected by COVID-19 (B = -1.38, 95% confidence interval [CI] -2.43, -0.34, p = 0.011), having pneumonia on chest X-ray (B = 0.81, 95%CI 0.34, 1.29, p = 0.002), being a boy (B = -0.65, 95%CI -1.17, -0.13, p = 0.018), and having higher C-reactive protein (CRP) values on admission (B = 0.12, 95%CI 0.07, 0.17, p = 0.001) were associated with the administration of a higher number of antibiotics. These factors, along with having fever (B = 3.20, 95%CI 1.03, 5.37, p = 0.006), were associated with a longer duration of antibiotic treatment in children aged 1-5 years. In children aged 5-17 years, having pharyngeal erythema (B = 1.37, 95%CI 0.61, 2.13, p = 0.001), fever (B = 0.43, 95%CI 0.07, 0.79, p = 0.018), and pneumonia on chest X-ray (B = 0.91, 95%CI 0.53, 1.29, p = 0.001), not having rhinorrhea (B = -1.27, 95%CI -2.47, -0.08, p = 0.037), being a girl (B = 0.52, 95%CI 0.08, 0.97, p = 0.021), and having higher CRP values on admission (B = 0.04, 95%CI 0.01, 0.06, p = 0.006) were associated with the administration of a higher number of antibiotics. These factors, not including the absence of rhinorrhea, were associated with a longer duration of antibiotics treatment in children aged 5-17 years. Demographic, epidemiological, clinical, and laboratory parameters were associated with the use of multiple antibiotics and a longer duration of antibiotic treatment both among children aged 1-5 years and those aged 5-17 years.
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Affiliation(s)
- Andreja Prijić
- Children’s Hospital for Lung Diseases and Tuberculosis, University Clinical Hospital Center “Dr Dragiša Mišović–Dedinje”, 11000 Belgrade, Serbia
| | - Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Sergej Prijić
- Mother and Child Health Institute of Serbia “Dr Vukan Čupić”, 11000 Belgrade, Serbia
| | - Stefan Mandić-Rajčević
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nataša Maksimović
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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E. Abou Warda A, Molham F, Salem HF, Mostafa-Hedeab G, ALruwaili BF, Moharram AN, Sebak M, Sarhan RM. Emergence of High Antimicrobial Resistance among Critically Ill Patients with Hospital-Acquired Infections in a Tertiary Care Hospital. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1597. [PMID: 36363554 PMCID: PMC9698311 DOI: 10.3390/medicina58111597] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/30/2022] [Accepted: 11/01/2022] [Indexed: 09/26/2023]
Abstract
Background and Objectives: Inappropriate antibiotic usage in hospitalized patients contributes to microbial resistance. Our study aimed to examine the incidence of clinical bacterial isolates and their antibiotic resistance burden among critically ill patients in different hospital units. Materials and Methods: A single-centered cross-sectional study was conducted in a 120-bed tertiary care hospital that included 221 critically ill patients with hospital-acquired infections. Bacterial cultures and sensitivity reports were obtained and followed by a formal analysis of the antibiogram results to explore recovered isolates' prevalence and antibiotic susceptibility patterns. Results: Gram-negative bacteria were the most predominant pathogens among recovered isolates from the various hospital units (71%). Klebsiella sp. was the most prevalent microbe, followed by Acinetobacter sp., with an incidence level of 28% and 16.2%, respectively. Among the Gram-positive organisms, the coagulase-negative Staphylococci were the most predominant organism (11.3%), while (6.3%) methicillin-resistant Staphylococcus aureus (MRSA) isolates were recovered from different hospital units. Antibiotic sensitivity testing showed that polymyxin B was the most effective antibiotic against Gram-negative bacteria, whereas vancomycin and linezolid were the most active antibiotics against Gram-positive pathogens. Moreover, 7% of the Gram-negative bacteria isolated from different units showed positive production of extended-spectrum beta-lactamase (ESBL). Conclusions: The current study describes the high antibiotic resistance patterns in various hospital units that need extra legislation to prevent healthcare providers from misprescription and overuse of antibiotics.
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Affiliation(s)
- Ahmed E. Abou Warda
- Clinical Pharmacy Department, Faculty of Pharmacy, October 6 University, Giza 12585, Egypt
| | - Fatma Molham
- Microbiology and Immunology Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62514, Egypt
| | - Heba F. Salem
- Pharmaceutics and Industrial Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62514, Egypt
| | - Gomaa Mostafa-Hedeab
- Pharmacology Department, Medical College, Jouf University, Sakaka 72388, Saudi Arabia
| | - Bashayer F. ALruwaili
- Community and Family Medicine Department, Division of Family Medicine, Medical College, Jouf University, Sakaka 72388, Saudi Arabia
| | - Ayman N. Moharram
- Critical Care Medicine Department, Faculty of Medicine, Cairo University, Giza 12613, Egypt
| | - Mohamed Sebak
- Microbiology and Immunology Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62514, Egypt
| | - Rania M. Sarhan
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62514, Egypt
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50
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Thomas GR, Corso A, Pasterán F, Shal J, Sosa A, Pillonetto M, de Souza Peral RT, Hormazábal JC, Araya P, Saavedra SY, Ovalle MV, Jiménez Pearson MA, Chacón GC, Carbon E, Mazariegos Herrera CJ, Velásquez SDCG, Satan-Salazar C, Villavicencio F, Touchet NM, Busignani S, Mayta-Barrios M, Ramírez-Illescas J, Vega ML, Mogdasy C, Rosas V, Salgado N, Quiroz R, El-Omeiri N, Galas MF, Ramón-Pardo P, Melano RG. Increased Detection of Carbapenemase-Producing Enterobacterales Bacteria in Latin America and the Caribbean during the COVID-19 Pandemic. Emerg Infect Dis 2022; 28:1-8. [PMID: 36286547 PMCID: PMC9622262 DOI: 10.3201/eid2811.220415] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
During 2020–2021, countries in Latin America and the Caribbean reported clinical emergence of carbapenemase-producing Enterobacterales that had not been previously characterized locally, increased prevalence of carbapenemases that had previously been detected, and co-production of multiple carbapenemases in some isolates. These increases were likely fueled by changes related to the COVID-19 pandemic, including empirical antibiotic use for potential COVID-19–related bacterial infections and healthcare limitations resulting from the rapid rise in COVID-19 cases. Strengthening antimicrobial resistance surveillance, epidemiologic research, and infection prevention and control programs and antimicrobial stewardship in clinical settings can help prevent emergence and transmission of carbapenemase-producing Enterobacterales.
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