Socioeconomic burden of pneumonia due to multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa in Korea

Phage Therapy in Korea: A Prescribers' Survey of Attitudes Amongst Korean Infectious Diseases Specialists Towards Phage Therapy

BACKGROUND

Concerns about the rise in antimicrobial resistance have led to renewed interest in phage therapy worldwide, but perceptions among relevant medical professionals in Korea remain largely unknown.

MATERIALS AND METHODS

We conducted a semi-quantitative online survey to evaluate the Korean infectious disease specialists' perception of phage therapy.

RESULTS

We sent out the link to the questionnaire to 380 subjects and received 91 replies, with 90/91 respondents identifying as Korean infectious diseases specialists or trainees. Ten out of 91 (11.0%) respondents scored themselves as well-informed about phage therapy. The majority (93.4%) of respondents would consider using phage therapy if the safety of the phage formulation is guaranteed, and 80% of respondents would consider participating in clinical trials with phage therapy given adequate support. The biggest concern was uncertainty about safety (73.6%) and efficacy (65.9%). Acinetobacter baumannii was ranked as a high priority for phage therapy research, as were bone and joint infections.

CONCLUSION

Korean infectious diseases specialists are receptive to phage therapy, but a better understanding of safety, efficacy and clinical trials are warranted to progress phage therapy within the Korean healthcare system.

Streptomyces monashensis MSK03-mediated synthesis of gold nanoparticles: characterization and antibacterial activity

Nanotechnology is a cutting-edge field with diverse applications, particularly in the utilization of gold nanoparticles (AuNPs) due to their stability and biocompatibility. AuNPs serve as pivotal components in medical applications, with a specific emphasis on their significant antibacterial efficacy. This study focuses on synthesizing AuNPs using the cell-free supernatant of Streptomyces monashensis MSK03, isolated from terrestrial soil in Thailand. The biosynthesis process involved utilizing the cell-free supernatant of S. monashensis MSK03 and hydrogen tetrachloroauric acid (HAuCl4) under controlled conditions of 37 °C and 200 rpm agitation. Characterization studies revealed spherical AuNPs with sizes ranging from 7.1 to 40.0 nm (average size: 23.2 ± 10.7 nm), as confirmed by TEM. UV-Vis spectroscopy indicated a localized surface plasmon resonance (LSPR) band at 545 nm, while XRD analysis confirmed a crystalline structure with characteristics of cubic lattice surfaces. The capping molecules on the surface of AuNPs carry a negative charge, indicated by a Zeta potential of -26.35 mV, and FTIR analysis identified functional groups involved in reduction and stabilization. XANES spectra further confirmed the successful reduction of Au3+ to Au0. Moreover, the synthesized AuNPs demonstrated antibacterial activity against drug-resistant strains of Pseudomonas aeruginosa and Acinetobacter baumannii. Interestingly, the AuNPs showed non-toxicity to Vero cell lines. These significant antibacterial properties of the produced nanoparticles mean they hold great promise as new antimicrobial treatments for tackling the increasing issue of antibiotic resistance.

Development and Validation of a Nomogram Prediction Model for Multidrug-Resistant Organisms Infection in a Neurosurgical Intensive Care Unit

Objective

To develop a predictive model for assessing the risk of multidrug-resistant organisms (MDROs) infection and validate its effectiveness.

We conducted a study on a total of 2516 patients admitted to the neurosurgery intensive care unit (NICU) of a Grade-III hospital in Nantong City, Jiangsu Province, China, between January 2014 and February 2022. Patients meeting the inclusion criteria were selected using convenience sampling. The patients were randomly divided into modeling and validation groups in a 7:3 ratio. To address the category imbalance, we employed the Synthetic Minority Over-sampling Technique (SMOTE) to adjust the MDROs infection ratio from 203:1558 to 812:609 in the training set. Univariate analysis and logistic regression analysis were performed to identify risk factors associated with MDROs infection in the NICU. A risk prediction model was developed, and a nomogram was created. Receiver operating characteristic (ROC) analysis was used to assess the predictive performance of the model.

Patients and Methods

Results

Logistic regression analysis revealed that sex, hospitalization time, febrile time, invasive operations, postoperative prophylactic use of antibiotics, mechanical ventilator time, central venous catheter indwelling time, urethral catheter indwelling time, ALB, PLT, WBC, and L% were independent predictors of MDROs infection in the NICU. The area under the ROC curve for the training set and validation set were 0.880 (95% CI: 0.857-0.904) and 0.831 (95% CI: 0.786-0.876), respectively. The model's prediction curve closely matched the ideal curve, indicating excellent predictive performance.

Conclusion

The prediction model developed in this study demonstrates good accuracy in assessing the risk of MDROs infection. It serves as a valuable tool for neurosurgical intensive care practitioners, providing an objective means to effectively evaluate and target the risk of MDROs infection.

Current Status of Antibiotic Stewardship and the Role of Biomarkers in Antibiotic Stewardship Programs

The importance of antibiotic stewardship is increasingly emphasized in accordance with the increasing incidences of multidrug-resistant organisms and accompanying increases in disease burden. This review describes the obstacles in operating an antibiotic stewardship program (ASP), and whether the use of biomarkers within currently available resources can help. Surveys conducted around the world have shown that major obstacles to ASPs are shortages of time and personnel, lack of appropriate compensation for ASP operation, and lack of guidelines or appropriate manuals. Sufficient investment, such as the provision of full-time equivalent ASP practitioners, and adoption of computerized clinical decision systems are useful measures to improve ASP within an institution. However, these methods are not easy in terms of both time commitments and cost. Some biomarkers, such as C-reactive protein, procalcitonin, and presepsin are promising tools in ASP due to their utility in diagnosis and forecasting the prognosis of sepsis. Recent studies have demonstrated the usefulness of algorithmic approaches based on procalcitonin level to determine the initiation or discontinuation of antibiotics, which would be helpful in decreasing antibiotics use, resulting in more appropriate antibiotics use.