Bactericidal activities of disinfectants against vancomycin-resistant enterococci

Synthesis, Biological Evaluation, and Molecular Modeling Studies of New 1,3,4-Thiadiazole Derivatives as Potent Antimicrobial Agents

In this work, the synthesis, characterization, and biological activities of a new series of 1,3,4-thiadiazole derivatives were investigated. The structures of final compounds were identified using ¹ H-NMR, ¹³ C-NMR, elemental analysis, and HRMS. All the new synthesized compounds were then screened for their antimicrobial activity against four types of pathogenic bacteria and one fungal strain, by application of the MIC assays, using Ampicilin, Gentamycin, Vancomycin, and Fluconazole as standards. Among the compounds, the MIC values of 4 and 8 μg/mL of the compounds 3f and 3g, respectively, are remarkable and indicate that these compounds are good candidates for antifungal activity. The docking experiments were used to identify the binding forms of produced ligands with sterol 14-demethylase to acquire insight into relevant proteins. The MD performed about 100 ns simulations to validate selected compounds' theoretical studies. Finally, using density functional theory (DFT) to predict reactivity, the chemical characteristics and quantum factors of synthesized compounds were computed. These results were then correlated with the experimental data. Furthermore, computational estimation was performed to predict the ADME properties of the most active compound 3f.

Mechanisms, Anti-Quorum-Sensing Actions, and Clinical Trials of Medicinal Plant Bioactive Compounds against Bacteria: A Comprehensive Review

Bacterial strains have developed an ability to resist antibiotics via numerous mechanisms. Recently, researchers conducted several studies to identify natural bioactive compounds, particularly secondary metabolites of medicinal plants, such as terpenoids, flavonoids, and phenolic acids, as antibacterial agents. These molecules exert several mechanisms of action at different structural, cellular, and molecular levels, which could make them candidates or lead compounds for developing natural antibiotics. Research findings revealed that these bioactive compounds can inhibit the synthesis of DNA and proteins, block oxidative respiration, increase membrane permeability, and decrease membrane integrity. Furthermore, recent investigations showed that some bacterial strains resist these different mechanisms of antibacterial agents. Researchers demonstrated that this resistance to antibiotics is linked to a microbial cell-to-cell communication system called quorum sensing (QS). Consequently, inhibition of QS or quorum quenching is a promising strategy to not only overcome the resistance problems but also to treat infections. In this respect, various bioactive molecules, including terpenoids, flavonoids, and phenolic acids, exhibit numerous anti-QS mechanisms via the inhibition of auto-inducer releases, sequestration of QS-mediated molecules, and deregulation of QS gene expression. However, clinical applications of these molecules have not been fully covered, which limits their use against infectious diseases. Accordingly, the aim of the present work was to discuss the role of the QS system in bacteria and its involvement in virulence and resistance to antibiotics. In addition, the present review summarizes the most recent and relevant literature pertaining to the anti-quorum sensing of secondary metabolites and its relationship to antibacterial activity.

Adaptation to Adversity: the Intermingling of Stress Tolerance and Pathogenesis in Enterococci

Enterococcus is a diverse and rugged genus colonizing the gastrointestinal tract of humans and numerous hosts across the animal kingdom. Enterococci are also a leading cause of multidrug-resistant hospital-acquired infections. In each of these settings, enterococci must contend with changing biophysical landscapes and innate immune responses in order to successfully colonize and transit between hosts. Therefore, it appears that the intrinsic durability that evolved to make enterococci optimally competitive in the host gastrointestinal tract also ideally positioned them to persist in hospitals, despite disinfection protocols, and acquire new antibiotic resistances from other microbes. Here, we discuss the molecular mechanisms and regulation employed by enterococci to tolerate diverse stressors and highlight the role of stress tolerance in the biology of this medically relevant genus.

Use of germicides in health care settings-is there a relationship between germicide use and antimicrobial resistance: A concise review

Despite the widespread use of disinfectants and antiseptics in hospitals, acquired resistance to current disinfectants has rarely been reported. Germicides, as with medications, should only be used when their benefit as demonstrated by scientific studies exceeds possible risks to human health or the environment.

Comparative Epidemiology of Vancomycin-Resistant Enterococci Colonization in an Acute-Care Hospital and Its Affiliated Intermediate- and Long-Term Care Facilities in Singapore

Vancomycin-resistant enterococci (VRE) are an important cause of nosocomial infections in acute-care hospitals (ACHs), intermediate-care facilities (ITCFs), and long-term care facilities (LTCFs). This study contemporaneously compared the epidemiology and risk factors for VRE colonization in different care settings in a health care network. We conducted a serial cross-sectional study in a 1,700-bed ACH and its six closely affiliated ITCFs and LTCFs in June and July of 2014 to 2016. Rectal swab or stool specimens were cultured for VRE. Multivariable logistic regression was used to assess for independent risk factors associated with VRE colonization. Of 5,357 participants, 523 (9.8%) were VRE colonized. VRE prevalence was higher in ACHs (14.2%) than in ITCFs (7.6%) and LTCFs (0.8%). Common risk factors between ACHs and ITCFs included prior VRE carriage, a longer duration of antibiotic therapy, surgery in the preceding 90 days, and the presence of a skin ulcer. Independent risk factors specific to ACH-admitted patients were prior methicillin-resistant Staphylococcus aureus carriage, a higher number of beds per room, prior proton pump inhibitor use, and a length of stay of >14 days. For ITCFs, a length of stay of >14 days was inversely associated with VRE colonization. Similarities and differences in risk factors for VRE colonization were observed between health care settings. VRE prevention efforts should target the respective high-risk patients.

Anti-staphylococcal properties of four plant extracts against sensitive and multi-resistant bacterial strains isolated from cattle and rabbits

The aim of this study is to investigate the biopotency of methanolic extracts of Vitex mollis, Psidium guajava, Dalbergia retusa, and Crescential alata leaves against various staphylococcal strains isolated from cattle and rabbits. Methicillin-resistant S. aureus strains were isolated from cattle, while other strains were isolated from rabbits using standard methodology. The total phytochemical phenolic and saponins contents were obtained being the main groups of the antinutritional factors. The antimicrobial activity of the extracts against the standard culture of S. aureus (control) and S. aureus isolated from cattle and rabbits were investigated comparatively relative to that of oxacillin. It was found that both the control S. aureus and the isolated S. aureus are susceptible to all the four plant extracts, and sensitive to oxacillin. Of all the S. aureus including the control, MRSA2 is the most susceptible to all the extracts at 1000 μg/mL, except that of V. mollis where it is the least susceptible. Among all the plant extracts, P. guajava is the most active against MRSA2 and SOSA2. Therefore, the isolates from cattle (MRSA1 and MRSA2) are more susceptible to all the plant extracts than the isolates from rabbits. Among all the rabbit isolates, CoNS3 is the least susceptible to the extracts. Since all the plant extracts exhibit remarkable inhibitory activities against all the S. aureus strains, they are promising towards the production of therapeutic drugs.

Syntheses and Antibiotic Evaluation of 2-{[(2R,4R)-4-Carboxy-2-hydroxypyrrolidin-1-yl]carbonyl}benzene-1,5-dicarboxylic Acids and 2-Carbamoylbenzene-1,5-dicarboxylic Acid Analogues

Our search for new antibiotics led to the syntheses and biological evaluation of new classes of dicarboxylic acid analogues. The syntheses involve nucleophilic addition of different substituted benzylamine, aniline, alkylamine, and 4-hydroxyl-L-proline with carbamoylbenzoic acid. The results of the antimicrobial activity as indicated by the zone of inhibition (ZOI) showed that Z₁₀ is the most active against Pseudomonas aeruginosa (32 mm) and least active against Candida stellatoidea (27 mm) and Vancomycin Resistant Enterococci (VRE) (27 mm), while Z₇ shows the least zone of inhibition (22 mm) against Methicillin Resistant Staphylococcus aureus (MRSA). The minimum inhibition concentration (MIC) determination reveals that Z₁₀ inhibits the growth of tested microbes at a low concentration of 6.25 μg/mL, while Z₉ and Z₁₂ inhibits the growth of most microbes at a concentration of 12.5 μg/mL, recording the least MIC. The Minimum Bactericidal/Fungicidal Concentration (MBC/MFC) results revealed that Z₁₀ has the highest bactericidal/fungicidal effect on the test microbes, at a concentration of 12.5 μg/mL, with the exception of Candida stellatoidea and Vancomycin Resistant Enterococci (VRE) with MBC/MFC of 25 μg/mL. The result of this investigation reveals the potential of the target compounds (Z_{1–3,5,7–12}) in the search for new antimicrobial agents.

ACTIVIDADE ANTIMICROBIANA E EFEITO COMBIANDO SOBRE DROGAS ANTIFÚNGICAS Y ANTIBACTERIANAS DO FRUTO DE Morinda citrifolia L

<p>O aparecimento de micro-organismos resistentes e a toxicidade associada aos fármacos antimicrobianos aumentam a necessidade de pesquisas por novos princípios ativos. <em>Morinda citrifolia </em>L., uma planta frutífera utilizada popularmente como antibacteriano e com diversos outros usos farmacológicos. Possui diversos metabólitos primários e secundários, principalmente flavonóides, triterpenóides e alcalóides. O presente trabalho visou testar o potencial antimicrobiano e modulador dos extratos do seu fruto. Os extratos do fruto foram testados quanto ao seu efeito antimicrobiano e em combinação com antibacterianos e antifúngicos contra microrganismos patógenos pelo método de microdiluição em caldo. Observou-se que as associações entre antibióticos e extratos mostraram resultados com relevância clínica diante dos testes com bactérias <em>Pseudomonas aeruginosa</em> e <em>Escherichia coli</em>. </p><p><strong>Actividad antimicrobiana y efecto</strong> <strong>combinado sobre medicamentos antifúngicos y antibacterianos del fruto de <em>Morinda citrifolia</em> L.</strong></p><p>La aparición de microorganismos resistentes y la toxicidad asociada a los antimicrobianos aumenta la necesidad de investigar nuevos principios activos. <em>Morinda citrifolia</em> L., es una planta fructífera utilizada popularmente como antibacteriano y con otros diversos usos farmacológicos. Posee diversos  metabolitos primarios y secundarios, principalmente flavonoides, triterpenoides y alcaloides. Este estudio tuvo como objetivo ensayar la potencial actividad antimicrobiana y moduladora de los extractos obtenidos de su fruta. Los extractos de las frutas fueron testados tanto para determinar el efecto antimicrobiano como también utilizándolo en combinación con agentes antibacterianos y antifúngicos contra microorganismos patógenos, por el método de microdilución en caldo. Se observó que la asociación entre antibióticos y extractos dió resultados clínicamente significativos en pruebas con bacterias <em>Pseudomonas aeruginosa </em>y <em>Escherichia coli</em>. </p><p><strong>Antimicrobial Activity and Combined Effects on Antifungal and Antibacterial Drugs the Fruit of <em>Morinda citrifolia </em>L.</strong></p><p>The rising of the drug resistant microrganisms and the toxicity related with the antimicrobial drugs enhances the necessity about the search of new bioactive compounds. <em>Morinda citrifolia </em>L. is a fruit tree traditionally used as antibacterial and with several other pharmacological properties. This plant presents several phytocompounds as flavonoids, alkaloids and triterpenes. The objective of this work was assay the antimicrobial and modulatory potential of the fruit extract. The extract was assayed alone and associated with antibiotics and antifungals against pathogenic microrganisms using the microdilution assay. The results demonstrated that the association between extract and antimicrobial drugs resulted in a potentiation of the drug activity clinically relevant against <em>Pseudomonas aeruginosa</em> and <em>Escherichia coli</em>.</p>

Is reduced susceptibility to disinfectants and antiseptics a risk in healthcare settings? A point/counterpoint review

BACKGROUND

Given the breadth and depth of antiseptic use, it is surprising how few large-scale studies have been undertaken into the consequences of their use, particularly in clinical practice. Depending on your point of view, this may either reflect an assurance that reduced susceptibility to antiseptics, and notably whether this confers cross-resistance to systemically administered antimicrobial agents, is not an issue of concern, or relative ignorance about the potential threat.

AIM

This point/counterpoint review offers a differentiated perspective and possible answers to the question, 'Should we be worried about reduced susceptibility to disinfectants and antiseptics in healthcare settings?'.

METHODS

This topic was the subject of a debate by MHW (point) and SH (counterpoint) during the SHEA Spring Conference 2013: Advancing healthcare epidemiology and the role of the environment, held in Atlanta, GA, USA on 4(th) May 2013. This review is a general representation of the main themes presented during the debate, rather than a systematic review of the literature.

FINDINGS

There are examples of reduced susceptibility to antiseptics in clinical practice; however, to date, there is no strong evidence that reduced susceptibility to antiseptics is a major clinical problem. Given the growing number of potential indications for use of biocidal active ingredients, the potential for emergence of reduced susceptibility remains a concern.

CONCLUSIONS

Changes in the clinical use of antiseptics should be matched with surveillance studies to understand whether there are unintended microbiological or clinical consequences, including the selection of bacterial strains that can survive exposure to antiseptics.

Aseptic simulation test challenged with microorganisms for validation of pharmacy operators

PURPOSE

Aseptic technique of pharmacy operators was assessed using simulated media-fill tests challenged with microorganisms.

METHODS

Simulation of the process was done in accordance with multiple transfer steps using tryptone soya broth. All stoppers of broth medium vials were deliberately contaminated with a challenge micro-organism (Enterococcus faecalis). Each final preparation (vials, syringes, and minibags), including the culture medium, was incubated for 14 days at 32 °C. Vials, syringes, and bags were held in front of light daily for 14 days to detect any visual turbidity. At the end of the 14-day period, all clear culture media were filtered via a 0.45-μm sterile filter, which was then incubated at 32 °C on a tryptone soya agar plate. Bags and vials not subjected to manipulation were incubated simultaneously and served as controls. Visual observation by a pharmacist was conducted during the media-fill test, and finger dabs were taken at the end of the media-fill test to test for contamination.

RESULTS

Ten operators previously trained in aseptic technique were assessed. The overall operator failure rate was 40%, and 2.3% of the 300 preparations were contaminated. Similarly, 10 of 60 finger dabs were found to be contaminated with E. faecalis, the challenge microorganism. There was no association between operators' years of experience and media-fill test results.

CONCLUSION

Optimized media-fill tests allowed for the detection of minor deviances from standard protocol and helped to provide evidence of improper aseptic technique used by pharmacy operators.

Use of germicides in the home and the healthcare setting: is there a relationship between germicide use and antibiotic resistance?

BACKGROUND

The spread of antibiotic-resistant pathogens represents an increasing threat in healthcare facilities. Concern has been expressed that the use of surface disinfectants and antiseptics may select for antibiotic-resistant pathogens.

OBJECTIVE

To review the scientific literature on whether there is a link between use of germicides (ie, disinfectants and antiseptics) and bacterial resistance to antibiotics. In addition, we will review whether antibiotic-resistant bacteria exhibit altered susceptibility to germicides that are recommended for use as disinfectants or antiseptics.

DESIGN

A review of the appropriate scientific literature.

RESULTS

In the laboratory, it has been possible to develop bacterial mutants with reduced susceptibility to disinfectants and antiseptics that also demonstrate decreased susceptibility to antibiotics. However, the antibiotic resistance described was not clinically relevant because the test organism was rarely a human pathogen, the altered level of antimicrobial susceptibility was within achievable serum levels for the antibiotic, or the antibiotic tested was not clinically used to treat the study pathogen. Similarly, wild-type strains with reduced susceptibility to disinfectants (principally, quaternary ammonium compounds) and antiseptics (principally, triclosan) have been reported. However, because the concentration of disinfectants used in the healthcare setting greatly exceeds the concentration required to kill strains with reduced susceptibility to disinfectants, the clinical relevance of these observations is questionable.

CONCLUSION

To date, there is no evidence that using recommended antiseptics or disinfectants selects for antibiotic-resistant organisms in nature. Disinfectants and antiseptics should be used when there are scientific studies demonstrating benefit or when there is a strong theoretical rationale for using germicides.

Guidelines for the control of glycopeptide-resistant enterococci in hospitals

The increase since the mid 1980s in glycopeptide resistant enterococci (GRE) raised concerns about the limited options for antimicrobial therapy, the implications for ever-increasing numbers of immunocompromised hospitalised patients, and fuelled fears, now realised, for the transfer of glycopeptide resistance to more pathogenic bacteria, such as Staphylococcus aureus. These issues underlined the need for guidelines for the emergence and control of GRE in the hospital setting. This Hospital Infection Society (HIS) and Infection Control Nurses Association (ICNA) working party report reviews the literature relating to GRE prevention and control. It provides guidance on microbiological investigation, treatment and management, including antimicrobial prescribing and infection control measures. Evidence identified to support recommendations has been categorized. A risk assessment approach is recommended and areas for research and development identified.

Debate—Guidelines for GRE control—the case for optimism

Although at first sight the spread of glycopeptide-resistant enterococci (GREs) appears to be following the same unrelenting path as that of methicillin-resistant Staphylococcus aureus, closer inspection of the Literature indicates success of certain interventions, particularly the control of antibiotic usage. There are grounds for optimism that assiduous application of antibiotic control and other infection control measures may further reduce the prevalence of GREs.

Efficacy of some neutralizers in suspension tests determining the activity of disinfectants

The ability of six mixtures to neutralize glutaraldehyde, o-phthalaldehyde and peracetic acid was tested using four reference strains: Pseudomonas aeruginosa CIP A22, Escherichia coli CIP 54127, Staphylococcus aureus CIP 53154, and Enterococcus faecium CIP 5855. Glutaraldehyde was the hardest to neutralize, and peracetic acid the easiest. The most effective mixture was Tween 80 with sodium bisulphate, sodium thioglycolate, lecithin and cysteine, and the least effective was Tween 80, lecithin and histidine. The efficacy of the neutralizers may indicate a propensity loss of activity from interfering substances when disinfectants are used in practice.